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Baldé H, Geurts B, Fischer HT, Menelik-Obbarius S, Kaba I, Merhi V, Stein K, Diaconu V, Bahr T, Weishaar H, Delamou A, Mbawah AK, El-Bcheraoui C. Responding to fluctuations in public and community trust and health seeking behaviour during the COVID-19 pandemic: a qualitative study of national decision-makers' perspectives in Guinea and Sierra Leone. BMC Public Health 2024; 24:2710. [PMID: 39367378 PMCID: PMC11452948 DOI: 10.1186/s12889-024-20181-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 09/24/2024] [Indexed: 10/06/2024] Open
Abstract
BACKGROUND The level of trust in health systems is often in flux during public health emergencies and presents challenges in providing adequate health services and preventing the spread of disease. Experiences during previous epidemics has shown that lack of trust can impact the continuity of essential health services and response efforts. Guinea and Sierra Leone were greatly challenged by a lack of trust in the system during the Ebola epidemic. We thus sought to investigate what was perceived to influence public and community trust in the health system during the COVID-19 pandemic, and what strategies were employed by national level stakeholders in order to maintain or restore trust in the health system in Guinea and Sierra Leone. METHODS This qualitative study was conducted through a document review and key informant interviews with actors involved in COVID-19 and/or in malaria control efforts in Guinea and Sierra Leone. Key informants were selected based on their role and level of engagement in the national level response. Thirty Six semi-structured interviews (16 in Guinea, 20 in Sierra Leone) were recorded, transcribed, and analyzed using an inductive and deductive framework approach to thematic analysis. RESULTS Key informants described three overarching themes related to changes in trust and health seeking behavior due to COVID-19: (1) reignited fear and uncertainty among the population, (2) adaptations to sensitization and community engagement efforts, and (3) building on the legacy of Ebola as a continuous process. Communication, community engagement, and on-going support to health workers were reiterated as crucial factors for maintaining trust in the health system. CONCLUSION Lessons from the Ebola epidemic enabled response actors to consider maintaining and rebuilding trust as a core aim of the pandemic response which helped to ensure continuity of care and mitigate secondary impacts of the pandemic. Monitoring and maintaining trust in health systems is a key consideration for health systems resilience during public health emergencies.
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Affiliation(s)
- Habibata Baldé
- Centre d'Excellence d'Afrique pour La Prévention et le Contrôle des Maladies Transmissibles (CEA-PCMT), Université Gamal Abdel Nasser, Conakry, Guinea
| | - Brogan Geurts
- Evidence-Based Public Health Unit, Center for International Health Protection, Robert Koch Institute, Berlin, Germany.
| | - Hanna-Tina Fischer
- Evidence-Based Public Health Unit, Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Sara Menelik-Obbarius
- Evidence-Based Public Health Unit, Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Ibrahima Kaba
- Centre d'Excellence d'Afrique pour La Prévention et le Contrôle des Maladies Transmissibles (CEA-PCMT), Université Gamal Abdel Nasser, Conakry, Guinea
| | - Vitali Merhi
- Evidence-Based Public Health Unit, Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Karoline Stein
- Evidence-Based Public Health Unit, Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Viorela Diaconu
- Evidence-Based Public Health Unit, Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Thurid Bahr
- Evidence-Based Public Health Unit, Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Heide Weishaar
- Evidence-Based Public Health Unit, Center for International Health Protection, Robert Koch Institute, Berlin, Germany
| | - Alexandre Delamou
- Centre d'Excellence d'Afrique pour La Prévention et le Contrôle des Maladies Transmissibles (CEA-PCMT), Université Gamal Abdel Nasser, Conakry, Guinea
| | - Abdul Karim Mbawah
- College of Medicine and Allied Health Sciences (COMAHS), University of Sierra Leone, Freetown, Sierra Leone
| | - Charbel El-Bcheraoui
- Evidence-Based Public Health Unit, Center for International Health Protection, Robert Koch Institute, Berlin, Germany.
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Joslin R, Allen E, Carter B. Understanding the importance of therapeutic alliance during physiotherapy treatment for musculoskeletal pain in children: a scoping review. FRONTIERS IN PAIN RESEARCH 2024; 5:1452771. [PMID: 39385755 PMCID: PMC11461466 DOI: 10.3389/fpain.2024.1452771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 09/12/2024] [Indexed: 10/12/2024] Open
Abstract
Introduction Musculoskeletal pain affecting children is common. Rehabilitation and treatment effectiveness can be influenced by multiple individual and contextual factors. The need for more rigorous evaluation of physiotherapy treatment for children's pain, identification of the role of specific techniques, and exploration of the influence of the therapeutic alliance is needed. This scoping review of research aimed to examine: (1) What are the perceptions of children, parents, and physiotherapists about the importance of therapeutic alliance during musculoskeletal pain treatment? (2) What are the key characteristics of therapeutic alliance during a child's musculoskeletal pain treatment from the perspectives of children, parents, and physiotherapists? and (3) What are the perceived impacts of therapeutic alliance (positive and negative) during a child's physiotherapy treatment for musculoskeletal pain? Methods The scoping review, based on Arksey and O'Malley's framework and reporting was guided by PRISMA-ScR. The search strategy was based on three concept blocks: (1) Study population: Children (<18 years); (2) Medical condition: Any musculoskeletal pain (acute, chronic primary, chronic secondary); (3) Intervention: Qualitative exploration of experience of physiotherapy treatment delivered by a physiotherapist from the perspective of a child, parent, or physiotherapist. The search (no date limit) was conducted in February 2024 across Medline, AMED and CINAHL. Results Following duplicate removal and assessment of eligibility of the initial 236 articles, nine articles were included; of these, only one specifically aimed to explore therapeutic alliance and it was the only paper to directly mention therapeutic alliance. All nine articles presented the child's experience. One overarching theme "Finding resilience within me through therapeutic alliance" and three main themes: "A trusted guide through the ups and the downs of rehabilitation"; "Having a route map"; and "Take me seriously but make it fun" were identified. Discussion Therapeutic alliance was considered important by children, parents and physiotherapist and it influenced child and parent perceptions of physiotherapy and overall treatment outcomes. Physiotherapists can foster the children's resilience when experiencing musculoskeletal pain by providing disciplinary expertise, connecting and collaborating with the child by becoming their trusted guide, and co-creating a route map for rehabilitation by helping them to learn about their body, pain and recovery timeline.
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Affiliation(s)
- Rhiannon Joslin
- School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom
- Women’s and Children’s Department, University Hospitals Sussex, St Richards Hospital, Chichester, United Kingdom
| | - Eve Allen
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
| | - Bernie Carter
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, United Kingdom
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Barr EA, Celniker JB, Ballantyne N. Advancing Vaccine Uptake in People With HIV: A Call for Research on Trust and Intellectual Humility in Health Care. J Assoc Nurses AIDS Care 2024; 35:456-459. [PMID: 39042495 PMCID: PMC11346704 DOI: 10.1097/jnc.0000000000000482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2024]
Abstract
ABSTRACT This article addresses the challenge of vaccine hesitancy among people with HIV (PWH), emphasizing the need for research on the potential impact of trust and intellectual humility in health care. It underscores the complexity of vaccine acceptance in PWH and the urgency of addressing hesitancy in PWH ahead of a future HIV vaccine. The article identifies trust in health care providers as a critical factor influencing vaccine uptake and proposes that providers who demonstrate intellectual humility-openly recognizing the limits of their knowledge-might enhance patient trust. The role of nurses is spotlighted because of their social positioning in the patient experience. The article advocates for interventions tailored to PWH's unique experiences and attitudes. Such strategies are essential for improving vaccine uptake and, consequently, public health outcomes.
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Affiliation(s)
- Emily A. Barr
- Emily A. Barr, PhD, RN, CPNP-PC, CNM, ACRN, FACNM, FAAN, is an Assistant Professor at the University of Texas Health Science Center at Houston at the Cizik School of Nursing, Houston, Texas, USA. Jared B. Celniker, PhD, is Research Director at Arizona State University, School of Historical, Philosophical, and Religious Studies, Tempe, Arizona, USA. Nathan Ballantyne, PhD, is Associate Professor of Philosophy, Cognition, and Culture at Arizona State University, School of Historical, Philosophical, and Religious Studies, Tempe, Arizona, USA
| | - Jared B. Celniker
- Emily A. Barr, PhD, RN, CPNP-PC, CNM, ACRN, FACNM, FAAN, is an Assistant Professor at the University of Texas Health Science Center at Houston at the Cizik School of Nursing, Houston, Texas, USA. Jared B. Celniker, PhD, is Research Director at Arizona State University, School of Historical, Philosophical, and Religious Studies, Tempe, Arizona, USA. Nathan Ballantyne, PhD, is Associate Professor of Philosophy, Cognition, and Culture at Arizona State University, School of Historical, Philosophical, and Religious Studies, Tempe, Arizona, USA
| | - Nathan Ballantyne
- Emily A. Barr, PhD, RN, CPNP-PC, CNM, ACRN, FACNM, FAAN, is an Assistant Professor at the University of Texas Health Science Center at Houston at the Cizik School of Nursing, Houston, Texas, USA. Jared B. Celniker, PhD, is Research Director at Arizona State University, School of Historical, Philosophical, and Religious Studies, Tempe, Arizona, USA. Nathan Ballantyne, PhD, is Associate Professor of Philosophy, Cognition, and Culture at Arizona State University, School of Historical, Philosophical, and Religious Studies, Tempe, Arizona, USA
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Haenssgen MJ, Elliott EM, Phommachanh S, Souksavanh O, Okabayashi H, Kubota S. Community engagement for stakeholder and community trust in healthcare: Short-term evaluation findings from a nationwide initiative in Lao PDR. Soc Sci Med 2024; 354:117079. [PMID: 38954978 DOI: 10.1016/j.socscimed.2024.117079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 06/15/2024] [Accepted: 06/25/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Trust remains a critical concept in healthcare provision, but little is known about the ability of health policy and interventions to stimulate more trusting relationships between communities and the health system. The CONNECT (Community Network Engagement for Essential Healthcare and COVID-19 Responses Through Trust) Initiative in Lao PDR provided an opportunity to assess the community-level impact of a trust-building community engagement approach. METHODS A mixed-method process evaluation was implemented from 10/2022-12/2023 among 14 diverse case study communities in four provinces across Lao PDR. Data collection involved two rounds of census surveys (3161 observations incl. panel data from 618 individuals) including an 8-item trust scale, 50 semi-structured interviews with villagers, and 50 contextualizing key informant interviews. The two data collection rounds were implemented before and three months after village-based CONNECT activities and helped discern impacts among activity participants, indirectly exposed villagers, and unexposed villagers in a difference-in-difference analysis. RESULTS Stakeholders attested strong support for the CONNECT Initiative although community-level retention of trust-related themes from the activities was limited. Quantitative data nevertheless showed that, at endline, the 8-item trust index (from [-8 to +8]) increased by 0.95 points from 4.44 to 5.39 and all trust indicators were universally higher. Difference-in-difference analysis showed that villagers exposed to the CONNECT activities had a 1.02-index-point higher trust index compared to unexposed villagers. Trust impacts improved gradually over time and were relatively more pronounced among men and ethnic minority groups. CONCLUSIONS The CONNECT Initiative had considerable direct and systemic effects on community members' trust in their local health centers in the short term, which arose from strong stakeholder mobilization and gradual institutional learning. Relational community engagement approaches have the potential to create important synergies in health policy and broader cross-sectorial strategies, but also require contextual grounding to identify locally relevant dimensions of trust.
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Affiliation(s)
- Marco J Haenssgen
- Department of Social Science and Development, Chiang Mai University, 239 Huay Kaew Rd. T. Suthep Muang, Chiang Mai, 50200, Thailand.
| | - Elizabeth M Elliott
- World Health Organization Regional Office for the Western Pacific, P.O. Box 2932, 1000, Manila, Philippines
| | - Sysavanh Phommachanh
- Institute of Research and Education Development, University of Health Sciences, Payawat Village, Sisattanak District, Vientiane Capital, Laos
| | - Ounkham Souksavanh
- World Health Organization Representative, Country Office for Lao People's Democratic Republic, 125 Saphanthong Road, Unit 5 Ban Saphangthongtai, Sisattanak District, Vientiane Capital, Laos
| | - Hironori Okabayashi
- World Health Organization Representative, Country Office for Lao People's Democratic Republic, 125 Saphanthong Road, Unit 5 Ban Saphangthongtai, Sisattanak District, Vientiane Capital, Laos
| | - Shogo Kubota
- World Health Organization Regional Office for the Western Pacific, P.O. Box 2932, 1000, Manila, Philippines
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Halloway S, Volgman AS, Schoeny ME, Arvanitakis Z, Barnes LL, Pressler SJ, Vispute S, Braun LT, Tafini S, Williams M, Wilbur J. Overcoming Pandemic-Related Challenges in Recruitment and Screening: Strategies and Representation of Older Women With Cardiovascular Disease for a Multidomain Lifestyle Trial to Prevent Cognitive Decline. J Cardiovasc Nurs 2024; 39:359-370. [PMID: 37167428 PMCID: PMC10638460 DOI: 10.1097/jcn.0000000000001000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND Recruiting participants with cardiovascular disease into research during the COVID-19 pandemic was challenging, particularly those at risk of health disparities. OBJECTIVE During the pandemic, 12 cohorts of older women with cardiovascular disease were recruited from cardiology clinics into a lifestyle intervention trial to prevent cognitive decline. Objectives were to ( a ) describe the results of modified recruitment/screening strategies to overcome pandemic-related challenges and ( b ) evaluate differences in age, race, and ethnicity between patients recruited/randomized, recruited/not randomized (entered recruitment but not randomized because of being ineligible or not interested), and not recruited (clinic patients who met preliminary criteria but did not enter recruitment). METHODS This was a cross-sectional descriptive analysis. In-person study strategies proposed before the COVID-19 pandemic were modified before study onset (September 2020). Women 65 years or older with cardiovascular disease were recruited from cardiology clinics by clinicians, posted flyers, and letters mailed to patients randomly selected from electronic health record data extractions. Patients were classified as recruited/randomized, recruited/not randomized, and not recruited. RESULTS Of 5719 patients potentially eligible, 1689 patients entered recruitment via referral (49.1%), posted flyers (0.5%), or mailed letters (50.3%), and 253 patients were successfully recruited/randomized. Recruited/randomized participants were, on average, 72.4 years old (range, 65-90 years old), non-Hispanic White (54.2%), non-Hispanic Black (38.3%), Hispanic/Latinx (1.6%), and other/not reported (5.1%). The recruited/randomized group was significantly younger with fewer patients of Hispanic/Latinx ethnicity compared with those not recruited. CONCLUSIONS During the pandemic, all recruitment/screening goals were met using modified strategies. Differences in sociodemographic representation indicate a need for tailored strategies.
