1
|
Moradi M, Noroozi M, Mostafavi F, Beigi M. Strategies to promote the provision of sexual health services during menopause: a qualitative study from the perspective of menopausal women and healthcare providers in Isfahan city, Iran. BMC Health Serv Res 2025; 25:101. [PMID: 39828681 DOI: 10.1186/s12913-025-12278-8] [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: 09/13/2024] [Accepted: 01/15/2025] [Indexed: 01/22/2025] Open
Abstract
BACKGROUND It is important to care for the sexual function of women during menopause as it can affect their quality of life. However, the services related to this area have been neglected in the health system and are not provided at the desired level. Therefore, the present study aimed to identify strategies to promote the provision of sexual health services during menopause in Isfahan city, Iran. METHODS Participants of this qualitative study consisted of 19 menopausal women and 15 health service providers with work experience in providing sexual health services to menopausal women, selected using purposive sampling with maximum variation in the city of Isfahan, Iran. Data were collected through in-depth semi-structured individual interviews plus field notes and analyzed using conventional qualitative content analysis. RESULTS Data analysis led to the extraction of three main categories: 1-providing comprehensive and client-centered care with five sub-categories, namely "screening and active search for recognition of sexual dysfunction", "compliance with cultural considerations in service delivery", "tailoring treatment plans for individual patients", "collaborative decision-making approach", and "improving specialty care follow-up"; 2- improving infrastructure for better service delivery with three sub-categories, namely "allocation of appropriate physical space", "strengthening teamwork and interdisciplinary cooperation", and "provision of cost-effective services"; and 3- expanding services as well as enhancing access with five sub-categories, namely "integration of sexual health services in primary health care", "using telemedicine to provide services", "expansion of intersectoral relations", "introducing sexual health services", and "conducting research on sexual health services". CONCLUSIONS The results emphasize the importance of providing comprehensive and client-centered services and care, improving service delivery infrastructure, expanding services, and promoting access to sexual health to enhance the sexual function of postmenopausal women. Through these strategies, healthcare systems can significantly contribute to improving postmenopausal women's sexual functioning and ultimately their quality of life.
Collapse
Affiliation(s)
- Maryam Moradi
- Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
- Counseling and Reproductive Health Research Centre, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahnaz Noroozi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Firoozeh Mostafavi
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Beigi
- Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
2
|
Alfattani MA, Bakudam WA, Alharbi WI. Factors Influencing Patient-Centered Care and Shared Decision-Making in Primary Care Settings in Saudi Arabia: A Scoping Review. Cureus 2024; 16:e76142. [PMID: 39711924 PMCID: PMC11663035 DOI: 10.7759/cureus.76142] [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] [Accepted: 12/21/2024] [Indexed: 12/24/2024] Open
Abstract
The Kingdom of Saudi Arabia has undergone many reforms in light of Vision 2030, and the health sector is no exception. Vision 2030 highlights the importance of utilization and increased quality in primary care. Patient-centered care (PCC) and shared decision-making (SDM) are two methods used to increase healthcare quality globally. However, there is limited research on the implementation of such methods in primary care within Saudi Arabia. Thus, this scoping review aims to address this gap by investigating the different factors influencing the implementation of PCC and SDM in primary care in Saudi Arabia. The scoping review completed a comprehensive search of three databases, Scopus, PubMed, and Web of Science, resulting in eight articles that met the inclusion criteria. The review found three major themes of influencing factors: patient-specific factors, physician-specific factors, and health system and external factors. The review highlights the lack of research in this area and provides context for the implementation of new reforms and policies in relation to PCC and SDM in primary care in the Kingdom of Saudi Arabia. Most notably, it emphasizes the importance of increasing health literacy, improving physician training, investigating cultural influence, and enhancing policies.
