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Wang S, Mo C, Chen Y, Dai X, Wang H, Shen X. Exploring the Performance of ChatGPT-4 in the Taiwan Audiologist Qualification Examination: Preliminary Observational Study Highlighting the Potential of AI Chatbots in Hearing Care. JMIR Med Educ 2024; 10:e55595. [PMID: 38693697 PMCID: PMC11067446 DOI: 10.2196/55595] [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] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/09/2024] [Accepted: 03/22/2024] [Indexed: 05/03/2024]
Abstract
Background Artificial intelligence (AI) chatbots, such as ChatGPT-4, have shown immense potential for application across various aspects of medicine, including medical education, clinical practice, and research. Objective This study aimed to evaluate the performance of ChatGPT-4 in the 2023 Taiwan Audiologist Qualification Examination, thereby preliminarily exploring the potential utility of AI chatbots in the fields of audiology and hearing care services. Methods ChatGPT-4 was tasked to provide answers and reasoning for the 2023 Taiwan Audiologist Qualification Examination. The examination encompassed six subjects: (1) basic auditory science, (2) behavioral audiology, (3) electrophysiological audiology, (4) principles and practice of hearing devices, (5) health and rehabilitation of the auditory and balance systems, and (6) auditory and speech communication disorders (including professional ethics). Each subject included 50 multiple-choice questions, with the exception of behavioral audiology, which had 49 questions, amounting to a total of 299 questions. Results The correct answer rates across the 6 subjects were as follows: 88% for basic auditory science, 63% for behavioral audiology, 58% for electrophysiological audiology, 72% for principles and practice of hearing devices, 80% for health and rehabilitation of the auditory and balance systems, and 86% for auditory and speech communication disorders (including professional ethics). The overall accuracy rate for the 299 questions was 75%, which surpasses the examination's passing criteria of an average 60% accuracy rate across all subjects. A comprehensive review of ChatGPT-4's responses indicated that incorrect answers were predominantly due to information errors. Conclusions ChatGPT-4 demonstrated a robust performance in the Taiwan Audiologist Qualification Examination, showcasing effective logical reasoning skills. Our results suggest that with enhanced information accuracy, ChatGPT-4's performance could be further improved. This study indicates significant potential for the application of AI chatbots in audiology and hearing care services.
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Affiliation(s)
- Shangqiguo Wang
- Human Communication, Learning, and Development Unit, Faculty of Education, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Changgeng Mo
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Yuan Chen
- Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Xiaolu Dai
- Department of Social Work, Hong Kong Baptist University, Hong Kong, China (Hong Kong)
| | - Huiyi Wang
- Department of Medical Services, Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoli Shen
- Department of Health and Early Childhood Care, Ningbo College of Health School, Ningbo, China
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Hasan MZ, Rabbani MG, Akter O, Mehdi GG, Ahmed MW, Ahmed S, Chowdhury ME. Patient Satisfaction With the Health Care Services of a Government-Financed Health Protection Scheme in Bangladesh: Cross-Sectional Study. JMIR Form Res 2024; 8:e49815. [PMID: 38656783 DOI: 10.2196/49815] [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: 06/10/2023] [Revised: 10/07/2023] [Accepted: 11/22/2023] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Since 2016, the government of Bangladesh has been piloting a health protection scheme known as Shasthyo Surokhsha Karmasuchi (SSK), which specifically targets households living below the poverty line. This noncontributory scheme provides enrolled households access to inpatient health care services for 78 disease groups. Understanding patients' experiences with health care utilization from the pilot SSK scheme is important for enhancing the quality of health care service delivery during the national-level scale-up of the scheme. OBJECTIVE We aimed to evaluate patient satisfaction with the health care services provided under the pilot health protection scheme in Bangladesh. METHODS A cross-sectional survey was conducted with the users of the SSK scheme from August to November 2019. Patients who had spent a minimum of 2 nights at health care facilities were selected for face-to-face exit interviews. During these interviews, we collected information on patients' socioeconomic characteristics, care-seeking experiences, and level of satisfaction with various aspects of health care service delivery. To measure satisfaction, we employed a 5-point Likert scale (very satisfied, 5; satisfied, 4; neither satisfied nor dissatisfied, 3; dissatisfied, 2; very dissatisfied, 1). Descriptive statistics, statistical inferential tests (t-test and 1-way ANOVA), and linear regression analyses were performed. RESULTS We found that 55.1% (241/438) of users were either very satisfied or satisfied with the health care services of the SSK scheme. The most satisfactory indicators were related to privacy maintained during diagnostic tests (mean 3.91, SD 0.64), physicians' behaviors (mean 3.86, SD 0.77), services provided at the registration booth (mean 3.86, SD 0.62), confidentiality maintained regarding diseases (mean 3.78, SD 0.72), and nurses' behaviors (mean 3.60, SD 0.83). Poor satisfaction was identified in the interaction of patients with providers about illness-related information (mean 2.14, SD 1.40), availability of drinking water (mean 1.46, SD 0.76), cleanliness of toilets (mean 2.85, SD 1.04), and cleanliness of the waiting room (mean 2.92, SD 1.09). Patient satisfaction significantly decreased by 0.20 points for registration times of 16-30 minutes and by 0.32 points for registration times of >30 minutes compared with registration times of ≤15 minutes. Similarly, patient satisfaction significantly decreased with an increase in the waiting time to obtain services. However, the satisfaction of users significantly increased if they received a complete course of medicines and all prescribed diagnostic services. CONCLUSIONS More than half of the users were satisfied with the services provided under the SSK scheme. However, there is scope for improving user satisfaction. To improve the satisfaction level, the SSK scheme implementation authorities should pay attention to reducing the registration time and waiting time to obtain services and improving the availability of drugs and prescribed diagnostic services. The authorities should also ensure the supply of drinking water and enhance the cleanliness of the facility.
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Affiliation(s)
- Md Zahid Hasan
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
- Leeds Institute of Health Sciences, University of Leeds, Leeds, United Kingdom
| | - Md Golam Rabbani
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Orin Akter
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Gazi Golam Mehdi
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | | | - Sayem Ahmed
- Health Economics and Health Technology Assessment, School of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom
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Mukundan RC, Singh S, Kumar A, Sathianandan TV. Evaluating the Quality of Life of Beneficiaries After Providing Financial Aid by a Multi-specialty Tertiary Care Hospital. Cureus 2024; 16:e59320. [PMID: 38689679 PMCID: PMC11059032 DOI: 10.7759/cureus.59320] [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] [Accepted: 04/29/2024] [Indexed: 05/02/2024] Open
Abstract
Background Financial aid programs offered by multi-specialty tertiary care hospitals play a crucial role in ensuring equitable access to healthcare. This study investigates the effect of financial aid on the quality of life (QoL) of beneficiaries, aiming to provide a comprehensive understanding of the multifaceted relationship between healthcare support and overall well-being. Aim The study's objectives included assessing changes in pre- and post-aid QoL, identifying influencing factors, understanding beneficiary experiences, and evaluating the effectiveness of financial aid programs. Methods The study adopted quantitative assessments through QoL questionnaires developed based on the WHO BREF questionnaire and insights obtained through interviews. A representative sample of beneficiaries was selected, informed consent was obtained, and an institutional ethical certificate was also obtained. Results The findings overwhelmingly support the alternative hypothesis. The alternative hypothesis was that after receiving financial support, recipients' quality of life would increase. Quantitative analysis revealed a statistically significant enhancement in the QoL of beneficiaries across physical, mental, and social well-being domains. The quality of life scores of patients before and after receiving the support was statistically tested using a paired t-test, and the quality of life score has improved significantly with a p-value of 4.156 × 10-28 (p value<0.001). The comparison of quality of life scores of the control group with the patient's group before getting the support was tested using an independent sample t-test and found to be non-significant (p=0.496), while a similar comparison between the control group and the patient's group after receiving the support was found to be statistically highly significant with a p-value of 8.721 × 10-28 (p-value<0.001). Conclusions This research demonstrates the substantial impact of financial aid on the QoL of beneficiaries in a multi-specialty tertiary care hospital setting. It underlines the importance of addressing economic barriers and providing patient-centered, holistic support. These insights have broader implications for healthcare policy and practice, promoting a more comprehensive approach to patient well-being.
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Affiliation(s)
- Rehana C Mukundan
- Patient Services, Amrita Institute of Medical Sciences and Research Center, Kochi, Kochi, IND
| | - Sanjeev Singh
- Medicine, Amrita Institute of Medical Sciences and Research Center, Faridabad, Faridabad, IND
| | - Ajith Kumar
- Commerce and Management, Amrita School of Arts and Sciences, Kochi, Kochi, IND
| | - T V Sathianandan
- Biostatistics, Amrita Institute of Medical Science and Research Center, Kochi, Kochi, IND
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Ojukwu E, Hirani S, Sotindjo T, McKay E, Okedo-Alex I, Magagula P, Pashaei A, Agudosi GM. The Impact of Intersectional Discrimination and Stigma on HIV Care for African, Caribbean, and Black Women Living With HIV During the COVID-19 Pandemic in British Columbia: A Descriptive Study. J Assoc Nurses AIDS Care 2024; 35:00001782-990000000-00096. [PMID: 38427789 PMCID: PMC11037459 DOI: 10.1097/jnc.0000000000000457] [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] [Indexed: 03/03/2024]
Abstract
ABSTRACT African, Caribbean, and Black women living with HIV (ACB WWH) in British Columbia experience discrimination on the basis of their race, sex, gender identity, sexual orientation, and HIV status. The various forms of stigma that ACB WWH experience intersect to create a uniquely marginalized experience that has negative consequences for quality of life and overall well-being. Eighteen semistructured interviews were completed with ACB WWH in British Columbia. Interviews were conducted by phone, Zoom, or in-person at the participant's request. Participants consistently reported experiences of various forms of discrimination. There was additional stigmatization due to COVID-19 pandemic that negatively influenced the lives of ACB WWH. Interventions and resources are needed to support ACB WWH in navigating how to work through the multifaceted impacts of intersectional stigmatization. Efforts are needed to identify ways to continue the delivery of resources like social support groups throughout future pandemics.
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Affiliation(s)
| | - Saima Hirani
- Emmanuela Ojukwu, PhD, RN, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Saima Hirani, PhD, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Tatiana Sotindjo, MD, FRCPC, is an Adolescent Medicine Specialist Physician, Division of Paediatric Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Emily McKay, BSN, RN, MSN is Nursing Graduate, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ijeoma Okedo-Alex, MBBS, MSC, MPH, FMCPH, is a Public Health Physician, (1) School of Population and Public Health, University of British Columbia; (2) African Institute for Health Policy and Health Systems, Ebonyi State University Abakaliki, Nigeria
- Patience Magagula, BSN, is a Director, Afro-Canadian Positive Network of British Columbia, Vancouver, British Columbia, Canada
- Ava Pashaei, BSN, MSN, is a PhD Student of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ginikachukwu Marylinda Agudosi, MSN, CRNP, is a MD Candidate, Trinity School of Medicine (MS-3), Warner Robins, Georgia, USA
| | - Tatiana Sotindjo
- Emmanuela Ojukwu, PhD, RN, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Saima Hirani, PhD, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Tatiana Sotindjo, MD, FRCPC, is an Adolescent Medicine Specialist Physician, Division of Paediatric Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Emily McKay, BSN, RN, MSN is Nursing Graduate, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ijeoma Okedo-Alex, MBBS, MSC, MPH, FMCPH, is a Public Health Physician, (1) School of Population and Public Health, University of British Columbia; (2) African Institute for Health Policy and Health Systems, Ebonyi State University Abakaliki, Nigeria
- Patience Magagula, BSN, is a Director, Afro-Canadian Positive Network of British Columbia, Vancouver, British Columbia, Canada
- Ava Pashaei, BSN, MSN, is a PhD Student of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ginikachukwu Marylinda Agudosi, MSN, CRNP, is a MD Candidate, Trinity School of Medicine (MS-3), Warner Robins, Georgia, USA
| | - Emily McKay
- Emmanuela Ojukwu, PhD, RN, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Saima Hirani, PhD, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Tatiana Sotindjo, MD, FRCPC, is an Adolescent Medicine Specialist Physician, Division of Paediatric Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Emily McKay, BSN, RN, MSN is Nursing Graduate, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ijeoma Okedo-Alex, MBBS, MSC, MPH, FMCPH, is a Public Health Physician, (1) School of Population and Public Health, University of British Columbia; (2) African Institute for Health Policy and Health Systems, Ebonyi State University Abakaliki, Nigeria
- Patience Magagula, BSN, is a Director, Afro-Canadian Positive Network of British Columbia, Vancouver, British Columbia, Canada
- Ava Pashaei, BSN, MSN, is a PhD Student of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ginikachukwu Marylinda Agudosi, MSN, CRNP, is a MD Candidate, Trinity School of Medicine (MS-3), Warner Robins, Georgia, USA
| | - Ijeoma Okedo-Alex
- Emmanuela Ojukwu, PhD, RN, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Saima Hirani, PhD, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Tatiana Sotindjo, MD, FRCPC, is an Adolescent Medicine Specialist Physician, Division of Paediatric Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Emily McKay, BSN, RN, MSN is Nursing Graduate, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ijeoma Okedo-Alex, MBBS, MSC, MPH, FMCPH, is a Public Health Physician, (1) School of Population and Public Health, University of British Columbia; (2) African Institute for Health Policy and Health Systems, Ebonyi State University Abakaliki, Nigeria
- Patience Magagula, BSN, is a Director, Afro-Canadian Positive Network of British Columbia, Vancouver, British Columbia, Canada
- Ava Pashaei, BSN, MSN, is a PhD Student of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ginikachukwu Marylinda Agudosi, MSN, CRNP, is a MD Candidate, Trinity School of Medicine (MS-3), Warner Robins, Georgia, USA
| | - Patience Magagula
- Emmanuela Ojukwu, PhD, RN, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Saima Hirani, PhD, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Tatiana Sotindjo, MD, FRCPC, is an Adolescent Medicine Specialist Physician, Division of Paediatric Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Emily McKay, BSN, RN, MSN is Nursing Graduate, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ijeoma Okedo-Alex, MBBS, MSC, MPH, FMCPH, is a Public Health Physician, (1) School of Population and Public Health, University of British Columbia; (2) African Institute for Health Policy and Health Systems, Ebonyi State University Abakaliki, Nigeria
- Patience Magagula, BSN, is a Director, Afro-Canadian Positive Network of British Columbia, Vancouver, British Columbia, Canada
- Ava Pashaei, BSN, MSN, is a PhD Student of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ginikachukwu Marylinda Agudosi, MSN, CRNP, is a MD Candidate, Trinity School of Medicine (MS-3), Warner Robins, Georgia, USA
| | - Ava Pashaei
- Emmanuela Ojukwu, PhD, RN, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Saima Hirani, PhD, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Tatiana Sotindjo, MD, FRCPC, is an Adolescent Medicine Specialist Physician, Division of Paediatric Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Emily McKay, BSN, RN, MSN is Nursing Graduate, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ijeoma Okedo-Alex, MBBS, MSC, MPH, FMCPH, is a Public Health Physician, (1) School of Population and Public Health, University of British Columbia; (2) African Institute for Health Policy and Health Systems, Ebonyi State University Abakaliki, Nigeria
- Patience Magagula, BSN, is a Director, Afro-Canadian Positive Network of British Columbia, Vancouver, British Columbia, Canada
- Ava Pashaei, BSN, MSN, is a PhD Student of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ginikachukwu Marylinda Agudosi, MSN, CRNP, is a MD Candidate, Trinity School of Medicine (MS-3), Warner Robins, Georgia, USA
| | - Ginikachukwu Marylinda Agudosi
- Emmanuela Ojukwu, PhD, RN, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Saima Hirani, PhD, is an Assistant Professor of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Tatiana Sotindjo, MD, FRCPC, is an Adolescent Medicine Specialist Physician, Division of Paediatric Infectious Diseases, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
- Emily McKay, BSN, RN, MSN is Nursing Graduate, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ijeoma Okedo-Alex, MBBS, MSC, MPH, FMCPH, is a Public Health Physician, (1) School of Population and Public Health, University of British Columbia; (2) African Institute for Health Policy and Health Systems, Ebonyi State University Abakaliki, Nigeria
- Patience Magagula, BSN, is a Director, Afro-Canadian Positive Network of British Columbia, Vancouver, British Columbia, Canada
- Ava Pashaei, BSN, MSN, is a PhD Student of Nursing, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- Ginikachukwu Marylinda Agudosi, MSN, CRNP, is a MD Candidate, Trinity School of Medicine (MS-3), Warner Robins, Georgia, USA
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Gonçalves LC, Heller P, Bachmann ACB, Barbolini J, Fuhrer C, Gétaz L, Luke E, Wolff H, Baggio S. Mental Health Consultations in Immigration Detention: What Can We Learn From Clinical Records? Int J Public Health 2024; 69:1605896. [PMID: 38332758 PMCID: PMC10850243 DOI: 10.3389/ijph.2024.1605896] [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: 02/15/2023] [Accepted: 01/15/2024] [Indexed: 02/10/2024] Open
Abstract
Objectives: Knowledge on mental health consultations in immigration detention and characteristics of people receiving consultations is scarce. Based on a sample of 230 adult men in immigration detention in Switzerland, we aimed to: (1) Quantify the proportion of persons receiving mental health consultations during detention; and (2) Identify socio-demographic and clinical characteristics associated with mental health consultations. Methods: Retrospective observational study with a cross-sectional design. Prevalence estimates, logistic regressions, and contingency tables were used to analyse the data. Results: A total of 30% of the sample received mental health consultations during detention. Time spent in immigration detention, mental health problems during detention, use of psychotropic medication, and self-harm were associated with mental health consultations. Although mental health consultations are provided to people with more severe mental health problems, 41% of persons with assessed mental health needs during the initial screening and 26% of those who self-harmed during detention did not receive mental health consultations. Conclusion: Mental health resources and screening procedures could be improved to ensure that mental health consultations are matched to clinical need in immigration detention settings.
