Rethinking Suicide Risk With a New Generation of Suicide Theories

2020 ◽  
Vol 34 (4) ◽  
pp. 389-408
Author(s):  
Tamara P. Keefner ◽  
Thomas Stenvig
Keyword(s):  
Health Care ◽  
Suicide Attempt ◽  
Health Care Providers ◽  
Common Factor ◽  
Theoretical Models ◽  
Care Providers ◽  
Suicidal Thinking ◽  
Action Theories ◽  
The Individual ◽  
New Generation

BackgroundSuicide is a global concern to nurses and other health-care providers. However, deaths by suicide are only part of the spectrum of suicide, as suicidal thinking and behaviors may precede a suicide attempt. Theoretical models are used infrequently in research to explain how the individual progresses from suicidal ideation to a suicide attempt. Thus, there is a critical need to advance the study of suicide with useful theoretical models to describe and explain processes whereby suicidal thoughts transition to attempts and to suicide.PurposeThis article provides a conceptual discussion and scoping review comparing historical and contemporary ideation-to-action theories of suicide.MethodSystematic reviews and meta-analyses from three databases (CINAHL, JSTOR, and PsychINFO) were reviewed to find literature describing suicide theories.ResultsHistorically, theory applications have limited capacity to differentiate between those individuals with suicidal ideations and those who attempt suicide. Newer theories, grounded in the ideation-to-action framework, propose distinct processes explaining what moves an individual from suicidal ideations toward suicidal behaviors.Implications for PracticeThe ideation-to-action theories can guide health-care providers' assessment of at-risk individuals beyond merely asking about suicidal thinking.ConclusionThe new generation of suicide theories suggest that suicidal ideations are only one component of risk. The common factor in ideation-to-action theories that distinguishes ideators from attempters is the acquired capability for suicide.

scholarly journals Patients’ Views on Self-Management of Chronic Musculoskeletal Pain

2020 ◽  
Vol 5 (4) ◽  
pp. 254-266
Author(s):  
Barbka Huzjan ◽  
Ivana Hrvatin
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Musculoskeletal Pain ◽  
Health Care Providers ◽  
Multidisciplinary Approach ◽  
Research Question ◽  
Chronic Musculoskeletal Pain ◽  
Self Management ◽  
Care Providers ◽  
The Individual

Research Question (RQ): Chronic musculoskeletal pain is a complex condition and one of the most important causes of suffering of modern times. Self-management refers to the individual’s ability to manage the symptoms, treatment, physical and psychosocial consequences and life style changes inherent in living with a chronic condition. The research question is; what is the view on the selfmanagement of chronic musculoskeletal pain from the patient's perspective? Purpose: The purpose of this literature review was to review original articles that reported how selfmanagement educational programmes are viewed from the patient’s perspective. Method: We used an integrative review of the literature. The search was conducted from November 2019 to March 2020 on the PubMed, PEDro and OTseeker databases. We included original studies, written in English that examined the patients’ point of view on self-management. The included studies, needed to be conducted on adult patients of both sexes, that were suffering from chronic pain and were educated on self-management of their pain. Two authors independently searched for original studies. Results: Nine article were included in the review. Most of the studies included a multidisciplinary approach. Patients reported they more frequently used passive strategies to manage their pain. They want to be included in the management and be able to communicate with the provider of selfmanagement. There are several positive aspects of a multidisciplinary and groups approach. Organization: Health care providers can encourage an individual to proactively behave through ongoing processes of communication, partnerships and the creation of appropriate self-management plans over time. Society: We assume that the analysis will help to identify the social responsibility of the individual and society in the common concern for the health of the population and the individual within it. Originality: The research provides an up-to-date, new overview of the patients' perspective on self management on chronic pain. The review can be helpful to health care providers s they can compare their expectations with patients's. Limitations / further research: Further research would focus on high quality studies, and specific forms of multidisciplinary approach, and finding what patients use at a home setting and how to help them continue in the self management of their pain. Limitations of this review include the lack of risk of bias assessment and the fact that this is not a systematic review.

scholarly journals Achievements and Challenges in Implementing Urban Family Physician Program in Iran: Viewpoint of Managers and Executives

