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Shalom T, Bashkin O, Gamus A, Blachar Y, Yaron S, Netzer D, Nevet A, Lavie G. Evaluation of Telephone Visits in Primary Care: Satisfaction of Pediatricians and Family Physicians and Their Perceptions of Quality of Care and Safety. Healthcare (Basel) 2024; 12:212. [PMID: 38255099 PMCID: PMC10815269 DOI: 10.3390/healthcare12020212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
Telehealth has accelerated since the outbreak of the COVID-19 virus. As telephone visits become more common, it is important to examine the challenges involved in using this modality of care. In this study, we examined family physicians' and pediatricians' perceptions regarding three aspects of the use of telephone visits: quality of care, safety of care, and physicians' satisfaction. A total of 342 family physicians and pediatricians responded to an online survey. Respondents were asked to rate their degree of agreement with 17 statements inquiring about quality, safety, and satisfaction with telephone visits on a Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). This was followed by in-depth interviews between January and April 2023 with 26 physicians. Participants expressed satisfaction (3.66 ± 0.80) with the use of telephone visits and lower assessments of safety (3.03 ± 0.76) and quality (2.27 ± 0.76) of care using the telephone modality. Eighty percent of the respondents think combining a face-to-face visit with a telephone visit is recommended, and 51% noted that the inability to examine patients closely affects and impedes a physician's decision making. Most interviewees indicated that telephone visits are safe only with former patients they had already seen in the clinic. The findings shed light on the perceptions of family physicians and pediatricians regarding telephone visits. The lower assessments of quality and safety compared to the assessment of satisfaction underscore the need for careful use of telephone visits in healthcare. A proper and balanced selection of patients, implementing technological upgrades to the modality, and performing patient education practices are recommended.
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Affiliation(s)
- Tamar Shalom
- Department of Health Systems Management, The College of Law and Business, Ramat Gan 52520, Israel; (A.G.); (Y.B.)
| | - Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ashkelon 78211, Israel
| | - Alexander Gamus
- Department of Health Systems Management, The College of Law and Business, Ramat Gan 52520, Israel; (A.G.); (Y.B.)
| | - Yoram Blachar
- Department of Health Systems Management, The College of Law and Business, Ramat Gan 52520, Israel; (A.G.); (Y.B.)
- Division of Community Medical Services, Clalit Health Services, Tel Aviv 62098, Israel; (S.Y.); (D.N.); (A.N.)
| | - Shlomit Yaron
- Division of Community Medical Services, Clalit Health Services, Tel Aviv 62098, Israel; (S.Y.); (D.N.); (A.N.)
| | - Doron Netzer
- Division of Community Medical Services, Clalit Health Services, Tel Aviv 62098, Israel; (S.Y.); (D.N.); (A.N.)
- Adelson School of Medicine, Ariel University, Ariel 40700, Israel
| | - Ayelet Nevet
- Division of Community Medical Services, Clalit Health Services, Tel Aviv 62098, Israel; (S.Y.); (D.N.); (A.N.)
| | - Gil Lavie
- Branch of Planning and Strategy, Clalit Health Services, Tel Aviv 62098, Israel;
- Ruth and Bruce Rappaport Faculty of Medicine, Technion, Israel Institute of Technology, Haifa 31096, Israel
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Jakobson DJ, Bashkin O, Kalatskaya V, Veinberg H, Chernoguz E, Nesi V, Levy C, Sherer Y. Challenging Organizational Factors Associated With Admission Delay to Intensive Care Unit-A Novel Quality Indicator. J Intensive Care Med 2023; 38:1121-1126. [PMID: 37403372 DOI: 10.1177/08850666231183899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
BACKGROUND Delays in admitting patients to the intensive care unit (ICU) can defer the timely initiation of life-sustaining therapies and invasive monitoring, jeopardizing the success of the treatment. Nevertheless, the availability of research on interventions that reduce or minimize admission delays is limited. OBJECTIVES The current study aimed to assess the factors related to delays in admission times of critically ill patients transferred to the ICU. METHODS A software was designed to follow-up, compare and measure the defined intervals of the time to admission, implemented at the ICU for 6 months. Measurements included 5 time intervals, referral department, and work shift at admission. Data from 1004 patients admitted to the ICU between July 2017 and January 2020 were analyzed in a retrospective observational study. RESULTS Precisely, 53.9% of total patients were referred from the hospital emergency department, and 44% were admitted during the evening shift. Significant differences were found in time intervals between shifts, showing the morning round had the longer total admission time (median: 67.8 min). Analysis showed that admission time was longer at times of full capacity compared to times of available bed (mean: 56.4 and 40.2 min, respectively; U = 68,722, p < .05). Findings demonstrated a significant shortening of time to admission after implementing a new time monitoring software by the Institutional Quality Control Commission (U = 5072, p < .001). CONCLUSIONS Our study opens doors for potential studies on applying effective initiatives in critical care settings to improve patient care and outcomes. Additionally, it generates new insights regarding how clinicians and nursing teams can jointly develop and promote multidisciplinary interventions in intensive care work environments.
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Affiliation(s)
- Daniel J Jakobson
- Intensive Care Department, Barzilai University Medical Center, Ashkelon, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel
| | - Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | | | - Halel Veinberg
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - Evgeny Chernoguz
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel
- Quality Department, Barzilai University Medical Center, Ashkelon, Israel
| | - Vicky Nesi
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel
- Quality Department, Barzilai University Medical Center, Ashkelon, Israel
| | - Chezy Levy
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel
- Hospital Direction Department, Barzilai University Medical Center, Ashkelon, Israel
| | - Yaniv Sherer
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel
- Hospital Direction Department, Barzilai University Medical Center, Ashkelon, Israel
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Nys E, Pauwels S, Ádám B, Amaro J, Athanasiou A, Bashkin O, Bric TK, Bulat P, Caglayan C, Guseva Canu I, Cebanu S, Charbotel B, Cirule J, Curti S, Davidovitch N, Dopelt K, Fikfak MD, Frilander H, Gustavsson P, Höper AC, Kiran S, Kogevinas M, Kudász F, Kolstad HA, Lazarevic SB, Macan J, Majery N, Marinaccio A, Mates D, Mattioli S, McElvenny DM, Mediouni Z, Mehlum IS, Merisalu E, Mijakoski D, Nena E, Noone P, Otelea MR, Pelclova D, Pranjic N, Rosso M, Serra C, Rushton L, Sandal A, Schernhammer ES, Stoleski S, Turner MC, van der Molen HF, Varga M, Walusiak-Skorupa J, Straif K, Godderis L. Recognition of COVID-19 with occupational origin: a comparison between European countries. Occup Environ Med 2023; 80:694-701. [PMID: 37984917 DOI: 10.1136/oemed-2022-108726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 10/03/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVES This study aims to present an overview of the formal recognition of COVID-19 as occupational disease (OD) or injury (OI) across Europe. METHODS A COVID-19 questionnaire was designed by a task group within COST-funded OMEGA-NET and sent to occupational health experts of 37 countries in WHO European region, with a last update in April 2022. RESULTS The questionnaire was filled out by experts from 35 countries. There are large differences between national systems regarding the recognition of OD and OI: 40% of countries have a list system, 57% a mixed system and one country an open system. In most countries, COVID-19 can be recognised as an OD (57%). In four countries, COVID-19 can be recognised as OI (11%) and in seven countries as either OD or OI (20%). In two countries, there is no recognition possible to date. Thirty-two countries (91%) recognise COVID-19 as OD/OI among healthcare workers. Working in certain jobs is considered proof of occupational exposure in 25 countries, contact with a colleague with confirmed infection in 19 countries, and contact with clients with confirmed infection in 21 countries. In most countries (57%), a positive PCR test is considered proof of disease. The three most common compensation benefits for COVID-19 as OI/OD are disability pension, treatment and rehabilitation. Long COVID is included in 26 countries. CONCLUSIONS COVID-19 can be recognised as OD or OI in 94% of the European countries completing this survey, across different social security and embedded occupational health systems.
