Prognosticating futures and the human experience of hope

2007 ◽  
Vol 5 (3) ◽  
pp. 227-239 ◽  
Author(s):  
Sally Thorne ◽  
Valerie Oglov ◽  
Elizabeth-Anne Armstrong ◽  
T. Gregory Hislop
Keyword(s):  
Health Care ◽  
Chronic Illness ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Secondary Analysis ◽  
Human Experience ◽  
Clinical Encounter ◽  
Care Providers ◽  
Health Care Communication ◽  
Patients With Cancer

Objectives: Communication between health care providers and patients with cancer and other chronic diseases typically references probabilities that certain future events will or will not occur. Beyond the context of diagnostic encounters and the transmission of “bad news,” such “prognostic” communications take place in various forms throughout the illness trajectory. It is well known that such information transmitted badly can have devastating psychosocial consequences for patients and their families and, conversely, that difficult information exchanged with sensitivity can lend tremendous support. This study aimed to extend our understanding of how such communications are received and interpreted by patients, so that we might optimally apply what we know about general principles of effective communication within the particularly challenging context of predicting futures.Methods: We conducted a combined secondary analysis of two prior qualitative studies into patient perceptions of helpful and unhelpful health care communication with 200 cancer patients and 30 persons with chronic illness. These data sets offered a rich resource for comparing perceptions across a range of contextual variables, and secondary analysis focused on future-oriented interactions, including both prognostication and prediction.Results: The accounts of patients with cancer and chronic illness reveal various ways in which health care communications involving future projections interact with their human experience of hope, powerfully shaping their capacity to make sense of and live with serious illness. They include a synthesis of what patients recommend health care professionals know and understand about this challenging dynamic.Significance of results: The findings of this study offer a distinct angle of vision onto the various communications that involve future predictions, illuminating a patient perspective with the potential to inform health care communication approaches that are both informative and therapeutic. As such, the study supports a dynamic understanding of the tenuous balance between hope and honesty in the clinical encounter.

scholarly journals Clinical Encounters and Treatment Initiation for Chronic Hepatitis C Patients: Applications of Adaptive Leadership Framework for Chronic Illness

SAGE Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 215824401882446 ◽  
Author(s):  
Donald E. Bailey ◽  
Andrew J. Muir ◽  
Judith A. Adams ◽  
N. Marcus Thygeson ◽  
Hants Williams ◽  
...  
Keyword(s):  
Health Care ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Illness ◽  
Chronic Hepatitis C ◽  
Health Care Providers ◽  
The United States ◽  
Clinical Encounter ◽  
Adaptive Leadership ◽  
Care Providers

Chronic hepatitis C (CHC) is the most common blood-borne infection in the United States. Patients with CHC undergoing treatment face many challenges including adherence to medications and management of symptoms; health care practitioners are well positioned to facilitate patients’ ability to address these challenges. We used the Adaptive Leadership for Chronic Illness Framework to investigate the difficulties inherent in affecting behavior change in patients undergoing treatment. We enrolled 11 patient participants and 10 provider participants. We used data from the first clinical encounter between patients and providers during which treatment was discussed. We found examples of adaptive leadership and categorized these behaviors into three themes: support for medication, coping with family/home life, and strategizing to manage employment. We also saw examples of what we termed missed opportunities for adaptive leadership. This study illustrates the contributions of adaptive leadership behaviors by health care providers and the potential risk to patients in their absence.

Knowledge, Beliefs, and Behaviors Related to Palliative Care Delivery Among Pediatric Oncology Health Care Providers

2018 ◽  
Vol 35 (4) ◽  
pp. 247-256 ◽  
Author(s):  
Jessica L. Spruit ◽  
Cynthia J. Bell ◽  
Valerie B. Toly ◽  
Maryjo Prince-Paul
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Providers ◽  
Pediatric Oncology ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Advanced Practice ◽  
Care Providers ◽  
The Public ◽  
Patients With Cancer

The care of pediatric patients with cancer and their families is complex and rapidly evolving. Despite significant advances in outcomes, symptoms of the disease and complications of therapy continue to cause suffering that may improve with the involvement of pediatric palliative care (PPC) services. This descriptive study responds to the observation of great variability in PPC utilization within pediatric oncology. Data collected from 156 health care professionals (nurses, advanced practice professionals, and physicians) from a statewide hematology alliance evaluates the knowledge, beliefs, and perceived barriers to PPC involvement. Data analysis reveals significant variability when comparing respondents from professional roles and practice environments. Despite progress in PPC availability, care delivery remains incongruent with current recommendations. Knowledge gained from this study emphasizes the important role for all health care providers in advocating for support of PPC programs, educating the public, and committing to intentional involvement of PPC services while caring for pediatric oncology patients.