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Affiliation(s)
- Leonel C. Gonçalves
- Division of Prison Health, Geneva University Hospitals & University of Geneva, Geneva, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Patrick Heller
- Division of Prison Health, Geneva University Hospitals, Geneva, Switzerland
| | - Anne-Claire B. Bachmann
- Division of Prison Health, Geneva University Hospitals & University of Geneva, Geneva, Switzerland
| | | | - Clara Fuhrer
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Laurent Gétaz
- Division of Prison Health, Geneva University Hospitals & University of Geneva, Geneva, Switzerland
- Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Eric Luke
- Private Practitioner, Geneva, Switzerland
| | - Hans Wolff
- Division of Prison Health, Geneva University Hospitals & University of Geneva, Geneva, Switzerland
| | - Stéphanie Baggio
- Division of Prison Health, Geneva University Hospitals & University of Geneva, Geneva, Switzerland
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
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Sagen JS, Kjeken I, Habberstad A, Linge AD, Simonsen AE, Lyken AD, Irgens EL, Framstad H, Lyby PS, Klokkerud M, Dagfinrud H, Moe RH. Patient Involvement in the Rehabilitation Process Is Associated with Improvement in Function and Goal Attainment: Results from an Explorative Longitudinal Study. J Clin Med 2024; 13:320. [PMID: 38256454 PMCID: PMC10816630 DOI: 10.3390/jcm13020320] [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: 12/04/2023] [Revised: 12/22/2023] [Accepted: 01/04/2024] [Indexed: 01/24/2024] Open
Abstract
The objective was to explore the associations between patient involvement in the rehabilitation process and improvements in function and goal attainment in the first year after rehabilitation. The longitudinal multicenter study RehabNytte provided data from participants who had been referred to rehabilitation (n = 2113). Quality indicator (QI) pass rates (% yes) were used to assess patient involvement in the rehabilitation process. The Patient-Specific Functional Scale (PSFS) (10 = best possible) was used to assess function. The outcome QI on goal achievement (response options of yes/no) was used to assess goal attainment. Logistic regression and paired sample t-tests were used to examine associations and mean changes in function from rehabilitation admission up to 3, 6, and 12 months. Most participants (95%) were involved in goal-setting, which was positively associated with younger age (OR 0.97, 95% CI 0.95-0.99) and female sex (OR 1.87, 95% CI 1.15-3.02). Function improved over the follow-up period, with greater improvements in the active goal-setting group. Being involved in goal planning almost tripled the odds of goal attainment (OR 2.78, 95% CI 1.60-4.83) and involvement in the rehabilitation plan almost doubled it (OR 1.99, 95% CI 1.41-2.81). Most participants were involved in rehabilitation goal-setting/planning and being involved was associated with beneficial functional outcomes and greater goal attainment.
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Affiliation(s)
- Joachim Støren Sagen
- Faculty of Health Sciences, Oslo Metropolitan University, St. Olavs plass 4, 0130 Oslo, Norway;
- Diakonhjemmet Hospital, Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Norwegian National Advisory Unit on Rehabilitation in Rheumatology (NKRR), Diakonveien 12, 0370 Oslo, Norway; (I.K.); (H.D.); (R.H.M.)
| | - Ingvild Kjeken
- Diakonhjemmet Hospital, Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Norwegian National Advisory Unit on Rehabilitation in Rheumatology (NKRR), Diakonveien 12, 0370 Oslo, Norway; (I.K.); (H.D.); (R.H.M.)
| | - Andreas Habberstad
- The Norwegian Federation of Organizations of Disabled People, Mariboesgate 13, 0183 Oslo, Norway;
| | - Anita Dyb Linge
- Muritunet Rehabilitation Center, Grandegata 58, 6210 Sylte, Norway;
| | | | - Anne Dorte Lyken
- Sørlandet Rehabilitation Center, Ola Garsons vei 1, 4596 Eiken, Norway;
| | - Eirik Lind Irgens
- Helsepartner Rehabilitation Center, Follumsvei 1, 9510 Alta, Norway;
| | - Heidi Framstad
- Røysumtunet Rehabilitation Center, Røysumlinna 41, 2770 Jaren, Norway; (A.E.S.); (H.F.)
| | - Peter Solvoll Lyby
- Catosenteret Rehabilitation Center, Kvartsveien 2, 1555 Store Brevik, Norway;
| | - Mari Klokkerud
- Faculty of Health Sciences, Oslo Metropolitan University, St. Olavs plass 4, 0130 Oslo, Norway;
| | - Hanne Dagfinrud
- Diakonhjemmet Hospital, Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Norwegian National Advisory Unit on Rehabilitation in Rheumatology (NKRR), Diakonveien 12, 0370 Oslo, Norway; (I.K.); (H.D.); (R.H.M.)
| | - Rikke Helene Moe
- Diakonhjemmet Hospital, Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Norwegian National Advisory Unit on Rehabilitation in Rheumatology (NKRR), Diakonveien 12, 0370 Oslo, Norway; (I.K.); (H.D.); (R.H.M.)
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Fong VC, Baumbusch J, Khan K. "Can you hear me OK?": Caregivers of Children With Medical Complexity and Their Perspectives of Virtual Care During COVID-19. J Pediatr Health Care 2024; 38:30-38. [PMID: 37725030 DOI: 10.1016/j.pedhc.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 07/25/2023] [Accepted: 08/23/2023] [Indexed: 09/21/2023]
Abstract
INTRODUCTION The rapid and widespread shift to virtual care during COVID-19 created new opportunities and unique challenges for families of children with medical complexity (CMC). However, few studies have examined perceptions of virtual care during the pandemic in this population. METHOD To address this gap, the current study used a qualitative approach and semistructured interviews via Zoom to explore parent perspectives of virtual care. Purposive sampling was used to recruit 30 parents residing with their CMC (aged 0-18 years) in British Columbia, Canada. RESULTS The findings identified from the data included (1) advantages and opportunities, (2) concerns and challenges, and (3) parent choice and preference. DISCUSSION Our findings indicate the need for healthcare professionals to receive training to use virtual care in their practice effectively. In addition, policies about standards for virtual care and ensuring families have access to the necessary technology will help reduce barriers and improve equity and inclusion for this population.
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Eliassen M, Sørensen BA, Hartviksen TA, Holm S, Zingmark M. Emplacing reablement co-creating an outdoor recreation model in the rural Arctic. Int J Circumpolar Health 2023; 82:2273013. [PMID: 37883476 PMCID: PMC10997308 DOI: 10.1080/22423982.2023.2273013] [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: 07/24/2023] [Accepted: 10/16/2023] [Indexed: 10/28/2023] Open
Abstract
Reablement aims to enable older persons with functional decline to re-engage in meaningful activities. The benefits of engagement in outdoor activities are significant; however, reablement services primarily target function in indoor environments whereas descriptions of outdoor activities are sparse. The aim of this study was to create a model that integrates outdoor recreation into reablement. We therefore elaborated on an experienced based co-design methodology to create a model that integrates outdoor recreation for older persons in reablement in an Arctic, rural context in northern Norway. Stakeholders (N = 35), including reablement participants, participated in workshops, focus groups, and individual interviews. Based on the results, we co-created a person-centred model for outdoor recreation in reablement, including an assessment tool that can guide reablement staff in goal-setting practices. Accordingly, we argue that cherished locations holds significant meaning in the lives of older people and warrant recognition in reablement programmes. There is a need to evaluate the effects and feasibility of the model and the possibility for its implementation in other health care settings.
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Affiliation(s)
- Marianne Eliassen
- Department of Health and Care Sciences, UiT, The Arctic University of Norway, Tromsø, Norway
| | - Bodil A. Sørensen
- Department of Research, Development and Innovation, Municipality of Vestvågøy. Postboks 203, Leknes, Norway
| | - Trude A. Hartviksen
- Department of Health and Care Sciences, UiT, The Arctic University of Norway, Municipality of Vestvågøy. Postboks 203, Leknes, Norway
| | - Solrun Holm
- Department of Research, Development and Innovation, Municipality of Vestvågøy. Postboks 203, Leknes, Norway
| | - Magnus Zingmark
- Department of Epidemiology and Global Health, Faculty of medicine, Umeå University, Umeå, Sweden
- Health and Social Care administration, Municipality of Östersund, Health and Social Care Administration, Östersund, Sweden
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Alharbi AA, Albalwi AA. Exploring the Influential Factors Impacting the Provision of Family-Centered Care for Children with Cerebral Palsy in Saudi Arabia. Children (Basel) 2023; 10:1868. [PMID: 38136070 PMCID: PMC10741779 DOI: 10.3390/children10121868] [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] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023]
Abstract
Family-centered care is widely considered as best practice in pediatric rehabilitation. We aimed to investigate parents' perception of the family-centeredness of health care services for their children with cerebral palsy (CP) using the Arabic Measure of Processes of Care-20 (AR-MPOC-20). We also explored factors related to the child (sex, secondary impairments, and gross motor classification system level) and environment (family and residential region) that may influence the family-centeredness of services in Saudi Arabia. This was a cross-sectional study of 223 children with CP (age 6 months-18.2 years, M = 6.2 + 3.7 years) and their parents. Generally, parents perceived services as less family-centered. The lowest average score was for 'Providing General Information' (M = 2.9 ± 1.5), while 'Respectful and Supportive Care' had the highest average (M = 4.6 ± 1.8). Factors influencing the provision of family-centered care included being a female child and a mother's educational level. In addition, all subscales of AR-MPOC-20 differed by region, p < 0.001, except for 'Providing Specific Information' which did not significantly differ by region p = 0.163. Clinicians should consider the families' need for information regarding their children's condition and available services, with special attention to the mothers of female children and mothers with low levels of education.
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Affiliation(s)
- Ahmad Abdullah Alharbi
- Department of Physical Therapy, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia;
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10
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Cheng K, Wang J, Liu J, Zhang X, Shen Y, Su H. Public health implications of computer-aided diagnosis and treatment technologies in breast cancer care. AIMS Public Health 2023; 10:867-895. [PMID: 38187901 PMCID: PMC10764974 DOI: 10.3934/publichealth.2023057] [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: 08/26/2023] [Accepted: 10/10/2023] [Indexed: 01/09/2024] Open
Abstract
Breast cancer remains a significant public health issue, being a leading cause of cancer-related mortality among women globally. Timely diagnosis and efficient treatment are crucial for enhancing patient outcomes, reducing healthcare burdens and advancing community health. This systematic review, following the PRISMA guidelines, aims to comprehensively synthesize the recent advancements in computer-aided diagnosis and treatment for breast cancer. The study covers the latest developments in image analysis and processing, machine learning and deep learning algorithms, multimodal fusion techniques and radiation therapy planning and simulation. The results of the review suggest that machine learning, augmented and virtual reality and data mining are the three major research hotspots in breast cancer management. Moreover, this paper discusses the challenges and opportunities for future research in this field. The conclusion highlights the importance of computer-aided techniques in the management of breast cancer and summarizes the key findings of the review.
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Affiliation(s)
- Kai Cheng
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, 264100, China
| | - Jiangtao Wang
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, 264100, China
| | - Jian Liu
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, 264100, China
| | - Xiangsheng Zhang
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, 264100, China
| | - Yuanyuan Shen
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, 264100, China
| | - Hang Su
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
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Chen Y, Wu Z, Wang P, Xie L, Yan M, Jiang M, Yang Z, Zheng J, Zhang J, Zhu J. Radiology Residents' Perceptions of Artificial Intelligence: Nationwide Cross-Sectional Survey Study. J Med Internet Res 2023; 25:e48249. [PMID: 37856181 PMCID: PMC10623237 DOI: 10.2196/48249] [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: 04/17/2023] [Revised: 07/07/2023] [Accepted: 09/01/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Artificial intelligence (AI) is transforming various fields, with health care, especially diagnostic specialties such as radiology, being a key but controversial battleground. However, there is limited research systematically examining the response of "human intelligence" to AI. OBJECTIVE This study aims to comprehend radiologists' perceptions regarding AI, including their views on its potential to replace them, its usefulness, and their willingness to accept it. We examine the influence of various factors, encompassing demographic characteristics, working status, psychosocial aspects, personal experience, and contextual factors. METHODS Between December 1, 2020, and April 30, 2021, a cross-sectional survey was completed by 3666 radiology residents in China. We used multivariable logistic regression models to examine factors and associations, reporting odds ratios (ORs) and 95% CIs. RESULTS In summary, radiology residents generally hold a positive attitude toward AI, with 29.90% (1096/3666) agreeing that AI may reduce the demand for radiologists, 72.80% (2669/3666) believing AI improves disease diagnosis, and 78.18% (2866/3666) feeling that radiologists should embrace AI. Several associated factors, including age, gender, education, region, eye strain, working hours, time spent on medical images, resilience, burnout, AI experience, and perceptions of residency support and stress, significantly influence AI attitudes. For instance, burnout symptoms were associated with greater concerns about AI replacement (OR 1.89; P<.001), less favorable views on AI usefulness (OR 0.77; P=.005), and reduced willingness to use AI (OR 0.71; P<.001). Moreover, after adjusting for all other factors, perceived AI replacement (OR 0.81; P<.001) and AI usefulness (OR 5.97; P<.001) were shown to significantly impact the intention to use AI. CONCLUSIONS This study profiles radiology residents who are accepting of AI. Our comprehensive findings provide insights for a multidimensional approach to help physicians adapt to AI. Targeted policies, such as digital health care initiatives and medical education, can be developed accordingly.
