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
Author(s):  
Awad Al-Zaben ◽  
Lina M.K. Al-Ebbini ◽  
Badr Qatashah

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.


2020 ◽  
Vol 135 (3) ◽  
pp. 313-321
Author(s):  
Julianna Cebollero ◽  
Suzanne M. Walton ◽  
Laurie Cavendish ◽  
Kristi Quairoli ◽  
Carrie Cwiak ◽  
...  

Objectives Despite the safety and efficacy of the human papillomavirus (HPV) vaccine, many persons are still not receiving it. The purpose of this pilot project was to evaluate the number of first doses of the 9-valent HPV (9vHPV) vaccination administered after a pharmacist-led intervention in the Adult Family Planning Clinic at Grady Health System (GHS), a large academic urban medical center in Atlanta, Georgia. Methods The pilot project had 3 phases: pre-intervention (November 15, 2016, through March 31, 2017), active intervention (November 15, 2017, through December 29, 2017), and post-intervention (December 30, 2017, through March 31, 2018). The pre-intervention phase was used as a historical control. The active intervention phase consisted of pharmacist interventions in the clinic and patient and health care provider education. The post-intervention phase evaluated the durability of pharmacist-led interventions performed and education provided during the active phase. Results Eighty-nine first-dose 9vHPV vaccines (of the 3-dose series) were administered to young adults aged 18-26 during the project period (November 15, 2017, through March 31, 2018); none were administered during the pre-intervention phase. Of 89 patients who received a first 9vHPV vaccine dose, 20 patients also received a second 9vHPV vaccine dose. During the project period, 166 doses of 9vHPV vaccine (first, second, or third doses) were administered. Conclusion This pharmacist-led intervention led to an increase in the number of young adult patients receiving their first dose of the 9vHPV vaccination series. With the support of other health care providers, pharmacist-led initiatives can expand vaccine-related health literacy and facilitate access to immunization services.


2021 ◽  
Author(s):  
Christa Sato ◽  
Anita Adumattah ◽  
Krisel Maria Abulencia ◽  
Peter Dennis Garcellano ◽  
Alan Tai-Wai Li ◽  
...  

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.


CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S97-S97
Author(s):  
A. Carter ◽  
M. Harrison ◽  
J. Kryworuchko ◽  
T. Kekwaletswe ◽  
S. Wong ◽  
...  

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.


2013 ◽  
Vol 56 (1) ◽  
pp. 29-32
Author(s):  
Iva Slánská ◽  
Jindřich Kopecký ◽  
Stanislav Filip

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.


2021 ◽  
Author(s):  
Maryam Esmaeili ◽  
Nahid Dehghan nayeri ◽  
Fatemeh Bahramnezhad ◽  
Samrand Fattah Ghazi ◽  
Parvaneh Asgari

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.


2020 ◽  
pp. 002076402097243
Author(s):  
Deldar Morad Abdulah ◽  
Bayar Mohammed Omar Abdulla ◽  
Pranee Liamputtong

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.


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