Benefits, Challenges, and Social Impact of Health Care Providers’ Adoption of Social Media

2021 ◽  
pp. 089443932110257
Author(s):  
Md Irfanuzzaman Khan ◽  
Jennifer (M.I.) Loh
Keyword(s):  
Health Care ◽  
Social Media ◽  
Health Promotion ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Community Support ◽  
Care Providers ◽  
Australian Health ◽  
Actual Use ◽  
Use Of Social Media

With the advent of telecommunication technologies and social media, many health care professionals are using social media to communicate with their patients and to promote health. However, the literature reveals a lacuna in our understanding of health care professionals’ perception of their behavioral intentions to use innovations. Using the Unified Technology Acceptance Framework (unified theory of acceptance and use of technology), in-depth interviews were conducted with 16 Australian health care experts to uncover their intent and actual use of social media in their medical practices. Results revealed that social media tools offered five significant benefits such as (i) enhanced communication between health care professionals and their patients, (ii) community support, (iii) enabled e-learning, (iv) enhanced professional network, and (v) expedited health promotion. However, result also revealed barriers to social media usage including (i) inefficiency, (ii) privacy concerns, (iii) poor quality of information, (iv) lack of trust, and (v) blurred professional boundary. Peer influence and supporting conditions were also found to be determinants of social media adoption behaviors among health care professionals. This study has important implications for health care providers, patients, and policy makers on the responsible use of social media, health promotion, and health communication. This research is also among the very few studies that explore Australian health care professionals’ intent and actual use of innovations within a health care setting.

scholarly journals Burnout Impact of COVID-19 Pandemic on Health-Care Professionals at Assiut University Hospitals, 2020

2021 ◽  
Vol 18 (10) ◽  
pp. 5368
Author(s):  
Shimaa A. Elghazally ◽  
Atef F. Alkarn ◽  
Hussein Elkhayat ◽  
Ahmed K. Ibrahim ◽  
Mariam Roshdy Elkhayat
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Emotional Exhaustion ◽  
Health Care Professionals ◽  
Maslach Burnout Inventory ◽  
Adverse Outcomes ◽  
Personal Accomplishment ◽  
Burnout Syndrome ◽  
Care Providers ◽  
University Hospitals

Background: burnout syndrome is a serious and growing problem among medical staff. Its adverse outcomes not only affect health-care providers’ health, but also extend to their patients, resulting in bad-quality care. The COVID-19 pandemic puts frontline health-care providers at greater risk of psychological stress and burnout syndrome. Objectives: this study aimed to identify the levels of burnout among health-care professionals currently working at Assiut University hospitals during the COVID-19 pandemic. Methods: the current study adopted an online cross-sectional design using the SurveyMonkey® website for data collection. A total of 201 physicians were included and the Maslach Burnout Inventory (MBI) scale was used to assess the three burnout syndrome dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. Results: about one-third, two-thirds, and one-quarter of the respondents had high emotional exhaustion, high depersonalization, and low personal accomplishment, respectively. Younger, resident, and single physicians reported higher burnout scores. The personal accomplishment score was significantly higher among males. Those working more than eight hours/day and dealing with COVID-19 patients had significantly higher scores. Conclusion: during the COVID-19 pandemic, a high prevalence of burnout was recorded among physicians. Age, job title, working duration, and working hours/day were significant predictors for burnout syndrome subscale results. Preventive and interventive programs should be applied in health-care organizations during pandemics.

scholarly journals Concerns of Patients With Cancer on Accessing Cannabis Products in a State With Restrictive Medical Marijuana Laws: A Survey Study

2019 ◽  
Vol 15 (10) ◽  
pp. 531-538 ◽  
Author(s):  
Vinita Singh ◽  
Ali J. Zarrabi ◽  
Kimberly A. Curseen ◽  
Roman Sniecinski ◽  
Justine W. Welsh ◽  
...  
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Providers ◽  
Medical Marijuana ◽  
Survey Study ◽  
Care Practice ◽  
Care Providers ◽  
Patients With Cancer ◽  
Medical Marijuana Laws ◽  
Source Of Information