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Affiliation(s)
- Yanhua Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
- School of Medicine, Tsinghua University, Beijing, China
| | - Ziye Wu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Peicheng Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China
- School of Medicine, Tsinghua University, Beijing, China
| | - Linbo Xie
- Vanke School of Public Health, Tsinghua University, Beijing, China
- School of Medicine, Tsinghua University, Beijing, China
| | - Mengsha Yan
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Maoqing Jiang
- Department of Radiology, Ningbo No. 2 Hospital, Ningbo, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jianjun Zheng
- Department of Radiology, Ningbo No. 2 Hospital, Ningbo, China
| | - Jingfeng Zhang
- Department of Radiology, Ningbo No. 2 Hospital, Ningbo, China
| | - Jiming Zhu
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
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Eliassen M, Moholt JM. Boundary work in task-shifting practices - a qualitative study of reablement teams. Physiother Theory Pract 2023; 39:2106-2119. [PMID: 35430950 DOI: 10.1080/09593985.2022.2064380] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 04/22/2021] [Revised: 03/28/2022] [Accepted: 04/04/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Health services worldwide have provided incentives for establishing teams to accommodate complex health care tasks, enhance patient outcomes and organizational efficiency, and compensate for shortages of health care professionals. Parallel to and partly due to the increased focus on teamwork, task shifting has become a health policy. Task shifting involves new tasks and responsibilities, which may result in social negotiations about occupational boundaries. OBJECTIVE The aim of this study was to explore how the division of tasks, responsibilities, and roles in reablement practices can appear as boundary work between physiotherapists (PTs) and home trainers (HTs). METHODS The study drew on data from fieldwork with seven Norwegian reablement teams, including observations and individual interviews with PTs and HTs. We conducted thematic analysis informed by a theoretical framework on professional boundaries. RESULTS We identified two different practices, which we labeled as: i) "The engine and the assistant" and ii) "The symbiotic team." We drew on these practices and theory of boundary making and boundary blurring to interpret the results. CONCLUSION The findings indicate that boundary-making processes may generate asymmetric power relations that may constrain autonomous work and job satisfaction in teams, whereas boundary-blurring processes may promote collaborative practices that enhance holistic approaches and mutual learning on reablement teams.
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Affiliation(s)
- Marianne Eliassen
- Department of Health and Care sciences, UiT, The Arctic University of Norway
| | - Jill-Marit Moholt
- Center for Care Sciences, North, UiT, The Arctic University of Norway
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Duale HA, Farah A, Salad A, Gele S, Gele A. Constraints to maternal healthcare access among pastoral communities in the Darussalam area of Mudug region, Somalia "a qualitative study". Front Public Health 2023; 11:1210401. [PMID: 37790717 PMCID: PMC10543082 DOI: 10.3389/fpubh.2023.1210401] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 08/31/2023] [Indexed: 10/05/2023] Open
Abstract
Background While countries embrace efforts to achieve Sustainable Development Goals (SDG) goal 3.1 (to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030 and end preventable deaths of new-borns and children), an estimated 2.5 million pastoralists in Somalia are struggling to access maternal and child healthcare services. Institutional delivery and access to antenatal care remained to be a challenge in Somalia, where pastoralism is a common means of livelihood. The aim of this study is to explore the maternal health services available for settled pastoralists (transhumant) and their families who still practice nomadic pastoralism in the Mudug region of Somalia. Methods A qualitative study, including 14 interviews and one FGD, was conducted in Darussalam village (a transhumant village along the border between Somalia and Ethiopia), Puntland State, from December 2022 to January 2023. The study participants were community members who support the maternal and child health clinic (MCH), village administration, and health providers. Results We found that the efficiency of the health facilities that serve for pastoralist women and children are hampered by staff-related, supply-related, patients-related and referral-related constraints. This study highlights that the absence of essential supplies, the unmet need for training among the staff as well as the absence of important facilities in the MCH such as ambulance and blood bags. Conclusion Numerous strides could be made in the provision of affordable maternal healthcare to pastoralist communities in Darussalam areas of the Mudug region when organizations that support health care in Somalia and the Ministry of Health include pastoralists' healthcare in their priorities.
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Affiliation(s)
- Hodan A. Duale
- Department of Maternal and Reproductive Health, Somali Institute for Health Research, Hargeisa, Somalia
| | - Abdiqani Farah
- Department of Maternal and Reproductive Health, Somali Institute for Health Research, Hargeisa, Somalia
- Faculty of Medicine, Al-Hayat Medical University, Mogadishu, Somalia
| | - Abdi Salad
- Faculty of Medicine, Somali National University, Mogadishu, Somalia
| | - Sumaya Gele
- Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Abdi Gele
- Department of Maternal and Reproductive Health, Somali Institute for Health Research, Hargeisa, Somalia
- Department of Health Service Research, Norwegian Institute of Public Health, Oslo, Norway
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Chong ASS, Ahmad MB, Alias H, Iqbal Hussain RB, Lateh AB, Chan CMH. Spiritual Coping Among Families of Children With Cancer: A Qualitative Study. Asia Pac J Public Health 2023; 35:408-412. [PMID: 37515530 DOI: 10.1177/10105395231190830] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 07/31/2023]
Abstract
The impact of a childhood cancer diagnosis precipitates caregiver's engagement in spiritual coping. This study aimed to explore spirituality among Malaysian Muslim caregivers of children with acute lymphoblastic leukemia. A total of 13 eligible caregivers participated in this qualitative semi-structured interview via purposive sampling. Each interview was audio recorded, transcribed verbatim, and analyzed using NVivo 12 via thematic analysis. Three main themes revolved around hope through the act of praying and recitation (du'ā' and dhikr), acceptance of God's will (redha), and faith toward God as the Provider of sustenance (rezeki). The findings of this study contribute to a holistic supportive care system in pediatric oncology as it informs health care providers the role of spirituality in mitigating the emotional impact of a cancer diagnosis and promoting psychological adaptation. As a multicultural country, future studies may explore spirituality in other cultures and religion in the country.
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Affiliation(s)
- Agnes Shu Sze Chong
- Clinical Psychology and Behavioural Health Program, Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mahadir Bin Ahmad
- Clinical Psychology and Behavioural Health Program, Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Hamidah Alias
- Department of Pediatrics, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | | | - Afifi Bin Lateh
- Department of Educational Evaluation and Research, Faculty of Education, Prince of Songkla University, Pattani, Thailand
| | - Caryn Mei Hsien Chan
- Clinical Psychology and Behavioural Health Program, Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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15
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Ho BV, van der Maarel-Wierink CD, de Vries R, Lobbezoo F. Oral health care services for community-dwelling older people with dementia: A scoping review. Gerodontology 2023; 40:288-298. [PMID: 36440580 DOI: 10.1111/ger.12670] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/02/2022] [Accepted: 11/09/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess whether, and if so, which oral health care services for community-dwelling older people with dementia are available. BACKGROUND Oral health in people with dementia is poor compared with people without dementia. Although multiple oral health care interventions have previously been studied for older people living in nursing homes, little is known about interventions or services for community-dwelling older people with dementia. MATERIALS AND METHODS A literature search was performed in the databases Pubmed, Embase and CINAHL. The following search terms were used: "Dementia", "Oral health", "Dental health services" and "Older person". The term "dental health services" was intended to be an as broad as possible construct because limited search results were expected. RESULTS The search generated 1624 unique references, of which seven studies were eligible for inclusion (four cohort studies, one cross-sectional study, and two qualitative studies). The included studies described two actual oral health care services: a telephone help line on oral health and dementia, and a mobile geriatric dental programme in adult day health centres. A need was found for services and strategies specific to community-dwelling older people with dementia. One identified solution was an intervention with individually tailored daily oral hygiene self-care supported by the informal caregiver. Furthermore, increasing accessibility of oral health care professionals with treatment at other locations than their own practices, better collaboration between health care professionals and preventive oral health care are highly necessary. CONCLUSION There is limited evidence on the availability of oral health care services for community-dwelling older people with dementia, while a need was found for oral health care services that focus on good accessibility, oral hygiene self-care, preventive strategies and collaboration among health care professionals.
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Affiliation(s)
- Bach Van Ho
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Claar D van der Maarel-Wierink
- Department of Oral Medicine, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ralph de Vries
- Medical Library, Vrije Universiteit, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Chang M, Michelet M, Skirbekk V, Langballe EM, Hopstock LA, Sund ER, Krokstad S, Strand BH. Trends in the use of home care services among Norwegians 70+ and projections towards 2050: The HUNT study 1995-2017. Scand J Caring Sci 2023; 37:752-765. [PMID: 36967552 DOI: 10.1111/scs.13158] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 01/20/2023] [Accepted: 02/13/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND Life expectancy (LE) is increasing worldwide, while there is lack of information on how this affects older individuals' use of formal home care services. AIM We aimed to decompose LE into years with and without home care services and estimate projected number of users towards 2050 in Norway for people 70 years or older. METHODS This study is based on a sample of 25,536 participants aged 70 years and older in the Trøndelag Health Study (HUNT) survey 2 (1995-1997), 3 (2006-2008), or 4 (2017-2019) linked with national data on mortality. Prevalence of home care services was standardised to the Norwegian population by age and sex. The Sullivan method was used to estimate expected years with and without home help services and nursing services for the years 1995, 2006 and 2016. Data from HUNT4 and Statistics Norway were used to estimate projected use of these services between 2020 and 2050. RESULTS During 1995-2017, the use of home help services decreased from 22.6% to 6.2% (p < 0.001), and from 6.4% to 5.5% (p = 0.004) for home nursing services. Adjusted for age and sex, the use of home help services decreased significantly over time (p < 0.001), while home nursing services were stable (p = 0.69). LE at age 70 increased from 11.9 to 15.3 years in men (p < 0.05) during 1995-2017, and from 14.7 to 17.1 in women (p < 0.05). In the same period, the expected years receiving home help decreased from 2.6 to 1.1 in men (p < 0.05), and from 4.4 to 2.1 in women (p < 0.05). The expected years receiving home nursing increased from 0.6 to 0.9 in men (p < 0.05), and from 1.3 to 1.7 in women (p < 0.05). Projected numbers of people 70+ in Norway in need of either of these services were estimated to rise from 64,000 in 2020 to 160,000 in 2050. CONCLUSION While overall life expectancy increased, the expected years receiving home help have decreased and home nursing slightly increased among the Norwegian population aged 70 years and older during 1995-2017. However, the substantial increase in the projected number of older adults using home care services in the future is an alert for the current health care planners.
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Affiliation(s)
- Milan Chang
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
- Icelandic Gerontological Research Institute, Reykjavik, Iceland
| | - Mona Michelet
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tonsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Vegard Skirbekk
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Ellen M Langballe
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tonsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Laila A Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Erik R Sund
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, NTNU Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
- Faculty of Nursing and Health Sciences, Nord University, Levanger, Norway
| | - Steinar Krokstad
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, HUNT Research Centre, NTNU Norwegian University of Science and Technology, Trondheim, Norway
- Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Bjørn H Strand
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tonsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
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Premanandan S, Ahmad A, Cajander Å, Ågerfalk P, van Gemert-Pijnen L. Designing and Evaluating IT Applications for Informal Caregivers: Protocol for a Scoping Review. JMIR Res Protoc 2023; 12:e47650. [PMID: 37410533 PMCID: PMC10360011 DOI: 10.2196/47650] [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: 03/28/2023] [Revised: 05/17/2023] [Accepted: 06/01/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND A growing number of informal caregivers in many countries are important for effective functioning of health care in our society. Hence, they must receive the required support and services to continue providing care. IT applications can be used to support informal caregivers in their caregiving activities. However, evidence-informed guidelines for developing such IT applications and their evaluation are scarce. Hence, this scoping review can aid researchers and designers by providing design recommendations for IT apps for caregivers and potentially improve the design of IT applications for caregivers to meet their needs better. OBJECTIVE This study aims to describe the proposal for a scoping review of current practices and recommendations in designing and evaluating IT applications for informal caregivers. The scoping review will also discuss the opportunities and challenges in designing these IT applications. METHODS We will use a 5-step scoping review methodology to map relevant literature published as follows: (1) identify the research question, (2) identify relevant studies, (3) select relevant studies for review, (4) chart the data from selected literature, and (5) summarize and report results. A structured search will be conducted in PubMed, Scopus, IEEE digital library, Web of Science, and ACM Digital Library databases. In addition, hand searches of reference lists and keyword searches in Google Scholar will also be conducted. Inclusion criteria will be researched (journal and conference) articles focused on IT applications designed for use by informal caregivers and study type to be qualitative studies. Two reviewers will independently identify articles for review and extract data. Conflicts will be discussed, and a third reviewer will be consulted if a consensus cannot be reached. These data will be analyzed using thematic analysis. RESULTS The results from this scoping review will be presented in a narrative form, and additional data on study characteristics will be presented in diagrams or tabular format. Uppsala University first initiated this scoping review protocol in December 2021 as part of the European Union-funded project ENTWINE. This work was also supported by the Swedish Research Council and the Swedish Cancer Society. The results will be presented in August 2023 and will be disseminated through a report to the European Union and a peer-reviewed journal publication. In addition, the team plans to share its findings on various public platforms, including social media, blog posts, and relevant conferences and workshops. CONCLUSIONS This is, to our knowledge, the first study to map the literature on the design and evaluation of IT applications for informal caregivers. The scoping review's results will detail the requirements, design suggestions, and user preferences, as well as the usability criteria and features of IT applications for informal caregivers. A mapping of studies could inform the design and implementation of future IT applications for informal caregivers. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/47650.
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Affiliation(s)
- Shweta Premanandan
- Department of Informatics and Media, Uppsala University, Uppsala, Sweden
| | - Awais Ahmad
- Division of Visual Information and Interaction, Department of Information Technology, Uppsala University, Uppsala, Sweden
| | - Åsa Cajander
- Division of Visual Information and Interaction, Department of Information Technology, Uppsala University, Uppsala, Sweden
| | - Pär Ågerfalk
- Department of Informatics and Media, Uppsala University, Uppsala, Sweden
| | - Lisette van Gemert-Pijnen
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health & Technology, University of Twente, Enschede, Netherlands
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Brainin E, Neter E. Refined Analysis of Older eHealth Users From an Agency Perspective: Quantitative Telephone Interview Study. JMIR Aging 2023; 6:e40004. [PMID: 37121572 PMCID: PMC10173039 DOI: 10.2196/40004] [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: 06/04/2022] [Revised: 01/04/2023] [Accepted: 02/03/2023] [Indexed: 05/02/2023] Open
Abstract
BACKGROUND Most studies on the eHealth divide among older people have compared users to nonusers and found that age, gender, and education were associated with eHealth misuse. They assumed that these characteristics were structural barriers to eHealth adoption. Furthermore, eHealth practices have been examined in a narrow and incomplete way, and the studies disagree about the association between health conditions and eHealth use. Using a more dynamic theoretical lens, we investigated the potential motivations driving older adults' agential adoption of eHealth practices despite their advanced age. OBJECTIVE This study aimed to obtain a complete and detailed description of eHealth uses among older adults; examine whether demographic characteristics such as age, gender, and education (previously related to eHealth misuse) are still associated with the various eHealth clusters; and determine whether contextual factors such as changes in the health condition of older eHealth users or their loved ones are associated with older adult eHealth use. METHODS We conducted a 30-minute telephone interview with a representative sample of 442 Israeli adults (aged ≥50 years) with a sampling error of 2.04%. The interviews were conducted in Hebrew, Arabic, and Russian. Using factor analysis with 21 eHealth use questions, we identified 4 eHealth clusters: instrumental and administrative information seeking, information sharing, seeking information from peers, and web-based self-tracking. In addition to age, gender, education, internet experience, frequency of internet use, perceived eHealth literacy, and self-rated health, we asked respondents to indicate how much they had used offline health services because of a health crisis in the past year. RESULTS We found differences in the number of older eHealth users in the various clusters. They used instrumental and administrative information (420/442, 95%) and obtained information from peers (348/442, 78.7%) the most; followed by web-based self-tracking related to health issues (305/442, 69%), and only a few (52/442, 11.3%) uploaded and shared health information on the web. When controlling for personal attributes, age, gender, and education were no longer predictors of eHealth use, nor was a chronic ailment. Instead, internet experience, frequency of internet use, and perceived eHealth literacy were associated with 3 eHealth clusters. Looking for health information for family and friends predicted all 4 eHealth clusters. CONCLUSIONS Many older adults can overcome structural barriers such as age, gender, and education. The change in their or their loved ones' circumstances encouraged them to make deliberate efforts to embrace the new practices expected from today's patients. Seeking health information for family and friends and dealing with unexpected health crises motivates them to use eHealth. We suggest that health professionals ignore their tendency to label older people as nonusers and encourage them to benefit from using eHealth and overcome stereotypical ways of perceiving these patients.
