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Park S, Lee Y, Kim L, Acharya SR, Kim N. Assessing Patient Satisfaction and the Need for Collaborative Treatment with Korean and Western Medicine. Healthcare (Basel) 2024; 12:1901. [PMID: 39337242 PMCID: PMC11431174 DOI: 10.3390/healthcare12181901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2024] [Revised: 09/17/2024] [Accepted: 09/19/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND The collaborative treatment of Korean medicine (KM) and Western medicine (WM) in Korea has gained prominence since its initiation. However, comprehensive evaluations of patient satisfaction and care effectiveness remain limited. Thus, this study aimed to evaluate patient satisfaction and the need for collaborative KM-WM treatment in the fourth phase of the national pilot project. METHODS A multicenter survey was conducted among 321 patients from 15 institutions participating in the fourth phase of the collaborative KM-WM pilot project, spanning from 1 August 2023 to 31 October 2023. Patient satisfaction and needs were assessed using a validated, semi-structured questionnaire with a 5-point Likert scale. Descriptive statistics and hierarchical multiple regression were used in the analysis. RESULTS The overall satisfaction with collaborative KM-WM treatment was notably high (91.25%). Among the participants, 91.58% indicated the necessity of the collaborative KM-WM pilot project, whereas 90.66% pointed out the need to incorporate inpatient services into collaborative care. Expansion of the pilot project to additional institutions and primary healthcare settings was substantially demanded (85.36% and 80.06%, respectively). Treatment effects (β, 0.344; 95% CI: 0.237-0.451), appropriate treatment time (β, 0.140; 95% CI: 0.051-0.229), medical procedural efficiency (β, 0.227; 95% CI: 0.126-0.328), and promotional activities (β, 0.175; 95% CI: 0.101-0.250) significantly contributed to overall patient satisfaction (each, p < 0.05). CONCLUSIONS The fourth phase of the KM-WM project reflects high patient satisfaction and a substantial need for collaborative treatment. Further research should include longitudinal studies and employ mixed-methods approaches to better understand, evaluate, and improve collaborative KM-WM treatment.
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Affiliation(s)
- Soyong Park
- College of Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea
| | - Yoonju Lee
- College of Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea
| | - Linae Kim
- Research Institute for Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea
| | - Shiva Raj Acharya
- Research Institute for Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea
| | - NamKwen Kim
- College of Korean Medicine, Pusan National University, Yangsan 50612, Republic of Korea
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Ibrahim AM. Nurses' ethical responsibilities: Whistleblowing and advocacy in patient safety. Nurs Ethics 2024:9697330241235306. [PMID: 38415609 DOI: 10.1177/09697330241235306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
BACKGROUND In the dynamic landscape of healthcare, nurses play a crucial role as ethical stewards, responsible for whistleblowing, nurse advocacy, and patient safety. Their duties involve ensuring patient well-being through ethical practices and advocacy initiatives. AIM This study investigates the ethical responsibilities of nurses regarding whistleblowing and advocacy in reporting concerns about patient safety. RESEARCH DESIGN A cross-sectional study utilized cluster and simple random sampling to gather a representative sample of actively practicing registered nurses. Data collection involved a demographic form, Nurse Whistleblowing Intentions Scale, Nursing Advocacy Scale, and Clinical Decision-Making Scale. PARTICIPANTS AND RESEARCH CONTEXT The study utilizing a robust sample size determination formula for reliable findings included 96 diverse nurses, predominantly females. Engaged actively in direct patient care across various outpatients clinics. The recruitment process specifically sought individuals with expertise in safety protocols and reporting, contributing to a nuanced understanding of the study's focus. ETHICAL CONSIDERATIONS Ethical approval was obtained from the ethics committee of the university and the hospitals involved. Written consent was obtained from the participants. A thorough ethical review was conducted to guarantee participant protection and adherence to ethical principles. RESULTS Surveyed nurses demonstrated positive whistleblowing (Overall Mean Score: 3.58), high advocacy (Overall Mean Score: 12.2), and nuanced ethical decision-making for patient safety (Overall Mean Score: 15.78). Demographic factors, such as nationality and ethical training, significantly impacted whistleblowing intentions, while age, gender, and ethical training correlated with nursing advocacy behavior. Associations with experience and qualification emerged in ethical decision-making. CONCLUSION The gained insights foster targeted interventions, improving ethical practices, advocacy, and informed decision-making in nursing. This study explores the intricate link between demographics and ethical considerations among surveyed nurses, acting as a catalyst for ongoing initiatives to strengthen the ethical foundation in healthcare sector.