2019 ◽  
Author(s):  
Mohammad Javad Kabir ◽  
Hasan Ashrafian Amiri ◽  
Zahra Hassanzadeh-Rostami ◽  
Reza Momtahen ◽  
Rasoul Zafarmand ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Family Physician ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Sustainable Resources ◽  
Urban Family ◽  
The Individual ◽  
Challenges And Strategies

Background: Urban family physician program is one of the relatively large reforms in Iran's health care system implemented in Fars and Mazandaran provinces since 2012. Nearly five years after implementation of the program, this study aimed to identify the achievements and challenges of this program from the viewpoints of managers and administrators. Methods: This cross-sectional study was conducted in winter of 2016. The research population included administrators and experts monitoring the urban family physician program and representatives of the family physicians and health care providers selected using the census method. The data collection tool was a two-part researcher-made questionnaire containing 15 questions with confirmed validity. To collect data, 29 panels of experts were held and the collected information was analyzed by SPSS 23 using independent t-tests and ANOVA. Results: Among the total of 647 participants in 2 provinces, 1540 achievement cases, 2387 challenge cases, and 1641 strategies were found. The average numbers of achievements, challenges, and strategies stated by each person were 2.38 ± 2.0, 3.70 ± 2.7, and 2.54 ± 2.0, respectively. The most frequent achievements, challenges, and strategies were increased disease detection and care (430), untimely payment to physicians (198), and providing sustainable resources for timely payments (119).  The means of achievements, challenges, and strategies had significant relationship with some of the individual and social variables (p < 0.05). Conclusion: This study showed that increasing the rate of detection was the most important achievement and lack of timely payment was the biggest challenge of the program, which should be considered by policy makers.

scholarly journals Developing HIV Assisted Partner Notification Services Tailored to Mexican Key Populations: A Qualitative Approach

2020 ◽  
Author(s):  
Heleen Vermandere ◽  
Santiago Aguilera-Mijares ◽  
Liliane Martínez-Vargas ◽  
M. Arantxa Colchero ◽  
Sergio Bautista-Arredondo
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Partner Notification ◽  
Essential Elements ◽  
Care Providers ◽  
Structured Interviews ◽  
Hiv Diagnosis ◽  
Hiv Awareness ◽  
Sex With Men ◽  
The Individual

Abstract Background. Assisted partner notification services (APNS) may increase HIV testing, early diagnosis, and treatment, but they are not formally implemented in Mexico, where the HIV epidemic is concentrated in men who have sex with men (MSM) and transwomen (TW).Methods. We conducted semi-structured interviews to explore partner notification with MSM, TW and health care providers to identify the essential elements to include in the design and implementation of APNS directed to MSM and TW in Mexico City. Afterwards, brainstorm sessions were carried out to produce strategies for implementing APNS.Results. Most participants reported experiences with informal partner notification, but not with APNS. Only one health care provider indicated assisting notification systematically. The main barriers for notifying mentioned by both MSM and TW included fear of (violent) reactions, discrimination and lacking contact information of casual partners. Participants thought it was easier notifying a formal partner, conditional of being well informed about HIV. Given current stigma and lack of awareness, it was suggested that APNS should be preceded by HIV awareness efforts, and be provided by counsellors or peers to mitigate potential rejection or violent reactions. Conclusions. While APNS are not formally implemented in Mexico, all participants supported the service, indicating that APNS can enhance early HIV diagnosis in Mexico. Strategies to implement such services need to be flexible addressing the individual needs of participants, guaranteeing the safety of more vulnerable participants.

scholarly journals Developing HIV Assisted Partner Notification Services Tailored to Mexican Key Populations: A Qualitative Approach

2020 ◽  
Author(s):  
Heleen Vermandere ◽  
Santiago Aguilera-Mijares ◽  
Liliane Martínez-Vargas ◽  
M. Arantxa Colchero ◽  
Sergio Bautista-Arredondo
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Partner Notification ◽  
Essential Elements ◽  
Care Providers ◽  
Structured Interviews ◽  
Hiv Diagnosis ◽  
Hiv Awareness ◽  
Sex With Men ◽  
The Individual