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Lechien JR. Editorial letter: Artificial Intelligence can be used to improve the humanity of care. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08691-0. [PMID: 38687377 DOI: 10.1007/s00405-024-08691-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 04/15/2024] [Indexed: 05/02/2024]
Affiliation(s)
- Jerome R Lechien
- Department of Laryngology and Broncho-Esophagology, EpiCURA Hospital, Anatomy Department of University of Mons, Mons, Belgium.
- Department of Otolaryngoly-Head Neck Surgery, Foch Hospital, University of Paris Saclay, Paris, France.
- Phonetics and Phonology Laboratory, UMR 7018 CNRS, Université Sorbonne Nouvelle/Paris 3, Paris, France.
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Biton L, Shvartsur R, Grinberg K, Kagan I, Linetsky I, Halperin O, Azab AN, Cohen O. Vaccinating without complete willingness against COVID-19: Personal and social aspects of Israeli nursing students and faculty members. Nurs Inq 2024; 31:e12601. [PMID: 37731259 DOI: 10.1111/nin.12601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 09/22/2023]
Abstract
Soon after the coronavirus disease 2019 (COVID-19) pandemic outbreak, it became clear that vaccination will be the most useful tool to combat the disease. Despite the apparent safety and efficacy of the developed anti-COVID-19 vaccines, relatively high percentages of the population worldwide refused to get vaccinated, including many health workers and health students. The present cross-sectional study examined the motives, attitudes, and personal characteristics of those who did not get vaccinated against COVID-19 or vaccinated without complete willingness among nursing students and nursing faculty members in Israel (n = 472). Results show that the vast majority of the study participants (97%) received at least one dose of the anti-COVID-19 vaccine. Nearly 37% of the participants indicated that they received the vaccine without complete willingness. As compared to faculty members, nursing students reported lower trust in the efficacy of the vaccine, perceived the COVID-19 pandemic as a health threat to a lesser extent, exhibited lower institutional and personal trust, and had higher levels of posttraumatic stress disorder symptoms. Non-Jewish participants were at risk of vaccinating without complete willingness. These findings underscore the need for developing evidence-based strategies to promote the safety and efficacy of the anti-COVID-19 vaccines in nursing schools.
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Affiliation(s)
- Linoy Biton
- Department of Nursing, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Rachel Shvartsur
- Department of Nursing, School of Health Sciences, Ashkelon Academic College, Israel
| | - Keren Grinberg
- Department of Nursing Sciences, Faculty of Social and Community Sciences, Ruppin Academic Center, Emek-Hefer, Israel
| | - Ilya Kagan
- Department of Nursing, School of Health Sciences, Ashkelon Academic College, Israel
| | - Irena Linetsky
- Department of Nursing Sciences, Faculty of Social and Community Sciences, Ruppin Academic Center, Emek-Hefer, Israel
| | - Ofra Halperin
- Department of Nursing, Max Stern Academic College of Emek-Yezreel, Jezreel Valley, Israel
| | - Abed N Azab
- Department of Nursing, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Odeya Cohen
- Department of Nursing, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Karachi F, van Nes MB, Gosselink R, Hanekom S. Patient perceptions of ICU physiotherapy: 'Your body needs to go somewhere to be recharged … '. SOUTHERN AFRICAN JOURNAL OF CRITICAL CARE 2023; 39:e1092. [PMID: 38357692 PMCID: PMC10866209 DOI: 10.7196/sajcc.2023.v39i3.1092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2023] [Indexed: 02/16/2024] Open
Abstract
Background Patient satisfaction is an essential concept to consider for the improvement of quality care in healthcare centres and hospitals and has been linked to increased patient compliance with treatment plans, better patient safety and improved clinical outcomes. Objectives As part of a before-and-after clinical trial aimed to investigate the implementation of an evidence-based and -validated physiotherapy protocol within a surgical intensive care unit (ICU), we decided to include the patient perception of physiotherapy received in the intervention unit. Methods A nested, exploratory, descriptive, qualitative study design was adopted. Purposively selected adult patients discharged from ICU during the implementation phase of the trial were interviewed. Results Eighteen patients (10 male) with a median age of 44 years and median ICU length of stay (LOS) of six days were included. Three themes and nine categories emerged: (i) linking therapy to clinical outcome (patient expectations and understanding; physiotherapy activities and the implication of mobilisation; physiotherapy benefits and progression); (ii) the importance of developing a trusting relationship (physiotherapy value; safety; continuity of care); and (iii) communication (satisfaction; interactions and patient perception and experience of physiotherapy). Conclusion While confirming barriers to early mobility, patients perceived participation in mobility activities as a marked jolt in their journey to recovery following a critical incident. Effective communication and preservation of trust between physiotherapist and patient are essential for understanding expectations and can facilitate improved outcomes. Clinicians can use the information when managing critically ill patients. Including patient-reported outcomes to measure physiotherapy interventions used in the ICU is feasible and can inform the development of such outcomes. Contribution of the study The study highlights the feasibility and importance of the use of patient-reported outcomes to measure physiotherapy interventions and informs the development of patient reported outcomes and the importance of patient centred physiotherapy care in the ICU setting.
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Affiliation(s)
- F Karachi
- Physiotherapy Department, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
| | - M B van Nes
- Physiotherapy Department, Department of Health and Rehabilitation Sciences, Stellenbosch University, Tygerberg, South Africa
| | - R Gosselink
- Respiratory Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Belgium; and Department of Physiotherapy, Stellenbosch University,
Tygerberg, South Africa
| | - S Hanekom
- Physiotherapy Department, Department of Health and Rehabilitation Sciences, Stellenbosch University, Tygerberg, South Africa
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Kong L, Chen Y, Wang L, Wang K, Liu C, Gan Y. Effect of Perspective-Taking on Trust Between Doctors and Patients: A Randomized Controlled Trial. J Clin Psychol Med Settings 2023; 30:708-715. [PMID: 36746850 PMCID: PMC9902241 DOI: 10.1007/s10880-022-09935-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2022] [Indexed: 02/08/2023]
Abstract
Tension between doctors and patients as a social problem has existed for a long time; thus far, there is no good solution. From the perspective of trust between doctors and patients, this research studies the relieving effect of perspective-taking interventions on the tension between doctors and patients. This study used a randomized, single-blind online experiment. 133 participants were randomly divided into an intervention group (n = 67) and control group (n = 66). Participants were asked to complete writing tasks from the doctor's perspective. Patients' trust in doctors was measured at 3 time points: before intervention, immediately after intervention, and 10 days after the intervention. Findings showed a significant interaction effect between time measurement and group. In the intervention group, a pairwise comparison of time measurements showed a significant difference between T1 and T2. Perspective-taking interventions can improve patients' trust in doctors, but this effect diminishes over time.
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Affiliation(s)
- Linghang Kong
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, 100871, China
| | - Yidi Chen
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, 100871, China
- Beijing Forest University, Beijing, China
| | - Lu Wang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, 100871, China
| | - Kaikai Wang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, 100871, China
| | - Chen Liu
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, 100871, China
| | - Yiqun Gan
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, 100871, China.
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Lesnewich LM, Hyde JK, McFarlin ML, Bolton RE, Bayley PJ, Chandler HK, Helmer DA, Phillips LA, Reinhard MJ, Santos SL, Stewart RS, McAndrew LM. 'She thought the same way I that I thought:' a qualitative study of patient-provider concordance among Gulf War Veterans with Gulf War Illness. Psychol Health 2023:1-19. [PMID: 37654203 DOI: 10.1080/08870446.2023.2248481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 07/15/2023] [Accepted: 08/10/2023] [Indexed: 09/02/2023]
Abstract
Objective: Medically unexplained symptoms (MUS), such as chronic fatigue syndrome, irritable bowel syndrome, and Gulf War Illness (GWI), are difficult to treat. Concordance-shared understanding between patient and provider about illness causes, course, and treatment-is an essential component of high-quality care for people with MUS. This qualitative paper focuses on the experiences of United States military Veterans living with GWI who have endured unique healthcare challenges. Methods & Measures: Qualitative interviews were conducted with 31 Veterans with GWI to explore factors that contribute to and detract from concordance with their Veteran Affairs (VA) healthcare providers. In addition to being seen by VA primary care, over half of participants also sought care at a War Related Illness and Injury Study Center, which specializes in post-deployment health. Deductive and inductive codes were used to organize the data, and themes were identified through iterative review of coded data. Results: Major themes associated with patient-provider concordance included validation of illness experiences, perceived provider expertise in GWI/MUS, and trust in providers. Invalidation, low provider expertise, and distrust detracted from concordance. Conclusion: These findings suggest providers can foster concordance with MUS patients by legitimizing patients' experiences, communicating knowledge about MUS, and establishing trust.
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Affiliation(s)
- Laura M Lesnewich
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs New Jersey Health Care System, East Orange, NJ, USA
| | - Justeen K Hyde
- Department of Medicine, Section General Internal Medicine, Boston University, Boston, MA, USA
- Center for Healthcare Organization and Implementation Research (CHOIR), Veterans Affairs Bedford Healthcare System, Bedford, MA, USA
| | | | - Rendelle E Bolton
- Center for Healthcare Organization and Implementation Research (CHOIR), Veterans Affairs Bedford Healthcare System, Bedford, MA, USA
- The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
| | - Peter J Bayley
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Helena K Chandler
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs New Jersey Health Care System, East Orange, NJ, USA
| | - Drew A Helmer
- Center for Innovations in Quality, Effectiveness & Safety (IQuESt), Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - L Alison Phillips
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs New Jersey Health Care System, East Orange, NJ, USA
- Department of Psychology, Iowa State University, IA, USA
| | - Matthew J Reinhard
- War Related Illness and Injury Study Center (WRIISC), Washington DC Veterans Affairs Medical Center, Washington, DC, USA high-quality
| | - Susan L Santos
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs New Jersey Health Care System, East Orange, NJ, USA
| | - Rachel S Stewart
- War Related Illness and Injury Study Center (WRIISC), Washington DC Veterans Affairs Medical Center, Washington, DC, USA high-quality
| | - Lisa M McAndrew
- War Related Illness and Injury Study Center (WRIISC), Veterans Affairs New Jersey Health Care System, East Orange, NJ, USA
- University at Albany, State University of New York (SUNY), Albany, NY, USA
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11
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Varga AI, Spehar I, Skirbekk H. Trustworthy management in hospital settings: a systematic review. BMC Health Serv Res 2023; 23:662. [PMID: 37340412 DOI: 10.1186/s12913-023-09610-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 05/26/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Trustful relationships play a vital role in successful organisations and well-functioning hospitals. While the trust relationship between patients and providers has been widely studied, trust relations between healthcare professionals and their supervisors have not been emphasised. A systematic literature review was conducted to map and provide an overview of the characteristics of trustworthy management in a hospital setting. METHODS We searched Web of Science, Embase, MEDLINE, APA PsycInfo, CINAHL, Scopus, EconLit, Taylor & Francis Online, SAGE Journals and Springer Link from database inception up until Aug 9, 2021. Empirical studies written in English undertaken in a hospital or similar setting and addressed trust relationships between healthcare professionals and their supervisors were included, without date restrictions. Records were independently screened for eligibility by two researchers. One researcher extracted the data and another one checked the correctness. A narrative approach, which involves textual and tabular summaries of findings, was undertaken in synthesising and analysing the data. Risk of bias was assessed independently by two researchers using two critical appraisal tools. Most of the included studies were assessed as acceptable, with some associated risk of bias. RESULTS Of 7414 records identified, 18 were included. 12 were quantitative papers and 6 were qualitative. The findings were conceptualised in two categories that were associated with trust in management, namely leadership behaviours and organisational factors. Most studies (n = 15) explored the former, while the rest (n = 3) additionally explored the latter. Leadership behaviours most commonly associated with employee's trust in their supervisors include (a) different facets of ethical leadership, such as integrity, moral leadership and fairness; (b) caring for employee's well-being conceptualised as benevolence, supportiveness and showing concern and (c) the manager's availability measured as being accessible and approachable. Additionally, four studies found that leaders' competence were related to perceptions of trust. Empowering work environments were most commonly associated with trust in management. CONCLUSIONS Ethical leadership, caring for employees' well-being, manager's availability, competence and an empowering work environment are characteristics associated with trustworthy management. Future research could explore the interplay between leadership behaviours and organisational factors in eliciting trust in management.