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Affiliation(s)
- Evelien Nys
- External Service for Prevention and Protection at Work, IDEWE vzw, Leuven, Belgium
| | - Sara Pauwels
- Centre Environment & Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Balázs Ádám
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, UAE
| | - João Amaro
- Epidemiology Research Unit (EPIUnit), Institute of Public Health, University of Porto, Porto, Portugal
| | - Athanasios Athanasiou
- Department of Labour Inspection, Ministry of Labour and Social Insurance, Nicosia, Cyprus
| | - Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | | | - Petar Bulat
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Serbian Institute of Occupational Health, Belgrade, Serbia
| | - Cigdem Caglayan
- Department of Public Health, Kocaeli University, Kocaeli, Turkey
| | - Irina Guseva Canu
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (unisanté), Lausanne, Switzerland
| | - Serghei Cebanu
- Department of Preventive Medicine, Nicolae Testemitanu State University of Medicine and Pharmacy, Chisinau, Moldova
| | | | - Jolanta Cirule
- Occupational and Radiation Medicine Center, Paul Stradins Clinical University Hospital, Riga, Latvia
| | - Stefania Curti
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Nadav Davidovitch
- Department of Health Policy and Management, Ben-Gurion University of the Negev, Beer-Sheva, Southern, Israel
| | - Keren Dopelt
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - Metoda Dodic Fikfak
- Institute of Occupational Traffic and Sports Medicine, Ljubljana University Medical Center, Ljubljana, Slovenia
| | - Heikki Frilander
- Occupational Medicine Team, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Per Gustavsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anje Christina Höper
- Department of Community Medicine, UiT Norges arktiske universitet, Tromso, Norway
- Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromso, Norway
| | - Sibel Kiran
- School of Medicine, Department of Public Health, Koc Universitesi, Istanbul, Turkey
| | | | - Ferenc Kudász
- National Center for Public Health, Budapest, Hungary
| | - Henrik A Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Sanja Brekalo Lazarevic
- Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina
- Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Jelena Macan
- Occupational and Environmental Health Unit, Institute for Medical Research and Occupational Health, Zagreb, Croatia
| | - Nicole Majery
- Service de Santé au travail Multisectoriel, Luxembourg City, Luxembourg
| | - Alessandro Marinaccio
- Epidemiology Unit, Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Dana Mates
- National Institute of Public Health, Bucharest, Romania
| | - Stefano Mattioli
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy
| | - Damien Martin McElvenny
- Insitute of Occupational Medicine, Edinburgh, UK
- Centre for Occupational and Environmental Health, University of Manchester, Manchester, UK
| | - Zakia Mediouni
- Department of Occupational and Environmental Health, Center for Primary Care and Public Health (unisanté), Lausanne, Switzerland
| | - Ingrid Sivesind Mehlum
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
- Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Eda Merisalu
- Institute of Forestry and Engineering, Estonian University of Life Sciences, Tartu, Estonia
| | - Dragan Mijakoski
- Institute of Occupational Health of RNM-Skopje, Skopje, North Macedonia
- Faculty of Medicine, Ss. Cyril and Methodius, University in Skopje, Skopje, North Macedonia
| | - Evangelia Nena
- Medical School, Democritus University of Thrace, Komotini, Greece
| | - Peter Noone
- Occupational Health Department, HSE Dublin North East, Lourdes Hospital, Dublin, Ireland
| | | | - Daniela Pelclova
- Department of Occupational Medicine, Charles University, Prague, Czech Republic
| | - Nurka Pranjic
- Department of Occupational Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina
- Clinic of Occupational Pathology and Toxicology, University Institute of Primary Health, Tuzla, Bosnia and Herzegovina
| | - Mark Rosso
- Occupational Health and Safety Authority, Pieta, Malta
| | - Consol Serra
- Centre of Research in Occupational Health, University Pompeu Fabra, Barcelona, Spain
- Center for Biomedical Research in Epidemiology and Public Health Network (CIBERESP), Madrid, Spain
| | - Lesley Rushton
- Epidemiology and Public Health, Imperial College, London, UK
| | - Abdulsamet Sandal
- Occupational Diseases Clinic, Ankara Occupational and Environmental Diseases Hospital, Ankara, Turkey
| | - Eva S Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Sasho Stoleski
- Institute of Occupational Health of RNM-Skopje, Skopje, North Macedonia
- Faculty of Medicine, Ss. Cyril and Methodius, University in Skopje, Skopje, North Macedonia
| | - Michelle C Turner
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Centre of Research in Occupational Health, University Pompeu Fabra, Barcelona, Spain
- Center for Biomedical Research in Epidemiology and Public Health Network (CIBERESP), Madrid, Spain
| | - Henk F van der Molen
- Department of Public and Occupational Health, Amsterdam University Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Marek Varga
- Department of Occupational Medicine and Clinical Toxicology, Medical Faculty of P. J. Šafarik University and University Hospital of Louis Pasteur, Kosice, Slovakia
| | | | - Kurt Straif
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Boston College, Chestnut Hill, Massachusetts, USA
| | - Lode Godderis
- External Service for Prevention and Protection at Work, IDEWE vzw, Leuven, Belgium
- Centre Environment & Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
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Bashkin O, Suisa A, Levi S. Higher Education in Public Health as a Tool to Reduce Disparities: Findings from an Exploratory Study among the Bedouin Community in Israel. Eur J Investig Health Psychol Educ 2023; 13:2082-2094. [PMID: 37887148 PMCID: PMC10606249 DOI: 10.3390/ejihpe13100147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/28/2023] Open
Abstract
The Bedouin community is a minority disadvantaged population in Israel that suffers from a variety of health and socioeconomic disparities and limited access to higher education. The current study aimed to examine perceptions, successes, and challenges experienced by Bedouin students during their studies and to assess an internship program developed on the principles of a community-based participatory research approach to public health. In-depth interviews were conducted with 34 Bedouin students studying in the public health academic track between January and April 2023. Grounded Theory was used to analyze the data. Three main themes emerged from the analysis: (1) facilitators for the decision to pursue higher education in public health, (2) challenges and coping strategies, and (3) experiences of success. The internship program included eleven Bedouin students who conducted six community intervention projects covering a range of topics with different target Bedouin populations. Higher education is crucial for empowering minorities, producing leadership, and reducing socioeconomic and health gaps. The field internship enabled the necessary alignment between academia and public health practice. It is important to further reflect on the integration of minority groups in public health studies and its role in decreasing health inequity.