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Affiliation(s)
- Esther Brainin
- Ruppin Academic Center, Department of Behavioral Sciences, Faculty of Community and Social Sciences, Emek Hefer District, Israel
| | - Efrat Neter
- Ruppin Academic Center, Department of Behavioral Sciences, Faculty of Community and Social Sciences, Emek Hefer District, Israel
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Fresán A, González-Castro TB, Pool-García S, Tovilla-Zárate CA, Sánchez de la Cruz JP, López-Narváez ML, Castillo-Avila RG, Ramos-Méndez MÁ. Chronic Pain and Depression are Increased in Outpatient Adults with Somatic Symptoms from Secondary Health Care Services. Pain Manag Nurs 2023:S1524-9042(23)00032-2. [PMID: 36890094 DOI: 10.1016/j.pmn.2023.02.004] [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: 02/11/2022] [Revised: 12/13/2022] [Accepted: 02/11/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND Somatic symptom disorder is described as excessive thoughts, feelings, or behaviors related to physical symptoms. The presence of somatic symptoms has been associated with depression, alexithymia, and the presence of chronic pain. Individuals with somatic symptom disorder are frequent attenders of primary health care services. AIM We focused on investigating if the presence of psychological symptoms, alexithymia, or pain could be risk factors for somatic symptoms in a secondary health care service. METHODS A cross-sectional and observational study. A total of 136 Mexican individuals who regularly attend a secondary health care service were recruited. The Visual Analogue Scale for Pain Assessment, the Symptom Checklist 90, and the Patient Health Questionnaire-15 were applied. RESULTS Of all the participants, 45.2% showed somatic symptoms. We observed that these individuals more frequently presented with complaints of pain (χ2 = 18.4, p < .001), as well as more severe (t = -4.6, p < .001), and prolonged (χ2 = 4.9, p = 0.02). They also exhibited higher severity in all psychological dimensions assessed (p < .001). Finally, cardiovascular disease (t = 2.52, p = .01), pain intensity (t = 2.94, p = .005), and SCL-90 depression (t = 7.58, p < .001) were associated with somatic symptoms. CONCLUSIONS In this study, we observed a high frequency of somatic symptoms in outpatients attending secondary health care services. They may be accompanied by comorbid cardiovascular conditions, higher pain intensity, and other mental health-related symptoms, which may aggravate the general clinical picture presented by the patient seeking health care. The presence and severity of somatization should be taken into consideration in the first and second level health care services for an early mental state evaluation and treatment of these outpatients to have a better clinical assessment and health outcome.
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Affiliation(s)
- Ana Fresán
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz, Ciudad de México, México
| | - Thelma Beatriz González-Castro
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Jalpa de Méndez, Jalpa de Méndez, Tabasco, México
| | - Sherezada Pool-García
- Hospital General de Comalcalco "Dr. Desiderio G. Rosado Carbajal", Secretaría de Salud, Comalcalco, Tabasco, México
| | - Carlos Alfonso Tovilla-Zárate
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Comalcalco, Comalcalco, Tabasco, México.
| | - Juan Pablo Sánchez de la Cruz
- Universidad Juárez Autónoma de Tabasco, División Académica Multidisciplinaria de Comalcalco, Comalcalco, Tabasco, México
| | - María Lilia López-Narváez
- Hospital Chiapas Nos Une Dr. Gilberto Gómez Maza, Secretaría de Salud de Chiapas, Tuxtla Gutiérrez, Chiapas, México
| | - Rosa Giannina Castillo-Avila
- Universidad Juárez Autónoma de Tabasco, División Académica de Ciencias de la Salud, Villahermosa, Tabasco, México
| | - Miguel Ángel Ramos-Méndez
- Universidad Juárez Autónoma de Tabasco, División Académica de Ciencias de la Salud, Villahermosa, Tabasco, México
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Mazurek MO, Sadikova E, Cheak-Zamora N, Hardin A, Sohl K, Malow BA. Health Care Needs, Experiences, and Perspectives of Autistic Adults. Autism Adulthood 2023; 5:51-62. [PMID: 36941853 PMCID: PMC10024270 DOI: 10.1089/aut.2021.0069] [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] [Indexed: 12/12/2022]
Abstract
Background Autistic adults have high rates of co-occurring health conditions, suicide, and premature mortality, yet often experience health care barriers and poor health outcomes. A better understanding of the health care needs and experiences of autistic adults is essential for improving the health care system and patient experience. Methods This study examined the perspectives of autistic adults regarding their health care experiences in primary care and other settings and their suggestions for improvement using both qualitative and quantitative methods. Twenty autistic adults (aged 18-35 years, 65% male) completed surveys and individual semi-structured interviews. Results Qualitative data analysis results revealed 10 subthemes across 3 overarching themes: (1) system- and clinic-level factors affect access to care, (2) aspects of the clinic environment affect health care experiences, and (3) provider knowledge and practices affect health care experiences. Within the first theme, participants described barriers to obtaining services, including scheduling logistics, costs and inadequate insurance coverage, and transportation barriers. The second theme focused on aspects of the clinic environment that participants found especially relevant to their health care experiences and that required specific accommodations. This included sensory input, anxiety-provoking situations and procedures, and wait time. Within the third theme, participants emphasized aspects of providers' care that affected their health care experiences. Key factors included provider knowledge about autism, communication, rapport, and individualized care and patient-provider partnerships. Conclusion Overall, the findings point to a need for provider training and improvements to the health care delivery system to better meet the unique needs of autistic adults.
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Affiliation(s)
- Micah O. Mazurek
- Department of Human Services, School of Education and Human Development, University of Virginia, Charlottesville, Virginia, USA
| | - Eleonora Sadikova
- Department of Human Services, School of Education and Human Development, University of Virginia, Charlottesville, Virginia, USA
| | - Nancy Cheak-Zamora
- Department of Health Sciences, University of Missouri, Columbia, Missouri, USA
| | - Amber Hardin
- Supporting Transformative Autism Research (STAR) Initiative, University of Virginia, Charlottesville, Virginia, USA
| | - Kristin Sohl
- Department of Child Health, University of Missouri, Columbia, Missouri, USA
| | - Beth A. Malow
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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21
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Urechescu H, Gheran-Vida E, Cuzic C, Ancusa O, Ursoniu S, Pricop M. Inflammatory Markers as Predictors for Prolonged Duration of Hospitalization in Maxillofacial Infections. J Clin Med 2023; 12. [PMID: 36769517 DOI: 10.3390/jcm12030871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/13/2023] [Accepted: 01/19/2023] [Indexed: 01/25/2023] Open
Abstract
Despite the progress made in diagnosing and treating maxillofacial infections, the course of infection can be unpredictable, leading to severe complications, prolonged hospitalization, and substantial financial costs to health care services. It is important to determine whether various serum inflammatory marker levels on admission may predict a prolonged hospital stay in these patients. To analyze the role of CRP, white blood cell count (WBC), and neutrophil-to-lymphocyte ratio (NLR) in predicting the prolonged duration of hospitalization in maxillofacial infections, we performed a retrospective study by collecting paper records data from 108 patients who met our inclusion criteria. The patients were divided into two groups according to the duration of hospitalization (group A < 5 days and group B ≥ 5 days). The predictor variables were CRP, WBC, and NLR, and the outcome variable was the duration of hospitalization. This study confirmed a positive linear correlation (p < 0.001) between the predictors and the outcome variable. The optimal cut-off values for WBC are 11,030 white blood cells/μL and 63 mg/L for CRP. Levels that exceed these optimal values predict a duration of hospitalization of over (≥) 5 days. Serum WBC and CRP on admission may predict the duration of hospitalization in patients with MFI.
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Aljarallah NA, Almuqbil M, Alshehri S, Khormi AMS, AlReshaidan RM, Alomran FH, Fawzan Alomar N, Alshahrani FF, Alshammari MS, Alsanie WF, Alhomrani M, Alamri AS, Asdaq SMB. Satisfaction of patients with health care services in tertiary care facilities of Riyadh, Saudi Arabia: A cross-sectional approach. Front Public Health 2023; 10:1077147. [PMID: 36711344 PMCID: PMC9880422 DOI: 10.3389/fpubh.2022.1077147] [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: 10/22/2022] [Accepted: 12/20/2022] [Indexed: 01/15/2023] Open
Abstract
As part of Saudi Vision 2030, the country's healthcare system is undergoing a significant makeover, with accessibility and effectiveness serving as the benchmarks for measuring patient care quality. This study's goal was to ascertain the degree of patient satisfaction with the medical care and services received in Riyadh's tertiary care facilities. The PSQ-18 (Patient Satisfaction Questionnaire-18), a standardized validated questionnaire including areas of "overall satisfaction," "technical quality," "interpersonal aspect," "communication," "financial aspect," "time spent with the doctor," and "accessibility and convenience," was used in this cross-sectional study on 384 patients of two tertiary care facilities in Riyadh, Saudi Arabia, over a 6-month period. The degree to which sociodemographic characteristics and components of patient satisfaction are correlated was assessed using binary and multiple regression analysis. When the P-value was < 0.05, the results were considered significant and were presented as adjusted odds ratios (AOR). To ascertain how each PSQ-18 subscale affected other subscales, a Pearson Correlation analysis was conducted. The overall degree of satisfaction with all 18 items was 73.77%. The financial component received a rating of 81% compared to 77% for general satisfaction. Technical quality (75%) was followed by accessibility and convenience (73.5%), communication (73%), and interpersonal elements (72%). At 68%, the time spent in the doctor's domain received the lowest rating. The odds of satisfaction were increased by 3.87 times, 3.45 times, and 3.36 times among those who are employed, qualified by university education, and married compared to unemployed (P-value = 0.018), less qualified (P-value = 0.015) and singles (P-value = 0.026), respectively. The younger age group also made 1.78 times more of a difference in higher satisfaction ratings. The general satisfaction domain showed a positive association with other areas. Participants who were satisfied with the communication and accessibility and convenience domains of healthcare providers were the only ones who were typically satisfied with the domain of doctor time spent. The study's findings could act as a benchmark for Saudi Arabia's healthcare services as well as a starting point for quality assurance procedures.
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Affiliation(s)
- Nasser Ali Aljarallah
- Department of Computer Science and Information Systems, College of Applied Sciences, AlMaarefa University, Ad Diriyah, Riyadh, Saudi Arabia,Department of Business Administration, College of Business Administration, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Mansour Almuqbil
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Sultan Alshehri
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Fayez Hadi Alomran
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, Dariyah, Riyadh, Saudi Arabia
| | | | - Fayez Faleh Alshahrani
- Department of Family Medicine, King Abdulaziz Medical City in Riyadh, Ministry of National Guard, Riyadh, Saudi Arabia
| | | | - Walaa F. Alsanie
- Department of Clinical Laboratory Sciences, The Faculty of Applied Medical Sciences, Taif University, Taif, Saudi Arabia,Centre of Biomedical Sciences Research (CBSR), Deanship of Scientific Research, Taif University, Taif, Saudi Arabia
| | - Majid Alhomrani
- Department of Clinical Laboratory Sciences, The Faculty of Applied Medical Sciences, Taif University, Taif, Saudi Arabia,Centre of Biomedical Sciences Research (CBSR), Deanship of Scientific Research, Taif University, Taif, Saudi Arabia
| | - Abdulhakeem S. Alamri
- Department of Clinical Laboratory Sciences, The Faculty of Applied Medical Sciences, Taif University, Taif, Saudi Arabia,Centre of Biomedical Sciences Research (CBSR), Deanship of Scientific Research, Taif University, Taif, Saudi Arabia
| | - Syed Mohammed Basheeruddin Asdaq
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, Dariyah, Riyadh, Saudi Arabia,*Correspondence: Syed Mohammed Basheeruddin Asdaq ✉ ; ✉
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Abstract
PURPOSE To study psychological distress and fatigue among persons with spina bifida (SB) 50 years or older and living in Norway. METHODS In 2017, cross-sectional data were collected (n = 30). The Hospital Anxiety and Depression Scale (HADS) and the Fatigue Severity Scale (FSS) were used. Descriptive statistics, non-parametric tests, and Spearman correlations were performed. Relevant information from previous studies on adults with chronic spinal cord injury (SCI) and the general population, were collected for comparison. RESULTS Participants were 18 women and 12 men, mean age 57.5 (SD 5.6), 26 with myelomeningocele, and six with hydrocephalus. Thirty percent scored above the HADS-A- and 20% above the HADS-D thresholds, thus in the same range as previous studies of SB, but higher compared to persons with SCI and norms. HADS-D correlated with pain and FSS scores. Forty percent reported fatigue symptoms (9/15 without hydrocephalus, 3/6 with hydrocephalus). CONCLUSIONS The study revealed a high prevalence of fatigue symptomatology among middle-aged and older adults with SB. Symptoms of anxiety and depression were more common than among persons with chronic SCI and norms. SB follow-ups should include awareness of psychological distress and fatigue, and investigate pain and medication side effects among possible influencing factors.IMPLICATIONS FOR REHABILITATIONClinicians treating adult persons with SB should be aware of possible psychological distress and fatigue symptomatology among these patients.We suggest an initial screening for psychological distress and fatigue in persons with SB during follow-up visits and rehabilitation.Interventions to reduce pain may influence levels of psychological distress and/or fatigue in patients with SB.Clinicians should enquire about the effects of medication on fatigue when assessing and prescribing new medications; a thorough medication review helps to assess the benefits and risks.