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Affiliation(s)
- Andreea Isabela Varga
- Department of Health Management and Health Economics, Institute of Health and Society, Medical Faculty, University of Oslo (UiO), P.O. Box 1089, Oslo, NO-0317, Norway
| | - Ivan Spehar
- Department of Health Management and Health Economics, Institute of Health and Society, Medical Faculty, University of Oslo (UiO), P.O. Box 1089, Oslo, NO-0317, Norway
- Institute of Psychology, Oslo New University College, Oslo, Norway
| | - Helge Skirbekk
- Department of Health Management and Health Economics, Institute of Health and Society, Medical Faculty, University of Oslo (UiO), P.O. Box 1089, Oslo, NO-0317, Norway.
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
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12
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Tegenu Lemma K, Tilahun Beyene D, Mekoya Jemaneh T, Melkamu Andualem E, Atomsa Hunde G. Patients’ Trust in Health Care Providers Among Hospitalized Patients, Jimma, South West Ethiopia. SAGE Open Nurs 2023; 9:23779608231167810. [PMID: 37032961 PMCID: PMC10080458 DOI: 10.1177/23779608231167810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 03/02/2023] [Accepted: 03/19/2023] [Indexed: 04/08/2023] Open
Abstract
Introduction Trust is a fundamental aspect of the patient–health care provider (HCP) relationship associated with adherence to medical treatment and continuity of follow-up. Despite its importance there is a paucity of information in Ethiopia. Objectives This study aimed to assess patient trust in HCPs at the Jimma medical center (JMC), Ethiopia. Methods An institution based cross-sectional study was conducted among 404 participants from April 16 to June 29, 2020. Study participants were selected using a systematic sampling technique. Data were collected on socio-demographic characteristics, health related and clinical characteristics, and patient trust in the patient–HCP. The collected data were entered into Epi-Data version 3.1 then exported to SPSS version 23.0 for analysis. Variables with a p-value <.25 on bivariate analysis were considered as candidates for multivariate analyses. Statistical significance on multivariable analysis was declared with p-value < .05 and 95% confidence intervals (CI). Results In our study, 38% of patients had low trust. Among the 397 study participants, 46.6% were female. One-third (33.2%) of respondents had no formal education. Patients who live alone [(AOR) 4.30(1.98–9.33), p = .00], and self-reported as a poor current health status [(AOR) 2.32(1.39–3.88), p = .002] were positively associated to patient trust in patient–HCP. On the other hand, duration of disease more than one year after diagnosis [(AOR) 0.48 (0.25–0.92), p = .028], comorbid disease [(AOR) 0.39(0.22−0.67), p = .001], and impaired physical mobility [(AOR) 0.27(0.16−0.45), p = .001] were negatively associated with patient trust in HCP. Conclusion This study pinpoints that 38 out of 100 patients had low trust. Living alone and having poor self-reported current health status increased low trust. This calls for HCPs to rebuild trust and give due attention to patients living alone and with poor health status.
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Affiliation(s)
- Kenenisa Tegenu Lemma
- School of Nursing, Institute of Health, Jimma University, Jimma, Ethiopia
- Kenenisa Tegenu Lemma, School of Nursing, Institute of Health, Jimma University, Jimma, Ethiopia.
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13
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Evered J, Andersen L, Foxwell A, Iroegbu C, Whitney C. Clinician-Patient Relationships in Virtual Care: A Dimensional Analysis of the Symbolic World of Cancer Care. QUALITATIVE HEALTH RESEARCH 2023; 33:284-296. [PMID: 36718991 DOI: 10.1177/10497323231153793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Rapid uptake of telehealth technologies has shifted clinician-patient relationships, a well-studied topic of sociological inquiry. The purpose of this dimensional analysis study was to understand the symbolic interaction of clinicians and patients within virtual supportive cancer care. Seventeen clinicians, eighteen patients, and three care partners receiving or providing care at a multi-site cancer center in the United States participated in interviews. Our analysis of supportive cancer care experiences reveals a key tension: clinicians need to rely on patients in order to share clinical tasks in a virtual care setting but can be reluctant to do so. We posit that dimming the light on cancer is a process that enables clinicians to overcome their reluctance to engage in clinician-patient task sharing by strengthening the relationship. Taken together, these findings reconceptualize the symbolic interaction of the clinician-patient relationship and highlight opportunities to actualize models of relationship-centered virtual care. We discuss implications for clinical practice, ethical relational care, and the literature on clinician-patient relationships and trust.
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Affiliation(s)
- Jane Evered
- 16142University of Pennsylvania School of Nursing, Philadelphia, PA, USA
- 5228University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Lucy Andersen
- 16142University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Anessa Foxwell
- 16142University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Christin Iroegbu
- 16142University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Clare Whitney
- 16142University of Pennsylvania School of Nursing, Philadelphia, PA, USA
- 16038Stony Brook University School of Nursing, Stony Brook, NY, USA
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14
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TAYLOR LAURENA, NONG PAIGE, PLATT JODYN. Fifty Years of Trust Research in Health Care: A Synthetic Review. Milbank Q 2023; 101:126-178. [PMID: 36689251 PMCID: PMC10037697 DOI: 10.1111/1468-0009.12598] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/21/2022] [Accepted: 08/01/2022] [Indexed: 01/24/2023] Open
Abstract
Policy Points First, policymakers can create conditions that will facilitate public trust in health care organizations by making creating and enforcing health policies that make exploitative behavior costly. Second, policymakers can bolster the trustworthiness of health care markets and organizations by using their regulatory authority to address and mitigate harm from conflicts-of-interest and regulatory capture. Third, policymakers and government agencies can further safeguard the public's trust by being transparent and effective about their role in the provision of health services to the public. CONTEXT Trust plays a critical role in facilitating health care delivery and calls for rebuilding trust in health care are increasingly commonplace. This article serves as a primer on the trust literature for health policymakers, organizational leaders, clinicians, and researchers based on the long history of engagement with the topic among health policy and services researchers. METHODS We conducted a synthetic review of the health services and health policy literatures on trust since 1970. We organize our findings by trustor-trustee dyads, highlighting areas of convergence, tensions and contradictions, and methodological considerations. We close by commenting on the challenges facing the study of trust in health care, the potential value in borrowing from other disciplines, and imperatives for the future. FINDINGS We identified 725 articles for review. Most focused on patients' trust in clinicians (n = 499), but others explored clinicians' trust in patients (n = 11), clinicians' trust in clinicians (n = 69), and clinician/patient trust in organizations (n = 19) and systems (n = 127). Across these five subliteratures, there was lack of consensus about definitions, dimensions, and key attributes of trust. Researchers leaned heavily on cross-sectional survey designs, with limited methodological attention to the relational or contextual realities of trust. Trust has most commonly been treated as an independent variable related to attitudinal and behavioral outcomes. We suggest two challenges have limited progress for the field: (1) conceptual murkiness in terms and theories, and (2) limited observability of the phenomena. Insights from philosophy, sociology, economics, and psychology offer insights for how to advance both the theoretical and empirical study of health-related trust. CONCLUSION Conceptual clarity and methodological creativity are critical to advancing health-related trust research. Although rigorous research in this area is challenging, the essential role of trust in population health necessitates continued grappling with the topic.
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Affiliation(s)
| | - PAIGE NONG
- University of Michigan School of Public HealthAnn ArborUSA
| | - JODYN PLATT
- University of Michigan Medical SchoolAnn ArborUSA
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15
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Rusu RN, Ababei DC, Bild W, Stoian I, Macadan I, Stanciu GD, Ciobica A, Bild V. Self-Medication in Rural Northeastern Romania: Patients' Attitudes and Habits. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14949. [PMID: 36429676 PMCID: PMC9690038 DOI: 10.3390/ijerph192214949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 06/16/2023]
Abstract
In recent years, many healthcare systems, along with healthcare professionals, have provided services in a patient-centered manner, in which patients are key actors in the care process. Encouraging self-care creates responsible patients, but it must be practiced responsibly. This study aims to analyze the tendency towards self-medication for patients from a rural area in Northeastern Romania. Data were collected using a questionnaire, which consisted of 25 questions, that has been developed by the research team. Student's T test or one-way ANOVA was used, and the reliability of the questionnaire was calculated using Cronbach's alpha coefficient. Fifty-eight patients agreed to participate and were interviewed. The results of the study suggest that respondents practice self-medication, which they resort to when their condition cannot be treated with natural remedies or herbs and when it impairs their ability to do their daily activities. Self-medication could be explained by the lack of self-care services as well as the trust patients have in the specific treatment. Patients prefer asking the pharmacist for drugs instead of visiting a physician, which could be due to higher accessibility and time-efficiency, while also being prone to stock up on certain medications due to limited access to healthcare.
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Affiliation(s)
- Razvan-Nicolae Rusu
- Department of Pharmacodynamics and Clinical Pharmacy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Daniela-Carmen Ababei
- Department of Pharmacodynamics and Clinical Pharmacy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
- Advanced Research and Development Center for Experimental Medicine (CEMEX), “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Walther Bild
- Department of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
- Center of Biomedical Research of the Romanian Academy, 700506 Iasi, Romania
| | - Ioana Stoian
- Department of Pharmacodynamics and Clinical Pharmacy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Ioana Macadan
- Department of Pharmacodynamics and Clinical Pharmacy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Gabriela Dumitrita Stanciu
- Advanced Research and Development Center for Experimental Medicine (CEMEX), “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
| | - Andrei Ciobica
- Department of Physiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Veronica Bild
- Department of Pharmacodynamics and Clinical Pharmacy, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
- Advanced Research and Development Center for Experimental Medicine (CEMEX), “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universitatii Street, 700115 Iasi, Romania
- Center of Biomedical Research of the Romanian Academy, 700506 Iasi, Romania
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He Q, Li Y, Wu Z, Su J. Explicating the Cognitive Process of a Physician's Trust in Patients: A Moderated Mediation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14446. [PMID: 36361323 PMCID: PMC9656963 DOI: 10.3390/ijerph192114446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/30/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
Trust is considered a critical factor in the physician-patient relationship. However, little is known about the development and impact of physicians trusting their patients. A model that is premised on the integrated model of organizational trust was proposed in this article to reveal the cognitive processes involved in physicians' trust, with perceived integrity and the ability of the patient as antecedents and the physicians' communication efficacy as the outcome. A cross-sectional survey of 348 physicians in Zhejiang province, China, revealed that a physician's trust in a patient mediated the relationship between the physicians' perception of the integrity and ability of the patient, and the physician's communication efficacy. The physicians' educational backgrounds and work experience were also found to moderate an indirect effect: a lower level of education and longer work experience intensified the impact of the perceived integrity and ability of the patient on the physician's trust, while shorter work experience made the association between the physician's trust and communication efficacy more salient. This paper provided implications for both physician and patient sides.
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Affiliation(s)
- Qijun He
- School of Journalism and Communication, Shanghai University, Shanghai 200072, China
| | - Yungeng Li
- School of Media and Communication, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Zhiyao Wu
- School of Journalism and Communication, Shanghai University, Shanghai 200072, China
| | - Jingjing Su
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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17
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O'Rourke K, Yelland J, Newton M, Shafiei T. Matching of woman and doula, and the generation of trust in an Australian volunteer doula program: Findings from a realist evaluation. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5423-e5433. [PMID: 35924682 PMCID: PMC10087570 DOI: 10.1111/hsc.13965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 05/31/2022] [Accepted: 07/25/2022] [Indexed: 05/15/2023]
Abstract
How women are cared for while pregnant and having a new baby can have profound and lasting effects on their health and well-being. While mainstream maternity care systems aspire to provide care that is woman-centred, women with fewest social and economic resources often have reduced access. Community-based doula support programs offer complementary care for these women and are known to, on average, have positive outcomes. Less understood is how, when and why these programs work. A realist evaluation of an Australian volunteer doula program provided for women experiencing socioeconomic adversity explored these questions. The program provides free non-medical, social, emotional, and practical support by trained doulas during pregnancy, birth and new parenting. This paper reports the testing and refinement of one program theory from the larger study. The theory, previously developed from key informant interviews and rapid realist review of literature, hypothesised that the cultural matching of woman (client) and doula led to best outcomes. This was tested in realist interviews with women and focus groups with doulas, in January-February 2020. Seven English speaking, and six Arabic speaking clients were interviewed. Two focus groups were conducted with a total of eight doulas from diverse cultural and professional backgrounds. Data were analysed in NVivo. The study found cultural matching to be valued by some but not all women, and only when the doula was also genuinely interested, kind, timely and reliable. These approaches (with or without cultural matching) generate trust between the doula and woman. Trust theory, reflexivity theory and social relations theory supported explanatory understanding of the causal contribution of a doula knowing what it takes to build trust, to a woman deciding to trust her doula.
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Affiliation(s)
- Kerryn O'Rourke
- Judith Lumley CentreLa Trobe UniversityBundooraVictoriaAustralia
- Realist Research Evaluation and Learning InitiativeNorthern Institute Charles Darwin UniversityCasuarina, DarwinNorthern TerritoryAustralia
| | - Jane Yelland
- Murdoch Children's Research InstituteParkvilleVictoriaAustralia
- Department General PracticeUniversity of MelbourneParkvilleAustralia
| | - Michelle Newton
- Judith Lumley CentreLa Trobe UniversityBundooraVictoriaAustralia
- School of Nursing and MidwiferyLa Trobe UniversityBundooraVictoriaAustralia
| | - Touran Shafiei
- Judith Lumley CentreLa Trobe UniversityBundooraVictoriaAustralia
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18
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Park SY, Yun GW, Friedman S, Hill K, Coppes MJ. Patient-Centered Care and Healthcare Consumerism in Online Healthcare Service Advertisements: A Positioning Analysis. J Patient Exp 2022; 9:23743735221133636. [PMID: 36311906 PMCID: PMC9597013 DOI: 10.1177/23743735221133636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Patient-centered care and healthcare consumerism are the two most dominant ideas about the relationship between patients and providers in the United States. To identify providers' positions between the two perspectives, we analyzed the content of direct-to-consumer healthcare service advertisements. The advertisements were collected in the state of Nevada (N = 323) and their landing pages were analyzed for provider attributes, patient experience features, and terms referring to patients and providers. The results showed that the advertisements fully embraced the notion of patient-centeredness by commonly claiming patient-centered care and frequently using the term "patient." The advertisements also contained multiple indicators of healthcare consumerism, although they avoided using the terms "consumer/customer/client" closely associated with consumerism. Contrary to the prominence of patient experience features, provider attributes were not common. An additional analysis of inter-specialty differences in advertising features confirmed the strong consumerism position of cosmetic surgery providers. Application of the healthcare service advertising analytic scheme developed for this study could help providers and healthcare administrators recognize how their advertising messages may reflect their values.
