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Gusdal AK, Söderman M, Pettersson T, Kaup J, Gustafsson LK. Healthcare and social care professionals' experiences of respite care: a critical incident study. Int J Qual Stud Health Well-being 2024; 19:2352888. [PMID: 38735060 PMCID: PMC11089915 DOI: 10.1080/17482631.2024.2352888] [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: 12/14/2023] [Accepted: 05/05/2024] [Indexed: 05/14/2024] Open
Abstract
INTRODUCTION Aging in place is favoured among older persons and supported by research in Sweden, although it poses challenges for overburdened informal caregivers. While respite care can offer support, its accessibility is hindered by organizational challenges and informal caregivers' delays in using it. The experiences of informal caregivers are well-studied, but the professionals' experiences of respite care quality and critical incident management are underexplored. AIM To explore professionals' experiences of critical incidents in respite care, consequences for the persons being cared for, and strategies to manage critical incidents. MATERIALS AND METHODS A qualitative, critical incident technique was used, and three group interviews with a total of 16 professionals were conducted. RESULTS Barriers to quality respite care included communication gaps during care transitions, environmental shortcomings in respite care facilities, lack of support for informal caregivers, and inadequacies in respite care decisions. Strategies to manage critical incidents included individualized care, continuity and communication in care transitions, a conducive environment, support for informal caregivers, and care professionals' positive approach. CONCLUSIONS The study emphasizes the need for focused efforts on communication, continuity, and a supportive environment. Addressing identified challenges and applying suggested strategies will be key to maximizing the potential of respite care as a vital support for care recipients and their informal caregivers.
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Affiliation(s)
- Annelie K. Gusdal
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden
| | - Mirkka Söderman
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden
| | - Tina Pettersson
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden
| | - Jaana Kaup
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden
| | - Lena-Karin Gustafsson
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna/Västerås, Sweden
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Md S, Kotta S. Advanced drug delivery technologies for postmenopausal effects. J Control Release 2024; 373:426-446. [PMID: 39038543 DOI: 10.1016/j.jconrel.2024.07.038] [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: 05/14/2024] [Revised: 07/08/2024] [Accepted: 07/15/2024] [Indexed: 07/24/2024]
Abstract
Postmenopause is the 12-month absence of menstrual periods, characterized by decreased estrogen and progesterone levels, leading to physical and psychological alterations such as hot flashes, mood swings, sleep disruptions, and skin changes. Present postmenopausal treatments include hormone replacement therapy, non-hormonal drugs, lifestyle modifications, vaginal estrogen therapy, bone health treatments, and alternative therapies. Advanced drug delivery systems (ADDSs) are essential in managing postmenopausal effects (PMEs), offering targeted and controlled delivery to alleviate symptoms and improve overall health. This review emphasizes such ADDSs for addressing PMEs. Emerging trends such as artificial ovaries are also reviewed. Additionally, the prospects of technologies such as additive manufacturing (3D and 4D printing) and artificial intelligence in further tailoring therapeutic strategies against PMEs are provided.
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Affiliation(s)
- Shadab Md
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; Center of Excellence for Drug Research and Pharmaceutical Industries, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Sabna Kotta
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; Center of Excellence for Drug Research and Pharmaceutical Industries, King Abdulaziz University, Jeddah 21589, Saudi Arabia.
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Posner J, Ndhlovu AP, Musangulule JM, Duffy M, Casella A, Madevu-Matson C, Davis N, Sharer M. Evaluating the Preliminary Effectiveness of the Person-Centered Care Assessment Tool (PCC-AT) in Zambian Health Facilities: Protocol for a Mixed Methods Cross-Sectional Study. JMIR Res Protoc 2024; 13:e54129. [PMID: 39042423 DOI: 10.2196/54129] [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: 10/30/2023] [Revised: 05/16/2024] [Accepted: 06/10/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Person-centered care (PCC) within HIV treatment services has demonstrated potential to overcome inequities in HIV service access while improving treatment outcomes. Despite PCC being widely considered a best practice, no consensus exists on its assessment and measurement. This study in Zambia builds upon previous research that informed development of a framework for PCC and a PCC assessment tool (PCC-AT). OBJECTIVE This mixed methods study aims to examine the preliminary effectiveness of the PCC-AT through assessing the association between client HIV service delivery indicators and facility PCC-AT scores. We hypothesize that facilities with higher PCC-AT scores will demonstrate more favorable HIV treatment continuity, viral load (VL) coverage, and viral suppression in comparison to those of facilities with lower PCC-AT scores. METHODS We will implement the PCC-AT at 30 randomly selected health facilities in the Copperbelt and Central provinces of Zambia. For each study facility, data will be gathered from 3 sources: (1) PCC-AT scores, (2) PCC-AT action plans, and (3) facility characteristics, along with service delivery data. Quantitative analysis, using STATA, will include descriptive statistics on the PCC-AT results stratified by facility characteristics. Cross-tabulations and/or regression analysis will be used to determine associations between scores and treatment continuity, VL coverage, and/or viral suppression. Qualitative data will be collected via action planning, with detailed notes collected and recorded into an action plan template. Descriptive coding and emerging themes will be analyzed with NVivo software. RESULTS As of May 2024, we enrolled 29 facilities in the study and data analysis from the key informant interviews is currently underway. Results are expected to be published by September 2024. CONCLUSIONS Assessment and measurement of PCC within HIV treatment settings is a novel approach that offers HIV treatment practitioners the opportunity to examine their services and identify actions to improve PCC performance. Study results and the PCC-AT will be broadly disseminated for use among all project sites in Zambia as well as other HIV treatment programs, in addition to making the PCC-AT publicly available to global HIV practitioners. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/54129.
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Affiliation(s)
- Jessica Posner
- International Division, JSI, Arlington, VA, United States
| | | | | | - Malia Duffy
- Health Across Humanity, LLC, Boston, MA, United States
- Department of Public Health, St. Ambrose University, Davenport, IA, United States
| | - Amy Casella
- International Division, JSI, Arlington, VA, United States
| | | | - Nicole Davis
- International Division, JSI, Arlington, VA, United States
| | - Melissa Sharer
- International Division, JSI, Arlington, VA, United States
- Department of Public Health, St. Ambrose University, Davenport, IA, United States
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Danielsen SO, Lie I. Evidence-based strategies for movement after sternotomy. Eur J Cardiovasc Nurs 2024; 23:e54-e56. [PMID: 38206819 DOI: 10.1093/eurjcn/zvad135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 01/13/2024]
Affiliation(s)
- Stein Ove Danielsen
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, St.Olavs plass, Oslo 0130, Norway
- Centre for Patient Centered Heart and Lung Research, Department of Cardiothoracic Surgery, Oslo University Hospital, Kirkeveien 166, Oslo 0450, Norway
| | - Irene Lie
- Centre for Patient Centered Heart and Lung Research, Department of Cardiothoracic Surgery, Oslo University Hospital, Kirkeveien 166, Oslo 0450, Norway
- Department of Health Sciences in Gjøvik, Norwegian University of Science and Technology, Gjøvik, Norway
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Engstrom T, Shteiman M, Kelly K, Sullivan C, Pole JD. What is measured matters: A scoping review of analysis methods used for qualitative patient reported experience measure data. Int J Med Inform 2024; 190:105559. [PMID: 39032453 DOI: 10.1016/j.ijmedinf.2024.105559] [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: 11/26/2023] [Revised: 07/11/2024] [Accepted: 07/16/2024] [Indexed: 07/23/2024]
Abstract
INTRODUCTION Hospitals are increasingly turning to patients for valuable feedback regarding their care experience. A common method to collect this information is patient reported experience measures (PREMs) surveys. Health care workers report qualitative PREMs as more interesting, relevant, and informative than quantitative survey responses. However, a major barrier to utilising qualitative PREMs data to drive quality improvements is a lack of resources to analyse the data. This scoping review aimed to review the methods used to analyse qualitative PREMs survey data from routine hospital care. METHODS We utilised the JBI scoping review methodology, and searched four databases for articles from 2013 to 2023 which analysed qualitative PREMs survey data from routine care in hospitals. Study characteristics were extracted, as well as the analysis method - specifically, whether the study used traditional manual analysis methods in which the researcher reads the text and categorise the data, or automated methods utilising computers and algorithms to read and categorise the data. RESULTS From 960 unique articles, 123 went through full-text review and 54 were deemed eligible. 75.9 % used only manual content analysis methods to analyse the qualitative responses, 16.7 % of studies used a combination of manual and automated methods, and only 7.4 % used exclusively automated methods. Automated methods were used in 27.5 % of studies published 2019-2023, compared to 14.3 % of studies published 2013-2018. All bar one study using automated methods focused on investigating the validity of the automated methodology or used it to complement manual content analysis. CONCLUSION The studies included in this review show a transition from traditional time-consuming manual analyses to computerised methods enabling analysis at a larger scale. As the volume of PREMs data collected grows, efficient and effective ways to analyse qualitative PREMs data at scale are required to enable health services to capture the patient voice and drive consumer-centred improvements in care.
