Obstetrician-Gynecologists’ Role Conflict in a Natural Disaster: Professional Versus Family Responsibilities

2018 ◽  
Vol 13 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Mark A. Turrentine ◽  
Manju Monga ◽  
Laurie S. Swaim
Keyword(s):  
Health Care ◽  
Natural Disaster ◽  
Role Conflict ◽  
Health Care Providers ◽  
Care Providers ◽  
Family Obligations ◽  
Family Responsibilities ◽  
Medicine Department ◽  
Survey Responses ◽  
At Home

ABSTRACTObjectiveThe purpose of this study was to evaluate role conflict between professional and familial responsibilities among obstetric health care providers during a natural disaster between those required to stay in the hospital versus those who were at home during a catastrophic weather event.MethodsA survey was used of obstetric attending and resident physicians in the Baylor College of Medicine, Department of Obstetrics and Gynecology following Hurricane Harvey on August 26, 2017.ResultsNinety one of 103 physicians (88%) completed the survey. Survey responses were compared between physicians who worked in the hospital (n = 47) versus those who were at home (n = 44) during the storm and its immediate aftermath. Physicians in the hospital and at home agreed (47% and 48%, respectively, P = 0.94) that professional duties conflicted with family obligations and felt torn (49% and 55%, respectively, P = 0.48) regarding family obligations. A majority of homebound health care providers disagreed with the statement that professional duties override family responsibilities, whereas less than half of in-hospital providers felt the same (68% at-home versus 47% of the hospital-team, P = 0.10).ConclusionAs organizations prepare for possible catastrophic situations, institutions must realize that obstetric health care providers will experience role conflict between professional and family responsibilities. (Disaster Med Public Health Preparedness. 2019;13:33–37)

TELE-MONITORING SYSTEM OF RISK IN RESPIRATORY PATIENTS

2021 ◽  
pp. 2150041
Author(s):  
Awad Al-Zaben ◽  
Lina M.K. Al-Ebbini ◽  
Badr Qatashah
Keyword(s):  
Health Care ◽  
Signal Processing ◽  
Health Care Providers ◽  
Mobile Phones ◽  
Model Parameters ◽  
Care Providers ◽  
Server Side ◽  
Respiration Signal ◽  
At Home

In many situations, health care professionals need to evaluate the respiration rate (RR) for home patients. Moreover, when cases are more than health care providers’ capacity, it is important to follow up cases at home. In this paper, we present a complete system that enables healthcare providers to follow up with patients with respiratory-related diseases at home. The aim is to evaluate the use of a mobile phone’s accelerometer to capture respiration waveform from different patients using mobile phones. Whereas measurements are performed by patients themselves from home, and not by professional health care personnel, the signals captured by mobile phones are subjected to many unknowns. Therefore, the validity of the signals has to be evaluated first and before any processing. Proper signal processing algorithms can be used to prepare the captured waveform for RR computations. A validity check is considered at different stages using statistical measures and pathophysiological limitations. In this paper, a mobile application is developed to capture the accelerometer signals and send the data to a server at the health care facility. The server has a database of each patient’s signals considering patient privacy and security of information. All the validations and signal processing are performed on the server side. The patient’s condition can be followed up over a few days and an alarm system may be implemented at the server-side in case of respiration deterioration or when there is a risk of a patient’s need for hospitalization. The risk is determined based on respiration signal features extracted from the received respiration signal including RR, and Autoregressive (AR) moving average (ARMA) model parameters of the signal. Results showed that the presented method can be used at a larger scale enabling health care providers to monitor a large number of patients.