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Affiliation(s)
- Sung-Yeon Park
- School of Public Health, University of Nevada, Reno, Reno, Nevada,
USA,Sung-Yeon Park, School of Public Health,
University of Nevada, Reno, NV 89557, USA.
| | - Gi Woong Yun
- Reynolds School of Journalism, University of Nevada, Reno, Reno,
Nevada, USA
| | - Sarah Friedman
- School of Public Health, University of Nevada, Reno, Reno, Nevada,
USA
| | - Kylie Hill
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Max J Coppes
- Departments of Pediatrics and Internal Medicine, University of
Nevada, Reno School of Medicine, Nevada, USA,Pennington Cancer Institute, Renown Health, Reno, Nevada, USA
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Im J, Evans JM, Grudniewicz A, Boeckxstaens P, Upshur R, Steele Gray C. On the same page? A qualitative study of shared mental models in an interprofessional, inter-organizational team implementing goal-oriented care. J Interprof Care 2022; 37:549-557. [DOI: 10.1080/13561820.2022.2113048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Jennifer Im
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, USA
| | - Jenna M. Evans
- DeGroote School of Business, McMaster University, Hamilton, ON, USA
| | - Agnes Grudniewicz
- Telfer School of Management, University of Ottawa, Ottawa, ON, Canada
| | - Pauline Boeckxstaens
- Community Health Centre Botermarkt. Ledeberg, Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium
- Department of Public Health and Primary Care, Ghent University, Ghent, Ghent
| | - Ross Upshur
- Dalla Lana School of Public Health, Lunenfeld Tanenbaum Research Institute, Sinai Health System, University of Toronto, Toronto, ON, USA
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, USA
| | - Carolyn Steele Gray
- Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, USA
- Bridgepoint Collaboratory for Research and Innovation, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, ON, USA
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Michel J, Mettler A, Stuber R, Müller M, Ricklin ME, Jent P, Hautz WE, Sauter TC. Effects and utility of an online forward triage tool during the SARS-CoV-2 pandemic: a mixed method study and patient perspectives, Switzerland. BMJ Open 2022; 12:e059765. [PMID: 35820749 PMCID: PMC9274020 DOI: 10.1136/bmjopen-2021-059765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To assess the effects (quantitatively) and the utility (qualitatively) of a COVID-19 online forward triage tool (OFTT) in a pandemic context. DESIGN A mixed method sequential explanatory study was employed. Quantitative data of all OFTT users, between 2 March 2020 and 12 May 2020, were collected. Second, qualitative data were collected through key informant interviews (n=19) to explain the quantitative findings, explore tool utility, user experience and elicit recommendations. SETTING The working group e-emergency medicine at the emergency department developed an OFTT, which was made available online. PARTICIPANTS Participants included all users above the age of 18 that used the OFTT between 2 March 2020 and 12 May 2020. INTERVENTION An OFTT that displayed the current test recommendations of the Federal Office of Public Health on whether someone needed testing for COVID-19 or not. No diagnosis was provided. RESULTS In the study period, 6272 users consulted our OFTT; 40.2% (1626/4049) would have contacted a healthcare provider had the tool not existed. 560 participants consented to a follow-up survey and provided a valid email address. 31.4% (176/560) participants returned a complete follow-up questionnaire. 84.7% (149/176) followed the recommendations given. 41.5% (73/176) reported that their fear was allayed after using the tool. Qualitatively, seven overarching themes emerged namely (1) accessibility of tool, (2) user-friendliness of tool, (3) utility of tool as an information source, (4) utility of tool in allaying fear and anxiety, (5) utility of tool in medical decision-making (6) utility of tool in reducing the potential for onward transmissions and (7) utility of tool in reducing health system burden. CONCLUSION Our findings demonstrated that a COVID-19 OFTT does not only reduce the health system burden but can also serve as an information source, reduce anxiety and fear, reduce potential for cross infections and facilitate medical decision-making.
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Affiliation(s)
- Janet Michel
- Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Annette Mettler
- Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Raphael Stuber
- Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Martin Müller
- Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Meret E Ricklin
- Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Philipp Jent
- Department of Infectious Diseases, Inselspital, University Hospital, University of Bern, Bern, Switzerland
| | - Wolf E Hautz
- Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, Bern, Switzerland
- Centre for Educational Measurement, University of Oslo, Oslo, Norway
| | - Thomas C Sauter
- Department of Emergency Medicine, Inselspital, University Hospital, University of Bern, Bern, Switzerland
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21
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Leese J, Zhu S, Townsend AF, Backman CL, Nimmon L, Li LC. Ethical issues experienced by persons with rheumatoid arthritis in a wearable-enabled physical activity intervention study. Health Expect 2022; 25:1418-1431. [PMID: 35303379 PMCID: PMC9327860 DOI: 10.1111/hex.13481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/29/2021] [Accepted: 03/02/2022] [Indexed: 02/05/2023] Open
Abstract
Introduction Using wearables to self‐monitor physical activity is a promising approach to support arthritis self‐management. Little is known, however, about the context in which ethical issues may be experienced when using a wearable in self‐management. We used a relational ethics lens to better understand how persons with rheumatoid arthritis (RA) experience their use of a wearable as part of a physical activity counselling intervention study involving a physiotherapist (PT). Methods Constructivist grounded theory and a relational ethics lens guided the study design. This conceptual framework drew attention to benefits, downsides and tensions experienced in a context of relational settings (micro and macro) in which participants live. Fourteen initial and eleven follow‐up interviews took place with persons with RA in British Columbia, Canada, following participation in a wearable‐enabled intervention study. Results We created three main categories, exploring how experiences of benefits, downsides and tensions when using the intervention intertwined with shared moral values placed on self‐control, trustworthiness, independence and productivity: (1) For some, using a wearable helped to ‘do something right’ by taking more control over reaching physical activity goals. Some, however, felt ambivalent, believing both there was nothing more they could do and that they had not done enough to reach their goal; (2) Some participants described how sharing wearable data supported and challenged mutual trustworthiness in their relationship with the PT; (3) For some, using a wearable affirmed or challenged their sense of self‐respect as an independent and productive person. Conclusion Participants in this study reported that using a wearable could support and challenge their arthritis self‐management. Constructing moral identity, with qualities of self‐control, trustworthiness, independence and productivity, within the relational settings in which participants live, was integral to ethical issues encountered. This study is a key step to advance understanding of ethical issues of using a wearable as an adjunct for engaging in physical activity from a patient's perspective. Patient or Public Contribution Perspectives of persons with arthritis (mostly members of Arthritis Research Canada's Arthritis Patient Advisory Board) were sought to shape the research question and interpretations throughout data analysis.
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Affiliation(s)
- Jenny Leese
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.,Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Siyi Zhu
- Arthritis Research Canada, Vancouver, British Columbia, Canada.,Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China.,Rehabilitation Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Anne F Townsend
- Arthritis Research Canada, Vancouver, British Columbia, Canada.,Division of Health Research, Health Innovation One, Lancaster University, Lancaster, UK
| | - Catherine L Backman
- Arthritis Research Canada, Vancouver, British Columbia, Canada.,Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Laura Nimmon
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Faculty of Medicine, Centre for Health Education Scholarship, P.A. Woodward Instructional Resources Centre (IRC), University of British Columbia, Vancouver, British Columbia, Canada
| | - Linda C Li
- Arthritis Research Canada, Vancouver, British Columbia, Canada.,Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
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Trust in the Healthcare System and Physicians in Croatia: A Survey of the General Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020993. [PMID: 35055815 PMCID: PMC8796022 DOI: 10.3390/ijerph19020993] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/08/2022] [Accepted: 01/12/2022] [Indexed: 11/25/2022]
Abstract
Trust in healthcare systems and physicians is considered important for the delivery of good healthcare. A cross-sectional survey was conducted on a random three-stage sample of the general population of Croatia (N = 1230), stratified by regions. Of respondents, 58.7% displayed a high or very high level of trust in the healthcare system, 65.6% in physicians, and 78.3% in their family physician. Respondents’ views regarding patients’ roles in the discussion of treatment options, confidence in physicians’ expertise, and underlying motives of physicians were mixed. Respondents with a lower level of education, those with low monthly incomes, and those from smaller settlements had lower levels of trust in physicians and the healthcare system. Trust in other institutions, religiosity and religious beliefs, tolerance of personal choice, and experience of caring for the seriously ill and dying were predictors of trust in healthcare and physicians. Our findings suggest that levels of healthcare-related trust in Croatia are increasing in comparison with previous research, but need improvement. Levels of trust are lowest in populations that are most vulnerable and most in need of care and protection.
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Nahum AS, Vongsachang H, Friedman DS, Collins ME. Parental Trust in School-Based Health Care: A Systematic Review. THE JOURNAL OF SCHOOL HEALTH 2022; 92:79-91. [PMID: 34773404 DOI: 10.1111/josh.13106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/18/2021] [Accepted: 04/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Health care delivery in schools is a frequently adopted approach to reduce health care inequalities. Lack of parental trust has been identified as impacting participation in school-based health care programs (SBHPs). The aim of our systematic review is to outline themes related to parental trust in SBHPs. METHODS We searched MEDLINE, Embase, CINHAL, ERIC, PsycInfo, and Web of Science for articles published between 1969 and 2019. Eligible studies (1) were peer-reviewed primary research articles; (2) were school-based health interventions or screening programs; (3) included parental trust data; and (4) were carried out on schoolchildren from pre-K to grade 12. Study location, data collection date, number of participants, demographics, intervention type, study aim and methodology, and all trust themes mentioned, were extracted. Studies were critically appraised using the CASP checklist for qualitative research. RESULTS We identified 9 themes related to parental trust in SBHPs: (1) safety; (2) effectiveness; (3) health professionals' training and credentials; (4) communication; (5) confidentiality; (6) providers; (7) government, authorities, and health service; (8) the pharmaceutical industry; and (9) research and data sharing. CONCLUSIONS The themes identified provide a framework for examining trust in SBHPs, and may guide the development of interventions to increase trust and engagement in SBHPs.
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Affiliation(s)
- Andrea S Nahum
- Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins School of Medicine, 600 N Wolfe Street, Baltimore, MD, 21287
- UCL Medical School, University College London, 74 Huntley Street, Bloomsbury, London, WC1E 6DE, UK
| | - Hursuong Vongsachang
- Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins School of Medicine, 600 N Wolfe Street, Baltimore, MD, 21287, USA
| | - David S Friedman
- Massachusetts Eye and Ear Infirmary, Glaucoma Center of Excellence, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, USA
| | - Megan E Collins
- Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins School of Medicine, 600 N Wolfe Street, Baltimore, MD, 21287, USA
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Mweemba C, Mapulanga M, Jacobs C, Katowa-Mukwato P, Maimbolwa M. Access barriers to maternal healthcare services in selected hard-to-reach areas of Zambia: a mixed methods design. Pan Afr Med J 2021; 40:4. [PMID: 34650654 PMCID: PMC8490167 DOI: 10.11604/pamj.2021.40.4.28423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 08/14/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction poor access to maternal health services is a one of the major contributing factors to maternal deaths in low-resource settings, and understanding access barriers to maternal services is an important step for targeting interventions aimed at promoting institutional delivery and improving maternal health. This study explored access barriers to maternal and antenatal services in Kaputa and Ngabwe; two of Zambia´s rural and hard-to-reach districts. Methods a concurrent mixed methods approach was therefore, undertaken to exploring three access dimensions, namely availability, affordability and acceptability, in the two districts. Structured interviews were conducted among 190 eligible women in both districts, while key informant interviews, in-depth interviews and focus group discussions were conducted for the qualitative component. Results the study found that respondents were happy with facilities´ opening and closing times in both districts. By comparison, however, women in Ngabwe spent significantly more time traveling to facilities than those in Kaputa, with bad roads and transport challenges cited as factors affecting service use. The requirement to have a traditional birth attendant (TBA) accompany a woman when going to deliver from the facility, and paying these TBAs, was a notable access barrier. Generally, services seemed to be more acceptable in Kaputa than in Ngabwe, though both districts complained about long queues, being delivered by male health workers and having delivery rooms next to male wards. Conclusion based on the indicators of access used in this study, maternal health services seemed to be more accessible in Kaputa compared to Ngabwe.