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Affiliation(s)
- Teyl Engstrom
- Queensland Digital Health Centre, Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia.
| | - Max Shteiman
- The University of Queensland-Ochsner Clinical School, Brisbane, QLD, Australia
| | - Kim Kelly
- Qualitative Research Center of Excellence, IQVIA, Tucson, AZ, USA
| | - Clair Sullivan
- Queensland Digital Health Centre, Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia; Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Jason D Pole
- Queensland Digital Health Centre, Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia; The University of Toronto, Dalla Lana School of Public Health, Toronto, ON, Canada
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Fuseini MSN, Gbedemah ZEE, Fordjuor SKEJ, Beecham RMEM, Baisie-Nkrumah EJ, Ennin CG, Buxton ENA, Amissah-Arthur KN. A qualitative study on the effect of a decision aid on knowledge of cataract surgery in patients in developing countries. Int Ophthalmol 2024; 44:298. [PMID: 38951286 DOI: 10.1007/s10792-024-03159-w] [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: 10/16/2023] [Accepted: 06/15/2024] [Indexed: 07/03/2024]
Abstract
BACKGROUND Despite cataract surgery being a safe procedure with a low incidence of perioperative complications rates, poor knowledge, concerns about the effectiveness of treatment and cost-benefit analysis of the procedure significantly hinder cataract surgery uptake rates in Africa. This study describes the effect of a decision aid on knowledge and decision conflict on cataract patients in Africa. METHODS AND ANALYSIS 120 patients with cataracts reporting to a tertiary hospital in Ghana were randomly assigned to receive a decision aid containing information on the possible outcomes of cataract surgery or a control booklet containing general knowledge about cataracts without information about cataract surgery. The primary outcome measured was the effect of the decision aid on their knowledge of cataract surgery. A score greater than 6/12 (50%) was deemed adequate knowledge. The secondary outcome was the decision conflict experienced by the participants assessed using the Decision Conflict Scale. RESULTS Compared to the control group, the participants in the intervention group scored higher marks across all sections of the questionnaire (2.92 vs 2.7, p = 0.042 in section "Background"; 2.62 vs 1.77, p < 0.001 in section "Materials"; 1.87 vs 1.55, p = 0.03 in section "Results"). The average total score was higher in the intervention group than in the control (36.7% difference; p < 0.001). Participants in the intervention group also demonstrated lower decision conflict scores than those in the control group (13.00 vs 37.17; p < 0.001). CONCLUSION The decision aid increased knowledge of cataract surgery and reduced decision conflict among patients in a developing country.
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Affiliation(s)
| | | | | | | | | | - Chloe Graham Ennin
- College of Health Science, University of Ghana Medical School, Korle Bu, Accra, Ghana
| | | | - Kwesi Nyan Amissah-Arthur
- College of Health Science, University of Ghana Medical School, Korle Bu, Accra, Ghana.
- Ophthalmology Unit, Department of Surgery, Korle Bu Teaching Hospital, Korle Bu, Accra, Ghana.
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Asare AA, Otchi E, Manu A. Relevance of meeting general outpatients' information needs to their perceptions of healthcare quality in a hospital in Ghana: a Healthcare Quality Survey using modified SERVQUAL analysis. BMJ Open Qual 2024; 13:e002683. [PMID: 38858077 PMCID: PMC11168125 DOI: 10.1136/bmjoq-2023-002683] [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: 11/10/2023] [Accepted: 05/28/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND Patients determine quality of healthcare by their perception of the gap between the healthcare they experience/receive and that which they expect. This can be influenced by the ability of healthcare staff to adequately communicate information about the healthcare provided. This study assessed the level of relevance of meeting patients' information needs with respect to their assessment of healthcare quality in a private hospital's general outpatient department in Ghana. DESIGN Study design was cross-sectional using exit self-administered questionnaires among 390 outpatients. Healthcare quality was measured using a modified form of the Service Quality model gap analysis (gap between experience and expectations). A negative gap signifies unmet patient expectations. Microsoft Excel and Stata V.15.0 were used for analysis using t-test and multiple linear regression. A p value ≤0.05 denotes statistical significance. FINDINGS The mean percentage of patients' expectations of quality of healthcare was 87.6% (SE 0.031), while patient experience was 86.0% (SE 0.029), with a significant negative gap of -0.08 (p<0.002). Their highest expectation of the quality of healthcare was for their information needs to be met, with a mean score of 4.44 (SE 0.03). Two of the four items under the information needs dimension that showed no statistically significant gaps were 'saying all their problems' (gap=0.00; p<0.9) and 'explanation of treatment/medications' (gap=0.01; p<0.6). Those with statistically significant negative gaps were 'explanation of investigations and procedures' (gap=-0.18; p<0.0001) and 'explanation of the diagnoses' (gap=-0.11; p<0.02), signifying unmet expectations. CONCLUSIONS The outpatient's greatest need for quality healthcare in this study was for their information needs to be met. Providing information on patient diagnoses and investigations are the areas least likely to be adequately communicated to patients.
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Affiliation(s)
| | - Elom Otchi
- Quality Management Unit, Korle Bu Teaching Hospital, Accra, Ghana
- Quality and Patient Safety, Africa Institute of Healthcare Quality Safety & Accreditation, Accra, Ghana
| | - Adom Manu
- School of Public Health, University of Ghana, Legon, Ghana
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Moldovan F, Moldovan L. An Orthopedic Healthcare Facility Governance Assessed with a New Indicator System. Healthcare (Basel) 2024; 12:1080. [PMID: 38891155 PMCID: PMC11172014 DOI: 10.3390/healthcare12111080] [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: 04/18/2024] [Revised: 05/17/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND AND OBJECTIVES A sustainability-oriented hospital governance has the potential to increase the efficiency of healthcare services and reduce the volume of expenses. The objective of this research is to develop a new complex tool for evaluating healthcare facility governance as a component of social responsibility, integrated into sustainability. MATERIALS AND METHODS We designed the research to develop the domains of a new reference framework for evaluating healthcare facility governance. The methodology for designing the indicators that make up the new reference framework consists of collecting and processing the most recent and relevant practices regarding the governance of healthcare facilities that have been reported by representative hospitals around the world. RESULTS We designed eight indicators that are brought together in the healthcare facility governance indicators matrix. They have descriptions and qualitative and quantitative rating scales with values from 0 to 5 that allow the degree of fulfillment to be quantified. The importance of the indicators is evaluated on a specific scale described qualitatively and quantitatively by values from 0 to 5. The values of the degree of achievement-importance couples of the indicators allow the development of improvement measures with priority according to the results revealed by the Eisenhower-type assessment diagram. CONCLUSIONS Validation in practice of the system of indicators at an emergency hospital in an orthopedic profile highlighted the fact that they can be integrated into other national and international reference frameworks implemented in the hospital. The added value of the implementation consists of the facilitation of sustainable development and the orientation of health personnel, patients, and interested parties toward sustainability.
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Affiliation(s)
- Flaviu Moldovan
- Orthopedics-Traumatology Department, Faculty of Medicine, "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Liviu Moldovan
- Faculty of Engineering and Information Technology, "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
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Malik S, Arutla V, Alamin T, Warraich F, Syed TA, Nepal M, Ashraf MF, Dunnigan KJ. Beyond the Diagnosis: A Deep Dive Into the End Stage Liver Disease Experience From the Patient Perspective. Am J Hosp Palliat Care 2024:10499091241256629. [PMID: 38780457 DOI: 10.1177/10499091241256629] [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: 05/25/2024] Open
Abstract
INTRODUCTION End-stage liver disease (ESLD) presents a multifaceted challenge that encompasses not only physical but also emotional, psychological, and social dimensions. This study aims to explore the experiences of ESLD patients within the United States healthcare system. METHODS Utilizing a convenience sampling methodology, 15 ESLD patients from a tertiary care hospital in the USA participated in semi-structured interviews between April 2023 and January 2024. Data analysis was conducted using MAXQDA 2023, employing a phenomenological approach to identify common themes. RESULTS The study identified six primary themes: the significance of communication style in diagnosis delivery, the crucial role of family and social support, varied understanding and preferences for palliative care, diverse attitudes towards advanced care planning, preferences for coordinated healthcare experiences, and the emotional and psychological impact of ESLD. CONCLUSION Our study underscores the complexity of ESLD patient care beyond medical treatment, highlighting the importance of clear communication, empathetic care, and the integration of family and palliative care services.