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Sun MW, Troxell D, Tibshirani R. Public health factors help explain cross country heterogeneity in excess death during the COVID19 pandemic. Sci Rep 2023; 13:16196. [PMID: 37758827 PMCID: PMC10533501 DOI: 10.1038/s41598-023-43407-0] [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: 11/30/2022] [Accepted: 09/23/2023] [Indexed: 09/29/2023] Open
Abstract
The COVID-19 pandemic has taken a devastating toll around the world. Since January 2020, the World Health Organization estimates 14.9 million excess deaths have occurred globally. Despite this grim number quantifying the deadly impact, the underlying factors contributing to COVID-19 deaths at the population level remain unclear. Prior studies indicate that demographic factors like proportion of population older than 65 and population health explain the cross-country difference in COVID-19 deaths. However, there has not been a comprehensive analysis including variables describing government policies and COVID-19 vaccination rate. Furthermore, prior studies focus on COVID-19 death rather than excess death to assess the impact of the pandemic. Through a robust statistical modeling framework, we analyze 80 countries and show that actionable public health efforts beyond just the factors intrinsic to each country are important for explaining the cross-country heterogeneity in excess death.
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Affiliation(s)
- Min Woo Sun
- Department of Biomedical Data Science, Stanford University, 450 Serra Mall, Stanford, CA, 94305, USA.
| | - David Troxell
- Department of Statistics, Stanford University, 450 Serra Mall, Stanford, CA, 94305, USA
| | - Robert Tibshirani
- Department of Biomedical Data Science, Stanford University, 450 Serra Mall, Stanford, CA, 94305, USA
- Department of Statistics, Stanford University, 450 Serra Mall, Stanford, CA, 94305, USA
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Even D, Shvarts S. Understanding and addressing populations whose prior experience has led to mistrust in healthcare. Isr J Health Policy Res 2023; 12:15. [PMID: 37085938 PMCID: PMC10120492 DOI: 10.1186/s13584-023-00565-w] [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: 05/11/2022] [Accepted: 04/13/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Policy makers need to maintain public trust in healthcare systems in order to foster citizen engagement in recommended behaviors and treatments. The importance of such commitment has been highlighted by the recent COVID-19 pandemic. Central to public trust is the extent of the accountability of health authorities held responsible for long-term effects of past treatments. This paper addresses the topic of manifestations of trust among patients damaged by radiation treatments for ringworm. METHODS For this mixed-methods case study (quan/qual), we sampled 600 files of Israeli patients submitting claims to the National Center for Compensation of Scalp Ringworm Victims in the years 1995-2014, following damage from radiation treatments received between 1946 and 1960 in Israel and/or abroad. Qualitative data were analyzed with descriptive statistics, and correlations were analyzed with chi-square tests. Verbal data were analyzed by the use of systematic content analysis. RESULTS Among 527 patients whose files were included in the final analysis, 42% held authorities responsible. Assigning responsibility to authorities was more prevalent among claimants born in Israel than among those born and treated abroad (χ2 = 6.613, df = 1, p = 0.01), claimants reporting trauma (χ2 = 4.864, df = 1, p = 0.027), and claimants living in central cities compared with those in suburban areas (χ2 = 18.859, df = 6, p < 0.01). Men, younger claimants, patients with a psychiatric diagnosis, and patients from minority populations expressed mistrust in health regulators. CONCLUSIONS Examining populations' perceived trust in healthcare institutions and tailoring health messages to vulnerable populations can promote public trust in healthcare systems.
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Affiliation(s)
- Dan Even
- Moshe Prywes Center for Medical Education, Faculty of Health Sciences, Ben-Gurion University of the Negev, P. O. Box 653, 8410501, Beer-Sheva, Israel.
| | - Shifra Shvarts
- Moshe Prywes Center for Medical Education, Faculty of Health Sciences, Ben-Gurion University of the Negev, P. O. Box 653, 8410501, Beer-Sheva, Israel
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Akafu W, Daba T, Tesfaye E, Teshome F, Akafu T. Determinants of trust in healthcare facilities among community-based health insurance members in the Manna district of Ethiopia. BMC Public Health 2023; 23:171. [PMID: 36698154 PMCID: PMC9878736 DOI: 10.1186/s12889-023-15124-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 01/10/2023] [Accepted: 01/23/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Low-income countries, including Ethiopia, face substantial challenges in financing healthcare services to achieve universal health coverage. Consequently, millions of people suffer and die from health-related conditions. These can be efficiently managed in areas where community-based health insurance (CBHI) is properly implemented and communities have strong trust in healthcare facilities. However, the determinants of community trust in healthcare facilities have been under-researched in Ethiopia. OBJECTIVE To assess the determinants of trust in healthcare facilities among community-based health insurance members in the Manna District of Ethiopia. METHODS A community-based cross-sectional study was conducted from March 01 to 30, 2020 among 634 household heads. A multistage sampling technique was used to recruit the study participants. A structured interviewer-administered questionnaire was used to collect the data. Descriptive statistics were computed as necessary. Multivariable linear regression analyses were performed, and variables with a p-value < 0.05 were considered to have a significant association with households' trust in healthcare facilities. RESULTS In total, 617 households were included in the study, with a response rate of 97.0%. Household age (ß=0.01, 95% CI:0.001, 0.0013), satisfaction with past health services (ß=0.13, 95% CI:0.05, 0.22), perceived quality of services (ß= -0.47, 95% CI: -0.64, -0.29), perceived provider's attitude towards CBHI members (ß = -0.68, 95% CI: -0.88, -0.49), and waiting time (ß= -0.002, 95% CI:- 0.003, -0.001) were determinants of trust in healthcare facilities. CONCLUSION This study showed that respondents' satisfaction with past experiences, older household age, long waiting time, perceived poor quality of services, and perceived unfavorable attitudes of providers towards CBHI members were found to be determinants of trust in healthcare facilities. Thus, there is a need to improve the quality of health services, care providers' attitudes, and clients' satisfaction by reducing waiting time in order to increase clients' trust in healthcare facilities.