110 Interim Federal Health Program (IFHP): Survey of Access & Utilization by Pediatric Health Care Providers

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e79-e80
Author(s):  
Caroline Leps ◽  
Jessica Monteiro ◽  
Tony Barozzino ◽  
Ashna Bowry ◽  
Meb Rashid ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Health Program ◽  
Subject Area ◽  
Refugee Children ◽  
Surveillance Program ◽  
Care Providers ◽  
Survey Responses ◽  
Interim Federal Health Program

Abstract Primary Subject area Public Health and Preventive Medicine Background Canada is currently facing an increasing number of refugees and refugee claimants, yet Canadian health professionals are underutilizing the system intended to provide these individuals with healthcare. The Interim Federal Health Program (IFHP) provides temporary healthcare coverage for those who are ineligible for provincial or territorial insurance, including resettled refugees and asylum seekers. Research suggests there are ongoing challenges around the program such as who is covered and what services are covered. Objectives The objective of this study was to assess Canadian pediatricians’ current understanding and utilization of the IFHP, and perceived barriers to its utilization. Design/Methods A one-time survey was administered via the Canadian Paediatric Surveillance Program. The ten question adaptive survey was available in English or French, in either paper or electronic format. Survey responses were collected for 6 weeks in early 2020 with two reminders sent prior to survey closing. In addition to descriptive statistics, multinomial logistic regressions were built to examine pediatrician use of the IFHP, work with IFHP-covered patients, and provider characteristics associated with registration and use. Results Of the 2,753 pediatricians and pediatric subspecialists surveyed, there were 1006 respondents (36.5% response rate). 52.2% of respondents had provided care to the IFHP-eligible patients in the previous 6 months. Of those participants, only 26.4% were registered IFHP providers, and just 10% could identify all services covered by the IFHP (Figure 1). Knowledge of 80% or more of supplemental benefits was associated with registration status (adjusted odds ratio [aOR] 1.92; 95% CI 1.09 - 3.37). Amongst those who knew they were not registered, 70.2% indicated they did not know they had to register. aOR demonstrated that those with fewer years of practice had higher odds of not knowing that they had to register (aOR 1.22; 95% CI 1.01 - 1.49) Conclusion We demonstrate that the IFHP is poorly utilized by pediatric providers, with low registration rates and poor understanding of the IFHP-covered supplemental services, even among those who have recently provided care to the IFHP-eligible patients. Efforts to improve registration and knowledge of the IFHP are essential to improving access to health care for refugee children and youth. Funding: Study funded by the CPSP Resident Research Grant

COVID-19 Mental Health Stressors of Health Care Providers in the Pandemic Acceptance and Commitment to Empowerment Response (PACER) Intervention (Preprint)

2021 ◽  
Author(s):  
Christa Sato ◽  
Anita Adumattah ◽  
Krisel Maria Abulencia ◽  
Peter Dennis Garcellano ◽  
Alan Tai-Wai Li ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Providers ◽  
Communicable Disease ◽  
Care Providers ◽  
Emotional Labour ◽  
Workplace Stressors ◽  
Social Ecological ◽  
Acceptance And Commitment ◽  
At Home

BACKGROUND Since the pandemic, more Canadians have reported poorer mental health. A vital group experiencing high level of stressors are health care providers (HCPs) caring for COVID-19 patients, carrying out public health responses, or working with vulnerable populations. The mental health of HCPs are negatively affected by the pandemic, not only at work but also at home and in the community. Intersecting stressors at multiple levels contribute to HCPs’ experiences of fatigue, insomnia, anxiety, depression, and post-traumatic stress symptoms. OBJECTIVE The aim of this study is to explore the pandemic stressors experienced by HCPs at work, at home and in the community before participating in the Pandemic Acceptance and Commitment to Empowerment Response (PACER) online intervention. METHODS Informed by a social ecological approach, we use a qualitative reflective approach to engage 74 HCPs in diverse roles. Data were collected during the first two waves of the COVID-19 pandemic (June 2020 to February 2021) in Canada. RESULTS Informed by a social ecological framework, five overarching themes were identified in our thematic analysis: 1) personal level stressors that highlight HCPs identities and responsibilities beyond the workplace; 2) interpersonal level stressors from disrupted social relationships; 3) organizational stressors that contributed to unsettled workplaces and moral distress; 4) community and societal stressors attributed to vicarious trauma and emotional labour; and 5) the multilevel and cumulative impacts of COVID-19 stressors on HCPs’ health. CONCLUSIONS COVID-19 is not merely a communicable disease but a social and political phenomenon that intensifies the effects of social inequities. Current understanding of pandemic stressors affecting HCPs is largely partial in nature. While workplace stressors of HCPs are real and intense, they need to be explored and understood in the context of stressors that exist in other domains of HCPs’ lives such as family and community to ensure these experiences are not being silenced by the ‘hero’ discourses or overshadowed by professional demands.

