Perspective from health professionals on delivery of sub-acute care in Hong Kong: A qualitative study in a health system

Health Policy ◽  
2011 ◽  
Vol 100 (2-3) ◽  
pp. 211-218 ◽  
Author(s):  
Eliza L.Y. Wong ◽  
Carrie H.K. Yam ◽  
Frank W.K. Chan ◽  
Annie W.L. Cheung ◽  
Fiona Y.Y. Wong ◽  
...  
Author(s):  
Anam Feroz ◽  
Anum Shiraz Ali ◽  
Mohsina Noor Ibrahim ◽  
Elizabeth M. McClure ◽  
Shiyam Sunder Tikmani ◽  
...  

Abstract Background Pakistan is considered to be one of the riskiest places in the world for childbirth as measured by its high stillbirth and neonatal mortality rates. Complete diagnostic autopsy remains the gold standard to determine the cause of death (CoD); however, it is not routinely implemented due to religious objections, sociocultural beliefs, limited resources and low demand from physicians and families. Recently, minimally invasive tissue sampling (MITS) using needle biopsies of multiple tissues to obtain tissue for histological examination and organism identification with PCR has been developed and promoted to determine CoD in low-resource areas. To ensure successful implementation of MITS, it is important to understand health professionals’ attitudes and perceptions related to MITS. Methods A qualitative study was conducted at the National Institute of Child Health (NICH), Karachi, Pakistan. Focus group discussions (FGDs) and Key-informant interviews (KIIs) were conducted with health professionals including doctors, nurses, trainees, clinicians, bioethics experts and public health experts to explore their perceptions and views on acceptability of MITS. Data were analyzed using NVivo 10 software. Results A total of 12 interviews (FGDs = 4; KIIs = 8) were conducted. Four overarching themes were identified: (I) acceptability of MITS; (II) perceived benefits of the MITS procedure; (III) factors facilitating the implementation of MITS; and (IV) health system requirements for implementing the MITS procedure. Generally, MITS was considered as a positive development for the health system. Diagnostic accuracy and identification of less common causes of death were highlighted as two main benefits of the MITS procedure. The study highlighted a number of facilitators for the acceptability of MITS including effective counseling, building trust with parents, fast procedure time, and approaching families within a few hours of death. In addition, lack of skilled staff, poorly equipped healthcare facilities and the potential high cost to conduct MITS were identified as challenges for the implementation of MITS. Conclusions This formative research provided a unique opportunity to explore health professionals’ views and attitudes towards the MITS procedure. Such insights are crucial to ensure successful implementation and integration of a new technique into the existing health system. The research identified the factors influencing the acceptability of MITS among health professionals in Pakistan. The study also informed factors that could help facilitate the implementation of the MITS procedures in the context of Pakistan and similar settings.


2022 ◽  
Vol 75 (2) ◽  
Author(s):  
Gleice Kelli Santana de Andrade ◽  
Elen Ferraz Teston ◽  
Sonia Silva Marcon ◽  
Bianca Cristina Ciccone Giacon-Arruda ◽  
Milena Dalariva Amorim ◽  
...  

ABSTRACT Objective: to know health professionals’ perceptions about care actions provided to children with Congenital Zika Virus Syndrome and their families. Methods: this is a qualitative study, carried out in a capital of center-western Brazil, based on the Unified Health System theoretical precepts. Data were collected in September and October 2020, through audio-recorded interviews with 12 health professionals from a specialized service and submitted to analysis of content, thematic modality. Results: the implementation of care actions with these children occurs through multidimensional assessment of children and their families, use of the Unique Therapeutic Project, therapeutic interventions for the development of children and the communication and exchange of interprofessional and family experiences, in addition to considering professionals’ prior knowledge and their search for it. Final considerations: children with CZS and their families need individualized, frequent, integrated and continuous care.


Author(s):  
Fernando Jesús Plaza del Pino ◽  
Oscar Arrogante ◽  
Juana Inés Gallego-Gómez ◽  
Agustín Javier Simonelli-Muñoz ◽  
Gracia M. Castro de Luna ◽  
...  

The Romani are the main European ethnic minority. The Romani people’s situation of social vulnerability and their difficulties in accessing the health system, make their health indicators worse than those of the non-Romani population. The present study will delve into the health beliefs and experiences with health services and their professionals through the perspectives of Romani women. In this qualitative study, 16 women of different ages were interviewed in a city located in the South of Spain. Four themes emerged from the analysis of data: the construction of the identity of Romani women, difficulties in life, health and disease beliefs and barriers in the access to the health system. We conclude that every project for the improvement of the health of the Romani community must take into account the active participation of Romani women and must consider the principles of Cultural Safety, by delving into the intercultural training of health professionals and addressing the social determinants of health which affect the Romani collective.