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Affiliation(s)
- Sheza Malik
- Internal Medicine, Rochester General Hospital, Rochester, NY, USA
| | - Venkat Arutla
- Internal Medicine, Rochester General Hospital, Rochester, NY, USA
| | - Tariq Alamin
- Internal Medicine, Rochester General Hospital, Rochester, NY, USA
| | - Fatima Warraich
- Gastroenterology & Hepatology, Rochester General Hospital, Rochester, NY, USA
| | - Tausif A Syed
- Gastroenterology & Hepatology, Rochester General Hospital, Rochester, NY, USA
| | - Mahesh Nepal
- Gastroenterology & Hepatology, Rochester General Hospital, Rochester, NY, USA
| | | | - Karin J Dunnigan
- Gastroenterology & Hepatology, Rochester General Hospital, Rochester, NY, USA
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Sharma S, White C, Appavoo S, Yong-Hing CJ. Optimizing Patient-Centered Care in Breast Imaging: Strategies for Improving Patient Experience. Acad Radiol 2024:S1076-6332(24)00278-2. [PMID: 38760272 DOI: 10.1016/j.acra.2024.04.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/19/2024]
Affiliation(s)
- Sonali Sharma
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Cheryl White
- Community Access to Ventilation Information (CAVI), Toronto, Canada
| | - Shushiela Appavoo
- Department of Radiology and Diagnostic Imaging, University of Alberta, 2A2.41 WMC 8440-112 Street, Edmonton, Alberta, AB T6G 2B7, Canada
| | - Charlotte J Yong-Hing
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Diagnostic Imaging, BC Cancer, Vancouver, British Columbia, Canada
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Wang J, Chen L, Wang Z, Fang X, Zhen Y. Perceptions, Attitudes, Beliefs, and Practices Toward Traditional Chinese Medicine Therapies for Herpes Zoster: A Cross-Sectional Study of Healthcare Professionals. Risk Manag Healthc Policy 2024; 17:1239-1251. [PMID: 38765781 PMCID: PMC11102122 DOI: 10.2147/rmhp.s461149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/05/2024] [Indexed: 05/22/2024] Open
Abstract
Introduction Traditional Chinese medicine (TCM) holds great potential in promoting healing and relieving pain for herpes zoster (HZ) treatments. Evidence showed that both healthcare professionals' (HCPs) belief and knowledge influence their attitudes, which result in their expression and direct behavior. However, little is known in this area regarding TCM treatments for HZ. This study aimed to understand the HCPs' perceptions, attitudes, beliefs, and practices toward TCM and its services for HZ. Methods During July 2021 and October 2022, a cross-sectional study of HCPs querying demographics, perceptions, attitudes, beliefs, and practices toward TCM and TCM services for HZ was conducted. The frequency and percentage or mean and standard deviation were used to present categorical data and continuous data, respectively. A Chi-square analysis compared nurses' and doctors' views on TCM treatments for HZ. Results Out of 306 eligible respondents, 66.0% used TCM content in clinical practice less than 40% of the time. Respondents reported that there were three main advantages of TCM for HZ, including better crusting and healing, fewer side effects, and mitigating complications. A total of 41.3% (81/196) of the respondents who had cared for/treated HZ patients applied TCM treatments. The three factors most associated with referrals/providing TCM to patients were postherpetic neuralgia, early erythema or papules, and acute pain. Compared to nurses, doctors showed more endorsement of the efficacy and cost-effectiveness of TCM treatments for HZ patients. Conclusion The study found that most healthcare professionals in HZ had a favorable view of TCM, but lacked practical experience administering it to patients. Programs should be developed to provide evidence-based TCM treatments and encourage combining TCM with Western medicine for better patient care.
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Affiliation(s)
- Jiani Wang
- School of Nursing, Sun Yat-Sen University, Guangzhou City, Guangdong Province, People’s Republic of China
| | - Liudan Chen
- Department of Traditional Chinese Medicine, Sun Yat-Sen Memorial Hospital, Guangzhou City, Guangdong Province, People’s Republic of China
| | - Zhuangfei Wang
- Department of Dermatology, Sun Yat-Sen Memorial Hospital, Guangzhou City, Guangdong Province, People’s Republic of China
| | - Xiaohong Fang
- Department of Dermatology, Sun Yat-Sen Memorial Hospital, Guangzhou City, Guangdong Province, People’s Republic of China
| | - Yan Zhen
- Department of Traditional Chinese Medicine, Sun Yat-Sen Memorial Hospital, Guangzhou City, Guangdong Province, People’s Republic of China
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Sawhney R, Proulx KR, Gerk A, Guadagno E, Poenaru D. Patient-Centered Surgical Care for Children in Low and Lower-Middle Income Countries (LMICs) - A Systematic Scoping Review of the Literature. J Pediatr Surg 2024; 59:900-907. [PMID: 38369399 DOI: 10.1016/j.jpedsurg.2024.01.040] [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: 01/13/2024] [Accepted: 01/22/2024] [Indexed: 02/20/2024]
Abstract
PURPOSE Studies exploring patient-centered care (PCC) in pediatric surgery have been disproportionately concentrated in high-income countries. This review aims to characterize the adoption of key PCC domains in low and lower-middle income countries (LMICs). METHODS Seven databases were searched from inception until January 2023 to retrieve relevant articles in pediatric surgery in LMICs. We focused on six key PCC domains: patient-reported outcomes (PROs), patient-reported experiences (PREs), shared decision-making (SDM), patient/parent education, patient/parent satisfaction, and informed consent. RESULTS Of 8050 studies screened, 230 underwent full-text review, and 48 were finally included. Most were single-center (87.5%), cross-sectional studies (41.7%) from the South-East Asian (35.4%) and Eastern Mediterranean regions (33.3%). Studies most frequently focused on postoperative care (45.8%) in pediatric general surgery (18.8%), and included 1-3 PCC domains. PREs (n = 30), PROs (n = 16) and patient/parent satisfaction (n = 16) were most common. Informed consent (n = 2) and SDM (n = 1) were least studied. Only 13 studies directly elicited children's perspectives. Despite all studies originating in LMICs, 25% of first and 17.8% of senior authors lacked LMIC affiliations. CONCLUSION The adoption of PCC in LMICs appears limited, focusing predominantly on PROs and PREs. Other domains such as informed consent and SDM are rarely addressed, and the voice of children and young people is rarely heard in their care. Opportunities to enhance PCC in LMICs abound, with the potential to improve the surgical care of children in resource-limited settings. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Riya Sawhney
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
| | - Kacylia Roy Proulx
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Ayla Gerk
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Elena Guadagno
- Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
| | - Dan Poenaru
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada; Harvey E. Beardmore Division of Pediatric Surgery, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada
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Salam B, Kravchenko D, Nowak S, Sprinkart AM, Weinhold L, Odenthal A, Mesropyan N, Bischoff LM, Attenberger U, Kuetting DL, Luetkens JA, Isaak A. Generative Pre-trained Transformer 4 makes cardiovascular magnetic resonance reports easy to understand. J Cardiovasc Magn Reson 2024; 26:101035. [PMID: 38460841 PMCID: PMC10981113 DOI: 10.1016/j.jocmr.2024.101035] [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: 11/24/2023] [Revised: 02/19/2024] [Accepted: 03/05/2024] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND Patients are increasingly using Generative Pre-trained Transformer 4 (GPT-4) to better understand their own radiology findings. PURPOSE To evaluate the performance of GPT-4 in transforming cardiovascular magnetic resonance (CMR) reports into text that is comprehensible to medical laypersons. METHODS ChatGPT with GPT-4 architecture was used to generate three different explained versions of 20 various CMR reports (n = 60) using the same prompt: "Explain the radiology report in a language understandable to a medical layperson". Two cardiovascular radiologists evaluated understandability, factual correctness, completeness of relevant findings, and lack of potential harm, while 13 medical laypersons evaluated the understandability of the original and the GPT-4 reports on a Likert scale (1 "strongly disagree", 5 "strongly agree"). Readability was measured using the Automated Readability Index (ARI). Linear mixed-effects models (values given as median [interquartile range]) and intraclass correlation coefficient (ICC) were used for statistical analysis. RESULTS GPT-4 reports were generated on average in 52 s ± 13. GPT-4 reports achieved a lower ARI score (10 [9-12] vs 5 [4-6]; p < 0.001) and were subjectively easier to understand for laypersons than original reports (1 [1] vs 4 [4,5]; p < 0.001). Eighteen out of 20 (90%) standard CMR reports and 2/60 (3%) GPT-generated reports had an ARI score corresponding to the 8th grade level or higher. Radiologists' ratings of the GPT-4 reports reached high levels for correctness (5 [4, 5]), completeness (5 [5]), and lack of potential harm (5 [5]); with "strong agreement" for factual correctness in 94% (113/120) and completeness of relevant findings in 81% (97/120) of reports. Test-retest agreement for layperson understandability ratings between the three simplified reports generated from the same original report was substantial (ICC: 0.62; p < 0.001). Interrater agreement between radiologists was almost perfect for lack of potential harm (ICC: 0.93, p < 0.001) and moderate to substantial for completeness (ICC: 0.76, p < 0.001) and factual correctness (ICC: 0.55, p < 0.001). CONCLUSION GPT-4 can reliably transform complex CMR reports into more understandable, layperson-friendly language while largely maintaining factual correctness and completeness, and can thus help convey patient-relevant radiology information in an easy-to-understand manner.