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Affiliation(s)
- Wakuma Akafu
- Department of Health Policy and Management, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Oromia Ethiopia
| | - Teferi Daba
- Department of Health Policy and Management, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Oromia Ethiopia
| | - Edosa Tesfaye
- School of Public Health, Institute of Health, Wollega University, Nekemte, Oromia Ethiopia
| | - Firanbon Teshome
- Department of Health, Behavior and Society, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Oromia Ethiopia
| | - Tesfaye Akafu
- Department of Natural Resource Management, Institute of Agriculture and Veterinary Medicine, Jimma University, Jimma, Oromia Ethiopia
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Thiagesan R, Gopichandran V, Soundari H. Ethical Framework to Address Barriers to Healthcare for People with Disabilities in India. Asian Bioeth Rev 2023; 15:1-11. [PMID: 36694541 PMCID: PMC9853476 DOI: 10.1007/s41649-023-00239-4] [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: 12/01/2022] [Revised: 01/06/2023] [Accepted: 01/10/2023] [Indexed: 01/22/2023] Open
Abstract
Disability is one of the key public health issues in India and the burden will increase given the trend of an aging population. People with disabilities experience greater vulnerability as they may develop secondary health issues. They face various barriers while accessing health services. This is a major ethical concern. In this article, we frame the barriers to healthcare provision to persons with disabilities and propose an ethical framework to address these barriers. This ethical framework is derived from the basic ethical principles of justice, fairness, trust, solidarity, stewardship, proportionality, and responsiveness. The framework proposes strategies to address these barriers to healthcare service delivery for persons with disabilities in India.
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Affiliation(s)
- Rajeswaran Thiagesan
- Centre for Applied Research, The Gandhigram Rural Institute – Deemed to be University, Dindigul, Tamil Nadu India
- Resource Group for Education and Advocacy for Community Health (REACH), Chennai, India
| | - Vijayaprasad Gopichandran
- Department of Community Medicine, ESIC Medical College & Post Graduate Institute of Medical Science and Research (PGIMSR), Chennai, India
| | - Hilaria Soundari
- Centre for Applied Research, The Gandhigram Rural Institute – Deemed to be University, Dindigul, Tamil Nadu India
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Reddy RV, Golan R, Loloi J, Diaz P, Saltzman RG, Watane A, Ramasamy R. Assessing the quality and readability of online content on shock wave therapy for erectile dysfunction. Andrologia 2022; 54:e14607. [PMID: 36240784 DOI: 10.1111/and.14607] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/07/2022] [Accepted: 09/15/2022] [Indexed: 11/28/2022] Open
Abstract
Patients are becoming increasingly reliant on online platforms for obtaining health information. Previous research has shown that the quality of information available on the internet regarding novel medical therapies is generally poor and frequently misleading. Shock wave therapy represents a novel restorative therapy for erectile dysfunction (ED) that has recently gained attention. We hypothesised that online sources regarding shock wave therapy for ED would be fraught with misleading claims and unreliable health information. Our objective was to evaluate the quality and readability of online medical information on shock wave therapy as a treatment for ED. Websites were generated using a Google search of 'shock wave therapy for erectile dysfunction' with location filters disabled. Readability was analysed using the Readable software (Readable.com, Horsham, United Kingdom). Quality was assessed independently by three reviewers using the DISCERN tool. Articles were subdivided into those from private clinic websites and those from universities or news media websites. Statistical analysis was conducted using the Student's t test. Nine articles that resulted from the Google search had mean readability scores as follows: Flesch-Kincaid grade level (10.8), Gunning-Fog Index (13.67), Coleman-Liau Index (12.74), Simple Measure of Gobbledygook (SMOG) Index (13.33), FORCAST Grade Level (11.33), and Automated Readability Index (11.08). The mean Flesch Reading Ease score was 46.4. The articles had a mean DISCERN score of 3.1, suggesting 'moderate quality' content. Articles from universities (n = 2) or news sources (n = 3) had significantly higher DISCERN scores than articles from private medical practices (n = 4). There was no difference in readability scores between the groups. Articles from private clinics are just as readable as those from universities or news media, but they are significantly more biased and misleading. The current online material relating to shock wave therapy for ED may not adequately inform patients in their medical decisions making, thereby necessitating closer collaboration between the sources disseminating information and urologists.
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Affiliation(s)
- Raghuram V Reddy
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA.,Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Roei Golan
- Department of Clinical Sciences, Florida State University College of Medicine, Tallahassee, Florida, USA
| | - Justin Loloi
- Department of Urology, Montefiore Medical Center, Bronx, New York, USA
| | - Parris Diaz
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Russell G Saltzman
- Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Arjun Watane
- Department of Ophthalmology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Ranjith Ramasamy
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
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