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Affiliation(s)
- Ingeborg Beate Lidal
- TRS National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Oslo, Norway
| | - Kerstin Lundberg Larsen
- TRS National Resource Centre for Rare Disorders, Sunnaas Rehabilitation Hospital, Oslo, Norway
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Kim DKD, Kim S. What if you have a humanoid AI robot doctor?: An investigation of public trust in South Korea. J Commun Healthc 2022; 15:276-285. [PMID: 36911896 DOI: 10.1080/17538068.2021.1994825] [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] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Humanoid robots with artificial intelligence have been implemented in many healthcare facilities including hospitals, nursing homes, and many others. Due to the development of technology and the increasing use of humanoid robots, it is expected that more advanced humanoid robots will be developed and implemented in healthcare facilities for better healthcare services. Based on this anticipation, this study proactively examined the public trust in humanoid AI robot (HAIR) doctors that we might have in the near future. METHODS This study employed two scales that have been predominantly used to measure patient-doctor trust through an extensive search across different scholarships. For data collection, online surveys were administered by posting a weblink to the online survey through social media, mostly Facebook, Twitter, and KakaoTalk, in South Korea. RESULTS Data analysis of 424 valid surveys found that the level of public trust in HAIR doctors as primary doctors was slightly higher than human doctors. For the data analysis using demographic variables, a series of t-test and ANOVA revealed that males showed a higher trust in HAIR doctors than females, while maintaining indifference in other demographic variables. CONCLUSION Based on the rapid development of AI and robot technology, the implementation of HAIR doctors for our healthcare service would be a reality in the near future as the public also becomes more familiar with interacting with humanoid robots. Therefore, a proactive preparation for the future is urgently needed for effective use of future technology as well as patients' satisfaction.
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Affiliation(s)
- Do Kyun David Kim
- Professor, Richard D'Aquin/BORSF Endowed Professor, Department of Communication, University of Louisiana at Lafayette, Lafayette, Louisiana, USA
| | - Sejin Kim
- Assistant Professor, University of Utah - Asia Campus, South Korea
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Rinne H, Perhoniemi R. Effects of Vocational Rehabilitation on the Use of Health Care Services in Finland: A Propensity Score Analysis. Int J Environ Res Public Health 2022; 19:15809. [PMID: 36497882 PMCID: PMC9735791 DOI: 10.3390/ijerph192315809] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/21/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Vocational rehabilitation may affect the frequency of health care use by improving the access or reducing the need for health care. We examined whether participation in rehabilitation effects the healthcare services use. Register-based data was utilized on all individuals aged 15-60 living in the city of Oulu, Finland, who started vocational rehabilitation in 2014-2015 (N = 784). We examined the use of outpatient health care services from 1.5 years before to 1.5 years after the start of rehabilitation and 1.5 years after the end of rehabilitation, and compared it to the propensity score matched controls. Rehabilitees had on average 1.5 visits to outpatient health care services in the 6th quarter before the start of rehabilitation. In the 4th quarter before the start of rehabilitation, that number increased to 1.8. After the rehabilitation period, the quarterly number of visits returned to the same level as at the beginning of the follow-up. The biggest changes were in the use of occupational health services. Compared to the propensity score matched controls, vocational rehabilitation did not appear to affect the use of health care services. Vocational rehabilitation seems to replace need for other services but not to affect the need to receive treatment for the underlying disease.
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Mullen I, Mariano MA, Aysola J. Interdisciplinary social needs response team: A community case study in social needs targeted care during the COVID-19 pandemic and beyond. Front Public Health 2022; 10:789396. [PMID: 36438214 PMCID: PMC9682102 DOI: 10.3389/fpubh.2022.789396] [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: 10/04/2021] [Accepted: 10/18/2022] [Indexed: 11/11/2022] Open
Abstract
This case study illustrates the role and value of a social needs response team during times of crisis and beyond. The COVID-19 pandemic resulted in two simultaneous crises-the infectious disease crisis and the socioeconomic crisis. Unemployment and lost wages, housing and food insecurity, and increased childcare needs are just a few examples of the socioeconomic needs that skyrocketed during the COVID-19 pandemic. At the start of the pandemic, the University of Pennsylvania Health System (UPHS) formed an interdisciplinary team of physicians, social workers, nurse practitioners and students of these professions to reimagine social needs screening in a way that could reach people during the pandemic and provide sustainable support for individual's evolving social needs. The Social Needs Response Team (SNRT) at UPHS utilized various secure platforms to keep members of the team connected with each other and their patients. Orientations for participating students included training on how to employ principles of crisis intervention theory, empathetic inquiry, and patient-led and family-centered care to best uncover and serve the needs of their patients. Alongside the illustrative case study, this piece details guiding principles and concepts that are essential to integrating social needs targeted care.
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Affiliation(s)
- Isabelle Mullen
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | | | - Jaya Aysola
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States,Center for Health Equity Advancement, Penn Medicine, Philadelphia, PA, United States,*Correspondence: Jaya Aysola
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Matlapeng KM, Babatunde GB, Akintola O. Acceptability and accessibility of HIV testing and treatment among men who have sex with men in Botswana. Afr J AIDS Res 2022; 21:261-269. [PMID: 36102064 DOI: 10.2989/16085906.2022.2077780] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 03/21/2022] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
Background: Although HIV testing and treatment are the cornerstones of a comprehensive prevention strategy, their acceptability and accessibility are complex within the healthcare system.Methods: We used Aday and Andersen's conceptual framework of access to healthcare services to explore factors influencing acceptability and accessibility of HIV testing and treatment among men who have sex with men (MSM) in Botswana. A qualitative descriptive study was conducted, using purposive sampling to recruit 20 MSM. Semi-structured interviews were conducted in Setswana and English. All data were audio-recorded, transcribed, translated into English, where necessary, and analysed using thematic analysis.Findings: This study found that acceptance of HIV testing and treatment was largely positive among MSM. Motivators were the expansion of HIV services, free healthcare services and the perceived risk of contracting HIV. Although perceptions of accessibility to HIV testing and treatment were positive, there were some concerns about privacy and confidentiality, perceived barriers and fear of positive diagnosis, making MSM reluctant to access HIV testing and treatment.Conclusion: This study highlights the need for novel approaches to increase the acceptability and accessibility of HIV testing and treatment. Barriers to accessing HIV services should be addressed to achieve satisfactory health outcomes, and sustainable HIV prevention barriers to accessing HIV should be addressed among MSM.
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Affiliation(s)
- Kgosiekae Maxwell Matlapeng
- School of Applied Human Sciences, University of KwaZulu-Natal, Durban, South Africa
- Public Health Science Department, Institute of Health Sciences, Serowe, Botswana
| | | | - Olagoke Akintola
- School of Public Health, University of the Western Cape, Bellville, South Africa
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Vähätalo L, Siukola A, Atkins S, Reho T, Sumanen M, Viljamaa M, Sauni R. Cooperation between Public Primary Health Care and Occupational Health Care Professionals in Work Ability-Related Health Issues. Int J Environ Res Public Health 2022; 19:11916. [PMID: 36231222 PMCID: PMC9564539 DOI: 10.3390/ijerph191911916] [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] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
Work disability creates significant expenses for nations and causes human suffering by limiting patients' lives. International studies show that to enhance recognition of and support for work disability, cooperation, mutual trust, and information exchange between public primary health care and occupational health care must be strengthened. However, little is known of how health care professionals experience this cooperation. The aim of this study was to understand how professionals experience the cooperation between public primary health care and occupational health services regarding patients' work ability. Semi-structured interviews were conducted with 29 health care professionals working in five small cities (<10,000 inhabitants) in Finland. Interviews were audio and video recorded, transcribed verbatim, and analyzed through inductive thematic analysis. Three key themes were identified from the interviews: attitudes toward the other health care sector, the exchange of information, and resources for cooperation. Professionals seem to have poor knowledge about the services available and how care is given in the other sector, appearing to lead to weak mutual trust. The public primary health care professionals especially emphasized the benefits of cooperation, but several issues were mentioned as barriers to cooperation. These results can be used when planning effective patient paths and service provisioning models.
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Affiliation(s)
- Lauri Vähätalo
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
| | - Anna Siukola
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
| | - Salla Atkins
- Health Sciences, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland
- Department of Global Public Health, Social Medicine Infectious Disease and Migration (SIM), Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Tiia Reho
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
| | - Markku Sumanen
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
| | | | - Riitta Sauni
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
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De Cock D, Myasoedova E, Aletaha D, Studenic P. Big data analyses and individual health profiling in the arena of rheumatic and musculoskeletal diseases (RMDs). Ther Adv Musculoskelet Dis 2022; 14:1759720X221105978. [PMID: 35794905 PMCID: PMC9251966 DOI: 10.1177/1759720x221105978] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 05/22/2022] [Indexed: 11/17/2022] Open
Abstract
Health care processes are under constant development and will need to embrace advances in technology and health science aiming to provide optimal care. Considering the perspective of increasing treatment options for people with rheumatic and musculoskeletal diseases, but in many cases not reaching all treatment targets that matter to patients, care systems bare potential to improve on a holistic level. This review provides an overview of systems and technologies under evaluation over the past years that show potential to impact diagnosis and treatment of rheumatic diseases in about 10 years from now. We summarize initiatives and studies from the field of electronic health records, biobanking, remote monitoring, and artificial intelligence. The combination and implementation of these opportunities in daily clinical care will be key for a new era in care of our patients. This aims to inform rheumatologists and healthcare providers concerned with chronic inflammatory musculoskeletal conditions about current important and promising developments in science that might substantially impact the management processes of rheumatic diseases in the 2030s.
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Affiliation(s)
- Diederik De Cock
- Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Elena Myasoedova
- Division of Rheumatology, Department of Internal Medicine and Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Daniel Aletaha
- Division of Rheumatology, Department of Internal Medicine 3, Medical University Vienna, Vienna, Austria
| | - Paul Studenic
- Division of Rheumatology, Department of Internal Medicine 3, Medical University Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
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M Selvarajah T, Yamamoto E, Saw YM, Kariya T, Hamajima N. Satisfaction With Health Care Services at the Pediatric Specialist Clinic of the National Referral Center in Malaysia: Cross-sectional Study of Caregivers' Perspectives. JMIRx Med 2022; 3:e33025. [PMID: 37725531 PMCID: PMC10414228 DOI: 10.2196/33025] [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: 08/18/2021] [Revised: 11/30/2021] [Accepted: 01/27/2022] [Indexed: 09/21/2023]
Abstract
BACKGROUND The concept of customer satisfaction is gaining hold in all corporate sectors worldwide, and a satisfaction survey is used as a tool to discover service problems and as a chance for customers to rate their experience with health care services. A high degree of patient satisfaction with the services given has been found in numerous studies conducted in Malaysian public health care facilities. However, there is limited information available on caregiver satisfaction with pediatric clinics run by the Ministry of Health (MoH) of Malaysia. OBJECTIVE This was the first research performed at a public hospital's pediatric clinic, which was the first hospital to adopt the public-private-partnership model under the MoH, with the aim of discovering the prevalence and factors affecting the satisfaction of caregivers at the national referral center. METHODS Cross-sectional research using the standard self-administered SERVQUAL questionnaire was conducted among caregivers accompanying their children to the clinic. The questionnaire consists of 16 paired statements to evaluate their expectations and experiences with the clinic services. RESULTS A total of 459 caregivers were involved in this study with a majority aged between 30 and 39 years (n=254, 55.4%). Caregivers from the Indian community (adjusted odds ratio [AOR] 2.91, 95% CI 1.37-6.18) and lower income groups (AOR 2.94, 95% CI 1.87-4.64), and those with lower educational backgrounds (AOR 3.58, 95% CI 1.19-10.72) were more likely to be satisfied with the quality of pediatric clinic services. Housewives/househusbands (AOR 0.48, 95% CI 0.25-0.90), on the other hand, appeared less likely to be satisfied with the services provided during their visit to the clinic. Looking at overall patient satisfaction, 50.5% (n=232) of caregivers demonstrated satisfaction with the quality of services, compared to 49.5% (n=227) of dissatisfied respondents. CONCLUSIONS This paper suggests that, although most caregivers are satisfied with the services, greater emphasis must be placed on delivering reliable service in response to the MoH's mission to provide quality and integrated people-centered health services in Malaysia.
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Affiliation(s)
- Thinakaran M Selvarajah
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Hospital Putrajaya, Ministry of Health, Putrajaya, Malaysia
| | - Eiko Yamamoto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yu Mon Saw
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Tetsuyoshi Kariya
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan
| | - Nobuyuki Hamajima
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Portacolone E, Torres JM, Johnson JK, Benton D, Rapp T, Tran T, Martinez P, Graham C. The Living Alone with Cognitive Impairment Project's Policy Advisory Group on Long-Term Services and Supports: Setting a Research Equity Agenda. Int J Environ Res Public Health 2022; 19:6021. [PMID: 35627558 PMCID: PMC9141001 DOI: 10.3390/ijerph19106021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/06/2022] [Accepted: 05/06/2022] [Indexed: 12/17/2022]
Abstract
(1) Background: A United States national policy advisory group (PAG) was convened to identify barriers and facilitators to expand formal long-term services and support (LTSS) for people living alone with cognitive impairment (PLACI), with a focus on equitable access among diverse older adults. The PAG's insights will inform the research activities of the Living Alone with Cognitive Impairment Project, which is aimed at ensuring the equitable treatment of PLACI. (2) Methods: The PAG identified barriers and facilitators of providing effective and culturally relevant LTSS to PLACI via one-on-one meetings with researchers, followed by professionally facilitated discussions among themselves. (3) Results: The PAG identified three factors that were relevant to providing effective and culturally relevant LTSS to PLACI: (i) better characterization of PLACI, (ii) leveraging the diagnosis of cognitive impairment, and (iii) expanding and enhancing services. For each factor, the PAG identified barriers and facilitators, as well as directions for future research. (4) Conclusions: The barriers and facilitators the PAG identified inform an equity research agenda that will help inform policy change.
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Affiliation(s)
- Elena Portacolone
- Institute for Health & Aging, University of California, San Francisco, CA 94158, USA; (J.K.J.); (T.T.); (P.M.); (C.G.)
- Philip Lee Institute for Health Policy Studies, University of California, San Francisco, CA 94158, USA
| | - Jacqueline M. Torres
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA 94158, USA;
| | - Julene K. Johnson
- Institute for Health & Aging, University of California, San Francisco, CA 94158, USA; (J.K.J.); (T.T.); (P.M.); (C.G.)
| | - Donna Benton
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA 90089, USA;
| | - Thomas Rapp
- LIRAES, Université Paris Cité, 75006 Paris, France;
- Sciences Po Paris, LIEPP, 75006 Paris, France
| | - Thi Tran
- Institute for Health & Aging, University of California, San Francisco, CA 94158, USA; (J.K.J.); (T.T.); (P.M.); (C.G.)
| | - Paula Martinez
- Institute for Health & Aging, University of California, San Francisco, CA 94158, USA; (J.K.J.); (T.T.); (P.M.); (C.G.)
| | - Carrie Graham
- Institute for Health & Aging, University of California, San Francisco, CA 94158, USA; (J.K.J.); (T.T.); (P.M.); (C.G.)
- Center for Health Care Strategies, Hamilton, NJ 08619, USA
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Soare T, Ianovici C, Gheorghe IR, Purcărea VL, Soare CM. A word-of-mouth perspective on consumers of family medicine services: a case study. J Med Life 2022; 15:655-660. [PMID: 35815082 PMCID: PMC9262271 DOI: 10.25122/jml-2022-0098] [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: 02/11/2022] [Accepted: 04/12/2022] [Indexed: 11/19/2022] Open
Abstract
In an increasingly competitive health care market, family physicians have to elaborate and implement new strategies to attract potential patients. A useful and powerful method is word-of-mouth (WOM) because it shapes the consumers' attitudes and behaviours. Based on the recommendations of actual consumers, potential health care patients choose their family physicians. The aim of this study was to investigate the usefulness of WOM in family medicine and determine the key factors in recommending a certain family physician. The sample consisted of 338 patients under the supervision of a family physician, and the instrument for collecting data was a self-administered questionnaire. The findings revealed that the most important factors in spreading WOM are the communication skills and the expertise of the family physician. In addition, for patients between 27–33 years and 41–47 years, expertise is an absolute skill, whereas, for the health care consumers between 21 and 26 years, communication skills are essential in spreading WOM. Further, WOM becomes relevant in the family physician's activity as it may contribute to the delivery of value and in building sustainable physician-patient relationships.