Collapse
Affiliation(s)
- Monzir A Alfattani
- Family Medicine, Albarzah Primary Health Care Center, Makkah Health Cluster, Ministry of Health, Makkah, SAU
- Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, IRL
| | | | - Waleed I Alharbi
- Family Medicine, Albarzah Primary Health Care Center, Makkah Health Cluster, Ministry of Health, Makkah, SAU
| |
Collapse
|
3
|
Sathe NA, Ovelman C, Ospina NS, Dewidar O, Terhune EA, Francis DK, Welch V, Heyn PC, Duque T, Viswanathan M. Paper 6: engaging racially and ethnically diverse interest holders in evidence syntheses. J Clin Epidemiol 2024; 176:111575. [PMID: 39442675 DOI: 10.1016/j.jclinepi.2024.111575] [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: 01/08/2024] [Revised: 10/14/2024] [Accepted: 10/15/2024] [Indexed: 10/25/2024]
Abstract
OBJECTIVES To inform methods for centering racial health equity in syntheses, we explored (1) how syntheses that assess health-related interventions and explicitly address racial health inequities have engaged interest holders and (2) guidance for engaging racially and ethnically diverse interest holders. STUDY DESIGN AND SETTING We systematically identified evidence syntheses (searches limited to January 1, 2020, through January 25, 2023) and guidance documents (no search date limits) for this overview. From syntheses we extracted data on engagement rationale and processes and extracted approaches suggested from guidance documents. We summarized findings qualitatively. RESULTS Twenty-nine of the 157 (18%) eligible syntheses reported using engagement. Syntheses typically lacked robust detail on why and how to use and structure engagement and outcomes/effects of engagement, though syntheses involving Indigenous populations typically included more detail. When reported, engagement typically occurred in early and later synthesis phases. We did not identify guidance documents that specifically intended to provide guidance for engaging racially/ethnically diverse individuals in syntheses; some related guidance described broader equity considerations or engagement in general. CONCLUSION This review highlights gaps in understanding of the use of engagement in racial health equity-focused syntheses and in guidance specifically addressing engaging racially and ethnically diverse populations. Syntheses and guidance materials we identified reported limited data addressing the whys, hows, and whats (ie, rationale for, approaches to, resources needed and effects of) of engagement, and we lack information for understanding whether engagement makes a difference to the conduct and findings of syntheses and when and how engagement of specific populations may contribute to centering racial health equity. A more informed understanding of these issues, facilitated by prospective and retrospective descriptions of engagement of diverse interest holders, may help advance actionable guidance and reviews. PLAIN LANGUAGE SUMMARY We identified evidence syntheses (a kind of research that identifies and summarizes findings of individual studies or publications to address research questions) that looked at studies of interventions to improve differences in effects on health for racial or ethnic populations to see (1) if and how they incorporated perspectives of interest holders, people with an interest in the subject being studied; (2) what guidance for how to engage or involve racially or ethnically diverse interest holders exists. We found that 29 of 157 syntheses addressing interventions to improve differences in effects on health reported involving interest holders but typically did not provide much detail about how to involve people. Syntheses that involved Indigenous people usually had more information, but overall, the syntheses did not have much information about how to involve people and what the impact of involving them may be. We did not find guidance information that specifically set out to provide information about engaging racially/ethnically diverse individuals in syntheses; some related guidance described considerations about involving people in syntheses in general. This review highlights gaps in understanding of how to engage people in racial health equity-focused syntheses and in guidance specifically addressing engaging racially and ethnically diverse populations. Syntheses and guidance materials we identified reported limited information about whys, hows, and whats (ie, reasons to use, how to do, and resources needed and effects of) related to engagement, and we lack information to help understand whether engagement makes a difference in doing syntheses and when and how engagement of specific populations may help to address racial health equity.