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Affiliation(s)
- Chris Mweemba
- Department of Health Policy, Systems and Management, School of Public Health, University of Zambia, Lusaka, Zambia
| | - Miriam Mapulanga
- Department of Public Health, University of Lusaka, Lusaka, Zambia
| | - Choolwe Jacobs
- Department of Epidemiology and Biostatistics, School of Public Health, University of Zambia, Lusaka, Zambia
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Bertram M, Brandt US, Hansen RK, Svendsen GT. Does higher health literacy lead to higher trust in public hospitals? Int J Equity Health 2021; 20:209. [PMID: 34530812 PMCID: PMC8447678 DOI: 10.1186/s12939-021-01528-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 08/10/2021] [Indexed: 12/02/2022] Open
Abstract
Background Does higher health literacy lead to higher trust in public hospitals? Existing literature suggests that this is the case since a positive association between the level of health literacy and the level of trust in physicians and the health care system has been shown. This study aims to challenge this assumption. Methods Based on theoretical arguments from game theory and analysis of empirical data, we argue that the association is better described as an inversely u-shaped curve, suggesting that low and high levels of health literacy lead to a lower level of trust than a medium level of health literacy does. The empirical analysis is based on a study of the Danes’ relationship to the overall health care system. More than 6000 Danes have been asked about their overall expectations of the health service, their concrete experiences and their attitudes to a number of change initiatives. Results Game theory analysis show that the combined perceived cooperation and benefit effects can explain an inversely u-shaped relationship between social groups and trust in the health care system. Based on quantitative, binary regression analyses of empirical data, the lowest degree of trust is found among patients from the lowest and highest social groups, while the highest degree of trust is found in the middle group. The main driver for this result is that while patients having low health literacy perceive that the health care system is not cooperative, patients with a high level of health literacy have high expectations about the quality, which the health care system might not be able to provide. This reduces the perceived benefit from their encounter with the health care system. Conclusion It is important that health care professionals understand that some patient groups have a higher chance of cooperation (e.g., agreeing on the choice of treatment) or defection (e.g. passing a complaint) than others. In perspective, future research should undertake further qualitative examinations of possible patient types and their demands in relation to different health care sectors, focusing specifically on the opportunities to improve the handling of different patient types.
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Affiliation(s)
- Maja Bertram
- Department of Public Health, Unit for Health Promotion Research, University of Southern Denmark, Esbjerg, Denmark.
| | - Urs Steiner Brandt
- Department of Sociology, Environmental and Business Economic, University of Southern Denmark, Esbjerg, Denmark
| | - Rikke Klitten Hansen
- Department for Planning and Finances, Odense University Hospital, Odense, Denmark
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26
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Alomari A, Alananzeh I, Lord H, Fernandez R. The Adherence to Healthy Lifestyle Among Arab Patients With Cardiovascular Disease: Mixed-Method Review. J Transcult Nurs 2021; 33:33-40. [PMID: 34318717 DOI: 10.1177/10436596211035176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Cardiovascular disease (CVD) accounts for 25% to 45% of deaths among Arab people. The purpose of this review was to investigate the level, predictors, motivators, and barriers to adherence to lifestyle recommendations among Arab patients with CVD. METHOD A systematic search of the literature was conducted and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. MEDLINE, EMCARE, CINAHL, Scopus, and the Cochrane Central Register of Controlled Trials were searched. Studies that explored adherence to a healthy lifestyle among Arab adult patients with CVD were included. RESULTS Twelve studies were included. Quantitative results showed low adherence among Arab people with CVD. Qualitative synthesized results revealed that internal motivators, personal desire as well as structural drivers impact the patient's ability to adhere to a healthy lifestyle. DISCUSSION Multidimensional solutions that consider religion and culture and include active involvement of families are required to improve adherence.
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Affiliation(s)
- Albara Alomari
- Western Sydney University, Penrith, New South Wales, Australia
| | | | - Heidi Lord
- South Eastern Sydney Local Health District, Kogarah, New South Wales, Australia
| | - Ritin Fernandez
- University of Wollongong, Liverpool, New South Wales, Australia
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Sibley KM, Gardner P, Bentley DC, Khan M, McGlynn M, Shing P, Shaffer J, O'Hoski S, Salbach NM. Exploring factors influencing physiotherapists' perceptions of measuring reactive balance following a theory-based multi-component intervention: a qualitative descriptive study. Disabil Rehabil 2021; 44:4709-4716. [PMID: 34148468 DOI: 10.1080/09638288.2021.1916840] [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: 10/21/2022]
Abstract
Purpose: Reactive balance is a critical consideration for mobility and fall avoidance, but is under-assessed among physiotherapists. The objective of this study was to explore factors influencing physiotherapist perceptions about measuring reactive balance upon completion of a 12-month theory-based, multi-component intervention to increase use of a measure of reactive balance.Methods: A qualitative descriptive approach was used. Semi-structured interviews were conducted with 28 physiotherapists treating adults with balance impairment in three urban Canadian rehabilitation hospitals that participated in the intervention. Interviews explored perceptions of reactive balance measurement and perceived changes in clinical behavior. Thematic analysis involved multiple rounds of coding, review and discussion, theme generation, and interpretation of findings through individual analysis and team meetings.Findings: Participants expressed contrasting views about integrating reactive balance measurement in their practice, despite consistent acknowledgement of the importance of reactive balance for function. Three themes were identified highlighting factors that mediated perceptions about measuring reactive balance: patient characteristics; trust between physiotherapist and patient; and the role of physiotherapist fear.Conclusions: The findings highlight that decision making for measuring reactive balance in rehabilitation settings is complex. There is a need for additional work to facilitate long-term implementation of clinical reactive balance measurement, such as refining patient criteria for administration, ensuring sufficient time to establish a trusting relationship, and developing and testing strategies to address physiotherapist fear.IMPLICATIONS FOR REHABILITATIONReactive balance is important for falls prevention and mobility, but is under-assessed among physiotherapists.This study identified three factors that influenced uptake of reactive balance measurement among physiotherapists in rehabilitation settings: patient characteristics; trust between physiotherapist and patient; and the role of physiotherapist fear.Knowledge of the identified factors may assist with design and use of reactive and other balance measurements.Strategies aimed at developing trusting relationships between physiotherapist and patient along with addressing physiotherapist fear could facilitate the uptake of clinical reactive balance measurement.
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Affiliation(s)
- K M Sibley
- Department ofCommunity Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.,George and Fay Yee Centre for Healthcare Innovation, Winnipeg, Canada.,Toronto Rehabilitation Institute- University Health Network, Toronto, Canada
| | - P Gardner
- Department of Health Sciences, Brock University, St. Catharines, Canada.,Bridgepoint Active Healthcare - Sinai Health System, Toronto, Canada
| | - D C Bentley
- Toronto Rehabilitation Institute- University Health Network, Toronto, Canada.,Division of Anatomy, University of Toronto, Toronto, Canada
| | - M Khan
- Department ofCommunity Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - M McGlynn
- Toronto Rehabilitation Institute- University Health Network, Toronto, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - P Shing
- Bridgepoint Active Healthcare - Sinai Health System, Toronto, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Canada
| | - J Shaffer
- Department of Physical Therapy, University of Toronto, Toronto, Canada.,Sunnybrook Health Sciences Centre - St. John's Rehab, Toronto, Canada
| | - S O'Hoski
- West Park Healthcare Centre, Toronto, Canada.,School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - N M Salbach
- Toronto Rehabilitation Institute- University Health Network, Toronto, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Canada
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Anstey Watkins J, Griffiths F, Goudge J. Community health workers' efforts to build health system trust in marginalised communities: a qualitative study from South Africa. BMJ Open 2021; 11:e044065. [PMID: 34011590 PMCID: PMC8137175 DOI: 10.1136/bmjopen-2020-044065] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Community health workers (CHWs) enable marginalised communities, often experiencing structural poverty, to access healthcare. Trust, important in all patient-provider relationships, is difficult to build in such communities, particularly when stigma associated with HIV/AIDS, tuberculosis and now COVID-19, is widespread. CHWs, responsible for bringing people back into care, must repair trust. In South Africa, where a national CHW programme is being rolled out, marginalised communities have high levels of unemployment, domestic violence and injury. OBJECTIVES In this complex social environment, we explored CHW workplace trust, interpersonal trust between the patient and CHW, and the institutional trust patients place in the health system. DESIGN, PARTICIPANTS, SETTING Within the observation phase of a 3-year intervention study, we conducted interviews, focus groups and observations with patients, CHWs, their supervisors and, facility managers in Sedibeng. RESULTS CHWs had low levels of workplace trust. They had recently been on strike demanding better pay, employment conditions and recognition of their work. They did not have the equipment to perform their work safely, and some colleagues did not trust, or value, their contribution. There was considerable interpersonal trust between CHWs and patients, however, CHWs' efforts were hampered by structural poverty, alcohol abuse and no identification documents among long-term migrants. Those supervisors who understood the extent of the poverty supported CHW efforts to help the community. When patients had withdrawn from care, often due to nurses' insensitive behaviour, the CHWs' attempts to repair patients' institutional trust often failed due to the vulnerabilities of the community, and lack of support from the health system. CONCLUSION Strategies are needed to build workplace trust including supportive supervision for CHWs and better working conditions, and to build interpersonal and institutional trust by ensuring sensitivity to social inequalities and the effects of structural poverty among healthcare providers. Societies need to care for everyone.
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Affiliation(s)
- Jocelyn Anstey Watkins
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Frances Griffiths
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
- Centre for Health Policy, School of Public Health, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
| | - Jane Goudge
- Centre for Health Policy, School of Public Health, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
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Ling J, Zahry NR, Liu CC. Stress management interventions among socioeconomically disadvantaged parents: A meta-analysis and moderation analysis. Int J Nurs Stud 2021; 120:103954. [PMID: 34111700 DOI: 10.1016/j.ijnurstu.2021.103954] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/11/2021] [Accepted: 04/15/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Socioeconomically disadvantaged parents experience high levels of stress, anxiety, and depression. Many interventions have been tested to reduce parental stress, but no meta-analysis has been conducted to quantitatively summarize the effects and explore the moderators of intervention effects among socioeconomically disadvantaged parents. OBJECTIVE This meta-analysis aimed to (1) quantitatively examine the intervention effects of prior stress management interventions among socioeconomically disadvantaged parents on reducing stress, depression, and anxiety; and (2) explore the potential moderators of intervention effects. METHODS Six databases, including CINAHL, PubMed, PsycINFO, Sociological Abstracts, Web of Science, and Cochrane, were searched in February 2021. After a two-step literature screening by two independent reviewers, 45 eligible articles were retained. Two evaluators independently assessed each eligible study's quality using the Evidence Project risk of bias tool. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guided the report. Meta-analyses (random-effects model) and moderation analyses (mixed-effects model) were performed. RESULTS Previous stress management interventions had a small effect of -0.24 in reducing parental stress (95% confidence interval [CI]: -0.33, -0.15) with a 7.6-month follow-up effect of -0.12 (95% CI: -0.27, 0.04). The pooled effects on reducing depression were -0.15 (95% CI: -0.26, -0.04) with a 9-month follow-up effect of 0.02 (95% CI: -0.21, 0.26). Two studies measured anxiety, and the average effects were -0.03 (95% CI: -0.16, 0.11). Intervention effects on stress were significantly moderated by country (p = .005), study design (p < .001), and intervention duration (p = .030). Interventions conducted in developing countries (g = -0.52) had a significantly larger effect in reducing stress than those conducted in developed countries (g = -0.19). Studies using a quasi-experimental design (g = -0.47) resulted in a significantly greater effect in reducing stress than RCTs (g = -0.12). Interventions with a duration of 1-3 months (g = -0.36) had a greater effect in reducing stress than those with a longer duration (g = -0.11 for 3-6 months, -0.20 for >6 months). Intervention effects on reducing depression were significantly moderated by intervention component (p = .030). Cognitive behavioral therapy (g = -0.20) and mindfulness-based interventions (g = -0.16) resulted in greater effects in reducing depression than interventions focusing on parenting/life/self-care skills (g = 0.003). CONCLUSIONS Previous stress management interventions have short-term beneficial effects on reducing parental stress and depression, but long-term follow-up effects are limited. Short-duration (1-3 months) mindfulness-based interventions and cognitive behavioral therapy in clinical settings are recommended for socioeconomically disadvantaged parents to reduce stress and depression.
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Affiliation(s)
- Jiying Ling
- Michigan State University College of Nursing, 1355 Bogue St., C241, East Lansing, MI 48824, United States.
| | - Nagwan R Zahry
- University of Tennessee at Chattanooga Department of Communication, Lupton Hall, 520 Oak St., Chattanooga, TN 37403, United States.
| | - Cheng-Ching Liu
- Michigan State University College of Nursing, 1355 Bogue St., C241, East Lansing, MI 48824, United States.
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Jang Y, Yoon H, Kim MT, Park NS, Chiriboga DA. Preference for patient-provider ethnic concordance in Asian Americans. ETHNICITY & HEALTH 2021; 26:448-459. [PMID: 30145909 PMCID: PMC6470060 DOI: 10.1080/13557858.2018.1514457] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 07/23/2018] [Indexed: 05/11/2023]
Abstract
Objectives: The present study examined factors associated with the preference for patient-provider ethnic concordance in Asian Americans.Design: With data drawn from the 2015 Asian American Quality of Life Survey (N = 2535), a logistic regression model of the preference for patient-provider ethnic concordance was tested with demographic (age, gender, ethnicity, marital status, education), health and access (chronic medical conditions, self-rated health, health insurance coverage), immigration-related (place of birth, length of stay in the US, English proficiency, acculturation), and adverse experience (perceived discrimination, communication problems in healthcare settings) variables.Results: Over half (52.4%) of those in the sample preferred to be treated by a healthcare provider from their own ethnic background. In a multivariate model, the odds for preferring ethnic concordance were 1.52-1.64 times higher among individuals in earlier stages of immigration, language acquisition, and acculturation. Individuals who had experienced communication problems in healthcare settings presented 3.74 times higher odds for preferring ethnic concordance than did counterparts without such experience.Conclusions: The results emphasized the value of paying attention to patient-provider concordance when treating Asian Americans either relatively new to the country or who have had previous problems communicating with health professionals. The findings also provide implications for improving workforce diversity in healthcare delivery and medical education.