PURPOSE: Several states, particularly in the Southeast, have restrictive medical marijuana laws that permit qualified patients to use specific cannabis products. The majority of these states, however, do not provide avenues for accessing cannabis products such as in-state dispensaries. METHODS: We conducted a survey of patients registered for medical marijuana (low tetrahydrocannabinol [THC] oil cards) in an ambulatory palliative care practice in Georgia (one of the states with restrictive medical marijuana laws). RESULTS: We had a total of 101 responses. Among our sample of patients who use cannabis as part of a state-approved low THC oil program, 56% were male and 64% were older than age 50 years. Advanced cancer was the most common reason (76%) for granting the patients access to a low THC oil card. Although patients reported cannabis products as being extremely helpful for reducing pain, they expressed considerable concerns about the legality issues (64%) and ability to obtain THC (68%). Several respondents were using unapproved formulations of cannabis products. For 48% of the patients, their physician was the source of information regarding marijuana-related products. Furthermore, they believed that their health care providers and family members were supportive of their use of cannabis (62% and 79%, respectively). CONCLUSION: Patients on Georgia’s medical marijuana program are most concerned about the legality of the product and their ability to obtain marijuana-related products. Therefore, we recommend that states with medical marijuana laws should provide safe and reliable access to cannabis products for qualifying patients.

scholarly journals Preferences and Perceptions of Patients Attending Emergency Departments with Low Acuity Problems in Hong Kong

2009 ◽  
Vol 16 (3) ◽  
pp. 148-154 ◽  
Author(s):  
CA Graham ◽  
WO Kwok ◽  
YL Tsang ◽  
TH Rainer
Keyword(s):  
Health Care ◽  
Hong Kong ◽  
Health Care Providers ◽  
Waiting Time ◽  
Health Care Professionals ◽  
Waiting Times ◽  
Medical Advice ◽  
Care Providers ◽  
Convenience Sample ◽  
Waiting Area

Objective To explore why patients in Hong Kong seek medical advice from the emergency department (ED) and to identify the methods by which patients would prefer to be updated on the likely waiting time for medical consultation in the ED. Methods The study recruited 249 semi-urgent and non-urgent patients in the ED of Prince of Wales Hospital from 26th September 2005 to 30th September 2005 inclusive. A convenience sample of subjects aged ≥15 years old in triage categories 4 or 5 were verbally consented and interviewed by research nurses using a standardized questionnaire. Results From 1715 potential patients, 249 were recruited ad hoc (mean age 44 years [SD18]; 123 females). About 63% indicated that an acceptable ED waiting time was less than or equal to two hours, and 88% felt that having individual number cards and using a number allocation screen in the ED waiting area would be useful. Perceived reasons for attending the ED rather than other health care providers such as primary health care or the general outpatient clinic (GOPC) included: a desire for more detailed investigations (56%); a perception that more professional medical advice was given in the ED (35%); patients were under the continuing care of the hospital (19%); and patients were referred to the ED by other health care professionals (11%). Notably, 26% of participants had considered attending the GOPC prior to attending the ED. Patients educated to tertiary level expected a shorter waiting time than those educated to lesser degrees (p=0.026, Kruskal-Wallis test). Suggestions were made on how to provide a more pleasant ED environment for the wait for consultations, which included the provision of a television screen with sound in the waiting area (43%), more comfortable chairs (37%) and health care promotion programs (32%). Conclusion Patients chose ED services because they believed they would receive more detailed investigations and more professional medical advice than available alternatives. Clear notification of the likely waiting times and enhancement of comfort before consultation are considered desirable by patients. Enhanced public education about the role of the ED and making alternatives to ED care more accessible may be useful in reducing inappropriate ED attendances in Hong Kong.