Abstract Background. Assisted partner notification services (APNS) may increase HIV testing, early diagnosis, and treatment, but they are not formally implemented in Mexico, where the HIV epidemic is concentrated in men who have sex with men (MSM) and transwomen (TW). We conducted semi-structured interviews to explore partner notification with MSM, TW and health care providers to identify the essential elements to include in the design and implementation of APNS directed to MSM and TW in Mexico City. Afterwards, brainstorm sessions were carried out to produce strategies for implementing APNS. Results. Most participants reported experiences with informal partner notification, but not with APNS. Only one health care provider indicated assisting notification systematically. The main barriers for notifying mentioned by both MSM and TW included fear of (violent) reactions, discrimination and lacking contact information of casual partners. Participants thought it was easier notifying a formal partner, conditional of being well informed about HIV. Given current stigma and lack of awareness, it was suggested that APNS should be preceded by HIV awareness efforts, and be provided by counsellors or peers to mitigate potential rejection or violent reactions. Conclusions. While APNS are not formally implemented in Mexico, all participants supported the service, indicating that APNS can enhance early HIV diagnosis in Mexico. Strategies to implement such services need to be flexible addressing the individual needs of participants, guaranteeing the safety of more vulnerable participants.

Managing Care in the New Era of “Systems-Think”: The Implications for Managed Care Organizational Liability and Patient Safety

2001 ◽  
Vol 29 (3-4) ◽  
pp. 290-304 ◽  
Author(s):  
Alice A. Noble ◽  
Troyen A. Brennan
Keyword(s):  
Health Care ◽  
Managed Care ◽  
Health Care Providers ◽  
Medical Error ◽  
Financial Incentives ◽  
Care Delivery ◽  
Care Providers ◽  
Dominant Form ◽  
New Era ◽  
The Individual

Three major trends in American health policy are intersecting in a fascinating way. First, managed care has grown to become the most dominant form of health-care delivery, leading to reductions in health-care costs as insurers are able to influence health-care providers with financial incentives. Second, the present growth of managed care has slowed, almost to a standstill, largely on account of consumers questioning what effects these financial incentives are having on the care of patients — questioning that has been expressed in particular through lawsuits against managed care companies.Third, we are experiencing a renewed interest in the existence of medical error and how it may be reduced as a result of the Institute of Medicine’s (IOM) report, To Err Is Human: Building a Safer Health System. The most important aspect of this renaissance in error reduction has been its emphasis on health care as a system that can be made better through system-oriented change. The most frustrating aspect is that the IOM did not endorse change in malpractice liability, which consistently puts the impetus for reducing medical error on the individual provider rather than the system as a whole.

Communication Between Provider and Patient: Values, Biography, and Empowerment in Clinical Practice

1996 ◽  
Vol 16 (6) ◽  
pp. 747-774 ◽  
Author(s):  
Phillip G. Clark
Keyword(s):  
Health Care ◽  
Health Care Provider ◽  
Health Care Providers ◽  
Care Provider ◽  
Communication Process ◽  
Care Providers ◽  
New Approaches ◽  
Communication Problems ◽  
Patient Values ◽  
The Individual

AbstractCommunication between elderly people and their health care providers is becoming more important due to the chronic nature of geriatric health problems and their impact on quality of life. At the core of the challenge of improving this dialogue are factors related to essential human values and the clash between two different cultures – one scientific and the other personal. Only by gaining an understanding of this clinical decisionmaking interaction can new approaches to bridge the communication gap be developed. The purpose of this paper is fourfold: (1) to summarise the fundamentally different bases for communication between health care provider and patient, (2) to discuss the shortcomings of various methods (such as advance directives) to embody patients’ wishes about their care, (3) to review new models of geriatric care that have implications for this communication process, and (4) to develop a framework – based on biographical methods and the concept of empowerment – that suggests some potential solutions to these communication problems. Such methods reflect new approaches to developing life stories and themes suggestive of ways to retain the personal life voice of the individual in the development of a clinical partnership with the health care provider.

scholarly journals PUBLIC HEALTH IN THE NEW MILLENIUM: CHALLENGES AND RESPONSES

2001 ◽  
Vol 1 (1) ◽  
pp. 1-7
Author(s):  
Osman Ali
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Leadership Roles ◽  
Care Providers ◽  
Equity In Health ◽  
Public Health Professionals ◽  
Promotion Strategies ◽  
New Generation ◽  
Equity In Health Care

Public health in the new millenium  will face greater challenges especially directly from globalisation. New challenges will required new responses. The quest for a relevant, quality, cost­ effective and equity in health care should be continued and strengthened by using the most appropriate and effective health promotion strategies and health care reform. New generation of health care providers especially public health professionals should play effective leadership roles, communicator, health provider, decision maker and health manager at the place or organisation they work with, to face ever changing challenges in the future.