Collapse
Affiliation(s)
- Nila A Sathe
- RTI International, Research Triangle Park, NC, USA; RTI International-University of North Carolina Evidence-Based Practice Center US Cochrane Affiliate, Research Triangle Park, NC, USA.
| | - Colleen Ovelman
- RTI International, Research Triangle Park, NC, USA; RTI International-University of North Carolina Evidence-Based Practice Center US Cochrane Affiliate, Research Triangle Park, NC, USA; Evidence Production and Methods Directorate, Central Editorial Service, Cochrane, London, UK
| | - Naykky Singh Ospina
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Omar Dewidar
- Temerty School of Medicine, University of Toronto, Toronto, Canada; Bruyère Research Institute, University of Ottawa, Ottawa, Canada
| | - Elizabeth A Terhune
- Center for Optimal Aging, Marymount University, Arlington, VA, USA; Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Damian K Francis
- School of Health and Human Performance, Georgia College and State University, Milledgeville, GA, USA
| | - Vivian Welch
- Bruyère Research Institute, University of Ottawa, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Patricia C Heyn
- Center for Optimal Aging, Marymount University, Arlington, VA, USA; Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Meera Viswanathan
- RTI International, Research Triangle Park, NC, USA; RTI International-University of North Carolina Evidence-Based Practice Center US Cochrane Affiliate, Research Triangle Park, NC, USA
| |
Collapse
|
4
|
AL-Ruzzieh MA, AL-Helih YM, Haroun A, Ayaad O. Higher and Middle Management Perspectives on Patient-Centered Care in an Oncology Setting: A Qualitative Study. NURSING REPORTS 2024; 14:3378-3390. [PMID: 39585135 PMCID: PMC11587424 DOI: 10.3390/nursrep14040244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Revised: 10/10/2024] [Accepted: 10/14/2024] [Indexed: 11/26/2024] Open
Abstract
BACKGROUND Patient center care (PCC) plays a crucial role in achieving the organizational and patient outcomes. Literature suggests that PCC enhance patient's adherence to treatment, lower the cost of health care organization. This study aimed explore the higher and middle managers' perceptions of patient-centered care (PCC) in an oncology setting, identify the PCC implementation challenges in the oncology setting, and understand the role of managers in facilitating PCC within the oncology context. METHODS Sampling involved the use of the purposive sampling technique on 17 middle managers and 6 upper managers who had been working in an oncology setting. The six-step thematic analysis method was used for data analysis. RESULTS The interviews identified six main themes and seventeen subthemes: "comprehensive care, partnership, and informed decision-making", "infrastructure and support systems", "leadership influence on patient-centered care", "cultural and operational barriers", "perceived outcomes", and "strategies to enhance PCC in oncology". The subthemes of comprehensive care included fostering partnerships and enabling informed decisions. The infrastructure and support systems encompassed educational empowerment and service integration. Leadership influence highlighted the role of elevating awareness, providing organizational support, and promoting comprehensive care. The cultural and operational barriers addressed the challenges faced in implementation. The perceived outcomes focused on the results of patient-centered care, while strategies to enhance PCC in oncology provided actionable insights for improvement. This provides a comprehensive understanding of the perceptions of middle and higher managers on patient-centered care (PCC) in oncology settings. It identifies key challenges in PCC implementation, highlights the critical role of managers in facilitating PCC, and offers actionable strategies for enhancing PCC.
Collapse
Affiliation(s)
- Majeda A. AL-Ruzzieh
- Nursing Department, King Hussein Cancer Center, P.O. Box 1269, AL-Jubeiha, Amman 11941, Jordan; (Y.M.A.-H.)
| | - Yahia M. AL-Helih
- Nursing Department, King Hussein Cancer Center, P.O. Box 1269, AL-Jubeiha, Amman 11941, Jordan; (Y.M.A.-H.)
| | - Anas Haroun
- Nursing Department, King Hussein Cancer Center, P.O. Box 1269, AL-Jubeiha, Amman 11941, Jordan; (Y.M.A.-H.)