The Use of and Attitude Towards Telehealth in Rural Communities

2007 ◽  
Vol 13 (3) ◽  
pp. 29 ◽  
Author(s):  
Emily Mauldon
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Routine Practice ◽  
Care Providers ◽  
Urban Hospital ◽  
Primary Health ◽  
The Impact ◽  
Rural Patients

This paper reports on the attitudes of a sample of health care providers towards the use of telehealth to support rural patients and integrate rural primary health and urban hospital care. Telehealth and other information technologies hold the promise of improving the quality of care for people in rural and remote areas and for supporting rural primary health care providers. While seemingly beneficial for rural patients, study participants believed that telehealth remains underused and poorly integrated into their practice. In general, participants thought that telehealth is potentially beneficial but places constraints on their activities, and few actually used it. Published literature usually reports either on the success of telehealth pilot projects or initiatives that are well resourced and do not reflect the constraints of routine practice, or has an international focus limiting its relevance to the Australian context. Because of the paucity of systematic and generalisable research into the effects of the routine use of telehealth to support rural patients, it is unclear why health care professionals choose to provide such services or the costs and benefits they incur in doing so. Research and policy initiatives continue to be needed to identify the impact of telehealth within the context of Australian primary health care and to develop strategies to support its use.

scholarly journals Safeguarding Abuse in Health Care

2018 ◽  
Vol 12 (2) ◽  
pp. 5-10
Author(s):  
Chanda Karki Bhandari ◽  
Gehanath Baral
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Care Facility ◽  
Health Care Facility ◽  
Healthcare Facility ◽  
Structural Level ◽  
Care Providers ◽  
Ethical Guidelines ◽  
Abuse In Health Care

Aims: The aim of the review is to understand the concept of abuse in health care in general and its various forms. It includes- review what is meant by healthcare and health care abuse; identify its various forms and to recognize who may be the most potential victims; find out the reasons of abuse by health care providers; and know the role of  ethical guidelines and institutional policy in confronting abuse in health care.Methods: Literatures and publications on the subject were searched in order to identify research studies investigating abuse in health care that were studied, analyzed and presented.  Results: Abuse in health care today is an emerging concept in need of a clear analysis and definition. At the same time, boundaries to the related concepts are not demarcated. Medical professionals and institutions are being targeted worldwide today for negligence and the medical litigation has become a huge challenge. Throughout history, health care professionals have been trusted because of their competency and caring abilities. However, the disturbing reality is that physical and psychological maltreatment of patients do occur in the health care settings throughout the world. The abuse can vary from treating someone with disrespect in a way which significantly affects the person's quality of life, to causing actual physical suffering. Differently able and dependent people are more susceptible to such abuse. Work overload, Staff burnout, lack of information and instructions were also indicated to underlie instances of abuse in health care.Conclusions: We in the healthcare facility should first accept that abuse in health care does occur and causes distress. This change needs to occur at individual, cultural and structural level. Next step will be for the staffs to be aware of abuse in health care when it happens and recognize it as such. It is always better to create a situation where we could prevent abuse from happening at health centers. Hospital personnel must implement a change in workplace culture to stop abusive behaviors wherever they occur. Each and every health care facility should be client friendly and respecting their rights. Effective ethical guidelines were needed to minimize abuse as existing ethical codes were found to be ineffective and above all there was a lack of awareness of the contents of the relevant ethical documents.

scholarly journals Massage Therapy in Outpatient Cancer Care: A Metropolitan Area Analysis

2017 ◽  
Vol 22 (4) ◽  
pp. 851-855 ◽  
Author(s):  
Virginia S. Cowen ◽  
Robin Streit Miccio ◽  
Bijal Parikh
Keyword(s):  
Health Care ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Health Care Providers ◽  
Metropolitan Area ◽  
Health Care Professionals ◽  
Treatment Plan ◽  
Therapeutic Touch ◽  
Care Providers ◽  
Systematic Analysis

Massage offers cancer patients general quality of life benefits as well as alleviation of cancer-related symptoms/cancer-treatment–related symptoms including pain, anxiety, and fatigue. Little is known about whether massage is accessible to cancer patients who receive treatment in the outpatient setting and how massage is incorporated into the overall cancer treatment plan. Outpatient cancer centers (n = 78) in a single metropolitan area were included this mixed-methods project that included a systematic analysis of website information and a telephone survey. Massage was offered at only 40 centers (51.3% of total). A range of massage modalities were represented, with energy-based therapies (Reiki and Therapeutic Touch) most frequently provided. Although massage therapists are licensed health care providers in the states included in this analysis, massage was also provided by nurses, physical therapists, and other health care professionals.

scholarly journals Are antiretrovirals prescribed according to the recommended prescribed daily doses in the private healthcare sector in South Africa