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Affiliation(s)
- Traian Soare
- Department of Healthcare Marketing and Medical Technology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Ciprian Ianovici
- Department of Oncological Surgery, Oncological Institute Prof. Dr. Al. Trestioreanu, Bucharest, Romania
| | - Iuliana-Raluca Gheorghe
- Department of Healthcare Marketing and Medical Technology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania,Corresponding Author: Iuliana-Raluca Gheorghe, Department of Healthcare Marketing and Medical Technology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania. E-mail:
| | - Victor Lorin Purcărea
- Department of Healthcare Marketing and Medical Technology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Cristina Maria Soare
- Department of Healthcare Marketing and Medical Technology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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d’Annunzio G, Bassi M, De Rose EL, Lezzi M, Minuto N, Calevo MG, Gaiero A, Fichera G, Borea R, Maghnie M. Increased Frequency of Diabetic Ketoacidosis: The Link With COVID-19 Pandemic. Front Clin Diabetes Healthc 2022; 3:846827. [PMID: 36992744 PMCID: PMC10012091 DOI: 10.3389/fcdhc.2022.846827] [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: 12/31/2021] [Accepted: 01/31/2022] [Indexed: 06/19/2023]
Abstract
AIMS Diabetic ketoacidosis is the most severe metabolic derangement due to prolonged insulin deficiency as in type 1 diabetes. Diabetic ketoacidosis, a life-threatening condition, is often diagnosed late. A timely diagnosis is mandatory to prevent its consequences, mainly neurological. The COVID-19 pandemic and lockdown have reduced the availability of medical care and access to hospitals. The aim of our retrospective study was to compare the frequency of ketoacidosis at the diagnosis of type 1 diabetes between the lockdown-post lockdown period and the previous two calendar years, in order to evaluate the impact of the COVID-19 pandemic. PATIENTS AND METHODS We retrospectively assessed the clinical and metabolic data at the diagnosis of type 1 diabetes in children in the Liguria Region during 3 different time periods: calendar year 2018 (Period A), calendar year 2019 until February 23,2020 (Period B) and from February 24, 2020 onwards to March 31, 2021 (Period C). RESULTS We analyzed 99 patients with newly-diagnosed T1DM from 01/01/2018 to 31/03/2021. Briefly, a younger age at diagnosis of T1DM was observed in Period 2 compared to Period 1 (p = 0.03). The frequency of DKA at clinical onset of T1DM was similar in Period A (32.3%) and Period B (37.5%), while it significantly increased in Period C (61.1%) compared to Period B (37.5%) (p = 0.03). PH values were similar in Period A (7.29 ± 0.14) and Period B (7.27 ± 0.17), while they were significantly lower in Period C (7.21 ± 0.17) compared to Period B (p = 0.04). CONCLUSIONS An increase in the frequency of diabetic ketoacidosis has been documented in newly diagnosed pediatric patients in the Liguria Region during and after the lockdown period compared to previous calendar years. This increase could have been caused by the delay in diagnosis following the restrictions imposed by the lockdown with consequently reduced access to health care facilities. More information on the risks of ketoacidosis is desirable by means of social and medical awareness campaigns.
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Affiliation(s)
- Giuseppe d’Annunzio
- Pediatric Clinic and Endocrinology Unit, Regional Center for Pediatric Diabetes, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Marta Bassi
- Pediatric Clinic and Endocrinology Unit, Regional Center for Pediatric Diabetes, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Pediatrics, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy
| | - Elena Lucia De Rose
- Pediatric Clinic and Endocrinology Unit, Regional Center for Pediatric Diabetes, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Pediatrics, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy
| | - Marilea Lezzi
- Pediatric Clinic and Endocrinology Unit, Regional Center for Pediatric Diabetes, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Nicola Minuto
- Pediatric Clinic and Endocrinology Unit, Regional Center for Pediatric Diabetes, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Maria Grazia Calevo
- Epidemiology and Biostatistics Unit, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Alberto Gaiero
- Pediatric and Neonatology Unit, San Paolo Hospital, Savona, Italy
| | | | | | - Mohamad Maghnie
- Pediatric Clinic and Endocrinology Unit, Regional Center for Pediatric Diabetes, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Pediatrics, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy
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Kisiała W, Rącka I, Suszyńska K. Population Access to Hospital Emergency Departments: The Spatial Analysis in Public Health Research. Int J Environ Res Public Health 2022; 19:1437. [PMID: 35162454 DOI: 10.3390/ijerph19031437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/23/2022] [Accepted: 01/25/2022] [Indexed: 11/17/2022]
Abstract
The emergency medical services support the primary health care system. Hospital emergency departments (HEDs), which provide medical assistance to all patients in a state of emergency are of considerable importance to the system. When studying access to HEDs, attention should be focused on spatial relations resulting from the location of HEDs and the places of residence of the potential patients. The aim of the paper is to explain the level of spatial accessibility of HEDs and its changes as a result of organizational and spatial transformations of HEDs' networks in Poland. The research was conducted within two time series, comparing the changes in the distribution of HEDs in 2011 and 2021. GIS techniques were used to measure the distances between emergency departments and places of residence. It was observed that the transformation of the spatial organization of the hospital emergency department network in 2011-2021 resulted in the overall improvement of the spatial accessibility of these facilities, reducing the distance between them and places of residence.
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Baldomero AK, Kunisaki KM, Bangerter A, Nelson DB, Wendt CH, Fortis S, Hagedorn H, Dudley RA. Beyond Access: Factors Associated With Spirometry Underutilization Among Patients With a Diagnosis of COPD in Urban Tertiary Care Centers. Chronic Obstr Pulm Dis 2022; 9:538-548. [PMID: 36040836 PMCID: PMC9718583 DOI: 10.15326/jcopdf.2022.0303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Rationale Many patients with suspected chronic obstructive pulmonary disease (COPD) do not undergo spirometry to confirm the diagnosis. Underutilization is often attributed to barriers to accessing spirometry. Objective Our objective wasto identify factors associated with spirometry underutilization for patients who are less likely to face access barriers related to travel, insurance, and availability of spirometry. Methods A retrospective analysis was conducted of patients enrolled in the Veterans Health Administration and living in urban areas with a new diagnosis of COPD between 2012 to 2015, reducing out-of-pocket cost and travel barriers, respectively. We included only patients whose primary care clinic was located in an academically affiliated tertiary level facility with spirometry available. We used logistic regression to estimate associations between patient characteristics and receipt of spirometry within 2 years before or after COPD diagnosis. Results Of 24,300 patients, 59.7% had spirometry. Compared to patients <55 years, patients 75-84 years had an adjusted odds ratio (aOR) of undergoing spirometry of 0.80 (95% confidence interval [CI]:0.72-0.90), while patients ≥85 years had an aOR of 0.47 (95%CI: 0.40-0.54). Compared to patients with a Charlson Comorbidity Index (CCI) ≥3, patients with a CCI of 0 had an aOR of 0.60 (95%CI:0.54-0.67). Patients who had not seen a pulmonary specialist had lower odds of receiving spirometry (aOR 0.38 [95%CI:0.35-0.41]). Conclusion Spirometry underutilization persists among patients who are less likely to have access barriers related to travel, insurance, and availability of spirometry. Spirometry underutilization is associated with older age, not having received pulmonary care, and having fewer comorbidities. COPD care quality initiatives will need to address these factors.
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Affiliation(s)
- Arianne K. Baldomero
- Pulmonary, Allergy, Critical Care, and Sleep Medicine, Minneapolis VA Health Care System, Minneapolis, Minnesota, United States,Pulmonary, Allergy, Critical Care, and Sleep Medicine, University of Minnesota, Minneapolis, Minnesota, United States,Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, United States
| | - Ken M. Kunisaki
- Pulmonary, Allergy, Critical Care, and Sleep Medicine, Minneapolis VA Health Care System, Minneapolis, Minnesota, United States,Pulmonary, Allergy, Critical Care, and Sleep Medicine, University of Minnesota, Minneapolis, Minnesota, United States
| | - Ann Bangerter
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, United States
| | - David B. Nelson
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, United States
| | - Chris H. Wendt
- Pulmonary, Allergy, Critical Care, and Sleep Medicine, Minneapolis VA Health Care System, Minneapolis, Minnesota, United States,Pulmonary, Allergy, Critical Care, and Sleep Medicine, University of Minnesota, Minneapolis, Minnesota, United States
| | - Spyridon Fortis
- Pulmonary, Critical Care, and Occupational Medicine, University of Iowa Hospital and Clinics, Iowa City, Iowa, United States,Center for Access and Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, Iowa, United States
| | - Hildi Hagedorn
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, United States
| | - R. Adams Dudley
- Pulmonary, Allergy, Critical Care, and Sleep Medicine, Minneapolis VA Health Care System, Minneapolis, Minnesota, United States,Pulmonary, Allergy, Critical Care, and Sleep Medicine, University of Minnesota, Minneapolis, Minnesota, United States,Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, United States
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Goula A, Chatzis A, Stamouli MA, Kelesi M, Kaba E, Brilakis E. Assessment of Health Professionals' Attitudes on Radiation Protection Measures. Int J Environ Res Public Health 2021; 18:ijerph182413380. [PMID: 34948989 PMCID: PMC8708066 DOI: 10.3390/ijerph182413380] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: Health professionals' knowledge, beliefs and perceptions concerning radiation protection may affect their behaviour during surgery and consequently influence the quality of health services. This study highlights the health professionals' average knowledge level and captures the beliefs, perceptions, and behaviours in a large public Greek hospital. (2) Materials and Methods: A cross-sectional study was carried out, including health professionals working in operating rooms. One hundred thirty-two staff members participated by responding to an original questionnaire. The sample consisted of nurses, radiographers and medical doctors of various specialties involved daily in surgical procedures where ionizing radiation is required. The survey was conducted from March to June 2021, and the response rate was 97%. (3) Results: The level of overall knowledge of health professionals regarding radiation protection safety was not satisfactory. Females and employees with a lower level of education had more misconceptions about radiation and radiation protection. Employees of younger ages and with less previous experience were more likely to have negative emotions towards radiation exposure. Finally, employees with fewer children tended to express physical complaints caused by their negative emotions due to radiation exposure. (4) Conclusions: Health professionals' lack of basic and specialized knowledge concerning radiation protection safety had a negative impact on the provision of health services. The continuing training of the staff seemed to be the only solution to reverse this trend. The training should highlight how radiation exposure can be minimized, safeguarding health professionals' trust and sense of security by significantly improving their working environment.
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Affiliation(s)
- Aspasia Goula
- Master of Health and Social Care Management, Department of Business Administration, School of Administrative, Economics and Social Sciences, University of West Attica, 12243 Athens, Greece; (A.C.); (M.-A.S.)
- Correspondence:
| | - Athanasios Chatzis
- Master of Health and Social Care Management, Department of Business Administration, School of Administrative, Economics and Social Sciences, University of West Attica, 12243 Athens, Greece; (A.C.); (M.-A.S.)
| | - Maria-Aggeliki Stamouli
- Master of Health and Social Care Management, Department of Business Administration, School of Administrative, Economics and Social Sciences, University of West Attica, 12243 Athens, Greece; (A.C.); (M.-A.S.)
| | - Martha Kelesi
- Department of Nursing, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (M.K.); (E.K.)
| | - Evridiki Kaba
- Department of Nursing, School of Health and Care Sciences, University of West Attica, 12243 Athens, Greece; (M.K.); (E.K.)
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Bardin A, Buja A, Barbiellini Amidei C, Paganini M, Favaro A, Saia M, Baldo V. Elderly People's Access to Emergency Departments during the COVID-19 Pandemic: Results from a Large Population-Based Study in Italy. J Clin Med 2021; 10:5563. [PMID: 34884265 DOI: 10.3390/jcm10235563] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 11/20/2021] [Accepted: 11/24/2021] [Indexed: 12/23/2022] Open
Abstract
Across the world, people have avoided seeking medical attention during the coronavirus pandemic, resulting in a marked reduction in emergency department (ED) visits. This retrospective cohort study examines in detail how the present pandemic affects ED use by the elderly. The regional database on ED visits in Veneto (northeastern Italy) was consulted to extract anonymous data on all ED visits during 2019 and 2020, along with details concerning patients' characteristics (access mode, triage code, chief complaint, and outcome). A year-on-year comparison was drawn between 2019 and 2020. There was a 25.3% decrease in ED visits in 2020 compared to the previous year. The decrease ranged from -52.4% in March to -18.4% in September when comparing the same months in the two years. This decrease started in late February 2020, with the lowest numbers of visits recorded in March and April 2020 (during the "first wave" of the COVID-19 pandemic in Italy), and in the autumn (during the "second wave"). The proportion of visits to the ED by ambulance has increased sharply since March 2020, and patients arrived more frequently with severe conditions (red or yellow triage tags) that often required a hospitalization. The greatest decrease was in fact observed for non-urgent complaints. This decreased concerned a wide range of conditions, including chest pain and abdominal pain. The sharp reduction observed in the present study is unlikely to be attributed entirely to the effect of lockdown measures. Individual psychological and media-induced fear of contagion most likely played a relevant role in leading people to avoid seeking medical attention.
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Ramachandran R, McShea MJ, Howson SN, Burkom HS, Chang HY, Weiner JP, Kharrazi H. Assessing the Value of Unsupervised Clustering in Predicting Persistent High Health Care Utilizers: Retrospective Analysis of Insurance Claims Data. JMIR Med Inform 2021; 9:e31442. [PMID: 34592712 PMCID: PMC8663459 DOI: 10.2196/31442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/21/2021] [Revised: 07/26/2021] [Accepted: 09/30/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND A high proportion of health care services are persistently utilized by a small subpopulation of patients. To improve clinical outcomes while reducing costs and utilization, population health management programs often provide targeted interventions to patients who may become persistent high users/utilizers (PHUs). Enhanced prediction and management of PHUs can improve health care system efficiencies and improve the overall quality of patient care. OBJECTIVE The aim of this study was to detect key classes of diseases and medications among the study population and to assess the predictive value of these classes in identifying PHUs. METHODS This study was a retrospective analysis of insurance claims data of patients from the Johns Hopkins Health Care system. We defined a PHU as a patient incurring health care costs in the top 20% of all patients' costs for 4 consecutive 6-month periods. We used 2013 claims data to predict PHU status in 2014-2015. We applied latent class analysis (LCA), an unsupervised clustering approach, to identify patient subgroups with similar diagnostic and medication patterns to differentiate variations in health care utilization across PHUs. Logistic regression models were then built to predict PHUs in the full population and in select subpopulations. Predictors included LCA membership probabilities, demographic covariates, and health utilization covariates. Predictive powers of the regression models were assessed and compared using standard metrics. RESULTS We identified 164,221 patients with continuous enrollment between 2013 and 2015. The mean study population age was 19.7 years, 55.9% were women, 3.3% had ≥1 hospitalization, and 19.1% had 10+ outpatient visits in 2013. A total of 8359 (5.09%) patients were identified as PHUs in both 2014 and 2015. The LCA performed optimally when assigning patients to four probability disease/medication classes. Given the feedback provided by clinical experts, we further divided the population into four diagnostic groups for sensitivity analysis: acute upper respiratory infection (URI) (n=53,232; 4.6% PHUs), mental health (n=34,456; 12.8% PHUs), otitis media (n=24,992; 4.5% PHUs), and musculoskeletal (n=24,799; 15.5% PHUs). For the regression models predicting PHUs in the full population, the F1-score classification metric was lower using a parsimonious model that included LCA categories (F1=38.62%) compared to that of a complex risk stratification model with a full set of predictors (F1=48.20%). However, the LCA-enabled simple models were comparable to the complex model when predicting PHUs in the mental health and musculoskeletal subpopulations (F1-scores of 48.69% and 48.15%, respectively). F1-scores were lower than that of the complex model when the LCA-enabled models were limited to the otitis media and acute URI subpopulations (45.77% and 43.05%, respectively). CONCLUSIONS Our study illustrates the value of LCA in identifying subgroups of patients with similar patterns of diagnoses and medications. Our results show that LCA-derived classes can simplify predictive models of PHUs without compromising predictive accuracy. Future studies should investigate the value of LCA-derived classes for predicting PHUs in other health care settings.