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Affiliation(s)
- Babak Salam
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Quantitative Imaging Lab Bonn (QILaB), University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Dmitrij Kravchenko
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Quantitative Imaging Lab Bonn (QILaB), University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Sebastian Nowak
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Quantitative Imaging Lab Bonn (QILaB), University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Alois M Sprinkart
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Quantitative Imaging Lab Bonn (QILaB), University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Leonie Weinhold
- University Hospital Bonn, Department of Medical Biometry, Informatics, and Epidemiology, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Anna Odenthal
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Narine Mesropyan
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Quantitative Imaging Lab Bonn (QILaB), University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Leon M Bischoff
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Quantitative Imaging Lab Bonn (QILaB), University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Ulrike Attenberger
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Daniel L Kuetting
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Quantitative Imaging Lab Bonn (QILaB), University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Julian A Luetkens
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Quantitative Imaging Lab Bonn (QILaB), University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Alexander Isaak
- Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Quantitative Imaging Lab Bonn (QILaB), University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany.
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Hamilton DK. Balancing Universal Constants With Regional and Cultural Expectations. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2024; 17:249-252. [PMID: 37964567 DOI: 10.1177/19375867231211889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Affiliation(s)
- D Kirk Hamilton
- School of Architecture, Texas A&M University, College Station, TX, USA
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15
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Malhotra R, Tan YW, Suppiah SD, Tay SSC, Tan NC, Liu J, Koh GCH, Chan A, Vaillancourt R. Pharmaceutical pictograms: User-centred redesign, selection and validation. PEC INNOVATION 2023; 2:100116. [PMID: 37214531 PMCID: PMC10194347 DOI: 10.1016/j.pecinn.2022.100116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 11/07/2022] [Accepted: 12/07/2022] [Indexed: 05/24/2023]
Abstract
Objective In an earlier study, several tested International Pharmaceutical Federation (FIP) pictograms did not achieve validity among older adults in Singapore. In this study, for 27 unvalidated FIP pictograms, we (1) developed variants of each pictogram, (2) elicited the most-preferred variant, and (3) assessed the validity of the most-preferred variant among older Singaporeans. Methods In phase 1, up to three variants of the 27 pictograms were developed, based on older adults' feedback from a previous study. In phase 2, the most-preferred variant of 26 pictograms, which had two or three variants, was selected by 100 older participants. In phase 3, the 27 most-preferred variants (including the pictogram with only one variant) were assessed for validity - transparency and translucency - among 278 older participants (10 pictograms per participant). To evaluate transparency, participants were first asked: "If you see this picture on a medicine label, what do you think it means?" for each assigned pictogram. If they responded, they were asked, "How do you know?", and if not, they were told, "Tell me everything you see in this picture". Then, participants were shown their assigned pictograms again, one by one, and the pictogram's intended meaning was revealed to evaluate translucency. Pictograms were classified as valid (≥66% participants interpreted its intended meaning correctly [transparency criterion] and ≥85% participants rated its representativeness as ≥ 5 [translucency criterion]), partially valid (only transparency criterion fulfilled) or not valid. Results In phase 1, 77 variants of the 27 pictograms were developed. In phase 2, a majority of the most-preferred variants were selected by >50% participants. In phase 3, 10 (37.0%) of the 27 pictograms tested were considered valid, and five (18.5%) were partially valid. A higher proportion of pictograms portraying dose and route of administration and precautions were valid or partially valid, versus those depicting indications or side effects. Conclusion Contextual redesigning and selection of pharmaceutical pictograms, which initially failed to achieve validity in a population, contributed to their validation. Innovation The redesigned validated pictograms from this study can be incorporated into relevant patient information materials in clinical practice.
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Affiliation(s)
- Rahul Malhotra
- Centre for Ageing Research & Education, Duke-NUS Medical School, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Yi Wen Tan
- Centre for Ageing Research & Education, Duke-NUS Medical School, Singapore
| | | | | | | | | | | | - Alexandre Chan
- Department of Clinical Pharmacy Practice, University of California, Irvine, USA
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Malhotra R, Suppiah SD, Tan YW, Sung P, Tay SSC, Tan NC, Koh GCH, Chan A, Chew LST, Ozdemir S. Older adult patient preferences for the content and format of prescription medication labels - A best-worst scaling and discrete choice experiment study. Res Social Adm Pharm 2023; 19:1455-1464. [PMID: 37507340 DOI: 10.1016/j.sapharm.2023.07.009] [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: 03/01/2023] [Revised: 06/28/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023]
Abstract
BACKGROUND Patient preferences for the content and format of prescription medication labels (PMLs, i.e., sticker labels placed on medication bottles/packets at dispensing) have been extensively studied. However, accommodating all preferences on PMLs is impractical due to space limitations. Understanding how patients prioritise the content and format attributes of PMLs can inform improvements while working within PML space constraints. OBJECTIVES We aimed to (1) identify a ranking of medication-related content attributes to be prioritised on PMLs using best-worst scaling (BWS), and (2) determine the relative importance of format attributes when incorporated onto PMLs using discrete choice experiment (DCE), from the perspective of older adult patients in Singapore. METHODS Attributes were informed by our prior qualitative study and PML best practice guidelines. For the BWS component, the assessed content attributes were indication, precautions, interaction or paired medicines, food instructions, side effects, expiry date, and missed dose action, all of which are currently not legally mandated on PMLs in Singapore. A BWS object case was used to rank the content attributes. For the DCE component, in a series of questions, participants were asked to choose between two PML options each time, that varied in the presentation of dosage-frequency instructions, font size, presentation of dosage, presentation of precautions, and font colour of precautions. A mixed logit model estimated the relative utilities of format attribute levels, enabling the calculation of importance scores of the format attributes. RESULTS The study recruited 280 participants (mean age: 68.8 ± 5.4 years). The three most-preferred content attributes were indication, precautions and interaction or paired medicines. The top three format preferences were tabular style presentation of dosage-frequency instructions, large font size and precautions in red colour. CONCLUSIONS Healthcare institutions should consider improving their PMLs based on the leading content and format preferences voiced by older adult patients. The methodology adopted in the study can also be used for aligning the content and format of other patient education materials with patient preferences.
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Affiliation(s)
- Rahul Malhotra
- Centre for Ageing Research & Education, Duke-NUS Medical School, Singapore; Signature Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore.
| | | | - Yi Wen Tan
- Centre for Ageing Research & Education, Duke-NUS Medical School, Singapore
| | - Pildoo Sung
- Centre for Ageing Research & Education, Duke-NUS Medical School, Singapore
| | | | | | | | - Alexandre Chan
- Department of Clinical Pharmacy Practice, University of California, USA
| | - Lita Sui Tjien Chew
- Department of Pharmacy, National Cancer Centre Singapore, Singapore; Department of Pharmacy, National University of Singapore, Singapore
| | - Semra Ozdemir
- Signature Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore; Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore; Department of Population Health Sciences, Duke Clinical Research Institute, Duke University, Durham, NC, USA
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17
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Tokede B, Yansane A, Ibarra-Noriega A, Mullins J, Simmons K, Skourtes N, Mehta U, Tungare S, Holmes D, White J, Walji M, Kalenderian E. Evaluating the Impact of an mHealth Platform for Managing Acute Postoperative Dental Pain: Randomized Controlled Trial. JMIR Mhealth Uhealth 2023; 11:e49677. [PMID: 37933185 PMCID: PMC10644946 DOI: 10.2196/49677] [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: 06/05/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 11/08/2023] Open
Abstract
Background Postoperative dental pain is pervasive and can affect a patient's quality of life. Adopting a patient-centric approach to pain management involves having contemporaneous information about the patient's experience of pain and using it to personalize care. Objective In this study, we evaluated the use of a mobile health (mHealth) platform to collect pain-related patient-reported outcomes over 7 days after the patients underwent pain-inducing dental procedures; we then relayed the information to the dentist and determined its impact on the patient's pain experience. Methods The study used a cluster-randomized experimental study design with an intervention arm where patients were prompted to complete a series of questions relating to their pain experience after receiving automated text notifications on their smartphone on days 1, 3, 5, and 7, with the resulting information fed back to dentists, and a control arm where patients received usual care. Providers were randomized, and patients subsequently assumed the enrollment status of their providers. Providers or their staff identified eligible patients and invited them to participate in the study. Provider interviews and surveys were conducted to evaluate acceptance of the mHealth platform. Results A total of 42 providers and 1525 patients participated. For the primary outcome (pain intensity on a 1 to 10 scale, with 10 being the most painful), intervention group patients reported an average pain intensity of 4.8 (SD 2.6), while those in the control group reported an average pain intensity of 4.7 (SD 2.8). These differences were not significant. There were also no significant differences in secondary outcomes, including pain interference with activity or sleep, patient satisfaction with pain management, or opioid prescribing. Patient surveys revealed reluctance to use the app was mostly due to technological challenges, data privacy concerns, and a preference for phone calls over texting. Providers had high satisfaction with the app and suggested integrating additional features, such as an in-system camera for patients to upload pictures and videos of the procedural site, and integration with the electronic health record system. Conclusions While the mHealth platform did not have a significant impact on acute postoperative pain experience, patients and providers indicated improvement in patient-provider communication, patient-provider relationship, postoperative complication management, and ability to manage pain medication prescribing. Expanded collaboration between mHealth developers and frontline health care providers can facilitate the applicability of these platforms, further help improve its integration with the normal clinic workflow, and assist in moving toward a more patient-centric approach to pain management.
