scholarly journals Utilising te Tiriti o Waitangi to approach health intervention development and research: pharmacist-facilitated medicines review interventions for Māori older adults

2021 ◽  
Vol 13 (2) ◽  
pp. 124 ◽  
Author(s):  
Joanna Hikaka ◽  
Rhys Jones ◽  
Carmel Hughes ◽  
Martin J. Connolly ◽  
Nataly Martini
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Intervention Development ◽  
Health Intervention ◽  
Service Development ◽  
Kaupapa Māori ◽  
Group A ◽  
Health Care Options ◽  
The Right ◽  
Health Service Development

ABSTRACT INTRODUCTIONte Tiriti o Waitangi guarantees Māori the right to: self-determination, equitable health outcomes, be well informed, health care options, including kaupapa Māori and culturally safe mainstream services, and partnership in the health care journey. Despite integration of these principles into policy, there remains a lack of application in health service development, and health inequities remain. AIMWe aimed to use te Tiriti o Waitangi to structure the development of a culturally safe health intervention, using as an exemplar pharmacist-facilitated medicines review for Māori older adults. METHODSPrevious research undertaken by our group (a systematic review, and interviews with stakeholders including Māori older adults) was used to inform the aspects to include in the intervention. Kaupapa Māori theory was used to underpin the approach. Intended outcomes, requirements for change, and outcome measures to assess change were mapped to te Tiriti o Waitangi principles as a way to structure the pharmacist-facilitated medicines review intervention and research processes. RESULTSFindings from our previous research identified 12 intended intervention outcomes, including that the intervention be flexible to adapt to diverse needs in a way that is acceptable and culturally safe for Māori and that it supports Māori older adults to control and have confidence in their medicine treatment and wellbeing. DISCUSSIONWe present an approach to the development of a pharmacist-facilitated medicines review intervention for Māori older adults, structured around the principles of te Tiriti o Waitangi, to support the implementation of a culturally safe, pro-equity intervention.

“The Right to Make Choices”: The National Resource Center for Supported Decision-Making

Inclusion ◽  
2015 ◽  
Vol 3 (1) ◽  
pp. 24-33 ◽  
Author(s):  
Peter Blanck ◽  
Jonathan G. Martinis
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Decision Making ◽  
Daily Life ◽  
Self Determination ◽  
Life Choices ◽  
Resource Center ◽  
Independent Life ◽  
The Right ◽  
National Resource

Abstract Research shows that self-determination and the right to make life choices are key elements for a meaningful and independent life. Yet, older adults and people with disabilities are often placed in overly broad and restrictive guardianships, denying them their right to make daily life choices about where they live and who they interact with, their finances, and their health care. Supported decision-making (SDM)—where people use trusted friends, family members, and professionals to help them understand the situations and choices they face, so they may make their own decisions—is a means for increasing self-determination by encouraging and empowering people to make decisions about their lives to the maximum extent possible. This article examines the implications of overly broad guardianship and the potential for supported decision-making to address such circumstances. It introduces the National Resource Center for Supported Decision-Making as one means to advance the use of supported decision-making and increase self-determination.

Insights Into Roles for Health-Care Professionals in Meeting the Needs of Older Adults and Unpaid Caregivers During Health-Care Transitions

2016 ◽  
Vol 48 (3-4) ◽  
pp. 70-79 ◽  
Author(s):  
Lori E. Weeks ◽  
Gloria McInnis-Perry ◽  
Colleen MacQuarrie ◽  
Sanja Jovanovic
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health System ◽  
Health Care Professionals ◽  
Online Survey ◽  
Care Transitions ◽  
Community Dwelling ◽  
Future Research ◽  
The Right ◽  
Health Care Transitions

We provided insights from older adults, their unpaid caregivers, and health-care professionals into specific roles for professionals within the health system to better meet the needs of community-dwelling older adults and their unpaid caregivers experiencing transitions between health services. We used a qualitative approach to collect data within one Canadian province from older adults and unpaid caregivers of older adults who participated in focus groups ( n = 98) and professionals working in the health system who participated in an online survey ( n = 52). Questions included experiences with health service transitions, strengths, challenges, and suggestions to improve transitions. Thematic analysis resulted in identifying seven specific roles for professionals in supporting health-care transitions: information and education, planning for future health needs, supporting the acceptance of necessary care, facilitating access to the right services at the right time, facilitating communication between services, facilitating the discharge planning process and advocacy for older adults and unpaid caregivers. Our results based on evidence from older adults, unpaid caregivers, and health-care professionals will inform future research and further development of the instrumental and relational roles for professionals supporting older adults and their caregivers experiencing health-care transitions.