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Affiliation(s)
- Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ben-Tzvi 12, Ashkelon 78211, Israel
| | - Avia Suisa
- Department of Public Health, Ashkelon Academic College, Ben-Tzvi 12, Ashkelon 78211, Israel
| | - Sharon Levi
- Department of Public Health, Ashkelon Academic College, Ben-Tzvi 12, Ashkelon 78211, Israel
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Kapra O, Asna N, Amoyal M, Bashkin O, Dopelt K. The Oncology Clinical Nurse Specialist: A Rapid Review of Implementation Models and Barriers around the World. Curr Oncol 2023; 30:7425-7438. [PMID: 37623019 PMCID: PMC10453893 DOI: 10.3390/curroncol30080538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 07/30/2023] [Accepted: 08/04/2023] [Indexed: 08/26/2023] Open
Abstract
The role of a clinical nurse specialist in oncology varies greatly between healthcare systems, and implementing this healthcare role with its multifaceted and co-existing responsibilities may prove challenging. While already integrated into healthcare systems and services in several European countries, Asia, Canada, and the United States, other countries are just beginning to develop clinical nursing specialties. The current study aims to provide healthcare policymakers with up-to-date evidence that focuses on the diverse modes of oncology clinical nurse specialist role implementation across several healthcare systems and pertinent implementation challenges as described in the literature. A rapid evidence assessment was carried out in order to provide policymakers with a rigorous review in a condensed timescale. Initially, only items in the English language were included, and "grey literature" was excluded. We searched PubMed between 1 January 2022 and 28 February 2022 and two independent scholars reviewed items. Based on 64 papers, both non-scientific and papers that met the initial criteria of the rapid review, we describe the modes of implementation of the oncology clinical nurse specialist in the United States, Canada, United Kingdom, Japan, Brazil and Australia. Barriers to implementation include conflicts around role boundaries, skepticism and lack of organizational support, as well as fears that oncology clinical nurse specialists will "encroach" on doctors' powers. In contrast, an oncology clinical nurse specialist is found to be universally more accessible to patients and their families and can help physicians deal with difficult workloads, among other advantages. Conclusions: This role offers a myriad of gains for cancer patients, oncology physicians, and the healthcare system. The literature demonstrates that it is a necessary role, albeit one that brings specific implementation challenges.
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Affiliation(s)
- Ori Kapra
- Department of Public Health, Ashkelon Academic College, Ashkelon 78211, Israel; (O.K.); (O.B.)
| | - Noam Asna
- Oncology Institute, Shaare Zedek Medical Center, Jerusalem 91031, Israel;
| | - Mazal Amoyal
- Palliative Care Unit, Barzilai Medical Center, Ashkelon 78306, Israel;
| | - Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ashkelon 78211, Israel; (O.K.); (O.B.)
| | - Keren Dopelt
- Department of Public Health, Ashkelon Academic College, Ashkelon 78211, Israel; (O.K.); (O.B.)
- School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84105, Israel
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Bashkin O, Asna N, Amoyal M, Dopelt K. The Role of Nurses in the Quality of Cancer Care Management: Perceptions of Cancer Survivors and Oncology Teams. Semin Oncol Nurs 2023; 39:151423. [PMID: 37055296 DOI: 10.1016/j.soncn.2023.151423] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 02/28/2023] [Accepted: 03/15/2023] [Indexed: 04/15/2023]
Abstract
OBJECTIVES This study aimed to explore the perceptions of cancer survivors and oncology professionals of quality in cancer care and the role of oncology nurses in prompting and maintaining quality across the cancer care continuum. DATA SOURCES Semistructured in-depth interviews were conducted with 16 cancer survivors and 22 healthcare professionals between August and October 2021. The interviews were transcribed and analyzed using ATLAS.ti v8 software according to a thematic analysis method based on grounded theory. The COnsolidated criteria for REporting Qualitative research (COREQ) was used to guide the report of the study. CONCLUSION Four main themes emerged from the interviews, which are outlined as follows. (1) Patient participation in the cancer care plan: shared information and decision-making; (2) emotional and support aspects in cancer care; (3) continuity in cancer care: from being a patient at the hospital to a survivor in the community; and (4) cancer care management. Cancer survivors pointed to elements that can increase the quality of cancer care, including the ongoing provision of information, support in decision-making, and continuity of care. Oncology staff interviewees mentioned the need for a single staff member to manage the cancer care plan and serve as a case manager for patients and survivors. IMPLICATIONS FOR NURSING PRACTICE Nurses have a central role in achieving the highest possible quality of cancer care for the growing number of survivors and their families. It is recommended to expand the role of oncology nurses, providing them the training and competencies needed to formally declare them as care managers throughout the continuum of cancer care.
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Affiliation(s)
- Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel.
| | - Noam Asna
- Oncology Institute, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Mazal Amoyal
- Palliative Care Unit, Barzilai Medical Center, Ashkelon, Israel
| | - Keren Dopelt
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel; Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
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Dopelt K, Shevach I, Vardimon OE, Czabanowska K, De Nooijer J, Otok R, Leighton L, Bashkin O, Duplaga M, Levine H, MacLeod F, Malowany M, Okenwa-Emegwa L, Zelber-Sagi S, Davidovitch N, Barach P. Simulation as a key training method for inculcating public health leadership skills: a mixed methods study. Front Public Health 2023; 11:1202598. [PMID: 37483956 PMCID: PMC10359821 DOI: 10.3389/fpubh.2023.1202598] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 06/22/2023] [Indexed: 07/25/2023] Open
Abstract
Background Successful management of public health challenges requires developing and nurturing leadership competencies. We aimed to evaluate the effectiveness of training simulations to assess public health leadership and decision-making competencies during emergencies as an effective learning and training method. Methods We examined the effects of two simulation scenarios on public health school students in terms of their experience (compared to face-to-face learning) and new skills acquired for dealing with similar emergent situations in the future. A mixed-methods design included developing a validated and pre-tested questionnaire with open-and closed-ended questions that examined the simulation impact and the degree of student satisfaction with the conditions in which it was conducted. Semi-structured in-depth interviews were conducted with the students after going through the simulations. The questionnaire results were evaluated using descriptive analytics. The interviews were analyzed using thematic analyses. All data were collected during June 2022. Results The questionnaire results indicate that students strengthened their interpersonal communication skills and learned about the importance of listening to the opinions of others before formulating their positions. Four themes emerged from 16 in-depth interviews, according to Kolb's experimental learning cycle. Students emphasized the effectiveness of experiential learning versus traditional classroom learning. The simulation scenarios were felt to realistically convey critical issues regarding leadership, decision-making, and teamwork challenges. They effectively conveyed the importance of building a culture of conducting substantive and respectful discussions. Conclusion Simulation is a powerful pedagogical training tool for public health leadership competencies. Simulations were seen to be advantageous over face-to-face learning in imparting a range of leadership skills and hands-on practice. We recommend integrating simulations in all public health leadership training programs.