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Affiliation(s)
- Bunmi Tokede
- The University of Texas Health Science Center, HoustonTX, United States
| | - Alfa Yansane
- School of Dentistry, University of California San Francisco, San FranciscoCA, United States
| | | | | | | | | | - Urvi Mehta
- The University of Texas Health Science Center, HoustonTX, United States
| | - Sayali Tungare
- The University of Texas Health Science Center, HoustonTX, United States
| | | | - Joel White
- School of Dentistry, University of California San Francisco, San FranciscoCA, United States
| | - Muhammad Walji
- The University of Texas Health Science Center, HoustonTX, United States
| | - Elsbeth Kalenderian
- School of Dentistry, University of California San Francisco, San FranciscoCA, United States
- Harvard School of Dental Medicine, BostonMA, United States
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Rodriguez Castells M, Baraibar I, Ros J, Saoudi N, Salvà F, García A, Alcaraz A, Tabernero J, Élez E. The impact of clinical and translational research on the quality of life during the metastatic colorectal cancer patient journey. Front Oncol 2023; 13:1272561. [PMID: 37909013 PMCID: PMC10614292 DOI: 10.3389/fonc.2023.1272561] [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: 08/04/2023] [Accepted: 09/30/2023] [Indexed: 11/02/2023] Open
Abstract
The journey of metastatic colorectal cancer patients is complex and challenging, requiring coordination and collaboration between multiple healthcare providers. Understanding patients' needs, fears, feelings, concerns, and behaviors is essential for providing individualized patient-centered care. In recent years, mCRC patients have experienced improvements in clinical outcomes, from 16 months of overall survival to 32 months, thanks to research. However, there is still room for improvement, and integrating clinical and translational research into routine practice can help patients benefit from treatments and techniques that would not be an option. In the Journey of mCRC patients, living well with cancer and quality of life becomes a priority given the outcomes of the disease. Patient reported outcomes (PRO) and Patient Reported Outcome Measures (PROMs) are becoming therefore new estimands in Oncology. Patient advocates represent important figures in this process by prioritizing issues and research questions; evaluating research designs and the performance of the research; the analysis and interpretation of data; and how results are disseminated. Multidisciplinary Tumor Boards and shared decision-making is essential for designing treatment strategies for individual patients. Quality of Life is often prioritized only when it comes to refractory advanced disease and end-of-life care, but it has to be integrated from the beginning, as the emotional impact of diagnosis leads to a vulnerable situation where patients' needs and preferences can be easily overseen. First-line treatment will be chosen among more treatment options than subsequent lines, with longer progression-free survival and a bigger impact on the outcomes. Practicing patient-centered care and optimizing first-line treatment for colorectal cancer patients requires a comprehensive understanding of patient experience and treatment outcomes, which can guide clinical practice and inform regulatory decisions for the benefit of patients.
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Affiliation(s)
- Marta Rodriguez Castells
- Medical Oncology Department, Vall d’Hebron University Hospital, Barcelona, Spain
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Iosune Baraibar
- Medical Oncology Department, Vall d’Hebron University Hospital, Barcelona, Spain
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Javier Ros
- Medical Oncology Department, Vall d’Hebron University Hospital, Barcelona, Spain
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Nadia Saoudi
- Medical Oncology Department, Vall d’Hebron University Hospital, Barcelona, Spain
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Francesc Salvà
- Medical Oncology Department, Vall d’Hebron University Hospital, Barcelona, Spain
| | - Ariadna García
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Adriana Alcaraz
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Josep Tabernero
- Medical Oncology Department, Vall d’Hebron University Hospital, Barcelona, Spain
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Elena Élez
- Medical Oncology Department, Vall d’Hebron University Hospital, Barcelona, Spain
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
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Kattouw CE, Aase K, Viksveen P. Stakeholder perspectives on the preferred service ecosystem for senior citizens living at home: a qualitative interview study. BMC Geriatr 2023; 23:576. [PMID: 37726648 PMCID: PMC10508029 DOI: 10.1186/s12877-023-04303-4] [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: 02/15/2023] [Accepted: 09/09/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Most senior citizens want to live independently at home as long as possible. The World Health Organization recommends an age-friendly community approach by transforming the service ecosystem for senior citizens and basing it on the question "What matters to you?". However, there is limited research-based knowledge to determine the characteristics of the preferred service ecosystem from the perspectives of multiple stakeholders. Therefore, the aim of the study was to gain a deeper understanding of multiple stakeholder perspectives on the preferred service ecosystem for senior citizens living at home. METHODS Four stakeholder groups (n = 57) from a Norwegian municipality participated in an interview study in 2019 and 2020: senior citizens, carers, healthcare professionals, and managers. Data were analysed according to qualitative content analysis. RESULTS Overall, there was considerable correspondence between the four stakeholder groups' perspectives on the preferred service ecosystem for senior citizens. Six themes were developed: (1) "self-reliance - living independently at home as long as possible"; (2) "remaining active and social within the community"; (3) "support for living at home as long as possible"; (4) "accessible information and services"; (5) "continuity of services"; and (6) "compassionate and competent healthcare professionals". CONCLUSIONS In order to adapt and meet changing needs, the preferred service ecosystem should support senior citizens' autonomy through interpersonal relationships and involvement. Healthcare managers and decision makers should consider a broader range of practical and social support services. Municipalities should plan for and develop age-friendly infrastructures, while healthcare professionals should rely on their compassion and competence to meet senior citizens' needs.
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Affiliation(s)
- Christophe Eward Kattouw
- Department of Quality and Health Technology, Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Post Box 8600, Forus, Stavanger, 4036, Norway.
| | - Karina Aase
- Department of Quality and Health Technology, Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Post Box 8600, Forus, Stavanger, 4036, Norway
| | - Petter Viksveen
- Department of Quality and Health Technology, Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Post Box 8600, Forus, Stavanger, 4036, Norway
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Hurvitz N, Ilan Y. The Constrained-Disorder Principle Assists in Overcoming Significant Challenges in Digital Health: Moving from "Nice to Have" to Mandatory Systems. Clin Pract 2023; 13:994-1014. [PMID: 37623270 PMCID: PMC10453547 DOI: 10.3390/clinpract13040089] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/16/2023] [Accepted: 08/18/2023] [Indexed: 08/26/2023] Open
Abstract
The success of artificial intelligence depends on whether it can penetrate the boundaries of evidence-based medicine, the lack of policies, and the resistance of medical professionals to its use. The failure of digital health to meet expectations requires rethinking some of the challenges faced. We discuss some of the most significant challenges faced by patients, physicians, payers, pharmaceutical companies, and health systems in the digital world. The goal of healthcare systems is to improve outcomes. Assisting in diagnosing, collecting data, and simplifying processes is a "nice to have" tool, but it is not essential. Many of these systems have yet to be shown to improve outcomes. Current outcome-based expectations and economic constraints make "nice to have," "assists," and "ease processes" insufficient. Complex biological systems are defined by their inherent disorder, bounded by dynamic boundaries, as described by the constrained disorder principle (CDP). It provides a platform for correcting systems' malfunctions by regulating their degree of variability. A CDP-based second-generation artificial intelligence system provides solutions to some challenges digital health faces. Therapeutic interventions are held to improve outcomes with these systems. In addition to improving clinically meaningful endpoints, CDP-based second-generation algorithms ensure patient and physician engagement and reduce the health system's costs.