| | - Omar Ayaad
- Quality and Accreditation Department, Sultan Qaboos Comprehensive Cancer Care and Research Center, University Medical City, P.O. Box 566, Muscat 123, Oman
| |
Collapse
|
5
|
Keshet Y, Popper-Giveon A, Adar T. Telemedicine and patient-centered care: The perspective of primary-care physicians. Health (London) 2024:13634593241290190. [PMID: 39397524 DOI: 10.1177/13634593241290190] [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: 10/15/2024]
Abstract
Patient-centered care (PCC) has become a central aim for healthcare systems worldwide due to recognition of its advantages. The growing use of telemedicine technologies (TT) raises concerns of diminishing interpersonal contact, especially in primary care, and questions the appropriate way of implementing PCC. This article aims to explore primary-care physicians' (PCP) experiences of PCC when using TT. During 2023 in-depth interviews were conducted with 20 Israeli PCP: family physicians and pediatricians. The PCP described their experiences of using TT in their communication with patients as including some characteristics of PCC but not others. They related to TT as a means of forming relationships and communicating with patients, highlighting its individualistic focus and describing it as a way of coordinating care. When describing the use of TT in their communication with patients, they barely related to empathy and respect for the patient, to their own involvement in the treatment, to shared decision-making, or to a holistic focus on the patient. The absence of interpersonal qualities and soft skills communication from the physicians' TT experience seems to erode their personal well-being and professional satisfaction and may even lead to burnout. We therefore recommend instructing PCP to better integrate PCC into their TT communication with patients since it contributes to the quality of healthcare and is significant for the well-being of both patients and physicians.
Collapse
Affiliation(s)
| | | | - Tamar Adar
- Technion and Clalit Health Services HMO, Israel
| |
Collapse
|
6
|
Tierney S, Wong G, Westlake D, Turk A, Markham S, Gorenberg J, Reeve J, Mitchell C, Husk K, Redwood S, Meacock T, Pope C, Baird B, Mahtani KR. Patient buy-in to social prescribing through link workers as part of person-centred care: a realist evaluation. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024:1-17. [PMID: 39344953 DOI: 10.3310/etnd8254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/01/2024]
Abstract
Background Social prescribing link workers have become part of primary health care in recent years. They help patients to recognise non-medical factors affecting their health and identify sources of support, often in the voluntary, community and social enterprise sector. They form part of wider work to strengthen person-centred care, which actively seeks to engage individuals in decision-making about their health, taking into account their medical, social, psychological, financial and spiritual circumstances. Objective To understand how buy-in to social prescribing and the link worker role is established for a patient, and how this relates to person-centred care. Design A realist evaluation. Setting Patients engaging with link workers in seven different parts of England were involved. Methods As part of data collection, we observed link workers interacting with 35 patients. We also interviewed 61 patients and re-interviewed 41 of them 9-12 months later. Data were coded and developed into context-mechanism-outcome configurations, which were used to produce a programme theory. Results Data highlighted how patients might be uncertain about the link worker role but agree to a referral as they sought assistance with their non-medical issues. Patients talked about experiencing a sense of hope through the trust they developed in a link worker. This trust was established through the communication skills and knowledge demonstrated by a link worker, and by their ability to act as an anchor point when required - a reliable, consistent source of support to whom patients could offload. The link worker role also involved connecting patients to external support, which called for sensitivity around how ready someone was to move forward; this was shaped by a patient's motivation but also their capacity to make changes given other demands in their life. Connecting patients to external support could be affected by structural factors outside the link workers' control (e.g. housing options or employment opportunities). Limitations We did not interview patients who had rejected the offer of social prescribing, and most had a positive view of meeting with a link worker. Conclusions Person-centred care is engendered by link workers through their skills, knowledge and ability to respond to the individual readiness of patients to engage with external support. It can be curtailed by structural factors outside link workers' sphere of control, such as access to housing or caring responsibilities of patients. This can hinder patients' ability to 'connect to', leaving link workers to continue 'connecting with' patients as they act as an anchor point. Future work Exploration is required of factors affecting patients who interact with a link worker but do not access external support. Longitudinal work with a cohort of patients, speaking to them on a regular basis, may provide further understanding in this respect. Funding This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR130247.