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Affiliation(s)
- Keren Dopelt
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - Itamar Shevach
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Ofek Eliad Vardimon
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
| | - Katarzyna Czabanowska
- Department of International Health, Care and Public Health Research Institute CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Jascha De Nooijer
- Department of Health Promotion, School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Robert Otok
- The Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium
| | - Lore Leighton
- The Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium
| | - Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - Mariusz Duplaga
- Department of Health Promotion and e-Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Hagai Levine
- The Israeli Association of Public Health Physicians (IPAPH), Israeli Medical Association, Ramat-Gan, Israel
- Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem-Hadassah, Jerusalem, Israel
| | - Fiona MacLeod
- School of Public Health, University College Cork, Cork, Ireland
| | - Maureen Malowany
- Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem-Hadassah, Jerusalem, Israel
| | - Leah Okenwa-Emegwa
- Department of Health Sciences, The Swedish Red Cross University (SRCU), Huddinge, Sweden
| | - Shira Zelber-Sagi
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Nadav Davidovitch
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel
- The Israeli Association of Public Health Physicians (IPAPH), Israeli Medical Association, Ramat-Gan, Israel
| | - Paul Barach
- College of Population Health, Thomas Jefferson University, Philadelphia, PA, United States
- Interdisciplinary Research Institute for Health Law and Science, Sigmund Freud University Vienna, Vienna, Austria
- Department of Surgery, Imperial College School of Medicine, London, United Kingdom
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Dopelt K, Asna N, Amoyal M, Bashkin O. Nurses and Physicians' Perceptions Regarding the Role of Oncology Clinical Nurse Specialists in an Exploratory Qualitative Study. Healthcare (Basel) 2023; 11:1831. [PMID: 37444665 DOI: 10.3390/healthcare11131831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/05/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
The purpose of the study was to examine the attitudes of nursing and medical teams about the role of oncology clinical nurse specialists in the healthcare system in Israel, where, unlike many countries in the world, such a role has not yet been developed or professionally defined. We conducted 24 interviews with physicians and nurses between August and October 2021. The interviews were transcribed and analyzed using a thematic analysis method. The Consolidated Criteria for Reporting Qualitative Research checklist was used to report the study. Five main themes emerged from the interviews: (1) contribution to the healthcare system, (2) contribution to the patient, (3) drawing professional boundaries, (4) additional responsibilities and authority for oncology clinical nurse specialists, and (5) the field's readiness for a new position of oncology clinical nurse specialists. The findings provide evidence about the need to develop the role of clinical nurse specialists in the oncology field due to its potential benefits for nurses, physicians, patients, family members, and the healthcare system. At the same time, an in-depth exploration of the boundaries of the role and its implementation, in full cooperation with the oncologists and relevant professional unions, is needed to prevent unnecessary conflicts in the oncology field. Professional development training programs in nursing must create a platform for open dialogue between key stakeholders, nurses, and physicians, in order to help all involved parties, place the benefits to the patients above any personal or status considerations.
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Affiliation(s)
- Keren Dopelt
- Department of Public Health, Ashkelon Academic College, Ashkelon 78211, Israel
- School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84105, Israel
| | - Noam Asna
- Oncology Institute, Shaare Zedek Medical Center, Jerusalem 91031, Israel
| | - Mazal Amoyal
- Palliative Care Unit, Barzilai Medical Center, Ashkelon 78306, Israel
| | - Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ashkelon 78211, Israel
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Bashkin O, Otok R, Kapra O, Czabanowska K, Barach P, Baron-Epel O, Dopelt K, Duplaga M, Leighton L, Levine H, MacLeod F, Neumark Y, Paillard-Borg S, Tulchinsky T, Mor Z. Identifying the Gaps Between Public Health Training and Practice: A Workforce Competencies Comparative Analysis. Int J Public Health 2022; 67:1605303. [PMID: 36618436 PMCID: PMC9812945 DOI: 10.3389/ijph.2022.1605303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives: The study aimed to generate insights on how best to enhance the compatibility between Public Health training program competencies and the implementation of competencies required by employers to address current and emerging public health needs. Methods: A survey adapted from the WHO-ASPHER Competency Framework for the Public Health Workforce was conducted online among Israeli public health managers from August to November 2021. The survey was formulated to mirror Essential Public Health Operations. Forty-nine managers participated (37.6% response rate) in an assessment of 44 public health competencies and the core organizational public health operations. Results: Analysis of Essential Public Health Operations revealed a notably high deficiency reported for Advocacy Communication and Social Mobilization for health competencies. Collaborations and Partnership and, Leadership and System Thinking were the most reported insufficient competencies, particularly in health departments and research institutes. Governmental offices reported Organizational Literacy and Adaptability competencies being deficient. Deficiencies were more impactful as the level of expertise increased. Conclusion: There is a clear need for public health professionals to acquire versatile and innovative competencies in response to the ever-changing health threats.
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Affiliation(s)
- Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel,*Correspondence: Osnat Bashkin,
| | - Robert Otok
- Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium
| | - Ori Kapra
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - Kasia Czabanowska
- School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Paul Barach
- Jefferson College of Population Health, Philadelphia, PA, United States,Interdisciplinary Research Institute for Health Law and Science, Sigmund Freud University Vienna, Vienna, Austria
| | - Orna Baron-Epel
- School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Keren Dopelt
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel,Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer-Sheva, Israel
| | - Mariusz Duplaga
- Department of Health Promotion and e-Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Lore Leighton
- Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium
| | - Hagai Levine
- The Israeli Association of Public Health Physicians (IPAPH), Israeli Medical Association, Ramat-Gan, Israel
| | - Fiona MacLeod
- School of Public Health, University College Cork, Cork, Ireland
| | - Yehuda Neumark
- Hadassah Braun School of Public Health and Community Medicine, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | | | - Zohar Mor
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
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Bashkin O, Dopelt K, Asna N. Patients' and oncologists' perceptions towards the discussion on high-cost innovative cancer therapies: findings from a qualitative study. BMJ Open 2022; 12:e062104. [PMID: 36167390 PMCID: PMC9516174 DOI: 10.1136/bmjopen-2022-062104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES In the last decades, innovative technologies for cancer treatment were developed rapidly. In most cases, their price is high, with no funding offered by public health systems. The present study examined the perceptions of oncologists, patients and family members regarding the challenges in discussing innovative cancer treatments. DESIGN Qualitative study, using in-depth semistructured interviews. Interviews examined public versus private financing, therapist-patient-family discourse, modes of decision making and implications on health policy and inequalities. PARTICIPANTS Sixteen cancer patients, six family members of cancer patients and 16 oncologists participated in the study. RESULTS Four themes emerged from data analysis: the economic consideration in the decision on cancer treatment, the options of funding high-cost private treatments, psychosocial aspects of the discussion on treatment costs and health policy in oncology and its social aspects. CONCLUSIONS Findings emphasise the importance of considering costs when recommending expensive care and addressing the emotional element of innovative treatment, as most patients expect. The findings present various psychosocial aspects taking part in the complicated decision to use unfunded cancer treatment and its broad implications, which may use as a basis for developing a guided framework for oncologist-patient discourse.