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Affiliation(s)
- Yuri Jang
- Steve Hicks School of Social Work, The University of Texas at Austin, Austin, TX, USA
| | - Hyunwoo Yoon
- School of Social Work, Texas State University, San Marcos, TX, USA
| | - Miyong T. Kim
- School of Nursing, The University of Texas at Austin, Austin, TX, USA
| | - Nan Sook Park
- School of Social Work, University of South Florida, Tampa, FL, USA
| | - David A. Chiriboga
- Department of Child and Family Studies, University of South Florida, Tampa, FL, USA
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Lawrence S, Namusanya D, Hamuza A, Huwa C, Chasweka D, Kelley M, Molyneux S, Voskuijl W, Denno DM, Desmond N. Hypothetical acceptability of hospital-based post-mortem pediatric minimally invasive tissue sampling in Malawi: The role of complex social relationships. PLoS One 2021; 16:e0246369. [PMID: 33539411 PMCID: PMC7861399 DOI: 10.1371/journal.pone.0246369] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 01/18/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Child mortality rates remain unacceptably high in low-resource settings. Cause of death (CoD) is often unknown. Minimally invasive tissue sampling (MITS)-using biopsy needles to obtain post-mortem samples-for histopathological and microbiologic investigation is increasingly being promoted to improve child and adult CoD attribution. "MITS in Malawi" is a sub-study of the Childhood Acute Illness & Nutrition (CHAIN) Network, which aims to identify biological and socioeconomic mortality risk factors among young children hospitalized for acute illness or undernutrition. MITS in Malawi employs standard MITS and a novel post-mortem endoscopic intestinal sampling approach to better understand CoD among children with acute illness and/or malnutrition who die during hospitalization. AIM To understand factors that may impact MITS acceptability and inform introduction of the procedure to ascertain CoD among children with acute illness or malnutrition who die during hospitalization in Malawi. METHODS We conducted eight focus group discussions with key hospital staff and community members (religious leaders and parents of children under 5) to explore attitudes towards MITS and inform consent processes prior to commencing the MITS in Malawi study. We used thematic content analysis drawing on a conceptual framework developed from emergent themes and MITS acceptability literature. RESULTS Feelings of power over decision-making within the hospital and household, trust in health systems, and open and respectful health worker communication with parents were important dimensions of MITS acceptability. Other facilitating factors included the potential for MITS to add CoD information to aid sense-making of death and contribute to medical knowledge and new interventions. Potential barriers to acceptability included fears of organ and blood harvesting, disfigurement to the body, and disruption to transportation and burial plans. CONCLUSION Social relationships and power dynamics within healthcare systems and households are a critical component of MITS acceptability, especially given the sensitivity of death and autopsy.
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Affiliation(s)
- Sarah Lawrence
- Department of Pediatrics, University of Washington, Seattle, Washington, United States of America
| | - Dave Namusanya
- Behaviour and Health Research Group, Malawi-Liverpool-Wellcome Trust, Blantyre, Malawi
| | - Andrew Hamuza
- Behaviour and Health Research Group, Malawi-Liverpool-Wellcome Trust, Blantyre, Malawi
| | - Cornelius Huwa
- Department of Paediatrics and Child Health, College of Medicine, Blantyre, Malawi
- The Childhood Acute Illness & Nutrition (CHAIN) Network, C/o KEMRI Wellcome Trust Research Programme, Nairobi, Kenya
| | - Dennis Chasweka
- Department of Paediatrics and Child Health, College of Medicine, Blantyre, Malawi
- The Childhood Acute Illness & Nutrition (CHAIN) Network, C/o KEMRI Wellcome Trust Research Programme, Nairobi, Kenya
| | - Maureen Kelley
- The Childhood Acute Illness & Nutrition (CHAIN) Network, C/o KEMRI Wellcome Trust Research Programme, Nairobi, Kenya
- Wellcome Centre for Ethics & Humanities and Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Sassy Molyneux
- The Childhood Acute Illness & Nutrition (CHAIN) Network, C/o KEMRI Wellcome Trust Research Programme, Nairobi, Kenya
- Wellcome Centre for Ethics & Humanities and Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Wieger Voskuijl
- Department of Paediatrics and Child Health, College of Medicine, Blantyre, Malawi
- The Childhood Acute Illness & Nutrition (CHAIN) Network, C/o KEMRI Wellcome Trust Research Programme, Nairobi, Kenya
- Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam University Medical Centres, Amsterdam, The Netherlands
- Amsterdam Centre for Global Child Health, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Donna M. Denno
- Department of Pediatrics, University of Washington, Seattle, Washington, United States of America
- The Childhood Acute Illness & Nutrition (CHAIN) Network, C/o KEMRI Wellcome Trust Research Programme, Nairobi, Kenya
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Nicola Desmond
- Behaviour and Health Research Group, Malawi-Liverpool-Wellcome Trust, Blantyre, Malawi
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Kuwawenaruwa A, Wyss K, Wiedenmayer K, Metta E, Tediosi F. The effects of medicines availability and stock-outs on household's utilization of healthcare services in Dodoma region, Tanzania. Health Policy Plan 2020; 35:323-333. [PMID: 31942625 PMCID: PMC7152726 DOI: 10.1093/heapol/czz173] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2019] [Indexed: 12/14/2022] Open
Abstract
Low- and middle-income countries have been undertaking health finance reforms to address shortages of medicines. However, data are lacking on how medicine availability and stock-outs influence access to health services in Tanzania. The current study assesses the effects of medicine availability and stock-outs on healthcare utilization in Dodoma region, Tanzania. We conducted a cross-sectional study that combined information from households and healthcare facility surveys. A total of 4 hospitals and 89 public primary health facilities were surveyed. The facility surveys included observation, record review over a 3-month period prior to survey date, and interviews with key staff. In addition, 1237 households within the health facility catchment areas were interviewed. Data from the facility survey were linked with data from the household survey. Descriptive analysis and multivariate logistic regressions models were used to assess the effects of medicine availability and stock-outs on utilization patterns and to identify additional household-level factors associated with health service utilization. Eighteen medicines were selected as ‘tracers’ to assess availability more generally, and these were continuously available in ∼70% of the time in facilities across all districts over 3 months of review. The main analysis showed that household’s healthcare utilization was positively and significantly associated with continuous availability of all essential medicines for the surveyed facilities [odds ratio (OR) 3.49, 95% confidence interval (CI) 1.02–12.04; P = 0.047]. Healthcare utilization was positively associated with household membership in the community health insurance funds (OR 1.97, 95% CI 1.23–3.17; P = 0.005) and exposure to healthcare education (OR 2.75, 95% CI 1.84–4.08; P = 0.000). These results highlight the importance of medicine availability in promoting access to health services in low-income settings. Effective planning and medicine supply management from national to health facility level is an important component of quality health services.
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Affiliation(s)
- August Kuwawenaruwa
- Ifakara Health Institute, Plot 463, Kiko Avenue Mikocheni, PO Box 78 373, Dar es Salaam, Tanzania.,Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Kaspar Wyss
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland.,University of Basel, Basel, Switzerland.,Swiss Centre for International Health (SCIH), Basel, Switzerland
| | - Karin Wiedenmayer
- Swiss Centre for International Health (SCIH), Basel, Switzerland.,Health promotion and System Strengthening (HPSS), Dodoma, Tanzania
| | - Emmy Metta
- Ifakara Health Institute, Plot 463, Kiko Avenue Mikocheni, PO Box 78 373, Dar es Salaam, Tanzania.,School of Public Health and Social Sciences (SPHSS), Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Fabrizio Tediosi
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland.,University of Basel, Basel, Switzerland
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Hardin HK, Bender AE, Hermann CP, Speck BJ. An integrative review of adolescent trust in the healthcare provider relationship. J Adv Nurs 2020; 77:1645-1655. [PMID: 33249644 DOI: 10.1111/jan.14674] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 09/23/2020] [Accepted: 10/29/2020] [Indexed: 11/27/2022]
Abstract
AIM To conduct an integrative review of empirical studies examining factors affecting trust in the healthcare provider (HCP) relationship among adolescents. DESIGN An integrative review was conducted. DATA SOURCES The keywords adolescent, trust, healthcare provider and related words were searched in multiple online research databases. The results were limited to research published between 2004 and 2019. Seventeen primary sources were identified and synthesized in the final review. REVIEW METHOD Guided by the Whittemore and Knafl integrative review method, a data-based convergent synthesis design was used to explore the key research question in both qualitative and quantitative research. RESULTS This integrative review found that health care provider behaviours, such as confidentiality, honesty, respect, and empathy, promote adolescent's trust of the HCP. Notable gaps in the literature were also identified, including a lack of diversity among adolescent samples and HCP types and underdeveloped measures of adolescent trust of HCP. CONCLUSION This integrative review informed the development of a new conceptual definition of adolescent trust of HCP, which embodies the key findings of the importance of HCP confidentiality, honesty, respect, and empathy. This definition can be used to develop instruments, interventions and policies that promote HCP trust among adolescents. Future research is needed to develop instruments to measure adolescents' trust of HCPs, evaluate trust of HCPs among diverse samples of adolescents and evaluate adolescent trust of HCPs with a variety of HCP types. IMPACT The new conceptual definition of adolescent trust of HCP can be used to enhance nursing practice and design behavioural interventions to improve trust of HCP. To foster adolescent trust of HCP, policies should be enacted in healthcare institutions to explain confidentiality, provide notification of reporting mandates and formalize consent, assent and dissent for adolescents seeking health care.
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Affiliation(s)
- Heather K Hardin
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Anna E Bender
- Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Carla P Hermann
- School of Nursing, Indiana University Southeast, New Albany, IN, USA
| | - Barbara J Speck
- School of Nursing, University of Louisville, Louisville, KY, USA
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Wang H, Zhang Y, Sun L. The effect of workplace violence on depression among medical staff in China: the mediating role of interpersonal distrust. Int Arch Occup Environ Health 2020; 94:557-564. [PMID: 33196860 DOI: 10.1007/s00420-020-01607-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 10/30/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Workplace violence has been recognized globally as a serious occupational hazard in health service occupations, and existing studies have identified that workplace violence can significantly lead to depression. Interpersonal distrust, an important topic, has also been proved associated with workplace violence and depression. However, the mediating effect of interpersonal distrust has not been tested before. Results of such testing can help us to understand further the effect mechanism of workplace violence on depression. METHODS In the current study, we collected 3426 valid questionnaires based on a cross-sectional design distributed among medical staff in Chinese hospitals. Depression, workplace violence, interpersonal distrust, social support, physical diseases, and some other social-demographic variables were evaluated. SPSS macros program (PROCESS v3.3) was used to test the mediating effect of interpersonal distrust on the association between workplace violence and depression. RESULTS The data analyzed in the current study demonstrated that 52.2% of medical staff had experienced workplace violence before. Experiencing verbal violence (β = 2.99, p < 0.001), experiencing physical violence (β = 3.70, p < 0.01), experiencing both kinds of violence (β = 4.84, p < 0.001), high levels of interpersonal distrust (β = 0.22, p < 0.001), working as a nurse (β = 1.10, p < 0.05), working as a manager (β = - 1.72, p < 0.001), suffering physical disease (β = 3.35, p < 0.001), and receiving social support (β = - 0.23, p < 0.001) were significantly associated with depression. Workplace violence had not only positive direct effects on depression, but also an indirect effect on depression through interpersonal distrust as a mediator. CONCLUSION Interpersonal distrust can mediate the association between workplace violence and depression. Increasing interpersonal trust or reducing workplace violence would be beneficial to promoting mental health status among medical staff.
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Affiliation(s)
- Haipeng Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, Shandong, China.,NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Yuxia Zhang
- Qilu Hospital of Shandong University, Jinan, 250012, China
| | - Long Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, Jinan, 250012, Shandong, China. .,NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.
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Ishimoto H, Ikeda T, Kadooka Y. Factors related to satisfaction of cancer patients with transfer arrangements made by university hospitals at the end-of-life in Japan: a cross-sectional questionnaire survey of bereaved family members. Support Care Cancer 2020; 29:3091-3101. [PMID: 33057817 DOI: 10.1007/s00520-020-05822-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/07/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Cancer patients in university hospitals often face a difficult decision regarding transfer to other care settings at the end-of-life. Arrangements for a satisfying transfer are important for reducing the psychosocial impact of the transition, but few studies have evaluated this aspect. This study aimed to identify factors related to the satisfying arrangement of transfers to other care settings from university hospitals. METHODS A total of 400 bereaved family members of cancer patients in Japan participated in this cross-sectional web-based questionnaire survey. Statistical methods including decision tree analysis were conducted to identify factors significantly associated with satisfying transfer arrangements. RESULTS More than 60% of cancer patients were satisfied with the transfer arrangements made by university hospitals. Decision tree analysis revealed that the factor most significantly associated with satisfaction with transfer arrangements was "satisfaction with contents of the explanation about transfer." The following significant factors were also extracted: "timing of being informed of transfer," "presence of primary care physician," and "presence of trustworthy staff." "Satisfaction with overall care from university hospital staff" and "involvement of palliative care team" were identified as factors contributing to a high degree of satisfaction with transfer arrangements. CONCLUSION In order to make satisfying transfer arrangements from university hospitals for cancer patients at the end-of-life, healthcare professionals should provide satisfactory explanations about the transfer process in order to meet the information needs of patients. To be effective, healthcare professionals should initiate transfer arrangements prior to cancer treatment, while simultaneously building trusting relationships with patients.