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Affiliation(s)
| | - Yaron Ilan
- Hadassah Medical Center, Department of Medicine, Faculty of Medicine, Hebrew University, POB 1200, Jerusalem IL91120, Israel;
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21
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Andraka-Christou B, Atkins DN, Shields MC, Golan OK, Totaram R, Cortelyou K, Lambie GW, Mazurenko O. Key person-centered care domains for residential substance use disorder treatment facilities: former clients' perspectives. Subst Abuse Treat Prev Policy 2023; 18:45. [PMID: 37461114 DOI: 10.1186/s13011-023-00554-x] [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: 03/13/2023] [Accepted: 07/12/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND While person-centered care (PCC) includes multiple domains, residential substance use disorder (SUD) treatment clients may value certain domains over others. We sought to identify the PCC domains most valued by former residential SUD treatment clients. We also sought to explore conceptual distinctions between potential theoretical PCC subdomains. METHODS We distributed an online survey via social media to a national convenience sample of former residential SUD treatment clients. Respondents were presented with ten PCC domains in an online survey: (a) access to evidence-based care; (b) integration of care; (c) diversity/respect for other cultures; (d) individualization of care; (e) emotional support; (f) family involvement in treatment; (g) transitional services; (h) aftercare; (i) physical comfort; and (j) information provision. Respondents were asked to select up to two domains they deemed most important to their residential SUD treatment experience. We used descriptive statistics to identify response frequencies and logistic regression to predict relationships between selected domains and respondents' race, gender, relationship status, parenting status, and housing stability. RESULTS Our final sample included 435 former residential SUD treatment clients. Diversity and respect for different cultures was the most frequently selected domain (29%), followed by integration of care (26%), emotional support (26%), and individualization of care (26%). Provision of information was the least frequently chosen domain (3%). Race and ethnicity were not predictive of selecting respect for diversity. Also, parental status, relationship status and gender were not predictive of selecting family integration. Employment and housing status were not predictive of selecting transitional services. CONCLUSIONS While residential SUD treatment facilities should seek to implement PCC across all domains, our results suggest facilities should prioritize (a) operationalizing diversity, (b) integration of care, and (c) emotional support. Significant heterogeneity exists regarding PCC domains deemed most important to clients. PCC domains valued by clients cannot be easily predicted based on client demographics.
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Affiliation(s)
- Barbara Andraka-Christou
- School of Global Health Management & Informatics, University of Central Florida, 525 W Livingston Street, Suite 401, Orlando, FL, 32801, USA.
- Department of Internal Medicine, University of Central Florida, Orlando, FL, USA.
| | - Danielle N Atkins
- Askew School of Public Administration, Florida State University, Tallahassee, FL, USA
| | - Morgan C Shields
- Brown School, Washington University in St. Louis, St. Louis, United States
| | - Olivia K Golan
- School of Public Health, Georgia State University, Atlanta, Georgia
| | - Rachel Totaram
- School of Global Health Management & Informatics, University of Central Florida, 525 W Livingston Street, Suite 401, Orlando, FL, 32801, USA
| | - Kendall Cortelyou
- School of Global Health Management & Informatics, University of Central Florida, 525 W Livingston Street, Suite 401, Orlando, FL, 32801, USA
| | - Glenn W Lambie
- Department of Counselor Education & School Psychology, University of Central Florida, Orlando, FL, USA
| | - Olena Mazurenko
- Department of Health Policy & Management, Fairbanks School of Public Health, Indiana University, Indianapolis, IN, USA
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Alomran A, Alyousefi N. Attitudes of Family Medicine Trainees Towards Patient-Centeredness Practice. Int J Gen Med 2023; 16:329-336. [PMID: 36726363 PMCID: PMC9885767 DOI: 10.2147/ijgm.s400820] [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] [Received: 12/08/2022] [Accepted: 01/18/2023] [Indexed: 01/28/2023] Open
Abstract
Objective The interaction between physicians and patients is essential in clinical practice. Patient-centered care (PCC) is becoming popular in healthcare and provides an approach to deliver high-quality healthcare to yield positive clinical outcomes. This study explores family medicine residents' attitudes toward the physician-patient relationship and patient-centered care and the possible influence of demographic characteristics, level of training, school of graduation, and previous training. Methods A cross-sectional study was conducted among family medicine residents in Riyadh. They were invited to enroll in a web-based survey that includes demographic data, training details, and the "Patient Practitioner Orientation Scale (PPOS).". Results A total of 114 family medicine residents completed the survey. There were 68 (59.6%) males and 46 (40.4%) female residents. The overall PPOS was 4.23 ± 0.53. The mean score for sharing domain was 3.97 ± 0.66. The caring domain scored 4.49 ± 0.57. No correlations were found between the residents' demographic data and other included variables, and the means of sharing domain, caring domain, and overall score. Conclusion Family medicine residents were found to have positive attitudes toward patient-centeredness. Integrating patient-centered training early in the curriculum can improve healthcare students' and trainees' attitudes toward patient-centered care. Future research can explore the possible interventions in systematic assessment and training programs that can improve PCP.
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Affiliation(s)
- Amal Alomran
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia,Department of Family and Community Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia,Correspondence: Amal Alomran, Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, 11362, Saudi Arabia, Tel +966114670836, Email
| | - Nada Alyousefi
- Department of Family and Community Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia,Department of Family and Community Medicine, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia
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da Silva-Brandao RR, de Oliveira SM, Correa JS, Zago LF, Fracolli LA, Padoveze MC, Currea GCC. Coping with in-locus factors and systemic contradictions affecting antibiotic prescription and dispensing practices in primary care-A qualitative One Health study in Brazil. PLoS One 2023; 18:e0280575. [PMID: 36662722 PMCID: PMC9857971 DOI: 10.1371/journal.pone.0280575] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 01/04/2023] [Indexed: 01/21/2023] Open
Abstract
Antimicrobial resistance (AMR) is an increasing threat to global health. The risks and sanitary consequences of AMR are disproportionately experienced by those living in Low- and Middle-Income Countries (LMICs). While addressing antibiotic use has largely been documented in hospital settings, the understanding of social drivers affecting antibiotic prescribing and dispensing practices in the context of human and animal health in primary care (PC) in LMICs remains extremely limited. We seek to explore how in-locus and multi-level social factors influence antibiotic prescriptions and dispensing practices in the context of human and animal health in primary care in Brazil. This is a baseline qualitative One Health study; semi-structured interviews and field observations were undertaken in primary care sites located in a socioeconomically vulnerable area in the city of São Paulo, the most populated city of Brazil. Twenty-five human and animal healthcare professionals (HP) were purposely sampled. Interview data were subject to thematic analysis. Three overlapping social drivers were identified across HPs' discourses: individual and behavioral challenges; relational and contextual factors influencing the overprescription of antibiotics (AB); and structural barriers and systemic contradictions in the health system. As a result of the interaction between multilevel in-locus and structural and contextual factors, HPs experience contextual and territorial challenges that directly influence their risk perception, diagnosis, use of laboratorial and image exams, time and decision to undergo treatment, choice of AB and strategies in coping with AB prescriptions. Additionally, in-locus factors influencing antibiotic prescriptions and dispensing practices are intertwined with individual accounts of risk management, systemic contradictions and ambivalences in the national health system. Our findings suggest interventions tackling AB use and AMR in Brazil should consider the social context, the complex health system structure and current integrated programs and services in PC.
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Affiliation(s)
- Roberto Rubem da Silva-Brandao
- Nursing School, University of São Paulo, São Paulo, Brazil
- School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Sandi Michele de Oliveira
- Section of General Practice, Institute of Public Health, Faculty of Health and Medical Sciences University of Copenhagen, Copenhagen, Denmark
| | | | | | | | | | - Gloria Cristina Cordoba Currea
- Section of General Practice, Institute of Public Health, Faculty of Health and Medical Sciences University of Copenhagen, Copenhagen, Denmark
- Antimicrobial Research Unit, School of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Collins-Fairclough A, Barn P, Hirsch-Allen AJ, Rideout K, Shellington EM, Lo W, Lanier T, Johnson J, Butcher A, Cheong SH, Rempel C, Strydom N, Camp PG, Carlsten C. Disparities in self-reported healthcare access for airways disease in British Columbia, Canada, during the COVID-19 pandemic. Insights from a survey co-developed with people living with asthma and chronic obstructive pulmonary disease. Chron Respir Dis 2023; 20:14799731231172518. [PMID: 37171831 PMCID: PMC10184213 DOI: 10.1177/14799731231172518] [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: 05/13/2023] Open
Abstract
Patients' perspectives on the impact of the COVID-19 pandemic on their access to asthma and COPD healthcare could inform better, more equitable care delivery. We demonstrate this topic using British Columbia (BC), Canada, where the impact of the pandemic has not been described. We co-designed a cross-sectional survey with patient partners and administered it to a convenience sample of people living with asthma and COPD in BC between September 2020 and March 2021. We aimed to understand how access to healthcare for these conditions was affected during the pandemic. The survey asked respondents to report their characteristics, access to healthcare for asthma and COPD, types of services they found disrupted and telehealth (telephone or video appointment) use during the pandemic. We analysed 433 responses and found that access to healthcare for asthma and COPD was lower during the pandemic than pre-pandemic (p < 0.001). Specialty care services were most frequently reported as disrupted, while primary care, home care and diagnostics were least disrupted. Multivariable logistic regression revealed that access during the pandemic was positively associated with self-assessed financial ability (OR = 22.0, 95% CI: 7.0 - 84.0, p < 0.001, reference is disagreeing with having financial ability) and living in medium-sized urban areas (OR = 2.3, 95% CI: 1.0 - 5.2, p = 0.04, reference is rural areas). These disparities in access should be validated post-pandemic to confirm whether they still persist. They also indicate the continued relevance of exploring approaches for more equitable healthcare.