scholarly journals P091: Essential elements to implementing the paramedics providing palliative care at home program: an application of the Consolidated Framework for Implementation Research (CFIR)

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S97-S97
Author(s):  
A. Carter ◽  
M. Harrison ◽  
J. Kryworuchko ◽  
T. Kekwaletswe ◽  
S. Wong ◽  
...  
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Providers ◽  
Essential Elements ◽  
Care Providers ◽  
Model Of Care ◽  
Home Program ◽  
Care Training ◽  
Care At Home ◽  
At Home

Introduction: Providing comfort care support at home without transport to hospital has not traditionally been part of paramedic practice. The innovative Paramedics Providing Palliative Care at Home Program includes a new clinical practice guideline, medications, a database to share goals of care, and palliative care training. This study aimed to determine essential elements for scale and spread of this model of care through the application of an implementation science model, the Consolidated Framework for Implementation Research (CFIR). Methods: Deliberative dialogue sessions were held with paramedic, palliative care, primary care, and administrative experts in a province that had the Program (Nova Scotia, March 2018) and one that had not (British Columbia, July 2018). Sessions were audio recorded and transcribed. The CFIR was used as the foundation for a framework analysis, which was conducted by four team members independently. Themes were derived by consensus with the broader research team. Results: Inter-sectoral communication between paramedics and other health care providers was key, and challenging due to privacy concerns. Relationships with health care providers are critical to promoting the new model of care to patients, managing expectations, and providing follow up/ongoing care. Training was an essential characteristic of the intervention that can be adapted to suit local needs, although cost is a factor. There were challenges due to the culture and implementation climate as a shift in the mindset of paramedics away from traditional roles is required to implement the model. Paramedic champions can play an important role in shifting the mindset of paramedics towards a new way of practice Conclusion: The CFIR construct of cosmopolitanism, emphasizing the importance of breaking down silos and engaging diverse stakeholders, emerged as one of the most important. This will be helpful for successful scale and spread of the program.

scholarly journals PROGRAM OF PALLIATIVE CANCER CARE – OUR EXPERIENCE

2013 ◽  
Vol 56 (1) ◽  
pp. 29-32
Author(s):  
Iva Slánská ◽  
Jindřich Kopecký ◽  
Stanislav Filip
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Home Health Care ◽  
Cancer Care ◽  
Hospice Care ◽  
Average Length ◽  
Home Care Services ◽  
Care Providers ◽  
Close Relatives ◽  
At Home

Introduction: Annually more than 27,000 persons die of cancer in the Czech Republic and the overall incidence of malignancies is still increasing. These data shows the need for affordable and good follow-up care especially for patients without any cancer treatment due to irreversible progression of tumor. Currently the outpatient palliative cancer care gets more into the forefront. Prerequisite for a well working outpatient palliative care is cooperation with general practitioners and home health care agencies. The purpose of the so called program of palliative cancer care is to guide a patient in palliative cancer care and to improve the cooperation among health care providers. Methods: During the period from January 2008 to October 2010 we evaluated in patient without any oncology treatment due to irreversible progression of tumor. Results: In palliative outpatient clinic we treated 446 patients, 119 of them received home care services with average length of 27.8 days. 77 patients died at home, 51 in health facilities and 41 in inpatient hospice care. Conclusion: We present pilot study focusing on outpatient palliative cancer care which shows the real benefit from early indication of palliative cancer care. This type of care allows patients to stay as long as possible at home among their close relatives.