Participation of Chronically Ill Older Adults in Their Life-Prolonging Treatment Decisions: Rights and Opportunity

1998 ◽  
Vol 17 (1) ◽  
pp. 1-23 ◽  
Author(s):  
Sarah Shidler
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Decision Making ◽  
Clinical Practice ◽  
Older Adult ◽  
Chronically Ill ◽  
Treatment Decisions ◽  
The Individual ◽  
The Right ◽  
Legal Guidelines

ABSTRACTThe right of the individual to participate in her life-prolonging treatment decisions, either as a decision maker or by having her treatment wishes used as a decision-making criterion, is the result of an evolution in legal guidelines over the last two decades. Although necessary, these legal guidelines are however not sufficient to assure the individual's opportunity to participate. For the chronically ill older adult residing in a health care institution, the opportunity to participate in decisions concerning life-prolonging treatments implicitly depends on the effective communication among three key actors (the individual, her physician, and her proxy). The necessity of this communication has important implications for clinical practice and future empirical research.

scholarly journals HOMELESSNESS, POVERTY AND DISCRIMINATION: IMPROVING PUBLIC HEALTH BY REALISING HUMAN RIGHTS

2005 ◽  
Vol 10 (1) ◽  
pp. 233 ◽  
Author(s):  
PHILIP LYNCH
Keyword(s):  
Public Health ◽  
Human Rights ◽  
Health Service ◽  
Right To Health ◽  
Service Development ◽  
Economic Determinants ◽  
Right To Participation ◽  
Poverty And Health ◽  
The Right ◽  
Health Service Development

<div class="page" title="Page 1"><div class="layoutArea"><div class="column"><p><span>[</span><span>There are clear casual and consequential links between homelessness, poverty, discrimination and poor health. This article argues that the engagement of homelessness and health in a human rights framework enables effective identification of socio-economic determinants of ill<br /> health and creation of the enabling conditions necessary for good<br /> health. The article contends that the integration of human rights principles into health service development, implementation and delivery, focuses attention on the need for health services to be adequate, accessible, non-discriminatory and appropriately targeted. The article also contends that a human rights approach to homelessness, poverty and health also imposes obligations - and enables measurement - in relation to realisation of the right to health and interconnected human rights (including the </span></p><p><span>right to adequate housing, the right to social security, the right to non-discrimination, the right to participation, and the right to human dignity and respect)</span><span>] </span></p></div></div></div>

Interdisciplinary Therapy Assessments for the Older Adult

2012 ◽  
Vol 17 (1) ◽  
pp. 11-16
Author(s):  
Lynn Chatfield ◽  
Sandra Christos ◽  
Michael McGregor
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Standardized Testing ◽  
Health Care Providers ◽  
Outcome Measurement ◽  
Care Providers ◽  
Patient Centered ◽  
Screening Process ◽  
Evidenced Based ◽  
Changing Economy

In a changing economy and a changing industry, health care providers need to complete thorough, comprehensive, and efficient assessments that provide both an accurate depiction of the patient's deficits and a blueprint to the path of treatment for older adults. Through standardized testing and observations as well as the goals and evidenced-based treatment plans we have devised, health care providers can maximize outcomes and the functional levels of patients. In this article, we review an interdisciplinary assessment that involves speech-language pathology, occupational therapy, physical therapy, and respiratory therapy to work with older adults in health care settings. Using the approach, we will examine the benefits of collaboration between disciplines, an interdisciplinary screening process, and the importance of sharing information from comprehensive discipline-specific evaluations. We also will discuss the importance of having an understanding of the varied scopes of practice, the utilization of outcome measurement tools, and a patient-centered assessment approach to care.

Auditory Dysfunction in Alzheimer's Disease

2010 ◽  
Vol 15 (1) ◽  
pp. 4-11 ◽  
Author(s):  
Sridhar Krishnamurti
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Health Care ◽  
Care Setting ◽  
Neurodegenerative Disorder ◽  
Disease Process ◽  
Clinical Protocols ◽  
Speech Language Pathologist ◽  
Auditory Dysfunction

Alzheimer's disease is neurodegenerative disorder which affects a growing number of older adults every year. With an understanding of auditory dysfunction in Alzheimer's disease, the speech-language pathologist working in the health care setting can provide better service to these individuals. The pathophysiology of the disease process in Alzheimer's disease increases the likelihood of specific types of auditory deficits as opposed to others. This article will discuss the auditory deficits in Alzheimer's disease, their implications, and the value of clinical protocols for individuals with this disease.