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Affiliation(s)
- Aneisha Collins-Fairclough
- Legacy for Airway Health, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
- Division of Respiratory Medicine, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Prabjit Barn
- Legacy for Airway Health, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - A J Hirsch-Allen
- Legacy for Airway Health, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
- Division of Respiratory Medicine, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Karen Rideout
- Legacy for Airway Health, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Erin M Shellington
- Legacy for Airway Health, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
- Division of Respiratory Medicine, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Winnie Lo
- Legacy for Airway Health, Community Stakeholder Committee, Vancouver, BC, Canada
| | - Tony Lanier
- Legacy for Airway Health, Community Stakeholder Committee, Vancouver, BC, Canada
| | - Jim Johnson
- Legacy for Airway Health, Community Stakeholder Committee, Vancouver, BC, Canada
| | - Adam Butcher
- Legacy for Airway Health, Community Stakeholder Committee, Vancouver, BC, Canada
| | - Sian-Hoe Cheong
- Legacy for Airway Health, Community Stakeholder Committee, Vancouver, BC, Canada
| | | | - Nardia Strydom
- Department of Family Medicine, Providence Health Care, Vancouver, BC, Canada
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Family and Community Medicine, Vancouver Coastal Health, Vancouver, BC, Canada
| | - Pat G Camp
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- Centre for Heart and Lung Innovation, University of British Columbia, Vancouver, BC, Canada
| | - Christopher Carlsten
- Legacy for Airway Health, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
- Division of Respiratory Medicine, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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Zago LF, Correa JS, da Silva‐Brandão RR, Fracolli LA, Padoveze MC, de Oliveira SM, Corboda Currea GC. Experiences of antibiotic use among Brazilian healthcare users: An exploratory study. Health Expect 2022; 26:343-354. [PMID: 36420763 PMCID: PMC9854310 DOI: 10.1111/hex.13664] [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: 08/17/2022] [Revised: 10/26/2022] [Accepted: 10/31/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION This article analyzes experiences of antibiotic use and bacterial infections among Primary Health Care users of the Brazilian Unified Health System (SUS) and the possible implications for antimicrobial resistance (AMR). The aim is to map aspects that shape users' lay knowledge regarding antibiotics use and AMR. METHODS This is an exploratory study, which consists primarily of individual in-depth interviews with 19 respondents. Recurrent interview topics were coded and analysed according to thematic content analysis. RESULTS Our findings show users' lived experiences constitute three dimensions related to users' previous antibiotic use: (1) lay knowledge about medicines; (2) previous bacterial infections and (3) communication during the consultation. Lay knowledge encompasses the users' understanding of how antibiotics work in comparison to other drugs and experimentations they make with medication. Users' narratives about bacterial infections are divided into situations of urinary tract infections and antibiotic treatments for other conditions. Communication during the consultation is mainly characterized by a lack of shared knowledge and trust in the doctor-patient relationship. DISCUSSION Users bring together knowledge learned from their own experiences to create the rationale, which shapes how they understand antibiotic use, bacterial infections and medical advice. These experiences are interwoven with information received from healthcare professionals (HPs) on these topics, creating a scenario that goes beyond professional information about antibiotic use. Users have knowledge about medication, antibiotics use and bacterial infection but do not have room to share it with HP, allowing lived experiences to take precedence over professional information. CONCLUSION Users ascribe symbolic meanings to antibiotics creating a lay knowledge frame, even if this knowledge is not scientifically correct. The personal experiences of bacterial infections and their treatment are also an important source of knowledge about antibiotic use and AMR among users. Users demand from their HPs both trust and willingness to listen to their health narratives and experiences. By considering lay knowledge as part of the assessment of a user's health condition, rather than dismissing it as erroneous and therefore unworthy of attention, HPs may enhance the compliance of users. PATIENT OR PUBLIC CONTRIBUTION Patients or community members did not participate in the design stage of the study. Primary Care patients were invited to participate as respondents of in-depth interviews, which were carried out by the first author at a Primary Care Unit (PCU) in the suburb of Campo Limpo, Southern region of São Paulo, Brazil. Patients were interviewed after reading and signing a Free and Informed Consent Form, holding with them a copy of the Form. Among the final activities of the project, a feedback session at the same PCU is planned to report on the results of the study. All respondents will have the opportunity to contribute further information regarding their antibiotic use and exchange knowledge and experiences on antimicrobial resistance.
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Affiliation(s)
- Luiz F. Zago
- Department of Nursing in Collective Health, School of NursingUniversity of São PauloSão PauloBrazil
| | - Juliana S. Correa
- Department of Nursing in Collective Health, School of NursingUniversity of São PauloSão PauloBrazil
| | | | - Lislaine A. Fracolli
- Department of Nursing in Collective Health, School of NursingUniversity of São PauloSão PauloBrazil
| | - Maria Clara Padoveze
- Department of Nursing in Collective Health, School of NursingUniversity of São PauloSão PauloBrazil
| | - Sandi Michele de Oliveira
- Section of General Practice, Institute of Public Health, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
| | - Gloria C. Corboda Currea
- Section of General Practice, Institute of Public Health, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark,Antimicrobial Research Unit, School of Health SciencesUniversity of Kwazulu‐NatalDurbanSouth Africa
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Karnieli-Miller O, Artom TR, Neufeld-Kroszynski G. Time to rise to the challenge of truly implementing patient-centered care and shared decision-making in Israel: The educational and policy mission. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2022; 171:68-73. [PMID: 35610130 DOI: 10.1016/j.zefq.2022.04.013] [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: 03/15/2022] [Revised: 04/05/2022] [Accepted: 04/15/2022] [Indexed: 06/15/2023]
Abstract
Five years ago, Israel was perceived to be on the verge of implementing shared decision making (SDM). However, as presented in this paper, SDM in Israel remains relatively unexplored, is implemented in only few research interventions, and is rarely taught in medical schools or continuing education. Furthermore, policies on patient-centered care and SDM are limited and lack clear regulations and training on how to apply them. This situation is of concern. The paper describes the current state of SDM, identifying higher-level barriers to implementation. They include the need to address healthcare professionals' attitudes regarding patients and relationships; the need to rename and clearly define SDM terminology in Hebrew; the need to place SDM in the larger context and training of PCC; and the call for the development of clear policies, regulations, and training truly to rise to the need for national implementation of PCC and SDM.
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Affiliation(s)
- Orit Karnieli-Miller
- Department of Medical Education, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Tamar R Artom
- Smokler Center for Health Policy Research, Myers-JDC-Brookdale Institute, Jerusalem, Israel
| | - Galit Neufeld-Kroszynski
- Department of Medical Education, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Briah Fund: Promoting women's rights in healthcare, Tel Aviv, Israel
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Hussen MA, Worku BT. Quality of Antenatal Care Service and Factors Associated with Client Satisfaction at Public Health Facilities of Bele Gasgar District. J Patient Exp 2022; 9:23743735221083163. [PMID: 35252558 PMCID: PMC8894960 DOI: 10.1177/23743735221083163] [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] [Indexed: 12/23/2022] Open
Abstract
Background: Quality of service and client satisfaction are crucial to increase services utilization. However, there is a paucity of data in this study area. Consequently, this study aimed to assess “Quality of Antenatal Care (ANC) and client satisfaction in Public Health Facilities”. Method: Facility-based cross-sectional study was conducted from March 11 to April 19, 2019. Systematic random sampling was used to select 366 women. Data were collected through the exit interview, data extraction, and observation. Result: Quality of ANC was 30% (95% CI = 25–35). About 55% (95% CI = 50–60) of women were satisfied with the services. Iron/folic acid supplementation (AOR = 2.23, 95% CI;1.30–4.79), measuring weight (AOR = 3.61, 95% CI = 1.40–9.31), travel time >60 min (AOR = 4, 95% CI;2.3–8.16) and 60–120 min (AOR = 3.68, 95% CI = 1.61–8.38), and consultation time (AOR = 2.89, 95% CI = 1.14–7.31) were positively associated with client satisfaction, while health professional initiation to ask question never (AOR = 0.20, 95% CI = 0.08–0.43) and to ask sometimes (AOR = 0.32, 95% CI = 0.16–0.65) were negatively associated. Conclusion: Quality of ANC was low while clients’ satisfaction was moderately low. Therefore, improvement in the area of input, process, and output is recommended.