When Technology Enters at Home: The Challenges of Home Health Care Providers in a Developing Country

2021 ◽  
Author(s):  
Maryam Esmaeili ◽  
Nahid Dehghan nayeri ◽  
Fatemeh Bahramnezhad ◽  
Samrand Fattah Ghazi ◽  
Parvaneh Asgari
Keyword(s):  
Health Care ◽  
Mechanical Ventilation ◽  
Home Care ◽  
Health Care Providers ◽  
Home Health Care ◽  
Invasive Mechanical Ventilation ◽  
Home Health ◽  
Care Providers ◽  
Care Agency ◽  
At Home

Abstract Background: The number of patients with chronic diseases requiring invasive mechanical ventilation at home is increasing. Family caregiving for patients with home mechanical ventilation (HMV) is associated with a particularly heavy workload. Thus, identifying the challenges of this valuable type of care can be an elective step for achieving health-related goals. This study was carried out to determine the challenges faced by home health care providers.Methods: 15 participants (9 family caregivers, 3 home nurses, and 3 home care attendants) were selected. Data were collected through semi-structured interviews and structured observation. All the interviews were recorded, transcribed, and then analyzed using qualitative content analysis and Max Qualitative Data Analysis 2010.Results: Three themes emerged from the data analysis: (1) Hospital-based challenges with two subthemes the family unpreparedness for home care and the lack of continuous education, (2) Home health care agency challenges with two sub themes. Home health care workers and the deficiency in organizational policies, and (3) Economic challenges.Conclusions: Three themes of hospital-related challenges, home health care agency challenges, and economic challenges emerged in the study showed that support from the insurance system, improvement of home care agency policies, and holistic care for patients through a multidisciplinary team approach are essential for addressing the current challenges of home care for patients under invasive mechanical ventilation at home.

scholarly journals Perspectives from health-care providers and women about completing human papillomavirus (HPV) self-testing at home

2016 ◽  
Vol 57 (10) ◽  
pp. 1161-1177 ◽  
Author(s):  
Mira L. Katz ◽  
Barret J. Zimmermann ◽  
Deborah Moore ◽  
Electra D. Paskett ◽  
Paul L. Reiter
Keyword(s):  
Health Care ◽  
Human Papillomavirus ◽  
Health Care Providers ◽  
Care Providers ◽  
Self Testing ◽  
At Home

Psychological response of children to home confinement during COVID-19: A qualitative arts-based research

2020 ◽  
pp. 002076402097243
Author(s):  
Deldar Morad Abdulah ◽  
Bayar Mohammed Omar Abdulla ◽  
Pranee Liamputtong
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Arts Based Research ◽  
Daily Lives ◽  
Global Pandemic ◽  
High Level ◽  
At Home

Background: The evidence has shown that children are more susceptible to the emotional effects of traumatic events such as outbreaks with the possible disruption in their daily lives. Aim: In this paper, we discussed the psychological wellbeing of children during the COVID-19 outbreak through the art-based qualitative study using the drawing method among children in Iraqi Kurdistan. Methods: In this qualitative arts-based research study, 15 children aged 6 to 13 years old who were confined at home during the COVID-19 outbreak for at least 1 month were included following obtaining the consent from their parents. The children were asked to draw his/her feelings, reflections, and responses during the COVID-19 on a paper. The children were guided to paint their reflections during the COVID-19 based on the following criteria: if they experienced loneliness, tiredness, insomnia, depression, worry or anxiety, or have behavior changes and their relationship with their parents and other siblings. Results: This study showed that children have a high level of stress at home during the COVID-19 outbreak. The children had great fear about the coronavirus. They experienced loneliness and stress, and felt sad, depressed due to home confinement and social distancing. The possibility of infection by coronavirus has occupied their entire mind. Mental health care providers must take the experiences of children who are caught in this global pandemic seriously and ensure that appropriate care is offered to the children and their parents. Conclusions: The children exhibited a strong feeling of distress, loneliness, and fear during the COVID-19 outbreak. This has implications for mental health care.

scholarly journals Health Care Provider Compliance with the HIPAA Right of Individual Access: a Scorecard and Survey (Revised)

2019 ◽  
Author(s):  
Deven McGraw ◽  
Nasha Fitter ◽  
Lisa Belliveau Taylor
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Records ◽  
Care Providers ◽  
Telephone Surveys ◽  
Actual Patient ◽  
Phone Calls ◽  
Survey Responses ◽  
Clinical Records ◽  
Right Of Access