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Affiliation(s)
- Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - Keren Dopelt
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
- Department of Health Policy and Management, Ben Gurion University of the Negev, Beere Sheva, Israel
| | - Noam Asna
- Department of Oncology, Shaare Zedek Medical Center, Jerusalem, Israel
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Bashkin O, Otok R, Leighton L, Czabanowska K, Barach P, Davidovitch N, Dopelt K, Duplaga M, Okenwa Emegwa L, MacLeod F, Neumark Y, Raz MP, Tulchinsky T, Mor Z. Emerging lessons from the COVID-19 pandemic about the decisive competencies needed for the public health workforce: A qualitative study. Front Public Health 2022; 10:990353. [PMID: 36117595 PMCID: PMC9479633 DOI: 10.3389/fpubh.2022.990353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 08/12/2022] [Indexed: 01/26/2023] Open
Abstract
The global COVID-19 crisis exposed the critical need for a highly qualified public health workforce. This qualitative research aimed to examine public health workforce competencies needed to face COVID-19 challenges and identify the gaps between training programs and the competency demands of real-world disasters and pandemics. Through a sample of thirty-one participant qualitative interviews, we examined the perspectives of diverse stakeholders from lead public health organizations in Israel. Grounded Theory was used to analyze the data. Six themes emerged from the content analysis: public health workforce's low professional status and the uncertain future of the public health workforce; links between the community and Higher Education institutions; the centrality of communication competencies; need to improve health promotion; the role of leadership, management, and partnership, and innovation in public health coherence. Increasing the attractiveness of the profession, professional and financial support, and improving the working conditions to ensure a sustainable and resilient PH system were deemed necessary. This paper describes and cultivates new knowledge and leadership skills among public health professionals, and lays the groundwork for future public health leadership preparedness programs.
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Affiliation(s)
- Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel,*Correspondence: Osnat Bashkin
| | - Robert Otok
- The Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium
| | - Lore Leighton
- The Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium
| | - Kasia Czabanowska
- Department of International Health, Care and Public Health Research Institute CAPHRI, Faculty of Health, Medicine & Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Paul Barach
- College of Population Health, Thomas Jefferson University, Philadelphia, PA, United States,College of Population Health, Sigmund Freud University, Vienna, Austria
| | - Nadav Davidovitch
- Faculty of Health Sciences, Department of Health Policy and Management, School of Public Health, Ben Gurion University of the Negev, Beersheba, Israel,The Israeli Association of Public Health Physicians (IPAPH), Israeli Medical Association, Ramat Gan, Israel
| | - Keren Dopelt
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel,Faculty of Health Sciences, Department of Health Policy and Management, School of Public Health, Ben Gurion University of the Negev, Beersheba, Israel
| | - Mariusz Duplaga
- Faculty of Health Sciences, Department of Health Promotion and e-Health, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
| | - Leah Okenwa Emegwa
- Department of Health Sciences, The Swedish Red Cross University College (SRCUC), Huddinge, Sweden
| | - Fiona MacLeod
- School of Public Health, University College Cork, Cork, Ireland
| | - Yehuda Neumark
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem, Israel
| | - Maya Peled Raz
- Faculty of Social Welfare and Health Sciences, School of Public Health, University of Haifa, Haifa, Israel
| | | | - Zohar Mor
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
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12
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Bashkin O, Nahmias R, Attar S, Moshe R, Asna N. Perspectives of cancer patients during the COVID-19 outbreak in Israel: The long-term implications on support and well-being in an exploratory qualitative study. Eur J Cancer Care (Engl) 2022; 31:e13657. [PMID: 35838182 PMCID: PMC9350153 DOI: 10.1111/ecc.13657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 06/01/2022] [Accepted: 07/05/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The COVID-19 pandemic's ongoing effects and long-term implications for the mental and social state of cancer patients are not yet fully known. The current study examined cancer patients' feelings about the pandemic's long-term impact on daily life 1 year after its outbreak in Israel and after the patient's vaccination against the virus. METHODS Ten in-depth semi-structured interviews were conducted with cancer patients between February and April 2021. RESULTS AND CONCLUSIONS Findings indicated four main themes: (1) managing medical care and support from the medical staff, (2) the effect of the pandemic on social interactions; (3) the impact of the pandemic on family and social support and (4) the patients' psychological well-being. Despite the patients being vaccinated, the full impact of the pandemic on cancer patients' mental and social states is still fully apparent. The findings reflect the need to assess and monitor the patients' mental state and social and medical needs during this complex time and the importance of developing external support networks.
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Affiliation(s)
- Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - Roni Nahmias
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - Sarah Attar
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - Reut Moshe
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - Noam Asna
- Oncology Department, Shaare Zedek Medical Center, Jerusalem, Israel
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13
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Bashkin O, Shapovalov N, Faingersch E, Abramov L. Mental health among college students a year after COVID-19 outbreak in Israel: The association between wellbeing and anxiety. J Am Coll Health 2022:1-7. [PMID: 35658122 DOI: 10.1080/07448481.2022.2082844] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 05/03/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
Objective: To evaluate anxiety and well-being among college students. Participants: The sample comprised 366 college students who responded to an online survey In January 2021. Methods: An online survey included demographics, a 7-item Generalized Anxiety Disorder Scale (GAD-7), and a 14-item Mental Health Continuum-Short Form (MHC-SF) measuring well-being. Results: Findings revealed low self-rated well-being compared to the general population. The mean anxiety level was 8.89, and 39% of respondents showed moderate to severe anxiety. Negative correlations were found between well-being and anxiety. A regression model showed that students who live with their parents, had been diagnosed with COVID-19, and have low emotional well-being scores, are at risk of suffering from anxiety (R2=0.32, F = 53, p < 0.001). Conclusions: Student mental health is significantly affected by the pandemic and should be carefully monitored. It is crucial to provide timely psychological support to prevent negative long-term implications of the crisis on student mental health.
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Affiliation(s)
- Osnat Bashkin
- Department of Public Health, School of Health Sciences, Ashkelon Academic College, Ashkelon, Israel
| | - Nicol Shapovalov
- Department of Public Health, School of Health Sciences, Ashkelon Academic College, Ashkelon, Israel
| | - Esfir Faingersch
- Department of Public Health, School of Health Sciences, Ashkelon Academic College, Ashkelon, Israel
| | - Liora Abramov
- Department of Public Health, School of Health Sciences, Ashkelon Academic College, Ashkelon, Israel
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14
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Dopelt K, Bashkin O, Asna N, Davidovitch N. Health locus of control in cancer patient and oncologist decision-making: An exploratory qualitative study. PLoS One 2022; 17:e0263086. [PMID: 35085354 PMCID: PMC8794183 DOI: 10.1371/journal.pone.0263086] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 01/11/2022] [Indexed: 11/30/2022] Open
Abstract
Objective To investigate how cancer patients’ and family members’ perspective and health locus of control are presented in clinical encounter decision-making. Methods Semi-structured in-depth interviews were carried out with 16 cancer patients and 6 family members living in Israel (n = 22). Interviews were transcribed verbatim, and data were analyzed using thematic analysis. Results Following the health locus of control model, the findings were divided into an external and internal locus of control themes, and we added a theme regarding shared decision-making. Internal locus of control sub-themes included asking for a second opinion, negotiating with the doctor, asking questions, looking for information, and fighting for their rights. External locus of control sub-themes included powerful others, oncologists, and fate. The dominant approach of most of the interviewees was an external locus of control. Women demonstrated more external locus of control than men. On the direct question of who should decide on treatment—the doctor, the patient, or both jointly—the answers ranged from only the doctor (n = 8) to together (n = 7) to only the patient (n = 8). Conclusions This study provides insights into different aspects of locus of control in the clinical encounter involving cancer patients. The findings reflect the need to devote comprehensive attention to cancer patients’ perceptions and experiences in the clinical encounter. A patient-centered care approach and a personalized framework for decision-making in cancer care are essential to achieving better treatment outcomes. Further research can engage in the development and validation of an up-to-date health locus of control questionnaire for cancer patients based on the findings of this study.