Collapse
Affiliation(s)
- Stephanie Tierney
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Geoffrey Wong
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Debra Westlake
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Amadea Turk
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Steven Markham
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Jordan Gorenberg
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Joanne Reeve
- Hull York Medical School, University of Hull, Hull, UK
| | - Caroline Mitchell
- School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | - Kerryn Husk
- Peninsula Medical School, University of Plymouth, Plymouth, UK
| | - Sabi Redwood
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Tony Meacock
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Catherine Pope
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Beccy Baird
- The King's Fund, Cavendish Square, London, UK
| | - Kamal R Mahtani
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| |
Collapse
|
7
|
Karaferis DC, Niakas DA, Balaska D, Flokou A. Valuing Outpatients' Perspective on Primary Health Care Services in Greece: A Cross-Sectional Survey on Satisfaction and Personal-Centered Care. Healthcare (Basel) 2024; 12:1427. [PMID: 39057571 PMCID: PMC11276435 DOI: 10.3390/healthcare12141427] [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: 06/17/2024] [Revised: 07/10/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
INTRODUCTION The aims of the study were to identify and analyze the determinants associated with outpatient satisfaction in Greek primary care. This is because there is a general consensus that primary care is the linchpin of effective person-centered care delivery. METHODS A cross-sectional survey was conducted with 1012 patients' exit interviews; sociodemographic variables were included in the questionnaire to obtain data on the satisfaction of primary care users with 20 public primary healthcare centers in Athens between June 2019 and April 2021. Statistical analysis was applied to 55 items and eight dimensions of patient satisfaction, namely, arrival and admission, waiting before the appointment, cleanliness of toilets, medical examination and behavior of physician, behavior of nursing staff, laboratories, departure, and contribution of the PHCs. Descriptive analyses and multiple linear regression were used to analyze the factors influencing patient satisfaction through coefficients (β) with 95% confidence intervals and associated tests of statistical significance. RESULTS Τwo-thirds (74.21%) of this survey's participants ranged from 45 to 74 years of age. More than half of the participants were women (62.15%). The most common reasons for visits were pathological (26.48%), followed by cardiological conditions (9.78%), orthopedics (9.49%), gynecologic conditions (8.70%), and ophthalmologic problems (7.31%). In the center of satisfaction with primary care was the medical care and the behavior of the physician (β = 0.427; p < 0.01), followed by the time during appointment (β = 0.390; p < 0.01). Dimensions like "accessibility and availability, 2.19/5"; "waiting times, 2.89/5"; "infrastructure of facilities (2.04/5) and cleanliness of them, (2/5)"; "laboratories, 2.99/5" and "bureaucracy in the departure, 2.29/5" were crucial for the trust and satisfaction of patients. Overall satisfaction was rated at a moderate level (2.62 ± 0.18) while person-centered care was rated as weak (2.49 ± 0.28). CONCLUSIONS Greece is recommended to increase the sensitivity of the use of the primary health care system by patients as a first contact, continuous, comprehensive, and effective patient- and family-focused care.