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Affiliation(s)
| | - Bekelu Teka Worku
- Department of Population and Family Health, Jimma University, Jimma, Oromia, Ethiopia
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Omkar Prasad R, Chew T, Giri JR, Hoerauf K. Patient Experience With Vascular Access Management Informs Satisfaction With Overall Hospitalization Experience. JOURNAL OF INFUSION NURSING 2022; 45:95-103. [PMID: 35272306 PMCID: PMC8920007 DOI: 10.1097/nan.0000000000000460] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Peripheral intravenous catheter (PIVC) insertion is a common invasive procedure performed during hospitalization. The present study reports results from a survey of 544 patients who have had PIVC insertion during their hospital stay in Singapore and the Philippines during the period between November 2018 and February 2019. The survey assessed the importance of 5 domains of patient-centered care on patient satisfaction with their hospitalization experience, including pain management, infection prevention, health care provider competence with vascular access, physical comfort, and effectiveness of communication during vascular access management. Health care provider competence, infection prevention, and pain management ranked as the most important determinants of patient satisfaction. Patients were more likely to lose their trust in health care providers and express anxiety if they experienced multiple needle insertion attempts or PIVC-related complications, whereas patients who were satisfied with their PIVC insertion were more likely to express satisfaction with their overall hospital stay. Improving vascular access management with a focus on enhancing vascular access skills, infection prevention, and pain management may improve patient satisfaction.
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Affiliation(s)
- Rohini Omkar Prasad
- The Economist Intelligence Unit, The Economist Group, Singapore (Dr Prasad and Mr Chew); Becton Dickinson Central South Asia and Japan, Singapore (Dr Giri); Medical University of Vienna, Vienna, Austria (Dr Hoerauf); Becton Dickinson, Franklin Lakes, New Jersey (Dr Hoerauf)
- Rohini Omkar Prasad, MBBS, MPH, is a senior manager of health policy and clinical evidence at the Economist Intelligence Unit in Singapore. In her role, Dr Prasad manages health policy and clinical evidence projects across the Asia region
- Timothy Chew, BSc, is currently manager of regional new product planning at Menarini Asia-Pacific, Singapore. He was previously a senior associate consultant at the Economist Intelligence Unit, Singapore, at the time the study was conducted. In that role, Mr Chew managed a wide range of research and consulting projects across clients in health care services and medical devices
- Jayant R. Giri, MD, is an associate director at Becton Dickinson, Singapore, and is responsible for Medical Affairs for Becton Dickinson in Central South Asia and Japan. Dr Giri is also a certified health care quality assessor by the Quality Council of India
- Klaus Hoerauf, MD, PhD, DBA, currently serves as world-wide vice president, medical affairs, medication delivery solutions, at Becton Dickinson, USA, and holds a professorship at the Medical University of Vienna (Austria). In this role, Dr Hoerauf leads medical and scientific affairs with the main responsibility for innovation and evidence generation
| | - Timothy Chew
- The Economist Intelligence Unit, The Economist Group, Singapore (Dr Prasad and Mr Chew); Becton Dickinson Central South Asia and Japan, Singapore (Dr Giri); Medical University of Vienna, Vienna, Austria (Dr Hoerauf); Becton Dickinson, Franklin Lakes, New Jersey (Dr Hoerauf)
- Rohini Omkar Prasad, MBBS, MPH, is a senior manager of health policy and clinical evidence at the Economist Intelligence Unit in Singapore. In her role, Dr Prasad manages health policy and clinical evidence projects across the Asia region
- Timothy Chew, BSc, is currently manager of regional new product planning at Menarini Asia-Pacific, Singapore. He was previously a senior associate consultant at the Economist Intelligence Unit, Singapore, at the time the study was conducted. In that role, Mr Chew managed a wide range of research and consulting projects across clients in health care services and medical devices
- Jayant R. Giri, MD, is an associate director at Becton Dickinson, Singapore, and is responsible for Medical Affairs for Becton Dickinson in Central South Asia and Japan. Dr Giri is also a certified health care quality assessor by the Quality Council of India
- Klaus Hoerauf, MD, PhD, DBA, currently serves as world-wide vice president, medical affairs, medication delivery solutions, at Becton Dickinson, USA, and holds a professorship at the Medical University of Vienna (Austria). In this role, Dr Hoerauf leads medical and scientific affairs with the main responsibility for innovation and evidence generation
| | - Jayant R. Giri
- The Economist Intelligence Unit, The Economist Group, Singapore (Dr Prasad and Mr Chew); Becton Dickinson Central South Asia and Japan, Singapore (Dr Giri); Medical University of Vienna, Vienna, Austria (Dr Hoerauf); Becton Dickinson, Franklin Lakes, New Jersey (Dr Hoerauf)
- Rohini Omkar Prasad, MBBS, MPH, is a senior manager of health policy and clinical evidence at the Economist Intelligence Unit in Singapore. In her role, Dr Prasad manages health policy and clinical evidence projects across the Asia region
- Timothy Chew, BSc, is currently manager of regional new product planning at Menarini Asia-Pacific, Singapore. He was previously a senior associate consultant at the Economist Intelligence Unit, Singapore, at the time the study was conducted. In that role, Mr Chew managed a wide range of research and consulting projects across clients in health care services and medical devices
- Jayant R. Giri, MD, is an associate director at Becton Dickinson, Singapore, and is responsible for Medical Affairs for Becton Dickinson in Central South Asia and Japan. Dr Giri is also a certified health care quality assessor by the Quality Council of India
- Klaus Hoerauf, MD, PhD, DBA, currently serves as world-wide vice president, medical affairs, medication delivery solutions, at Becton Dickinson, USA, and holds a professorship at the Medical University of Vienna (Austria). In this role, Dr Hoerauf leads medical and scientific affairs with the main responsibility for innovation and evidence generation
| | - Klaus Hoerauf
- Corresponding Author: Klaus Hoerauf, MD, PhD, DBA, Becton Dickinson, USA, 1 Becton Dr, Franklin Lakes, NJ 07417 ()
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McNeil H, McMurray J, Byrne K, Grindrod K, Stolee P. Engagement of older adults in regional health innovation: The ECOTECH concept mapping project. SAGE Open Med 2022; 10:20503121211073333. [PMID: 35083046 PMCID: PMC8785349 DOI: 10.1177/20503121211073333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 12/20/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives: Regional health innovation ecosystems can activate collaboration and support planning, self-management and development and commercialization of innovations. We sought to understand how older adults and their caregivers can be meaningfully engaged in regional health innovation ecosystems focused on health and aging–related technology innovation. Methods: A six-phase concept mapping technique gathered data over six time points across Canada. Brainstorming conducted online and in person identified engagement ideas. Statements were sorted by similarity and rated by participants on importance and feasibility. Qualitative approaches and multidimensional scaling, hierarchical cluster analysis, descriptive statistics and t tests were used for analysis. Results: Sixty-two unique ideas were assembled into a seven-cluster framework of priorities for engagement in regional health innovation ecosystems including public forums, co-production and partnerships, engagement, linkage and exchange, developing cultural capacity, advocacy and investment in the ecosystem. Conclusions: This study identified a framework of priorities for directions and strategies for older adult and caregiver engagement in regional health innovation ecosystems. Next steps include collaborations to develop regional health innovation ecosystems that actively engage older adults and their caregivers in health and aging–related technology innovation.
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Affiliation(s)
- Heather McNeil
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Lazaridis School of Business and Economics/Health Studies, Wilfrid Laurier University, Brantford, ON, Canada
| | - Josephine McMurray
- Lazaridis School of Business and Economics/Health Studies, Wilfrid Laurier University, Brantford, ON, Canada
| | - Kerry Byrne
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Kelly Grindrod
- School of Pharmacy, University of Waterloo, Waterloo, ON, Canada
| | - Paul Stolee
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
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Hamilton DK. Design for an Evolving Patient Experience. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2022; 15:22-28. [PMID: 34974768 DOI: 10.1177/19375867211060826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- D Kirk Hamilton
- College of Architecture, Texas A&M University, College Station, TX, USA
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