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Affiliation(s)
- Keren Dopelt
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
- * E-mail:
| | - Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - Noam Asna
- Oncology Institute, Ziv Medical Center, Safed, Israel
| | - Nadav Davidovitch
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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15
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Bashkin O, Faingersch E, Abramov L, Shapovalov N. Wellbeing and anxiety among students during COVID-19 crisis: results from an initial survey in Israel. Eur J Public Health 2021. [PMCID: PMC8574905 DOI: 10.1093/eurpub/ckab165.588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background The COVID-19 crisis that has burdened the world for the past year posed a life threat and caused psychological implications for public well-being. Well-being is an essential element of mental health that affects learning and productivity. Students are vulnerable to suffering from low well-being and developing mental problems caused by various stressors such as the ongoing COVID-19 health crisis. In addition, the spread of the epidemic, quarantine requirements, and the delayed academic year have had significant psychological impacts on students. The purpose of the study was to evaluate anxiety and well-being among college students at the end of the first year of the COVID-19 epidemic. Methods On January 2021, during the third lockdown in Israel, 366 college students responded to an online survey that included demographics, 7-item Generalized Anxiety Disorder Scale (GAD-7), and a 14-item Mental Health Continuum-Short Form (MHC-SF) measuring emotional, psychological, and social well-being. Results Findings revealed low self-rated well-being compared to the general population. The mean anxiety level was 8.89. 39% showed moderate to severe anxiety. Negative correlations were found between anxiety and well-being. Women expressed low levels of well-being and higher anxiety compared to men. A regression model showed that students living with parents diagnosed with Covid-19 and having low emotional well-being are at risk of suffering from anxiety (R2=0.32, F = 53, p < 0.001). Conclusions The mental health of college students is significantly affected by the pandemic, therefore should be monitored and requires attention: Further investigation of factors influencing mental health and well-being of students. Detecting students with a higher risk of developing mental health problems and providing timely psychological support. Develop initiatives to raise awareness among students and interventions to prevent negative implications of the COVID-19 crisis on mental health.
Key messages Students report low well-being and show high risk of developing anxiety disorder during COVID-19 crisis. It is crucial to detect students with a higher risk of developing mental health problems and provide timely psychological support.
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Affiliation(s)
- O Bashkin
- Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - E Faingersch
- Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - L Abramov
- Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - N Shapovalov
- Public Health, Ashkelon Academic College, Ashkelon, Israel
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16
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Bashkin O, Davidovitch N, Asna N, Schwartz D, Dopelt K. Individual and organizational perceptions of hospital workers during COVID-19: the link with burnout. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
The COVID-19 crisis poses challenges to healthcare systems and their employees. Medical staff are at the front of the battle against COVID-19. They must cope with a crisis accompanied by personal health and occupational ramifications and ongoing job stressors, which may lead to adverse mental health symptoms and may affect the quality of medical care provided to patients. This study evaluated health workers' perceptions and concerns about the COVID-19 crisis and its management in an Israeli hospital.
Methods
At the end of the pandemic's first wave in Israel, 547 healthcare workers responded to an online survey, which inquired about COVID-19 concerns at the individual and family level, perceptions at the national and organizational level, perceptions of the way the crisis was managed, self-assessment of coping with the crisis and burnout, and demographics.
Results
Findings showed that healthcare workers expressed deep concerns for family members and apprehension at a national level. Respondents noted that they were coping well with the crisis while expressing negative perceptions of how the crisis was managed. The regression model showed that concerns for family members, perceptions at the system level, working directly with COVID-19 patients, and having negative perceptions towards the crisis management at the national level, were associated with burnout.
Conclusions
The findings of this study deepen our understanding of issues that require systemic attention to strengthen mental resilience among hospital staff. Several actions are recommended to improve healthcare systems' ability to continue fighting the virus and confront future health crises:
Further examination and monitoring of healthcare workers' concerns and job stressors. Providing psychosocial support plans for frontline workers to ensure their safety and health and prevent burnout. Strengthening supportive organizational culture.
Key messages
Healthcare workers express deep concerns and perceptions associated with burnout. Health services management needs a good understanding of workers' concerns and develop strategies to address them.
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Affiliation(s)
- O Bashkin
- Public Health, Ashkelon Academic College, Ashkelon, Israel
| | - N Davidovitch
- Health Systems Management, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - N Asna
- Oncology Institute, Ziv Medical Center, Safed, Israel
| | - D Schwartz
- Risk Management Unit, Soroka University Medical Center, Beer Sheva, Israel
| | - K Dopelt
- Public Health, Ashkelon Academic College, Ashkelon, Israel
- Health Systems Management, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Bashkin O, Dopelt K, Mor Z, Leighton L, Otok R, Duplaga M, MacLeod F, De Nooijer J, Neumark Y, Paillard-Borg S, Tulchinsky T, Zelber-Sagi S, Davidovitch N. The Future Public Health Workforce in a Changing World: A Conceptual Framework for a European-Israeli Knowledge Transfer Project. Int J Environ Res Public Health 2021; 18:9265. [PMID: 34501853 PMCID: PMC8430594 DOI: 10.3390/ijerph18179265] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/28/2021] [Accepted: 08/31/2021] [Indexed: 11/16/2022]
Abstract
Health services quality and sustainability rely mainly on a qualified workforce. Adequately trained public health personnel protect and promote health, avert health disparities, and allow rapid response to health emergencies. Evaluations of the healthcare workforce typically focus on physicians and nurses in curative medical venues. Few have evaluated public health workforce capacity building or sought to identify gaps between the academic training of public health employees and the needs of the healthcare organizations in which they are employed. This project report describes the conceptual framework of "Sharing European Educational Experience in Public Health for Israel (SEEEPHI): harmonization, employability, leadership, and outreach"-a multinational Erasmus+ Capacity Building in Higher Education funded project. By sharing European educational experience and knowledge, the project aims to enhance professionalism and strengthen leadership aspects of the public health workforce in Israel to meet the needs of employers and the country. The project's work packages, each jointly led by an Israeli and European institution, include field qualification analysis, mapping public health academic training programs, workforce adaptation, and building leadership capacity. In the era of global health changes, it is crucial to assess the capacity building of a well-qualified and competent workforce that enables providing good health services, reaching out to minorities, preventing health inequalities, and confronting emerging health challenges. We anticipate that the methods developed and the lessons learned within the Israeli context will be adaptable and adoptable by other countries through local and cultural adjustments.
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Affiliation(s)
- Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ben Tzvi 12, Ashkelon 78211, Israel; (K.D.); (Z.M.); (T.T.)
| | - Keren Dopelt
- Department of Public Health, Ashkelon Academic College, Ben Tzvi 12, Ashkelon 78211, Israel; (K.D.); (Z.M.); (T.T.)