2011 ◽  
Vol 16 (1) ◽  
Author(s):  
Norah L. Katende-Kyenda ◽  
Martie Lubbe ◽  
Juan H.P. Serfontein ◽  
Ilse Truter
Keyword(s):  
South Africa ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Health Care Sector ◽  
Hiv And Aids ◽  
Healthcare Sector ◽  
Private Health Care ◽  
Care Providers ◽  
Increased Risk

Current antiretroviral treatment (ART) guidelines recommend different combinations that have led to major improvements in the management of HIV and AIDS in the developed and developing world. With the rapid approval of many agents, health care providers may not be able to familiarise themselves with them all. This lack of knowledge leads to increased risk of dose- prescribing errors, especially by non-HIV and AIDS specialists. The purpose of this retrospective non-experimental, quantitative drug utilisation study was to evaluate if antiretrovirals (ARVs) are prescribed according to the recommended prescribed daily doses (PDDs) in a section of the private health care sector in South Africa (SA). Analysed ARV prescriptions (49995, 81096 and 88988) for HIV and AIDS patients were claimed from a national medicine claims database for the period 1 January 2005 through to 31 December 2007. ARV prescriptions prescribed by general practitioners (GPs) with PDDs not according to the recommended ARV dosing increased dramatically, from 12.33% in 2005 to 24.26% in 2007. Those prescribed by specialists (SPs) increased from 15.46% in 2005 to 35.20% in 2006 and decreased to 33.16% in 2007. The highest percentage of ARV prescriptions with PDDs not according to recommended ARV dosing guidelines was identified in ARV regimens with lopinavir−ritonavir at a PDD of 1066.4/264 mg and efavirenz at a PDD of 600 mg prescribed to patients in the age group of Group 3 (19 years > age ≤ 45 years). These regimens were mostly prescribed by GPs rather than SPs. There is a need for more education for all health care professionals and/or providers in the private health care sector in SA on recommended ARV doses, to avoid treatment failures, development of resistance, drug-related adverse effects and drug interactions.OpsommingHuidige riglyne vir behandeling met antiretrovirale middels beveel verskillende kombinasies aan wat tot groot verbetering in die beheer van MIV en VIGS in die ontwikkelde en ontwikkelende wêreld gelei het. Met die vinnige goedkeuring van talle nuwe middels kan dit gebeur dat verskaffers van gesondheidsorg nie kan bybly om hulle hiermee op hoogte te hou nie. Hierdie gebrek aan kennis lei tot ‘n hoër risiko vir foute in die voorgeskrewe dosis en veral deur persone wat nie spesialiste in MIV en VIGS is nie. Die doel van hierdie nie-eksperimentele, retrospektiewe, kwantitatiewe studie van die gebruik van geneesmiddels was om te bepaal of antiretrovirale middels in ‘n deel van die privaat gesondheidsorgsektor in Suid-Afrika (SA) volgens die aanbevole voorgeskrewe daaglikse dosisse (VDD) voorgeskryf word. Voorskrifte van antiretrovirale middels (49995, 81096 en 88988) aan pasiënte met MIV en VIGS wat in die periode van 1 Januarie 2005 tot 31 Desember 2007 van ‘n nasionale medisyne databasis geëis is, is ontleed. Voorskrifte van antiretrovirale middels deur algemene praktisyns (APs) met VDDs wat nie volgens die aanbevole dosisse vir antiretrovirale middels was nie, het dramaties van 12.33% in 2005 tot 24.26% in 2007 toegeneem. Die wat deur spesialiste (SPs) voorgeskryf is, het van 15.46% in 2005 tot 35.20% in 2006 toegeneem en in 2007 tot 33.16% gedaal. Die hoogste persentasie van voorskrifte vir antiretrovirale middels met VDDs wat nie volgens die riglyne was nie, was in die regimens met lopinavir−ritonavir met ‘n VDD van 1066.4/264 mg en efavirens met ‘n VDD van 600 mg wat aan pasiënte in die ouderdomsgroep van ouer as 19 tot en met 45 jaar voorgeskryf is. Hierdie regimens is meer deur APs as deur SPs voorgeskryf. Daar is ‘n behoefte aan nog opleiding van alle gesondheidsprofessies en/of voersieners in die privaat gesondheidsorgsektor in SA oor die aanbevole antiretrovirale middel-dosisse om mislukking van behandeling, ontwikkeling van weerstand, nadelige effekte vanweë geneesmiddels en geneesmiddel interaksies te voorkom.

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