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Affiliation(s)
- Hiroko Ishimoto
- Department of Bioethics, Kumamoto University Graduate School of Medical Sciences, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan.
| | - Tokunori Ikeda
- Laboratory of Clinical Pharmacology and Therapeutics, Sojo University Faculty of Pharmaceutical Sciences, 4-22-1 Ikeda, Nishi-ku, Kumamoto, 860-0082, Japan
- Department of Medical Information Sciences and Administration Planning, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto, 860-8556, Japan
| | - Yasuhiro Kadooka
- Department of Bioethics, Kumamoto University Faculty of Life Sciences, 1-1-1 Honjyo, Chuo-ku, Kumamoto, 860-8556, Japan
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Building a trust-based doctor recommendation system on top of multilayer graph database. J Biomed Inform 2020; 110:103549. [PMID: 32871286 DOI: 10.1016/j.jbi.2020.103549] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 11/22/2022]
Abstract
In healthcare applications, developing a data model for storing patient-doctor relationships is important. Though relational models are popular for many commercial and business applications, they may not be appropriate for modeling patient-doctor relationships due to their inherent irregular nature and complexities. In this paper, as a case study, we propose to build a doctor recommendation system for the patients. The recommendation system is built on top of a multilayer graph data model. Contemporary research papers have already shown that multilayer graph data models can be efficiently used in many applications where large, heterogeneous data are to be modeled. As part of the recommendation system, the paper also introduces a concept of trust which is one important ingredient of any kind of recommendation. The trust factor introduced in the paper exploits certain characteristics of the multilayer graph model. The paper also presents some analysis to demonstrate the efficiency of the graph data model in comparison with relational data model.
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Murphy M, Salisbury C. Relational continuity and patients' perception of GP trust and respect: a qualitative study. Br J Gen Pract 2020; 70:e676-e683. [PMID: 32784221 PMCID: PMC7425201 DOI: 10.3399/bjgp20x712349] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 02/16/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Despite the benefits of relational continuity of care, particularly for patients with multimorbidity, the traditional model of continuity is changing. Revisiting what patients with ongoing problems want from relational continuity could encourage initiatives to achieve these within a modern healthcare system. AIM To examine the attributes of GPs that patients with long-term conditions value most, and which attributes patients believe are facilitated by relational continuity. DESIGN AND SETTING Qualitative study in UK general practice. METHOD A thematic analysis was carried out, based on secondary analysis of interviews with 25 patients with long-term conditions that were originally conducted to inform a patient-reported outcome measure for primary care. RESULTS Patients with long-term conditions wanted their GPs to be clinically competent, to examine, listen to, care for, and take time with them, irrespective of whether they have seen them before. They believed that relational continuity facilitates a GP knowing their history, giving consistent advice, taking responsibility and action, and trusting and respecting them. Patients acknowledged practical difficulties and safety issues in achieving the first three of these without relational continuity. However, patients felt that GPs should trust and respect them even when continuity was not possible. CONCLUSION Policy initiatives promoting continuity with a GP or healthcare team should continue. Many patients see continuity as a safety issue. When patients experience relationship discontinuity, they often feel that they are not taken seriously or believed by their GP. GPs should therefore consistently seek to visibly demonstrate trust in their patients, particularly when they have not seen them before.
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Affiliation(s)
- Mairead Murphy
- Centre for Academic Primary Care, University of Bristol, Bristol Medical School, Bristol
| | - Chris Salisbury
- Centre for Academic Primary Care, University of Bristol, Bristol Medical School, Bristol
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38
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Wilson OW, Bopp CM, Papalia Z, Duffey M, Bopp M. College Students’ Experiences and Attitudes Toward Physical Activity Counseling. J Nurse Pract 2020. [DOI: 10.1016/j.nurpra.2020.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sheehan R, Fealy G. Trust in the nurse: Findings from a survey of hospitalised children. J Clin Nurs 2020; 29:4289-4299. [PMID: 32815219 DOI: 10.1111/jocn.15466] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 06/01/2020] [Accepted: 08/13/2020] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES To measure hospitalised children's trust in the nurse. BACKGROUND Trust is central to the therapeutic relationship between the nurse and the patient. There can be no trusting relationship between the nurse and child if the parents have no trust or block the relationship (Bricher [Journal of Clinical Nursing, 8: 452, 1999]). DESIGN This study was a cross-sectional, correlational descriptive design using a self-complete questionnaire to measure children's trust in nurses, to examine the relationship between children's trust and their parents, and the correlations between trust and medication adherence, fear and interactions with the nurse. METHODS A modified version of the Children's Trust in General Nurses Scale designed by Rotenberg et al. (Journal for Specialists in Pediatric Nursing, 20: 298, 2015) was used. This Scale is a short self-report questionnaire designed to elicit information on children's beliefs in, and attitudes to, trust in nurses. The Strengthening the Reporting of Observational Studies in Epidemiology statement for observational studies was applied (von Elm [British Medical Journal, 335: 806, 2007]). RESULTS The results indicated high levels of trust beliefs in the nurse. The children's and parents' trust beliefs were found to be correlated. Gender did not influence trust beliefs. Younger children had higher levels of trust than older children, particularly in relation to the perceived honesty of the nurse. Trust beliefs in the nurse lessened with previous exposure to the hospital setting. One-fifth of children reported fear of the nurse. Positive interaction with the nurse was shown to be positively related to adherence to care. RELEVANCE TO CLINICAL PRACTICE Children's level of trust in the nurse can be measured. A trusting child is likely to be less fearful and experience clinical procedures as less threatening and is more likely to adhere to treatment. Children's nurses should recognise that trust can change with age and with multiple hospital admissions.
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40
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Davis JM, Thomas LC, Dirkes JE, Datta SK, Dennis PA. Comparison of referral methods into a smoking cessation program. J Comp Eff Res 2020; 9:807-815. [PMID: 32795088 DOI: 10.2217/cer-2020-0004] [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: 11/21/2022] Open
Abstract
Rational, aims & objectives: The goal of this observational study was to compare three referral methods and determine which led to the highest utilization of the Duke Smoking Cessation Program (DSCP). Materials & methods: We conducted two assessments within the Duke health system: a 12-month assessment of Traditional Referral (a provider refers a patient during a patient visit) and Best Practice Advisory (BPA) (a provider refers a patient after responding to an alert within the electronic health record); and a 30-day assessment of Population Outreach (a list of smokers is generated through the electronic health record and patients are contacted directly). Results: Over the 12-month assessment, a total of 13,586 smokers were seen throughout health system clinics receiving services from the DSCP. During this period, the service utilization rate was significantly higher for Traditional Referral (3.8%) than for BPA (0.6%); p < 0.005. The 30-day pilot assessment of showed a service utilization rate for Population Outreach of 6.3%, significantly higher than Traditional Referral (3.8%); p < 0.005 and BPA (0.6%; p < 0.005). Conclusion: Population Outreach appears to be an effective referral method for increasing utilization of the DSCP.
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Affiliation(s)
- James M Davis
- Duke Cancer Institute, Duke University, Durham, NC 27705, USA.,Duke University, Department of Medicine, Durham, NC 27705, USA
| | - Leah C Thomas
- Duke Cancer Institute, Duke University, Durham, NC 27705, USA
| | | | - Santanu K Datta
- Duke University, Department of Medicine, Durham, NC 27705, USA.,Duke University Department of Psychiatry & Behavioral Sciences, Durham, NC 27705, USA
| | - Paul A Dennis
- College of Public Health, University of Florida, Gainesville, FL 32611, USA.,Durham VA, Duke University, Durham, NC 27705, USA
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41
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Hardin HK, Moore SM, Moore SE, Uli NK. Associations between Trust of Healthcare Provider and Body Mass Index in Adolescents. Compr Child Adolesc Nurs 2020; 44:197-208. [PMID: 32574088 PMCID: PMC7755707 DOI: 10.1080/24694193.2020.1783028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 06/10/2020] [Indexed: 02/07/2023]
Abstract
Adolescent obesity continues to be a serious concern around the world, placing young people at risk for chronic conditions and early death. Research has shown that social relationships are important in making health behavior changes, such as following health-care recommendations for eating and physical activity. Specifically, the trust of health-care providers has been shown to be important in making health behavior change. Evidence suggests that obese young adults are less trusting of health-care providers than their healthy weight peers, but it is not known if this also applies to obese adolescents. The purpose of this secondary analysis study was to determine relationships between the trust of health-care providers and body mass index percentile in adolescents. Participants were 224 adolescents aged 14-19 years attending a public high school in the Midwestern United States. The Wake Forest Physician Trust scale measured the trust of health-care providers. Height and weight were collected at a school screening; body mass index percentile categories were determined according to age- and sex-adjusted body mass index percentiles. One-way analysis of variance and post hoc Tukey tests showed trust scores varied significantly between body mass index percentile categories of girls. Results suggest it may be necessary for health-care providers to make additional efforts to build trust with obese adolescent girls than with other groups of adolescents.
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Affiliation(s)
- Heather K Hardin
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Shirley M Moore
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Scott E Moore
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Naveen K Uli
- School of Medicine, Case Western Reserve University
- Director of Pediatric Endocrinology, Rainbow Babies and Children's Hospital, Cleveland Medical Center, Cleveland, OH, USA
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42
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Maidment ID, Lawson S, Wong G, Booth A, Watson A, McKeown J, Zaman H, Mullan J, Bailey S. Medication management in older people: the MEMORABLE realist synthesis. HEALTH SERVICES AND DELIVERY RESEARCH 2020. [PMID: 32579319 DOI: 10.3310/hsdr08260] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Background
The number and proportion of older people in the UK are increasing, as are multimorbidity (potentially reducing quality of life) and polypharmacy (increasing the risk of adverse drug events). Together, these complex factors are challenging for older people, informal carers, and health and care practitioners.
Objectives
MEMORABLE (MEdication Management in Older people: Realist Approaches Based on Literature and Evaluation) aimed to understand how medication management works and propose improvements.
Design
A realist approach informed three work packages, combining a realist review of secondary data with a realist evaluation of primary interview data, in a theory-driven, causal analysis.
Setting
The setting was in the community.
Participants
Older people, informal carers, and health and care practitioners.
Interventions
Studies relating to medication management and to reviewing and reconciling medications; and realist-informed interviews.
Main outcome measures
Not applicable.
Data sources
MEDLINE, CINAHL (Cumulative Index of Nursing and Allied Health Literature) and EMBASE were searched (all searched from January 2009 to July 2017; searched on 1 August 2017). Supplementary articles were identified by the Research Team. Data were also obtained through interviews.
Review methods
Searches of electronic databases were supplemented by citation-tracking for explanatory contributions, as well as accessing topic-relevant grey literature. Following RAMESES (Realist And Meta-narrative Evidence Syntheses: Evolving Standards) guidelines, articles were screened and iteratively analysed with interview data, to generate theory-informed (normalisation process theory) explanations.
Results
Developing a framework to explain medication management as a complex intervention across five stages: identifying problem (Stage 1), starting, changing or stopping medications (Stage 3) and continuing to take medications (Stage 4), where older people, sometimes with informal carers, make individual decisions and follow routines that fit medication management into their day-to-day lives, engendering a sense of control. In getting diagnosis and/or medications (Stage 2) and reviewing/reconciling medications (Stage 5), older people and practitioners share decision-making in time-limited contacts: involving four steps – sense-making, relationships, action and reflection/monitoring (normalisation process theory); and conceptualising burden – through a detailed analysis of Stage 5, generating a theoretical framework and identifying five burden types amendable to mitigation: ambiguity, concealment, unfamiliarity, fragmentation and exclusion. Proposing interventions: risk identification – a simple way of identifying older people and informal carers who are not coping, at risk and who need appropriate help and support; and individualised information – a short, personalised record and reference point, co-produced and shared by older people, informal carers and practitioners that addresses the experience of living with multimorbidities and polypharmacy.
Limitations
Few studies directly address the complexity of medication management as a process and how it works. Limitations included, having identified the overall complexity, the need to focus the analysis on reviewing/reconciling medications (Stage 5), the exclusion of non-English-language literature, the focus on non-institutionalised populations and the broad definition of older people.
Conclusions
MEMORABLE explored the complexity of medication management. It highlighted the way interpersonal stages in the medication management process, notably reviewing/reconciling medications, contribute to the mitigation of burdens that are often hidden.
Future work
Co-produced studies to scope and trial the two proposed interventions; studies to extend the detailed understanding of medication management, linked to burden mitigation; and a study to clarify the medication management outcomes wanted by older people, informal carers and practitioners.
Study registration
This study is registered as PROSPERO CRD42016043506.
Funding
This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 26. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Ian D Maidment
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Sally Lawson
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Geoff Wong
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Andrew Booth
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Anne Watson
- Medicines Management Department, West Heath Hospital, Birmingham Community Healthcare NHS Trust, West Heath, UK
| | - Jane McKeown
- Sheffield Health and Social Care NHS Foundation Trust, Sheffield, UK
| | - Hadar Zaman
- Bradford School of Pharmacy, School of Life Sciences, University of Bradford, Bradford, UK
| | - Judy Mullan
- Australian Health Services Research Institute (AHSRI), University of Wollongong, Wollongong, NSW, Australia
| | - Sylvia Bailey
- Patient and public involvement representative, School of Life and Health Sciences, Aston University, Birmingham, UK
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Lindblad M, Unbeck M, Nilsson L, Schildmeijer K, Ekstedt M. Identifying no-harm incidents in home healthcare: a cohort study using trigger tool methodology. BMC Health Serv Res 2020; 20:289. [PMID: 32252755 PMCID: PMC7137226 DOI: 10.1186/s12913-020-05139-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 03/23/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Patient safety in home healthcare is largely unexplored. No-harm incidents may give valuable information about risk areas and system failures as a source for proactive patient safety work. We hypothesized that it would be feasible to retrospectively identify no-harm incidents and thus aimed to explore the cumulative incidence, preventability, types, and potential contributing causes of no-harm incidents that affected adult patients admitted to home healthcare. METHODS A structured retrospective record review using a trigger tool designed for home healthcare. A random sample of 600 home healthcare records from ten different organizations across Sweden was reviewed. RESULTS In the study, 40,735 days were reviewed. In all, 313 no-harm incidents affected 177 (29.5%) patients; of these, 198 (63.2%) no-harm incidents, in 127 (21.2%) patients, were considered preventable. The most common no-harm incident types were "fall without harm," "deficiencies in medication management," and "moderate pain." The type "deficiencies in medication management" was deemed to have a preventability rate twice as high as those of "fall without harm" and "moderate pain." The most common potential contributing cause was "deficiencies in nursing care and treatment, i.e., delayed, erroneous, omitted or incomplete treatment or care." CONCLUSION This study suggests that it is feasible to identify no-harm incidents and potential contributing causes such as omission of care using record review with a trigger tool adapted to the context. No-harm incidents and potential contributing causes are valuable sources of knowledge for improving patient safety, as they highlight system failures and indicate risks before an adverse event reach the patient.