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, P.O. Box 653, Beer Sheva 8410501, Israel;
| | - Zohar Mor
- Department of Public Health, Ashkelon Academic College, Ben Tzvi 12, Ashkelon 78211, Israel; (K.D.); (Z.M.); (T.T.)
| | - Lore Leighton
- The Association of Schools of Public Health in the European Region (ASPHER), Avenue de Tervueren 153, 1150 Brussels, Belgium; (L.L.); (R.O.)
| | - Robert Otok
- The Association of Schools of Public Health in the European Region (ASPHER), Avenue de Tervueren 153, 1150 Brussels, Belgium; (L.L.); (R.O.)
| | - Mariusz Duplaga
- Department of Health Promotion and e-Health, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, ul. Skawińska 8, 31-066 Kraków, Poland;
| | - Fiona MacLeod
- School of Public Health, University College Cork, T12 XF62 Cork, Ireland;
| | - Jascha De Nooijer
- School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands;
| | - Yehuda Neumark
- Braun School of Public Health and Community Medicine, Hebrew University-Hadassah, Jerusalem 91120, Israel;
| | - Stephanie Paillard-Borg
- Department of Health Sciences, The Swedish Red Cross University College (SRCUC), P.O. Box 1059, 14121 Huddinge, Sweden;
| | - Theodore Tulchinsky
- Department of Public Health, Ashkelon Academic College, Ben Tzvi 12, Ashkelon 78211, Israel; (K.D.); (Z.M.); (T.T.)
| | - Shira Zelber-Sagi
- Faculty of Social Welfare and Health Sciences, School of Public Health, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, Haifa 3498838, Israel;
| | - Nadav Davidovitch
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, P.O. Box 653, Beer Sheva 8410501, Israel;
- The Israeli Association of Public Health Physicians (IPAPH), Israeli Medical Association, P.O. Box 3566, Ramat Gan 5213604, Israel
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Bashkin O, Dopelt K, Asna N, Davidovitch N. Recommending Unfunded Innovative Cancer Therapies: Ethical vs. Clinical Perspectives among Oncologists on a Public Healthcare System-A Mixed-Methods Study. Curr Oncol 2021; 28:2902-2913. [PMID: 34436020 PMCID: PMC8395438 DOI: 10.3390/curroncol28040254] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 07/30/2021] [Accepted: 08/01/2021] [Indexed: 11/26/2022] Open
Abstract
Over the past decade, there has been a growing development of innovative technologies to treat cancer. Many of these technologies are expensive and not funded by health funds. The present study examined physicians' perceptions of the ethical and clinical aspects of the recommendation and use of unfunded technologies for cancer treatment. This mixed-methods study surveyed 127 oncologists regarding their perceptions toward using unfunded innovative cancer treatment technologies, followed by in-depth interviews with 16 oncologists. Most respondents believed that patients should be offered all treatment alternatives, regardless of their financial situation. However, 59% indicated that they often face dilemmas regarding recommending new unfunded treatments to patients with financial difficulties and without private health insurance. Over a third (38%) stated that they felt uncomfortable discussing the cost of treatment with patients. A predictive model found that physicians facing patients whose medical condition worsened due to an inability to access new treatments, and who expressed the opinion that physicians can assist in locating funding for patients who cannot afford treatments, were more likely to recommend unfunded innovative therapies to patients (F = 5.22, R2 = 0.15, p < 0.001). Subsequent in-depth interviews revealed four key themes: economic considerations in choosing therapy, patient-physician communication, the public healthcare fund, and discussion of treatment costs. Physicians feel a professional commitment to offer patients the best medical care and a moral duty to discuss costs and minimize patients' financial difficulty. There is a need for careful and balanced use of innovative life-prolonging technologies while putting patients at the center of discourse on this complex and controversial issue. It is essential to develop a psychosocial support program for physicians and patients dealing with ethical and psychosocial dilemmas and to set guidelines for oncologists to conduct a comprehensive and collaborative physician-patient discourse regarding all aspects of treatment.
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Affiliation(s)
- Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ashkelon 78211, Israel;
| | - Keren Dopelt
- Department of Public Health, Ashkelon Academic College, Ashkelon 78211, Israel;
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 8410501, Israel;
| | - Noam Asna
- Oncology Institute, Ziv Medical Center, Safed 13100, Israel;
| | - Nadav Davidovitch
- Department of Health Policy and Management, School of Public Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 8410501, Israel;
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19
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Bashkin O, Davidovitch N, Asna N, Schwartz D, Dopelt K. The Organizational Atmosphere in Israeli Hospital during COVID-19: Concerns, Perceptions, and Burnout. Int J Environ Res Public Health 2021; 18:ijerph18115544. [PMID: 34067309 PMCID: PMC8196839 DOI: 10.3390/ijerph18115544] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 01/15/2023]
Abstract
The COVID-19 crisis poses challenges to healthcare systems and requires micro- and macro-organizational adaptations. This study examined the organizational atmosphere in Israeli hospitals by evaluating workers’ perceptions and concerns about the COVID-19 crisis and its management. At the end of the pandemic’s first wave in Israel, 547 healthcare workers responded to an online survey, which inquired about COVID-19 concerns at the individual and family level, perceptions at the national and organizational level, perceptions of the way the crisis was managed, self-assessment of coping with the crisis and burnout, and demographics. Findings showed that healthcare workers expressed deep concerns for family members and apprehension at a national level. Respondents noted that they were coping well with the crisis while expressing negative perceptions of how the crisis was managed. A regression model showed that the low self-assessment of medical staff of coping with the crisis, deep concerns at the organizational level, negative perceptions of crisis management, and providing care for COVID-19 patients were predictors of burnout. The findings emphasize the importance of developing a supportive organizational culture for hospital workers. Awareness of their concerns and perceptions is essential to improve organizational culture and healthcare systems’ ability to continue fighting the virus and confront future health crises.
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Affiliation(s)
- Osnat Bashkin
- Department of Public Health, Ashkelon Academic College, Ashkelon 78211, Israel;
- Correspondence: ; Tel.: +972-54-797-0886
| | - Nadav Davidovitch
- Department of Health Systems Management, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel;
| | - Noam Asna
- Ziv Medical Center, Oncology Institute, Safed 13100, Israel;
| | - Doron Schwartz
- Risk Management Unit, Soroka University Medical Center, Beer Sheva 84101, Israel;
| | - Keren Dopelt
- Department of Public Health, Ashkelon Academic College, Ashkelon 78211, Israel;
- Department of Health Systems Management, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel;
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20
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Hanassi E, Frei E, Wacht O, Bashkin O. [PUBLIC WILLINGNESS TO PERFORM CARDIOPULMONARY RESUSCITATION: KNOWLEDGE, ATTITUDES, AND BARRIERS]. Harefuah 2020; 159:498-502. [PMID: 32720767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Cardiac arrest is the most common cause of death in the Western world. Its pre-hospital survival rates depend on cardiopulmonary resuscitation (CPR) performed by those near the person. Despite epidemiological data showing a significant increase in the survival rate of people who had a cardiac arrest and were resuscitated by bystanders, the levels of public willingness to resuscitate are still low. OBJECTIVES To examine knowledge, attitudes, and barriers among the Israeli public toward responding in CPR cases. METHODS A total of 218 men and women aged 18-72 participated in a survey that included socio-demographic items, questions probing knowledge of CPR, statements describing attitudes, and statements describing barriers against resuscitation. RESULTS Findings showed that respondents expressed positive attitudes toward performing CPR. However, they displayed a low level of knowledge on 60% of the items. In addition, respondents who showed low levels of knowledge regarding CPR also expressed intense barriers against CPR and had more negative attitudes toward CPR. Barriers against performing CPR were found as a mediating variable in the association between knowledge and attitude toward CPR (F= 83.28, p<0.01). The barriers which were expressed at the highest rates were fear of injuring the person while performing CPR (57%), fear of contagion during CPR (45%), and no defibrillator nearby (56%). CONCLUSIONS The respondents' attitudes toward CPR were associated with various barriers that mediated between them and knowledge about CPR and pre-hospital cardiac arrest. It is recommended to develop intervention programs that emphasize support strategies and tools that reinforce bystander knowledge of and access to proper CPR concerning the barriers exposed. Such programs should focus on broader deployment of defibrillators, use of assistance from emergency hotlines, training programs and media campaigns.