Regulation of “Downstream” and Direct Risk Contracting by Health Care Providers: The Quest for Consumer Protection and a Level Playing Field

1997 ◽  
Vol 23 (4) ◽  
pp. 449-486
Author(s):  
Douglas J. Witten
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Delivery ◽  
Quality Care ◽  
Effective Means ◽  
Economic Incentives ◽  
Care Providers ◽  
Levels Of Care ◽  
Playing Field ◽  
The Individual

As the delivery of health care continues to be driven by the search for an effective means of reducing costs and delivering quality care to the greatest number of people, the industry’s most beloved buzzword, perhaps ironically, has a root suggestive of a focus on the individual: capitation. Capitation is widely regarded as a method of realigning economic incentives to produce fair prices, real value, reasonable profits and predictable growth in costs. Beyond being a mere payment mechanism, though, capitation represents a philosophical shift to an accountability approach for health care delivery, whereby focus is increasingly directed on prepayment of capitated amounts to risk-bearing delivery systems. Theoretically, the premise makes a great deal of sense: to achieve optimal levels of care delivered and costs expended, incentivize persons or entities with the capacity to affect such levels so that economic reward follows effective management of resources.Placing, for the moment, faith in the innovative capacities of the marketplace to seek out new and improved ways of delivering health care, the evolution of the capitated arrangement indicates that what makes sense in theory may also make sense in practice.

“Compassion Fatigue” is a Misnomer: How Compassion Can Increase Quality of Life

2020 ◽  
Vol 26 (4) ◽  
pp. 246-252
Author(s):  
Jennifer DeDecker
Keyword(s):  
Health Care ◽  
Job Performance ◽  
Compassion Fatigue ◽  
Health Care Providers ◽  
Health Care Workers ◽  
Negative Consequences ◽  
Care Providers ◽  
Care Workers ◽  
The Individual

Health-care workers are at risk of experiencing negative consequences for their own health and job performance due to a wide variety of stressors. Care providers suffer from varying expressions of a generalized symptom set that has been termed “burnout” or “compassion fatigue.” These terms can help us understand the phenomenon that is happening in our health system, but a strong understanding of the physical, mental, emotional, and psychological implications will increase the efficacy of treatment and benefit of preventive care. This article asserts that the term “compassion fatigue” is a misnomer, resulting in a misunderstanding of the causes and effects of compassion on the individual. This article challenges the term, positing that it has become outdated based on what we now know about the neuroscience of compassion, empathy, and mindfulness. Instead, this discussion offers the relevance of the term “empathic distress leading to empathic distress fatigue,” suggesting that contemplative practice, mindfulness, and compassion training can protect and empower health-care providers.

Concealing an HIV-Positive Status in Medical Settings: Discussions in Russian Online Forums

2020 ◽  
Vol 30 (9) ◽  
pp. 1379-1391
Author(s):  
Victoria I. Dudina ◽  
Elizabeth J. King ◽  
Anna V. Tsareva
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
People Living With Hiv ◽  
Care Providers ◽  
Online Forums ◽  
Hiv Status ◽  
Major Barrier ◽  
Medical Settings ◽  
Related Stigma ◽  
The Individual

Concealment of diagnosis is one of the most important manifestations of HIV-related stigma, which is a major barrier to addressing the growing HIV epidemic in Russia. The purpose of our research was to understand how and why people living with HIV (PLHIV) conceal their HIV status in medical settings. We analyzed data collected through two major Russian online forums for PLHIV. We found that concealing HIV status in medical settings is connected to worries about breach of confidentiality, denial of quality medical care, and judgment from health care providers. PLHIV discuss the dilemmas between risks of disclosing and potential legal or health-related consequences of concealment. We identified strategies that PLHIV use to conceal their status including falsifying medical records, hiding test results, and offering payments to doctors. Understanding status concealment is important for building more effective interactions between health care providers and PLHIV, at both the individual and the institutional levels.

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