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Affiliation(s)
- Marléne Lindblad
- School of Engineering Sciences in Chemistry, Biotechnology and Health, Royal Institute of Technology, Stockholm, Sweden
- Department of Healthcare Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Maria Unbeck
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Acute and Reparative Medicine Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Lena Nilsson
- Department of Anesthesiology and Intensive Care, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Kristina Schildmeijer
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
| | - Mirjam Ekstedt
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
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Doekhie KD, Strating MMH, Buljac‐Samardzic M, Paauwe J. Trust in older persons: A quantitative analysis of alignment in triads of older persons, informal carers and home care nurses. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:1490-1506. [PMID: 31347234 PMCID: PMC6852099 DOI: 10.1111/hsc.12820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 06/18/2019] [Accepted: 07/08/2019] [Indexed: 06/10/2023]
Abstract
Self-management by older persons could be influenced by the level of trust found in triads of informal carers, formal care providers and care recipient, the older person. Little research has been done on care providers' trust in older persons. This study aims to explore the level of trust that informal carers and home care nurses have in older persons, the extent of alignment in triads and the relationship between trust in older persons and self-management. We conducted a cross-sectional survey study in the Netherlands, sampling 133 older persons, 64 informal carers and 72 nurses, which resulted in 39 triads. Alignment level was analysed through Intraclass Correlation Coefficient 1 scores and absolute and mean difference scores. Correlation analysis and one-way analysis of variance measured the relationship between trust and self-management. The results show that triads contain both alignment and misalignment. Misalignment occurs mostly when informal carers and nurses have little trust in the older person while this person views their own behaviour towards their caregivers positively. Care providers' trust levels relate significantly to their perception of the person's ability to self-manage, but not to the person's self-rated ability. This could be explained by care providers not communicating their intrinsic trust in the older person to them. Trust building could be enhanced by organising discussions of mutual expectations of trust and both formal and informal care providers could benefit from compassionate assessment training, to learn how to openly express their trust in the older person.
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Affiliation(s)
- Kirti D. Doekhie
- Erasmus School of Health Policy & Management (ESHPM)Erasmus University RotterdamRotterdamThe Netherlands
| | - Mathilde M. H. Strating
- Erasmus School of Health Policy & Management (ESHPM)Erasmus University RotterdamRotterdamThe Netherlands
| | - Martina Buljac‐Samardzic
- Erasmus School of Health Policy & Management (ESHPM)Erasmus University RotterdamRotterdamThe Netherlands
| | - Jaap Paauwe
- Erasmus School of Health Policy & Management (ESHPM)Erasmus University RotterdamRotterdamThe Netherlands
- Department of Applied EconomicsErasmus University RotterdamRotterdamThe Netherlands
- Department of Human Resource StudiesTilburg UniversityTilburgThe Netherlands
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Hashemiparast M, Negarandeh R, Theofanidis D. Exploring the barriers of utilizing theoretical knowledge in clinical settings: A qualitative study. Int J Nurs Sci 2019; 6:399-405. [PMID: 31728392 PMCID: PMC6838863 DOI: 10.1016/j.ijnss.2019.09.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 06/18/2019] [Accepted: 09/11/2019] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Although effective performance in clinical settings requires the integration between theory and practice, there is a gap between theoretical knowledge as taught in the classroom and what the students experience in clinical settings. This study aimed to elicit and explore the barriers of utilizing theoretical knowledge in clinical settings. METHODS A qualitative study was adopted with a conventional content analysis approach. Fifteen nursing and paramedic's students, faculty members and experienced nursing staff participated in the study. Data were collected by semi-structured individual interviews until data saturation and concurrently analyzed via MAXQDA 10. RESULTS Five main categories emerged as barriers of utilizing theoretical knowledge in the clinical settings i.e. non-standard practices in clinical settings; lack of trust in clinical competence; lack of perceived professional support; insufficiencies in teaching and learning process; and differences between doing things in simulated and real clinical situations. CONCLUSION Transferring theory into practice in a structured manner requires professional support in the workplace, trust and the opportunity for direct experience, using valid and up-to-date knowledge by clinical staff and bridging the simulated situations with real life scenarios.
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Affiliation(s)
- Mina Hashemiparast
- Department of Public Health, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Reza Negarandeh
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Huang ECH, Pu C, Huang N, Chou YJ. Resident burnout in Taiwan Hospitals—and its relation to physician felt trust from patients. J Formos Med Assoc 2019; 118:1438-1449. [DOI: 10.1016/j.jfma.2018.12.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 09/15/2018] [Accepted: 12/19/2018] [Indexed: 10/27/2022] Open
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Ericsson C, Skagerström J, Schildmeijer K, Årestedt K, Broström A, Pakpour A, Nilsen P. Can patients contribute to safer care in meetings with healthcare professionals? A cross -sectional survey of patient perceptions and beliefs. BMJ Qual Saf 2019; 28:657-666. [PMID: 31018984 PMCID: PMC6716360 DOI: 10.1136/bmjqs-2018-008524] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 03/05/2019] [Accepted: 04/06/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To investigate patients' perceptions of their meetings with healthcare professionals and the extent to which they believe they can influence patient safety in these meetings. DESIGN Cross-sectional survey of patients using a study-specific questionnaire. Data were analysed using both parametric and non-parametric statistics. SETTING The study was conducted in primary and secondary care in three county councils in southeast Sweden by means of a survey questionnaire despatched in January 2017. PARTICIPANTS Survey data were collected from 1445 patients, 333 of whom were complainants (patients who had filed a complaint about being harmed in healthcare) and 1112 regular patients (patients recruited from healthcare units). MAIN OUTCOME MEASURES Patients' perceptions of meetings with physicians and nurses, beliefs concerning patients' contributions to safer care and whether the patients had suffered harm in healthcare during the past 10 years. RESULTS Most respondents reported that it was easy to ask physicians and nurses questions (84.9% and 86.6%) and to point out if something felt odd in their care (77.7% and 80.7%). In general, complainants agreed to a higher extent compared with regular patients that patients can contribute to safer care (mean 1.92 and 2.13, p<0.001). Almost one-third (31.2%) of the respondents (both complainants and regular patients) reported that they had suffered harm in healthcare during the past 10 years. CONCLUSIONS Most respondents believed that healthcare professionals can facilitate patient interaction and increase patient safety by encouraging patients to ask questions and take an active part in their care. Further research will need to identify strategies to support such questioning in routine practice and ensure that it achieves its intended goals.
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Affiliation(s)
- Carin Ericsson
- Cardiology and Speciality Medicine Centre, Region Ostergotland, Linkoping, Sweden
- Department of Medical and Health Sciences, Linköping University, Linkoping, Sweden
| | - Janna Skagerström
- Department of Medical and Health Sciences, Linköping University, Linkoping, Sweden
- Research and Development Unit, Region Ostergotland, Linkoping, Sweden
| | | | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
- The Research Section, Kalmar County Council, Kalmar, Sweden
| | - Anders Broström
- Department of Nursing, School of Health and Welfare, Jonkoping University, Jonkoping, Sweden
- Department of Clinical Neurophysiology, Region Ostergotland, Linkoping, Sweden
| | - Amir Pakpour
- Department of Nursing, School of Health and Welfare, Jonkoping University, Jonkoping, Sweden
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Per Nilsen
- Department of Medical and Health Sciences, Linköping University, Linkoping, Sweden
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Sizear MMI, Nababan HY, Siddique MKB, Islam S, Paul S, Paul AK, Ahmed SM. Perceptions of appropriate treatment among the informal allopathic providers: insights from a qualitative study in two peri-urban areas in Bangladesh. BMC Health Serv Res 2019; 19:424. [PMID: 31242900 PMCID: PMC6595608 DOI: 10.1186/s12913-019-4254-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 06/12/2019] [Indexed: 12/01/2022] Open
Abstract
Background How the informal providers deliver health services are not well understood in Bangladesh. However, their practices are often considered inappropriate and unsafe. This study attempted to fill-in this knowledge gap by exploring their perceptions about diagnosis and appropriate treatment, as well as identifying existing barriers to provide appropriate treatment. Methods This exploratory study was conducted in two peri-urban areas of metropolitan Dhaka. Study participants were selected purposively, and an interview guideline was used to collect in-depth data from thirteen providers. Content analysis was applied through data immersion and themes identification, including coding and sub-coding, as well as data display matrix creation to draw conclusion. Results The providers relied mainly on the history and presenting symptoms for diagnosis. Information and guidelines provided by the pharmaceutical representatives were important aids in their diagnosis and treatment decision making. Lack of training, diagnostic tools and medicine, along with consumer demands for certain medicine i.e. antibiotics, were cited as barriers to deliver appropriate care. Effective and supportive supervision, training, patient education, and availability of diagnostics and guidelines in Bangla were considered necessary in overcoming these barriers. Conclusion Informal providers lack the knowledge and skills for delivering appropriate treatment and care. As they provide health services for substantial proportion of the population, it’s crucial that policy makers become cognizant of the fact and take measures to remedy them. This is even more urgent if government’s goal to reach universal health coverage by 2030 is to be achieved. Electronic supplementary material The online version of this article (10.1186/s12913-019-4254-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Herfina Y Nababan
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Md Kaoser Bin Siddique
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Shariful Islam
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | | | | | - Syed Masud Ahmed
- James P. Grant School of Public Health, BRAC University, Dhaka, Bangladesh
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Kovacs RJ, Lagarde M, Cairns J. Measuring patient trust: Comparing measures from a survey and an economic experiment. HEALTH ECONOMICS 2019; 28:641-652. [PMID: 30767317 DOI: 10.1002/hec.3870] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 10/12/2018] [Accepted: 11/07/2018] [Indexed: 05/15/2023]
Abstract
Despite its importance in health care, empirical evidence on patient trust is limited. This is likely because, as with many complex concepts, trust is difficult to measure. This study measured patient trust in health care providers in a sample of 667 patients in Senegal. Two instruments were used to measure patient trust in providers: a survey questionnaire and an incentivised behavioural economic experiment-a "trust game." The results show that the two measures are significantly, but weakly, associated. Using information from patients and providers, we find that continuity of care, provider communication ability, and clinical competence were positively associated with patient trust. Based on the results obtained from both methods, the trust game seems to have higher construct validity than the survey instrument in this context. This paper contributes to the methodological literature on patient trust and the evidence on the determinants of patient trust. It suggests that researchers interested in studying patient trust in providers should rely more on economic experiments and explore their validity in different contexts.
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Affiliation(s)
- Roxanne J Kovacs
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Mylene Lagarde
- Department of Health Policy, London School of Economics, London, UK
| | - John Cairns
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Morera-Balaguer J, Botella-Rico JM, Catalán-Matamoros D, Martínez-Segura OR, Leal-Clavel M, Rodríguez-Nogueira Ó. Patients' experience regarding therapeutic person-centered relationships in physiotherapy services: A qualitative study. Physiother Theory Pract 2019; 37:17-27. [PMID: 31002005 DOI: 10.1080/09593985.2019.1603258] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Introduction: Person-centered care has emerged as a key principle in the provision of health and rehabilitation services. To implement this approach, health professionals must strive to develop a person-centered therapeutic relationship. The aim of this study was to explore the barriers and facilitators for the establishment of a person-centered relationship, based on the experience of physiotherapy patients. Methods: A qualitative study was conducted based on four focus groups including 31 participants. The focus group discussions were audiotaped, transcribed verbatim and analyzed thematically using the method of constant comparisons. Results: Patients described specific traits, characteristics and behaviors relating to the health professional, the patient and the environment, that they felt may hinder or favor the establishment of therapeutic person-centered relationships. Some participants focused on aspects concerning the health professional, both regarding their characteristics as well as their relational skills, meaning that the physiotherapist may be responsible for using several strategies in order to put the person at the center of care. Conclusions: Person-centered care and the therapeutic relationship are important aspects in the field of rehabilitation, requiring further studies to improve our understanding of the same, and to inform both health professionals, and managers of health institutions.
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Affiliation(s)
- Jaume Morera-Balaguer
- Physiotherapy Department, Health Sciences School, Universidad CEU Cardenal Herrera. Calle Carmelitas , Alicante, Spain
| | - José M Botella-Rico
- Physiotherapy Department, Health Sciences School, Universidad CEU Cardenal Herrera. Calle Carmelitas , Alicante, Spain
| | - Daniel Catalán-Matamoros
- Department of Journalism and Communication, University Carlos III of Madrid , Getafe, Madrid.,Research group Health Sciences, University of Almeria, Calle Universidad de Almería , Almería, Spain
| | | | - Marina Leal-Clavel
- Nursing Department, Health Sciences School, Universidad CEU Cardenal Herrera , Alicante, Spain
| | - Óscar Rodríguez-Nogueira
- Nursing and Physical Therapy Department, Health Sciences School, Universidad de León , Ponferrada, León, Spain
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