Collapse
Affiliation(s)
| | - Dimitris A. Niakas
- Department of Health Economics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece;
| | - Dimitra Balaska
- Department of Business Administration, University of West Attica, 12241 Athens, Greece
| | - Angeliki Flokou
- School of Social Sciences, Hellenic Open University, 26335 Patra, Greece
| |
Collapse
|
8
|
Schut T, van de Meeberg B, Lucassen P, Etz RS, van den Muijsenbergh M, Akkermans RP, Olde Hartman TC. Dutch Translation and Psychometric Evaluation of the Person-Centered Primary Care Measure. Ann Fam Med 2024; 22:288-293. [PMID: 39038965 PMCID: PMC11268680 DOI: 10.1370/afm.3135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 03/20/2024] [Accepted: 04/12/2024] [Indexed: 07/24/2024] Open
Abstract
PURPOSE Person-centered care is foundational to good quality primary care and has positive effects on health outcomes and patient satisfaction. The Person-Centered Primary Care Measure (PCPCM) is a recently developed, patient-reported survey able to assess person-centeredness and has demonstrated strong validity and reliability. Little is known, however, about the feasibility of the PCPCM in non-English-speaking settings. We aimed to translate the questionnaire into Dutch, psychometrically evaluate the translated version, and ensure its feasibility for patients in Dutch primary care. METHODS We translated the PCPCM into Dutch using forward-backward translations. We conducted psychometric evaluations to ensure its feasibility among Dutch-speaking primary care patients, with special attention to low literacy populations. Next, we assessed structural validity, convergent validity using the Quality of Care Through the Patient's Eyes (QUOTE) questionnaire, and internal consistency in a cross-sectional study in primary care. RESULTS Translation and adaptation for low literacy populations required 4 iterations. In 4 general practices, 205 patients completed the survey. Confirmatory factor analyses could not confirm the 1-factor solution. The 3-factor solution was found to be a more optimal fit: comprehensiveness of care, personal relation, and contextual care. Internal reliability was high (Cronbach's α were 0.82, 0.73, and 0.86, respectively). We found a strong correlation between the total PCPCM and QUOTE scores (Spearman's ρ = 0.65, P <.001), indicating good convergent validity. CONCLUSION The Dutch version of the PCPCM has acceptable validity and reliability for measuring person-centeredness in primary care among Dutch-speaking populations including those with low literacy.
Collapse
Affiliation(s)
- Talitha Schut
- Department of Primary and Community Care, Radboud Institute for Health Services, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bernard van de Meeberg
- Department of Primary and Community Care, Radboud Institute for Health Services, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Peter Lucassen
- Department of Primary and Community Care, Radboud Institute for Health Services, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rebecca S Etz
- Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Maria van den Muijsenbergh
- Department of Primary and Community Care, Radboud Institute for Health Services, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Reinier P Akkermans
- Department of Primary and Community Care, Radboud Institute for Health Services, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Tim C. Olde Hartman
- Department of Primary and Community Care, Radboud Institute for Health Services, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
9
|
Dobarrio-Sanz I, Chica-Pérez A, López-Entrambasaguas OM, Martínez-Linares JM, Granero-Molina J, Hernández-Padilla JM. Promoting the empowerment and emancipation of community-dwelling older adults with chronic multimorbidity through a home visiting programme: a hermeneutical study. BMC Nurs 2024; 23:444. [PMID: 38943097 PMCID: PMC11212443 DOI: 10.1186/s12912-024-02117-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 06/20/2024] [Indexed: 07/01/2024] Open
Abstract
INTRODUCTION Nurse-led preventive home visiting programmes can improve health-related outcomes in community-dwelling older adults, but they have not proven to be cost-effective. Home visiting programmes led by nursing students could be a viable alternative. However, we do not know how community-dwelling older adults with chronic multimorbidity experience home visiting programmes in which nursing students carry out health promotion activities. The aim of the study is to understand how community-dwelling older adults with chronic multimorbidity experience a home visiting programme led by nursing students. METHODS A qualitative study based on Gadamer's hermeneutics. Thirty-one community-dwelling older adults with chronic multimorbidity were interviewed in-depth. Fleming's method for conducting hermeneutic, Gadamerian-based studies was followed and ATLAS.ti software was used for data analysis. RESULTS Two main themes were generated: (1) 'The empowering experience of a personalised health-promoting intervention', and (2) 'The emancipatory effect of going beyond standardised self-care education'. CONCLUSIONS The home visiting programme contributed to the community-dwelling older adults feeling more empowered to engage in health-promoting self-care behaviours. It also improved the older adults' sense of autonomy and self-efficacy, while reducing their loneliness and addressing some perceived shortcomings of the healthcare system. CLINICAL RELEVANCE Older adults participating in a home visiting programme led by nursing students feel empowered to implement self-care behaviours, which has a positive impact on their perceived health status. Nurse leaders and nursing regulatory bodies could collaborate with nursing faculties to integrate preventive home visiting programmes led by nursing students into the services offered to community-dwelling older adults with chronic multimorbidity.