2019 ◽  
Vol 17 (2) ◽  
Author(s):  
Martins Corrêa da Silva ◽  
Claudia Feio da Maia Lima ◽  
Miriam Da Costa Lindolpho ◽  
Thiara Joanna Peçanha da Cruz ◽  
Célia Pereira Caldas

Aim: present the results of activities conducted by nurses to improve support to family caregivers of the elderly. Method: This is a qualitative study based on participatory methodology. Meetings were held with twelve family caregivers and team meetings with 8 nurses from July to March 2016. The records of the speeches were submitted to content analysis. Results: the caregivers exposed their difficulties, their dilemmas and the contradiction between public policies and reality. In response to caregivers, the nurses constructed a plan of action. Discussion: the problematization of the relationship between services, health professionals and population increased the network of support to caregivers accompanied in the Unified Health System. Conclusion: group activities are more than a moment of catharsis; they produce interaction, the strengthening of the service, and contribute to the promotion of health.


Author(s):  
Amparo Talens ◽  
Mercedes Guilabert ◽  
Blanca Lumbreras ◽  
María Teresa Aznar ◽  
Elsa López-Pintor

Lack of adherence constitutes one of the most important challenges in patients undergoing treatment with oral antineoplastic drugs (ANEO). Understanding cancer patients’ experiences with respect to their medication is key for optimizing adherence and therapeutic results. We aimed to assess the medication experience (ME) in patients with cancer in treatment with ANEO, to describe the barriers and facilitators related to the disease and its treatment and to compare them with the healthcare professionals’ perspectives. We carried out an exploratory qualitative study in the University Hospital of San Juan de Alicante, Spain. Three focus groups and two nominal group discussions were conducted with 23 onco-hematological patients treated with ANEO and 18 health professionals, respectively. The data were analyzed using content analyses and were eventually triangulated. The most impactful aspects in patients’ ME were the presence of adverse effects; lack of information about treatment; beliefs, needs and expectations regarding medications; social and family support; and the relationship with the health professionals. Both patients and professionals agreed on considering the negative side effects and the information about treatment as the main barriers and facilitators of adherence, respectively, although the approaches differed between both profiles. The professionals offered a more technical vision while patients prioritized the emotional burden and motivation associated with the disease and medication. This study allowed us to understand the real-life experiences of patients being treated with ANEO and explore the factors which had an impact on adherence to treatment. This understanding enables professionals to have a positive influence on patients’ behavior and provide individualized care plans. Pharmacists’ assistance is relevant to support patients’ adherence and self-management.


Author(s):  
Sachin R. Pendharkar ◽  
Evan Minty ◽  
Caley B. Shukalek ◽  
Brendan Kerr ◽  
Paul MacMullan ◽  
...  

Abstract Background The evolving COVID-19 pandemic has and continues to present a threat to health system capacity. Rapidly expanding an existing acute care physician workforce is critical to pandemic response planning in large urban academic health systems. Intervention The Medical Emergency-Pandemic Operations Command (MEOC)—a multi-specialty team of physicians, operational leaders, and support staff within an academic Department of Medicine in Calgary, Canada—partnered with its provincial health system to rapidly develop a comprehensive, scalable pandemic physician workforce plan for non-ventilated inpatients with COVID-19 across multiple hospitals. The MEOC Pandemic Plan comprised seven components, each with unique structure and processes. Methods In this manuscript, we describe MEOC’s Pandemic Plan that was designed and implemented from March to May 2020 and re-escalated in October 2020. We report on the plan’s structure and process, early implementation outcomes, and unforeseen challenges. Data sources included MEOC documents, health system, public health, and physician engagement implementation data. Key Results From March 5 to October 26, 2020, 427 patients were admitted to COVID-19 units in Calgary hospitals. In the initial implementation period (March–May 2020), MEOC communications reached over 2500 physicians, leading to 1446 physicians volunteering to provide care on COVID-19 units. Of these, 234 physicians signed up for hospital shifts, and 227 physicians received in-person personal protective equipment simulation training. Ninety-three physicians were deployed on COVID-19 units at four large acute care hospitals. The resurgence of cases in September 2020 has prompted re-escalation including re-activation of COVID-19 units. Conclusions MEOC leveraged an academic health system partnership to rapidly design, implement, and refine a comprehensive, scalable COVID-19 acute care physician workforce plan whose components are readily applicable across jurisdictions or healthcare crises. This description may guide other institutions responding to COVID-19 and future health emergencies.


2021 ◽  
pp. 103049
Author(s):  
Benjamin Hartung ◽  
Michelle Lalonde ◽  
Brandi Vanderspank-Wright ◽  
J. Craig Phillips

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