The Role of Nurses in the Implementation of Patient Safety and Protection of Patient Rights at the Rahayu Yakkum Purwodadi Hospital

SOEPRA ◽  
2020 ◽  
Vol 5 (2) ◽  
pp. 254
Author(s):  
Christina Nur Widayati ◽  
Endang Wahyati Yustina ◽  
Hadi Sulistyanto
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Codes Of Conduct ◽  
Rights Protection ◽  
Patient’S Rights ◽  
Nurses Role ◽  
The Republic ◽  
The Right ◽  
Service Standards

Patient Safety was the right of a patient who was receiving health care. A nurse was one of the health professionals in a hospital having a very important role in realizing Patient Safety. In realizing Patient Safety Panti Rahayu Yakkum Hospital of Purwodadi had involved the role of the nurses. In carrying out their role the nurses could support the protection of the patient’s rights. The nurses performed health care by conducting six Patient Safety goals that were based on professional standards, service standards and codes of conduct so that the Patient Safety would be realized.This research applied a socio-legal approach to having analytical-descriptive specifications. The data used were primary and secondary those were gathered by field and literature studies. The field study was conducted by having interviews to, among others, the Director of Panti Rahayu Yakkum Hospital of Purwodadi, Head of Room and Chairman of Patient Safety Committee, nurses and patients. The data were then qualitatively analyzed.The arrangement of nurses’ role in implementing Patient Safety and the patient’s rights protection was based on the Constitution of the Republic of Indonesia of 1945, Health Act, Hospital Act, Labor Act, and Nursing Act. These bases made the hospital obliged to implement Patient Safety. The regulations leading the hospital to provide Patient Safety were Health Minister’s Regulation Nr. 11 of 2017 on Patient Safety, Statute of Panti Rahayu Yakkum Hospital of Purwodadi (Hospital ByLaws), Internal Nursing Staff ByLaws. In implementing Patient Safety Panti Rahayu Yakkum Hospital of Purwodadi had established a committee of Patient Safety team consisting of the nurses that would implement six targets of Patient Safety. Actually, the Patient Safety implementation had been accomplished but it had not been optimally done because of several factors, namely juridical, social and technical factors. The supporting factors in influencing the implementation were, among others, the establishment of the Patient Safety team that had been well socialized whereas the inhibiting factors were limitedness of time and funds to train the nurses besides the operational procedure standard (OPS) that was still less understood. Lack of learning motivation among the nurses also appeared as an inhibiting factor in understanding Patient Safety implementation.

DeVega versus ring annuloplasty in severe functional tricuspid insufficiency and their impact on the right ventricle

2019 ◽  
Vol 1 (4) ◽  
pp. 133-139
Author(s):  
Yasser Hamdy ◽  
Mohammed Mahmoud Mostafa ◽  
Ahmed Elminshawy
Keyword(s):  
Right Ventricular ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Early Postoperative Period ◽  
Tricuspid Valve Repair ◽  
Ring Annuloplasty ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
The Right

Background: Functional tricuspid valve regurgitation secondary to left-sided valve disease is common. DeVega repair is simple, but residual regurgitation with subsequent impairment of the right ventricular function is a concern. This study aims to compare tricuspid valve repair using DeVega vs. ring annuloplasty and their impact on the right ventricle in the early postoperative period and after six months. Methods: This is a prospective cohort study of 51 patients with rheumatic heart disease who underwent tricuspid valve repair for secondary severe tricuspid regurgitation. Patients were divided into two groups: group A; DeVega repair (n=34) and group B; ring annuloplasty repair (n=17). Patients were assessed clinically and by echocardiography before discharge and after six months for the degree of tricuspid regurgitation, right ventricular diameter and tricuspid annular plane systolic excursion (TAPSE). Results: Preoperative echocardiographic assessment showed no difference in left ventricular end-systolic diameter, end-diastolic diameter, ejection fraction and right ventricular diameter, however; group A had significantly better preoperative right ventricular function measured by TAPSE (1.96 ± 0.27 vs1.75 ± 0.31 cm; p=0.02). Group B had significantly longer cardiopulmonary bypass time (127.65 ± 13.56 vs. 111.74 ± 18.74 minutes; p= 0.003) and ischemic time (99.06 ± 11.80 vs. 87.15 ± 16.01 minutes; p= 0.009). Pre-discharge, there was no statistically significant difference in the degree of tricuspid regurgitation, but the right ventricular diameter was significantly lower in group B (2.66 ± 0.41 and 2.40 ± 0.48 cm; p=0.049). After six months of follow up, the degree of tricuspid regurgitation (p= 0.029) and the right ventricular diameter were significantly lower in the ring annuloplasty group (2.56 ± 0.39 and 2.29 ± 0.44 cm; p=0.029). Although there was a statistically significant difference in preoperative TAPSE, this difference disappeared after six months. Conclusion: Both DeVega and ring annuloplasty techniques were effective in the early postoperative period, ring annuloplasty was associated with lesser residual regurgitation and better right ventricular remodeling in severe functional tricuspid regurgitation than DeVega procedure after 6-months of follow up.

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