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Affiliation(s)
- Emily Hanassi
- Department of Public Health, School of Health Sciences, Ashkelon Academic College, Ashkelon, Israel
| | - Ester Frei
- Department of Public Health, School of Health Sciences, Ashkelon Academic College, Ashkelon, Israel
| | - Oren Wacht
- Department of Emergency Medicine, Ben-Gurion University, Beer-Sheva, Israel
| | - Osnat Bashkin
- Department of Public Health, School of Health Sciences, Ashkelon Academic College, Ashkelon, Israel
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21
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Bashkin O. Depression Among Older Adults with Diabetes in Israel: Pattern of Symptoms and Risk Factors. Isr Med Assoc J 2018; 20:222-226. [PMID: 29629729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Osnat Bashkin
- Department of Public Health, School of Health Sciences, Ashkelon Academic College, Ashkelon, Israel
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Bashkin O, Horne R, Bridevaux IP. Influence of Health Status on the Association Between Diabetes and Depression Among Adults in Europe: Findings From the SHARE International Survey. Diabetes Spectr 2018; 31:75-82. [PMID: 29456429 PMCID: PMC5813307 DOI: 10.2337/ds16-0063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The association between diabetes and depression, a common health comorbidity in people with diabetes, has been recognized but not well understood. The purpose of this study was to explore the association between diabetes and depression in a large international sample of adults, adjusting for demographics, socioeconomic status, behavioral risks, and current health status. METHODS The association between diabetes and depression was assessed in a sample of 57,004 Europeans ≥50 years of age from 15 European countries using data from the fifth wave of SHARE (the Survey of Health, Ageing, and Retirement in Europe). Multiple logistic regression models of the association between diabetes and depression were conducted, adjusting for potential confounders. RESULTS Analyses showed that, despite diabetes being associated with depression in crude and partially adjusted models, further adjustment for self-perceived health made the association between diabetes and depression no longer statistically significant (odds ratio 1.0, 95% CI 0.9-1.0). CONCLUSION Adjustment for a variety of demographic, socioeconomic, behavioral risk, and health status variables reduced the estimated association between diabetes and depression until it was no longer significant. Further research should explore the specific symptoms of distress characterized in people with diabetes.
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Affiliation(s)
- Osnat Bashkin
- Department of Public Health, School of Health Sciences, Ashkelon Academic College, Ashkelon, Israel
| | - Ron Horne
- Statistical Consulting & Analytical Tools, London, UK
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23
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Bashkin O, Tulchinsky TH. Establishing undergraduate public health education: process, challenges, and achievements in a case study in Israel. Public Health Rev 2017; 38:11. [PMID: 29450083 PMCID: PMC5809819 DOI: 10.1186/s40985-017-0057-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 03/28/2017] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND In this paper, we describe the development process of the first undergraduate public health baccalaureate program, in the Ashkelon Academic College in Israel. Expansion of degree-granting colleges in Israel is part of the democratization of higher education providing access to and increasing educational opportunities for groups underrepresented in universities. The main objectives of the program at Ashkelon Academic College have been to open accessible and affordable career opportunities for current workers in the health system and for new entries to health careers for academic advancement in a peripheral and relatively poor region of the country. CASE PRESENTATION The program focuses on well-established and literature-based learning goals of public health education but also includes basic medical sciences, incorporation of arts and sciences into public health, development of critical thinking and quantitative skills, experiential field learning, and integrative learning for facing global health challenges. The curricula of the program is composed of seven modules including introductory courses, methodology courses, health organization courses, epidemiology courses, courses related to core content of public health, elective courses and practicum. The first class will graduate in 2017; this will allow for final approval of the Council of Higher Education of Israel and possible revision of curriculum. A second BA program is now seeking approval in Israel and cooperation with post-graduate schools of public health is developing. CONCLUSIONS Our program is in keeping with trends in Europe and the USA to broaden public health education, to reduce inequality of career opportunity, to expand the workforce, and to promote public health.
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Affiliation(s)
- Osnat Bashkin
- Department of Public Health, School of Health Professions, Ashkelon Academic College, Ashkelon, Israel
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Bashkin O, Caspi S, Haligoa R, Mizrahi S, Stalnikowicz R. Organizational factors affecting length of stay in the emergency department: initial observational study. Isr J Health Policy Res 2015; 4:38. [PMID: 26473027 PMCID: PMC4606993 DOI: 10.1186/s13584-015-0035-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 07/22/2015] [Indexed: 11/16/2022] Open
Abstract
Background Length of stay (LOS) is considered a key measure of emergency department throughput, and from the perspective of the patient, it is perceived as a measure of healthcare service quality. Prolonged LOS can be caused by various internal and external factors. This study examined LOS in the emergency department and explored the main factors that influence LOS and cause delay in patient care. Methods Observations of 105 patients were performed over a 3-month period at the emergency room of a community urban hospital. Observers monitored patients from the moment of entrance to the department until discharge or admission to another hospital ward. Results Analysis revealed a general average total emergency department LOS of 438 min. Significant differences in average LOS were found between admitted patients (Mean = 544 min, SD = 323 min) and discharged patients (Mean = 291 min, SD = 286 min). In addition, nurse and physician change of shifts and admissions to hospital wards were found to be significant factors associated with LOS. Using an Ishikawa causal diagram, we explored various latent organizational factors that may prolong this time. Conclusions The study identified several factors that are associated with high average emergency department LOS. High LOS may lead to increases in expenditures and may have implications for patient safety, whereas certain organizational changes, communication improvement, and time management may have a positive effect on it. Interdisciplinary methods can be used to explore factors causing prolonged emergency department LOS and contribute to a better understanding of them.
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Affiliation(s)
- Osnat Bashkin
- Department of Public Health, School of Health Sciences, Ashkelon Academic College, Ashkelon, Israel
| | - Sigalit Caspi
- Department of Emergency Medicine, Hadassah Medical Center-Mt. Scopus, Jerusalem, Israel
| | - Rachel Haligoa
- Department of Industrial Engineering & Management, Azrieli College of Engineering, Jerusalem, Israel
| | - Sari Mizrahi
- Department of Industrial Engineering & Management, Azrieli College of Engineering, Jerusalem, Israel
| | - Ruth Stalnikowicz
- Department of Emergency Medicine, Hadassah Medical Center-Mt. Scopus, Jerusalem, Israel
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