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Affiliation(s)
- Raghav Ramachandran
- Applied Physics Laboratory, Johns Hopkins University, Baltimore, MD, United States
| | - Michael J McShea
- Applied Physics Laboratory, Johns Hopkins University, Baltimore, MD, United States
| | - Stephanie N Howson
- Applied Physics Laboratory, Johns Hopkins University, Baltimore, MD, United States
| | - Howard S Burkom
- Applied Physics Laboratory, Johns Hopkins University, Baltimore, MD, United States
| | - Hsien-Yen Chang
- Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, MD, United States
| | - Jonathan P Weiner
- Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, MD, United States
| | - Hadi Kharrazi
- Center for Population Health Information Technology, Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, MD, United States
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Jreige N, Talutis SD, Zambrano S, Heckscher D, Mehrazarin K, Rosen AK. Health Care Needs of Incarcerated Patients: A Case Study at a Large Urban Hospital. J Correct Health Care 2021; 27:272-279. [PMID: 34788134 DOI: 10.1089/jchc.19.10.0077] [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] [Indexed: 11/13/2022]
Abstract
This study examined a sample of incarcerated patients who received health care at an urban safety-net hospital in Massachusetts. Sociodemographic, clinical, and utilization data were obtained from patients' charts and administrative data. Our sample was 87% male and 36% Black and included a large proportion of patients with substance-related use. Incarcerated patients receiving outside care had a wide range of acute and chronic medical and surgical conditions, necessitating both emergent and scheduled care. The most frequent outpatient encounters included surgery (neurosurgery and oral/maxillofacial surgery), ophthalmology, medicine, and radiation oncology. Our findings provide a better understanding of the health care services that incarcerated patients may require outside their facilities and the kinds of interventions and policies that are needed to increase access to more timely care.
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Affiliation(s)
- Nina Jreige
- Department of Internal Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Stephanie D Talutis
- Department of Surgery, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Sarah Zambrano
- Department of Internal Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Dylan Heckscher
- Department of Internal Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Kian Mehrazarin
- Department of Internal Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Amy K Rosen
- Department of Surgery, Boston University School of Medicine, Boston, Massachusetts, USA.,Research Service, Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, Boston, Massachusetts, USA
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Abstract
Pulmonary rehabilitation is a strongly recommended and effective treatment for people with chronic lung disease. However, access to pulmonary rehabilitation is poor. Globally, pulmonary rehabilitation is accessed by less than 3% of people with chronic lung disease. Barriers to referral, uptake and completion of pulmonary rehabilitation are well documented and linked with organizational, practitioner and patient-related factors. Enhancing the knowledge of health care professionals, family carers, and people with chronic lung disease about the program and its benefits produces modest increases in referral and uptake rates, but evidence of the sustainability of such approaches is limited. Additionally, initiatives focusing on addressing organizational barriers to access, such as expanding services and implementing alternative models to the conventional center-based setting, are not yet widely used in clinical practice. The COVID-19 pandemic has highlighted the urgent need for health care systems to deliver pulmonary rehabilitation programs remotely, safely, and efficiently. This paper will discuss the pressing need to address the issue of the low accessibility of pulmonary rehabilitation. It will also highlight the distinctive challenges to pulmonary rehabilitation delivery in rural and remote regions, as well as low-income countries.
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Affiliation(s)
- Aroub Lahham
- Department of Immunology and Pathology, Monash University, Melbourne 3800, Australia;
| | - Anne E. Holland
- Department of Immunology and Pathology, Monash University, Melbourne 3800, Australia;
- Institute for Breathing and Sleep, Melbourne 3084, Australia
- Department of Physiotherapy, Alfred Health, Melbourne 3004, Australia
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Yan CH, Naveed M, Alobaidi A, Kopfman M, Nutescu EA, Sharp LK, Cannegieter DS. Association between transportation barriers and anticoagulation control among an inner-city, low-income population: A prospective observational cohort study. Res Pract Thromb Haemost 2021; 5:e12605. [PMID: 34755020 PMCID: PMC8558473 DOI: 10.1002/rth2.12605] [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: 04/12/2021] [Revised: 09/09/2021] [Accepted: 09/20/2021] [Indexed: 11/06/2022] Open
Abstract
Background Anticoagulation with warfarin represents a transportation-sensitive treatment state. Transportation barrier is a common reason for not using health care services. Objective To assess the association between transportation barriers to anticoagulation clinic and anticoagulation control (AC) among an inner-city, low-income population. Patients/Methods Adults expected to be on chronic warfarin therapy were recruited from an ambulatory anticoagulation clinic. Participants completed a validated questionnaire that assessed transportation barriers to clinic, defined as self-reported trouble getting transportation to a clinic and a composite score of the presence of transportation barriers. Suboptimal AC was defined as time in therapeutic range (TTR) <60% over 6 months. Prevalence ratios with 95% confidence intervals (CIs), adjusted for age, sex, and annual household income, described the association of transportation trouble and barriers with AC. Results Of 133 participants, 42.9% had suboptimal AC. Mean age was 60.4 (SD, 13.6) years, and the majority of participants were women (62.2%). Participants with transportation trouble were more likely to report being disabled/unable to work (63.6%) and annual household income <$15 000 (45.5%). Mean TTR was significantly lower for participants with transportation trouble compared to those without (53.8% [SD, 24.7%] vs 64.7% [SD, 25.0%]; P = .03). Participants reporting transportation trouble or at least one transportation barrier were 1.60 (95% CI, 1.07-2.39) and 1.68 (95% CI, 1.01-2.80) times more likely, respectively, to have suboptimal AC compared to those without. Conclusion Inner-city, low-income individuals with transportation barriers were more likely to have suboptimal AC. Further research is warranted to evaluate the impact of alleviating patient-specific transportation barriers on anticoagulation outcomes.
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Affiliation(s)
- Connie H Yan
- Department of Pharmacy Systems, Outcomes & Policy, College of Pharmacy University of Illinois at Chicago Chicago IL USA
| | - Maryam Naveed
- Department of Pharmacy Systems, Outcomes & Policy, College of Pharmacy University of Illinois at Chicago Chicago IL USA
| | - Ali Alobaidi
- Department of Pharmacy Systems, Outcomes & Policy, College of Pharmacy University of Illinois at Chicago Chicago IL USA
| | - Miranda Kopfman
- Department of Pharmacy Systems, Outcomes & Policy, College of Pharmacy University of Illinois at Chicago Chicago IL USA
| | - Edith A Nutescu
- Department of Pharmacy Systems, Outcomes & Policy, College of Pharmacy University of Illinois at Chicago Chicago IL USA.,Center for Pharmacoepidemiology & Pharmacoeconomic Research University of Illinois at Chicago Chicago IL USA.,Department of Pharmacy Practice, College of Pharmacy University of Illinois at Chicago Chicago IL USA
| | - Lisa K Sharp
- Department of Pharmacy Systems, Outcomes & Policy, College of Pharmacy University of Illinois at Chicago Chicago IL USA.,Center for Pharmacoepidemiology & Pharmacoeconomic Research University of Illinois at Chicago Chicago IL USA
| | - Dr Suzanne Cannegieter
- Department of Pharmacy Systems, Outcomes & Policy, College of Pharmacy University of Illinois at Chicago Chicago IL USA.,Center for Pharmacoepidemiology & Pharmacoeconomic Research University of Illinois at Chicago Chicago IL USA.,Department of Pharmacy Practice, College of Pharmacy University of Illinois at Chicago Chicago IL USA
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Stenczel ND, Soare T, Ianovici C, Sovaila S, Gheorghe IR, Purcarea VL. The goldmine of patient satisfaction-interaction and communication in the context of infectious diseases. J Med Life 2021; 14:536-543. [PMID: 34621379 PMCID: PMC8485371 DOI: 10.25122/jml-2021-0258] [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: 06/01/2021] [Accepted: 07/27/2021] [Indexed: 11/30/2022] Open
Abstract
This study aimed to investigate the patient satisfaction level in terms of communication and interaction with the physicians from a Romanian Infectious Disease hospital. The objectives of the study were related to the identification of the general level of satisfaction of the patients, the evaluation of the physicians’ interaction type with their physicians, by using specific behavioral variables, such as respect and attention, as well as to determine the physician-patient communication quality. The data were collected with a self-administered questionnaire and were analyzed using IBM SPSS version 25. The sample comprised 82 patients who were hospitalized in the Department of Infectious Diseases. The quantitative variables were evaluated with the Shapiro-Wilk test and were described by the means and standard deviations, while the qualitative data were described by using the absolute values and percentages. The vast majority of patients were aged between 18–28 years old, were mostly females from urban areas, and 41.5% had university degrees. The outcomes of the study revealed that the general satisfaction of the patients, from a communication perspective, was reflected in the perceived and provided quality of information about the treatment. Although the vast majority of patients highly appreciated the interaction and the communication with their physicians, some individuals felt the need to read more information about their disease, especially from online sources, and they would have preferred their physicians to recommend trustful websites or health care platforms.
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Affiliation(s)
- Norbert Dacian Stenczel
- Department of Healthcare Marketing and Medical Technology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Infectious Diseases and Psychiatry Hospital, Baia Mare, Romania
| | - Traian Soare
- Department of Healthcare Marketing and Medical Technology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Ciprian Ianovici
- Department of Healthcare Marketing and Medical Technology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Silvia Sovaila
- Department of Healthcare Marketing and Medical Technology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Iuliana Raluca Gheorghe
- Department of Healthcare Marketing and Medical Technology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Victor Lorin Purcarea
- Department of Healthcare Marketing and Medical Technology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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Wu D, An J, Yu P, Lin H, Ma L, Duan H, Deng N. Patterns for Patient Engagement with the Hypertension Management and Effects of Electronic Health Care Provider Follow-up on These Patterns: Cluster Analysis. J Med Internet Res 2021; 23:e25630. [PMID: 34581680 PMCID: PMC8512186 DOI: 10.2196/25630] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/10/2021] [Accepted: 08/10/2021] [Indexed: 02/06/2023] Open
Abstract
Background Hypertension is a long-term medical condition. Electronic and mobile health care services can help patients to self-manage this condition. However, not all management is effective, possibly due to different levels of patient engagement (PE) with health care services. Health care provider follow-up is an intervention to promote PE and blood pressure (BP) control. Objective This study aimed to discover and characterize patterns of PE with a hypertension self-management app, investigate the effects of health care provider follow-up on PE, and identify the follow-up effects on BP in each PE pattern. Methods PE was represented as the number of days that a patient recorded self-measured BP per week. The study period was the first 4 weeks for a patient to engage in the hypertension management service. K-means algorithm was used to group patients by PE. There was compliance follow-up, regular follow-up, and abnormal follow-up in management. The follow-up effect was calculated by the change in PE (CPE) and the change in systolic blood pressure (CSBP, SBP) before and after each follow-up. Chi-square tests and z scores were used to ascertain the distribution of gender, age, education level, SBP, and the number of follow-ups in each cluster. The follow-up effect was identified by analysis of variances. Once a significant effect was detected, Bonferroni multiple comparisons were further conducted to identify the difference between 2 clusters. Results Patients were grouped into 4 clusters according to PE: (1) PE started low and dropped even lower (PELL), (2) PE started high and remained high (PEHH), (3) PE started high and dropped to low (PEHL), and (4) PE started low and rose to high (PELH). Significantly more patients over 60 years old were found in the PEHH cluster (P≤.05). Abnormal follow-up was significantly less frequent (P≤.05) in the PELL cluster. Compliance follow-up and regular follow-up can improve PE. In the clusters of PEHH and PELH, the improvement in PE in the first 3 weeks and the decrease in SBP in all 4 weeks were significant after follow-up. The SBP of the clusters of PELL and PELH decreased more (–6.1 mmHg and –8.4 mmHg) after follow-up in the first week. Conclusions Four distinct PE patterns were identified for patients engaging in the hypertension self-management app. Patients aged over 60 years had higher PE in terms of recording self-measured BP using the app. Once SBP reduced, patients with low PE tended to stop using the app, and a continued decline in PE occurred simultaneously with the increase in SBP. The duration and depth of the effect of health care provider follow-up were more significant in patients with high or increased engagement after follow-up.
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Affiliation(s)
- Dan Wu
- College of Biomedical Engineering and Instrument Science, Ministry of Education Key Laboratory of Biomedical Engineering, Zhejiang University, Hangzhou, China
| | - Jiye An
- College of Biomedical Engineering and Instrument Science, Ministry of Education Key Laboratory of Biomedical Engineering, Zhejiang University, Hangzhou, China
| | - Ping Yu
- School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Hui Lin
- College of Biomedical Engineering and Instrument Science, Ministry of Education Key Laboratory of Biomedical Engineering, Zhejiang University, Hangzhou, China
| | - Li Ma
- General Hospital of Ningxia Medical University, Yinchuan, China
| | - Huilong Duan
- College of Biomedical Engineering and Instrument Science, Ministry of Education Key Laboratory of Biomedical Engineering, Zhejiang University, Hangzhou, China
| | - Ning Deng
- College of Biomedical Engineering and Instrument Science, Ministry of Education Key Laboratory of Biomedical Engineering, Zhejiang University, Hangzhou, China
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Hopstaken JS, Verweij L, van Laarhoven CJHM, Blijlevens NMA, Stommel MWJ, Hermens RPMG. Effect of Digital Care Platforms on Quality of Care for Oncological Patients and Barriers and Facilitators for Their Implementation: Systematic Review. J Med Internet Res 2021; 23:e28869. [PMID: 34559057 PMCID: PMC8501408 DOI: 10.2196/28869] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/17/2021] [Accepted: 06/30/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Oncological health care services are challenged by the increasing number of cancer survivors, long-term follow-up care, and fragmentation of care. Digital care platforms are potential tools to deliver affordable, patient-centered oncological care. Previous reviews evaluated only one feature of a digital care platform or did not evaluate the effect on enhancement of information, self-efficacy, continuity of care, or patient- and health care provider-reported experiences. Additionally, they have not focused on the barriers and facilitators for implementation of a digital care platform in oncological care. OBJECTIVE The aim of this systematic review was to collect the best available evidence of the effect of a digital care platform on quality of care parameters such as enhancement of available information, self-efficacy, continuity of care, and patient- and health care provider-reported experiences. Additionally, barriers and facilitators for implementation of digital care platforms were analyzed. METHODS The PubMed (Medline), Embase, CINAHL, and Cochrane Library databases were searched for the period from January 2000 to May 2020 for studies assessing the effect of a digital care platform on the predefined outcome parameters in oncological patients and studies describing barriers and facilitators for implementation. Synthesis of the results was performed qualitatively. Barriers and facilitators were categorized according to the framework of Grol and Wensing. The Mixed Methods Appraisal Tool was used for critical appraisal of the studies. RESULTS Seventeen studies were included for final analysis, comprising 8 clinical studies on the effectiveness of the digital care platform and 13 studies describing barriers and facilitators. Usage of a digital care platform appeared to enhance the availability of information and self-efficacy. There were no data available on the effect of a digital care platform on the continuity of care. However, based on focus group interviews, digital care platforms could potentially improve continuity of care by optimizing the exchange of patient information across institutes. Patient-reported experiences such as satisfaction with the platform were considerably positive. Most barriers for implementation were identified at the professional level, such as the concern for increased workload and unattended release of medical information to patients. Most facilitators were found at the patient and innovation levels, such as improved patient-doctor communication and patient empowerment. There were few barriers and facilitators mentioned at the economic and political levels. CONCLUSIONS The use of digital care platforms is associated with better quality of care through enhancement of availability of information and increased self-efficacy for oncological patients. The numerous facilitators identified at the patient level illustrate that patients are positive toward a digital care platform. However, despite these favorable results, robust evidence concerning the effectiveness of digital care platforms, especially from high-quality studies, is still lacking. Future studies should therefore aim to further investigate the effectiveness of digital care platforms, and the barriers and facilitators to their implementation at the economic and political levels.