Collapse
Affiliation(s)
- Iria Dobarrio-Sanz
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, 04120, Spain
| | - Anabel Chica-Pérez
- Emera Nursing and Residential Home for Older Adults, Almería, 04007, Spain.
| | | | | | - José Granero-Molina
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, 04120, Spain
- Facultad de Ciencias de la Salud. Universidad Autónoma de Chile, Santiago de Chile, Chile
| | | |
Collapse
|
10
|
Steel A, Foley H, Graham K, Harnett J, Adams J. Patient experiences of information-sharing and patient-centred care across the broad landscape of primary care practice and provision: a nationally representative survey of Australian adults. BMC PRIMARY CARE 2024; 25:151. [PMID: 38704562 PMCID: PMC11070095 DOI: 10.1186/s12875-024-02359-8] [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] [Received: 11/10/2023] [Accepted: 04/01/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Australian government strategies and frameworks have been developed in recent years to encourage the integration and coordination of primary care delivery; including patient-centred approaches to clinical and preventative care, and health promotion. This study aims to explore patient experiences of information-sharing and patient-centred care across various primary care clinical settings, with a particular focus on clinical encounters with GPs, naturopaths, osteopaths and acupuncturists. METHODS Data about healthcare utilisation and experiences from a 63-item cross-sectional survey obtained from a nationally representative sample of Australian adults aged ≥ 18 years were analysed. Chi-square and Kruskal-Wallis H tests were used to explore differences in the experiences of knowledge and information sharing during GP consultations among those who also consulted with a naturopath, osteopath or acupuncturist, compared those who had not. Logistic regression was used to investigate correlations between participants perceptions about GP consultation outcomes, and the GP's information-sharing behaviour or perceived experience of patient-centredness. RESULTS Across 2354 participants, verbal explanation (76.3%) and/or individualised handouts (16.8%) were the most common type of information shared in GP consultations. Individuals who consulted with a GP and a naturopath, an osteopath, or an acupuncturist reported a lower rate of receiving a verbal explanation from their GP but higher rate of receiving other types of information sources including handouts. Over one quarter of study participants who visited a GP did not discuss any of their health information with their GP. Information sharing was lower for individuals who also visited a naturopath, osteopath or acupuncturist. Participants scored their consultations with a GP as patient-centred, but these scores were lower among participants who also consulted with at least one other primary care practitioner type included in the study. CONCLUSIONS Public health and health services researchers, policymakers and leaders of primary care professions have a role and responsibility to ensure practitioners are confident and competent in sharing health information with their patients that considers their health literacy needs, and the importance of patient-centred care. Research focussed on a more in-depth understanding of the differences and relationships observed across the primary care landscape in this study is recommended.
Collapse
Affiliation(s)
- Amie Steel
- ARCCIM, School of Public Health, Faculty of Health, University of Technology Sydney, 235-253 Jones St, Ultimo, NSW, Australia.