AbstractBackgroundHistorically, patients have had difficulty obtaining copies of their medical records, notwithstanding the legal right to do so. In 2018, a study of 83 top hospitals found discrepancies between those hospitals’ published information and telephone survey responses regarding their processes for release of records to patients, indicating noncompliance with the HIPAA right of individual access.ObjectiveAssess state of compliance with the HIPAA right of access across a broader range of health care providers and in the context of real records requests from patients.MethodsEvaluate the degree of compliance with the HIPAA right of access 1) through telephone surveys of health care institutions regarding release of records to patients and 2) by scoring the responses of a total of 210 health care providers to actual patient record requests against the HIPAA right of access requirements. (51 of those providers were part of an initial cohort of 51 scored for an earlier version of this paper.)ResultsBased on the scores of responses of 210 health care providers to record requests and the responses of nearly 3000 healthcare institutions to telephone surveys, more than 50% of health care providers are out of compliance with the HIPAA right of access. The most common failure was refusal to send records to patient or patient’s designee in the form and format requested by the patient, with 86% of noncompliance due to this factor. The number of phone calls required to obtain records in compliance with HIPAA, and the lack of consistency in provider responses to actual requests, makes the records retrieval process a challenging one for patients.ConclusionsRecent federal proposals prioritize patient access to medical records through certified electronic health record (EHR) technology, but access by patients to their complete clinical records via EHRs is years away. In the meantime, health care providers need to focus more attention on compliance with the HIPAA right of access, including better training of staff on HIPAA requirements. Greater enforcement of the law will help motivate providers to prioritize this issue.

scholarly journals Home Intravenous Self-Injection of Antibiotic Therapy

1994 ◽  
Vol 5 (suppl c) ◽  
pp. 51C-55C ◽  
Author(s):  
Alain Y Martel
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Home Treatment ◽  
Alternative Methods ◽  
Hospital Treatment ◽  
Care Providers ◽  
Exclusion Criteria ◽  
Economical Analysis ◽  
Intravenous Antibiotics ◽  
At Home

The current medical climate has forced all health care providers to search for alternative methods for the delivery of health care. This search has led to the use of sites outside the conventional hospital walls for peritoneal dialysis, parenteral hyperalimentation, blood or blood product transfusions, etc. Home intravenous self-injection of antibiotics is such an alternative to prolonged and/or repeated hospitalization for patients requiring intravenous antibiotics administration only. This alternative was started as a pilot study and soon became a usual service in the Centre hospitalier de l’Université Laval following receipt of a grant from the National Health Research and Development Program. After careful development of inclusion/exclusion criteria and a teaching manual for patient and health care providers. and the standardization of medical. pharmaceutical and nursing approach, a clinical, psychosocial and economical analysis of patients who agreed to participate in a clinical study comparing the two methods of health care delivery (hospital versus home) was started. Patients who met inclusion/exclusion criteria, agreeing to finish their treatment at home instead of staying hospitalized to receive intravenous antibiotics only, were taught the various techniques of intravenous self-injection. Once they were judged to be able to self-administer the antibiotics, they were sent home with the material needed to carry on their treatment, To date, more than 100 patients have participated in the home-treatment, of which 50 were analyzed. The duration of home treatment varied from two days to several months. Most patients had osteomyelitis, septic arthritis, septic bursitis, bacterial cellulitis or lung infections. The therapy allowed some newly defined patients with complicated infections (AIDS patients with cytomegalovirus retinitis) to continue their treatment at home. The clinical outcome of patients treated at home was identical to the outcomes of those treated in the hospital. Side effects were comparable with the hospital treatment and were mainly catheter-related. Compared with hospitalization. home treatment was preferred by the majority of patients. Psychological analysis of the patients showed that those who choose home therapy had a higher internal “locus of control” than those who preferred to stay in the hospital for the entire length of therapy. The economical analysis showed a potential reduction of cost varying between $941.00 and $3325.00 per treatment. Home intravenous self-injection of antibiotics allowed health self-monitoring by the patients or/and their friends or family and increased health care efficiency.

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