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Affiliation(s)
- Jana S Hopstaken
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Lynn Verweij
- Department of Hematology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Cees J H M van Laarhoven
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Nicole M A Blijlevens
- Department of Hematology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Martijn W J Stommel
- Department of Surgery, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands
| | - Rosella P M G Hermens
- Department of IQ Healthcare, Radboud University Medical Center, Nijmegen, Netherlands
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Xu H, Yang H, Wang H, Li X. The Association of Residence Permits on Utilization of Health Care Services by Migrant Workers in China. Int J Environ Res Public Health 2021; 18:9623. [PMID: 34574548 DOI: 10.3390/ijerph18189623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 08/30/2021] [Accepted: 09/07/2021] [Indexed: 12/12/2022]
Abstract
Due to the limitations in the verifiability of individual identity, migrant workers have encountered some obstacles in access to public health care services. Residence permits issued by the Chinese government are a solution to address the health care access inequality faced by migrant workers. In principle, migrant workers with residence permits have similar rights as urban locals. However, the validity of residence permits is still controversial. This study aimed to examine the impact of residence permits on public health care services. Data were taken from the China Migrants Dynamic Survey (CMDS). Our results showed that the utilization of health care services of migrant workers with residence permits was significantly better than others. However, although statistically significant, the substantive significance is modest. In addition, megacities had significant negative moderating effects between residence permits and health care services utilization. Our research results emphasized that reforms of the household registration system, taking the residence permit system as a breakthrough, cannot wholly address the health care access inequality in China. For developing countries with uneven regional development, the health care access inequality faced by migrant workers is a structural issue.
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Robillard R, Daros AR, Phillips JL, Porteous M, Saad M, Pennestri MH, Kendzerska T, Edwards JD, Solomonova E, Bhatla R, Godbout R, Kaminsky Z, Boafo A, Quilty LC. Emerging New Psychiatric Symptoms and the Worsening of Pre-existing Mental Disorders during the COVID-19 Pandemic: A Canadian Multisite Study: Nouveaux symptômes psychiatriques émergents et détérioration des troubles mentaux préexistants durant la pandémie de la COVID-19: une étude canadienne multisite. Can J Psychiatry 2021; 66:815-826. [PMID: 33464115 PMCID: PMC8504288 DOI: 10.1177/0706743720986786] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has caused global disruptions with serious psychological impacts. This study investigated the emergence of new psychiatric symptoms and the worsening of pre-existing mental disorders during the COVID-19 pandemic, identified factors associated with psychological worsening, and assessed changes in mental health service use. METHODS An online survey was circulated between April 3 and June 23, 2020. Respondents were asked to complete mental health questionnaires based on 2 time referents: currently (i.e., during the outbreak) and in the month preceding the outbreak. A total of 4,294 Canadians between 16 and 99 years of age were subdivided based on the presence of self-reported psychiatric diagnoses. RESULTS The proportion of respondents without prior psychiatric history who screened positive for generalized anxiety disorder and depression increased by 12% and 29%, respectively, during the outbreak. Occurrences of clinically important worsening in anxiety, depression, and suicidal ideation symptoms relative to pre-outbreak estimates were significantly higher in those with psychiatric diagnoses. Furthermore, 15% to 19% of respondents reported increased alcohol or cannabis use. Worse psychological changes relative to pre-outbreak estimate were associated with female sex, younger age, lower income, poorer coping skills, multiple psychiatric comorbidities, previous trauma exposure, deteriorating physical health, poorer family relationships, and lower exercising. Reductions in mental health care were associated with increased suicidal ideation. CONCLUSION The worsening in mental health symptoms and the decline in access to care call for the urgent development of adapted interventions targeting both new mental disorders and pre-existing psychiatric conditions affected by the COVID-19 pandemic.
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Affiliation(s)
- Rebecca Robillard
- The Royal’s Institute of Mental Health Research, Ottawa, Ontario, Canada
- School of Psychology, University of Ottawa, Ontario, Canada
| | | | - Jennifer L. Phillips
- The Royal’s Institute of Mental Health Research, Ottawa, Ontario, Canada
- Department of Psychiatry, University of Ottawa, Ontario, Canada
| | - Meggan Porteous
- The Royal’s Institute of Mental Health Research, Ottawa, Ontario, Canada
- School of Psychology, University of Ottawa, Ontario, Canada
| | - Mysa Saad
- The Royal’s Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - Marie-Helene Pennestri
- Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
- Hopital en santé mentale Rivières-des-Prairies, CIUSSS du Nord-de-l’Ile-de-Montreal, Quebec, Canada
| | - Tetyana Kendzerska
- The Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada
| | - Jodi D. Edwards
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Elizaveta Solomonova
- Mind and Brain research group, Division of Social and Transcultural Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Rajiv Bhatla
- Department of Psychiatry, University of Ottawa, Ontario, Canada
- The Royal Ottawa Mental Health Centre, Ottawa, Ontario, Canada
| | - Roger Godbout
- Hopital en santé mentale Rivières-des-Prairies, CIUSSS du Nord-de-l’Ile-de-Montreal, Quebec, Canada
- Department of PSychiatry, Université de Montréal, Québec, Canada
| | - Zachary Kaminsky
- The Royal’s Institute of Mental Health Research, Ottawa, Ontario, Canada
| | - Addo Boafo
- The Children’s Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Lena C. Quilty
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Ontario, Canada
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Terkamo-Moisio A, Karki S, Kangasniemi M, Lammintakanen J, Häggman-Laitila A. Towards remote leadership in health care: Lessons learned from an integrative review. J Adv Nurs 2021; 78:595-608. [PMID: 34462938 DOI: 10.1111/jan.15028] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 07/26/2021] [Accepted: 08/11/2021] [Indexed: 11/30/2022]
Abstract
AIM To gather and synthesize current empirical evidence on remote leadership and to provide knowledge that can be used to develop successful remote leadership in health care. DESIGN A integrative literature review with an integrated mixed methods design. DATA SOURCES The literature search was carried out between February and March 2019 in the CINAHL, Medline (Ovid), PsycInfo, Scopus, SocIndex, Web of Science and Business Source Elite (EBSCO) databases. REVIEW METHODS An integrative review was conducted to identify relevant studies published from 2010 to 2019. Of the 88 eligible studies, 21 studies met the inclusion criteria and were selected for the final review. The included studies were analysed using mixed methods synthesis, more specifically, data-based convergent synthesis. RESULTS The performed analysis identified three main themes: characteristics of successful remote leadership; enhancing the leader-member relationship; and challenges in remote leadership. The first theme included the following sub-themes: remote leader characteristics; trust; communication; and leading the team culture. The second theme covered the importance of organizing regular face-to-face meetings, clear communication policies and the connection between positive team spirit and good remote leader-member relationship, while the third theme emphasized leader- and member-related challenges for remote work. CONCLUSIONS As none of the identified studies had been conducted in a health care setting, future remote leadership research must also specifically consider the health care context. This will be pivotal to exploring how remote work can foster a safe workplace culture, empower health care workers, increase job satisfaction and improve patient outcomes. IMPACT Remote leadership has rarely been studied in the health care context. Trust, communication, team spirit and a leader's characteristics are central to remote leadership, a finding which is useful for re-evaluating and improving the current culture at health care organizations.
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Affiliation(s)
- Anja Terkamo-Moisio
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Suyen Karki
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Mari Kangasniemi
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Johanna Lammintakanen
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Arja Häggman-Laitila
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.,City of Helsinki, Social and Health Care, Helsinki, Finland
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Alrawi Y. Exploring barriers to family planning service utilization and uptake among women in Iraq. East Mediterr Health J 2021; 27:818-825. [PMID: 34486718 DOI: 10.26719/emhj.21.015] [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] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 12/20/2020] [Indexed: 11/09/2022]
Abstract
Background Family planning helps to avoid unwanted pregnancy and reduce maternal mortality and morbidity. Contraceptive prevalence is still relatively low (58%) in Iraq compared with other countries in the Eastern Mediterranean Region, and the unmet need (12%) and total fertility (4.2 children per woman) rates are still high. Services are available free of charge or heavily subsidized in many public and private health facilities, yet many women may still not use them due to social, cultural, financial or health care services constraints. Aims This scoping review explores barriers to family planning services utilization and uptake among women in Iraq. Methods The review uses an adapted conceptual framework from quality of care and human rights-based frameworks to analyse published scientific studies. Results At policy level, the government has supported family planning but not enough resources were allocated. At the service level, low family planning promotion from health care providers (especially during antenatal care visits) along with provider bias for certain types of contraception, have contributed to inaccurate information and misconceptions. At the community and individual level, women's choice is still largely influenced by the husband's position on contraception as men are still considered the key decision-makers in regard to fertility. Valuing a large family is still a barrier to family planning services utilization and uptake whereas religion was found to support the use of family planning. Conclusion There is a need to provide promotional messages and encouraging mutual fertility decisions.
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Affiliation(s)
- Yousuf Alrawi
- United Nations Population Fund, Eritrea Country Office, Asmara, Eritrea
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Merlin E, Goix L, Moret C, Petrovic T, Langeron F, Chanzy E, Aguadisch E, Adnet F, Reuter PG, Delvau N, Lapostolle F. COVID-19 Infection Epidemic in the South Pacific Island of New Caledonia and in the Greater Paris: Where Is the Highest Wave? Asia Pac J Public Health 2021; 33:923-927. [PMID: 34259075 DOI: 10.1177/10105395211014636] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION New-Caledonia, an island located in the South-Pacific, was the first (overseas) French country hit by the coronavirus disease-2019 (COVID-19) pandemic to come out of lockdown. The epidemic was rapidly controlled. Analyzing the impact of an epidemic only makes sense if it is compared with a zone with a similar health care system. OBJECTIVE To compare epidemic evolution in New-Caledonia and Paris suburb. METHODS Health care organization is similar in New-Caledonia and Seine-Saint-Denis, based on an Emergency Medical System call center. We recorded the numbers of patients managed by SAMU (Service d'Aide Médicale Urgente)-Emergency Medical System, transferred to the emergency department and managed in prehospital setting by mobile intensive care unit. We compared these parameters during the reference (February 1-23, 2020) and the COVID-19 (February 24, 2020, to April 19, 2020) periods. Primary end-point: number of days over the 95th percentile of the reference period. RESULTS Number of patients managed was over the 95th percentile during 27 and 47 days in New-Caledonia and Seine-Saint-Denis, respectively. Number of emergency department transfers was more than the 95th percentile during 4 and 31 days, respectively. Number of mobile intensive care unit sent was over the 95th percentile during 3 and 14 days, respectively. Peaks were similar. CONCLUSION The duration of the critical period rather than its spread affected the health care system.
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Affiliation(s)
| | - Laurent Goix
- Université Paris 13, Sorbonne Paris Cité, Inserm U942, Bobigny, France
| | | | - Tomislav Petrovic
- Université Paris 13, Sorbonne Paris Cité, Inserm U942, Bobigny, France
| | | | - Erick Chanzy
- Université Paris 13, Sorbonne Paris Cité, Inserm U942, Bobigny, France
| | - Elise Aguadisch
- Université Paris 13, Sorbonne Paris Cité, Inserm U942, Bobigny, France
| | - Frédéric Adnet
- Université Paris 13, Sorbonne Paris Cité, Inserm U942, Bobigny, France
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Barros-Tornay R, Ferrándiz L, Martín-Gutiérrez FJ, Fernández-Orland A, Serrano-Gotarredona A, de la Torre JM, Conejo-Mir MD, Ojeda-Vila T, Márquez-Enríquez J, Hernández C, Ocaña MJ, Herrerías-Esteban JM, Moreno-Ramírez D. Feasibility and cost of a telemedicine-based short-term plan for initial access in general dermatology in Andalusia, Spain. JAAD Int 2021; 4:52-57. [PMID: 34409393 PMCID: PMC8362296 DOI: 10.1016/j.jdin.2021.05.002] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2021] [Indexed: 01/30/2023] Open
Abstract
Background In developed countries, health care delivery in dermatology is hampered by the low availability of dermatologists. Objective To analyze the feasibility of a teledermatology-based action plan to provide initial dermatologic care in areas with low availability of dermatologists. Methods A cross-sectional study describing the feasibility and cost of a 12-month action plan based on a store-and-forward teledermatology (TD) connecting primary care centers and a TD center. Teleconsultations from patients complaining of any cutaneous condition were included. The primary outcome measure was the percentage of patients not referred to the local dermatologist. Results Among the total of 15,523 teleconsultations attended in the TD-based action plan, 3360 (21.65%) required a face-to-face visit with a local dermatologist. In 32.32% (n = 5017) of the cases, a therapeutic and follow-up plan report was issued. The most common conditions managed were melanocytic nevi (15.63%, n = 2426), followed by seborrheic keratosis (14.89%, n = 2312), and actinic keratosis (8.65%, n = 1342). The average response time was 14.52 days (95% CI 14.35-15.23). The additional total investment in this action plan was $142,681.01, with a unit cost of 9.20$/patient. Limitations Noncontrolled study. Conclusions Experienced dermatologists working with store-and-forward TD can deliver a fast and effective response in health care areas with access limitations.
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Affiliation(s)
- Ruben Barros-Tornay
- Teledermatology Group, Department of Medical-&-Surgical Dermatology, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Lara Ferrándiz
- Teledermatology Group, Department of Medical-&-Surgical Dermatology, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Francisco J Martín-Gutiérrez
- Teledermatology Group, Department of Medical-&-Surgical Dermatology, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Almudena Fernández-Orland
- Teledermatology Group, Department of Medical-&-Surgical Dermatology, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Amalia Serrano-Gotarredona
- Teledermatology Group, Department of Medical-&-Surgical Dermatology, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - José M de la Torre
- Teledermatology Group, Department of Medical-&-Surgical Dermatology, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - María D Conejo-Mir
- Teledermatology Group, Department of Medical-&-Surgical Dermatology, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Teresa Ojeda-Vila
- Teledermatology Group, Department of Medical-&-Surgical Dermatology, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | | | - María J Ocaña
- Dermatology Unit, Hospital San Agustín, Linares, Spain
| | | | - David Moreno-Ramírez
- Teledermatology Group, Department of Medical-&-Surgical Dermatology, Hospital Universitario Virgen Macarena, Sevilla, Spain
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