| | - Hope Foley
- ARCCIM, School of Public Health, Faculty of Health, University of Technology Sydney, 235-253 Jones St, Ultimo, NSW, Australia
| | - Kim Graham
- ARCCIM, School of Public Health, Faculty of Health, University of Technology Sydney, 235-253 Jones St, Ultimo, NSW, Australia
| | - Joanna Harnett
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jon Adams
- ARCCIM, School of Public Health, Faculty of Health, University of Technology Sydney, 235-253 Jones St, Ultimo, NSW, Australia
| |
Collapse
|
11
|
Jackson JE, Wild R, Hallam J, Graves R, Woodstein BJ, Stothard P. Exploring the healthcare experiences and support needs of chestfeeding or breastfeeding for trans and non-binary parents based in the United Kingdom. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2023; 25:738-750. [PMID: 39465072 PMCID: PMC11500517 DOI: 10.1080/26895269.2023.2265371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/29/2024]
Abstract
Background: Trans and/or non-binary parents experience structural exclusion in family healthcare and there is a need for specialist training for healthcare professionals so that they are able to create a gender inclusive environment. Aim: As part of a continued effort to address health inequity this study explores the body experiences of infant feeding within trans and non binary communities. Method: Semi structured interviews were conducted with seven trans or non-binary parents, based in the United Kingdom, who have experienced chestfeeding or breastfeeding. Results: A reflexive thematic analysis was utlitised to identify three main themes which centered around baby, body and support in health care settings. Parents were informed of the benefits of their milk and were strongly motivated by their child's needs. However, body feeding was emotionally and physically challenging. Conclusion: Person-centered care with consistent attention to language is required when supporting lactation.
Collapse
Affiliation(s)
- Jessica Eve Jackson
- College of Health, Psychology and Social Care, University of Derby, Derby, UK
| | - Ray Wild
- College of Health, Psychology and Social Care, University of Derby, Derby, UK
| | - Jenny Hallam
- College of Health, Psychology and Social Care, University of Derby, Derby, UK
| | - Rudy Graves
- Leeds Teaching Hospital NHS Trust, Leeds, UK
| | | | - Penny Stothard
- College of Health, Psychology and Social Care, University of Derby, Derby, UK
| |
Collapse
|
12
|
Arsat N, Lah NASN, Thomas DC, Soong SF, Chong LT, Sawatan W, Dasan N, Wider W. The effect of work setting and demographic factors on caring behaviour among nurses in the public hospitals and public health services, Sabah, Malaysia. BMC Nurs 2023; 22:194. [PMID: 37291559 DOI: 10.1186/s12912-023-01359-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/27/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND The nursing profession's uniqueness contributes to the development of knowledge, experience, age, education, economy, and position, as well as a unique gender role. Thus, the development and advancement of demographic characteristics of nurses while in this profession influences their caring behavior. OBJECTIVE The purpose of this study was to determine the effect of work setting and demographic factors on nurses' caring behaviour, as well as the differences in nurses' caring behaviour based on demographic factors between nurses in public hospitals and nurses in public health services in Sabah, Malaysia. METHODS This research is a cross-sectional study using the survey method. Data were collected from 3,532 nurses (88.3% response rate) in public hospitals and public health services within Sabah, Malaysia. Data were analysed using two-way ANOVA. RESULTS The two-way ANOVA test revealed no significant impact of the work setting on CB, nor was there a notable interaction between the work setting and demographic factors influencing nurses' CB. However, demographic factors such as gender, age, education, economic status, position, and experience had a significant effect on CB. CONCLUSION The present research has provided convergent evidence on the effect of demographic factors on nurses caring behavior and the differences in caring behavior based on demographic factors among nurses in public hospitals and public health services in Sabah, Malaysia.
Collapse
Affiliation(s)
- Norkiah Arsat
- Department of Nursing, Faculty of Medicine and Health Science, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Nik Amin Sahid Nik Lah
- Department of Surgery, Faculty of Medicine and Health Science, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Deena Clare Thomas
- Department of Nursing, Faculty of Medicine and Health Science, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Sui Fun Soong
- Nursing Department, Cyberjaya College, Kota Kinabalu, Malaysia
| | - Li Tsu Chong
- Department of Nursing, Faculty of Medicine and Health Science, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Waidah Sawatan
- Department of Nursing, Faculty of Medicine and Health Science, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Norsimah Dasan
- Faculty of Psychology and Education, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Walton Wider
- Faculty of Business and Communications, INTI International University, Nilai, Negeri Sembilan, Malaysia.
| |
Collapse
|