scholarly journals Factors associated with health care providers speaking with older patients about being subjected to abuse

2021 ◽  
pp. 1-18
Author(s):  
Atbin Motamedi ◽  
Mikael Ludvigsson ◽  
Johanna Simmons
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Older Patients ◽  
Care Providers ◽  
Factors Associated

scholarly journals Influencing Factors for Prevention of Postpartum Hemorrhage and Early Detection of Women at Risk in The Northern Province of Rwanda: Beneficiary and Health Worker Perspectives

2020 ◽  
Author(s):  
Oliva Bazirete ◽  
Manassé Nzayirambaho ◽  
Aline Umubyeyi ◽  
Marie Chantal Uwimana ◽  
Evans Marilyn
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Early Detection ◽  
Focus Groups ◽  
Health Care Providers ◽  
Health Workers ◽  
Northern Province ◽  
Care Providers ◽  
Factors Associated ◽  
Childbearing Women

Abstract Background: Reduction of maternal mortality and morbidity is a major global health priority. However, much remains unknown regarding factors associated with postpartum hemorrhage (PPH) among childbearing women in the Rwandan context. The aim of this study is to explore the influencing factors for prevention of PPH and early detection of women at risk as perceived by beneficiaries and health workers in the Northern Province of Rwanda. Methods: A qualitative descriptive exploratory study was drawn from a larger sequential exploratory‐mixed methods study. Semi‐structured interviews were conducted with 11 women who experienced PPH within the 6 months prior to interview. In addition, focus group discussions were conducted with: women’s partners or close relatives (2 focus groups), community health workers (CHWs) in charge of maternal health (2 focus groups) and health care providers (3 focus groups). A socio ecological model was used to develop interview guides to describe factors related to early detection and prevention of PPH in consideration of individual attributes, interpersonal, family and peer influences, intermediary determinants of health and structural determinants. The research protocol was approved by the University of Rwanda, College of Medicine and Health Sciences Institutional Ethics Review Board. Results: We generated four interrelated themes: (1) Meaning of PPH: beliefs, knowledge and understanding of PPH: (2) Organizational factors; (3) Caring and family involvement and (4) Perceived risk factors and barriers to PPH prevention. The findings from this study indicate that PPH was poorly understood by women and their partners. Family members and CHWs feel that their role for the prevention of PPH is to get the woman to the health facility on time. The main factors associated with PPH as described by participants were multiparty and retained placenta. Low socioeconomic status and delays to access health care were identified as the main barriers for the prevention of PPH. Conclusions: Addressing the identified factors could enhance early prevention of PPH among childbearing women. Placing emphasis on developing strategies for early detection of women at higher risk of developing PPH, continuous professional development of health care providers, developing educational materials for CHWs and family members could improve the prevention of PPH. Involvement of all levels of the health system was recommended for a proactive prevention of PPH. Further quantitative research, using case control design is warranted to develop a screening tool for early detection of PPH risk factors for a proactive prevention.

Treatment Persistence Among Insured Patients Newly Starting Buprenorphine/Naloxone for Opioid Use Disorder

2018 ◽  
Vol 52 (5) ◽  
pp. 405-414 ◽  
Author(s):  
Natalia Shcherbakova ◽  
Gary Tereso ◽  
Jacqueline Spain ◽  
Robert J. Roose
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Delivery ◽  
Opioid Use Disorder ◽  
Prescription Opioid ◽  
Care Providers ◽  
Opioid Use ◽  
Treatment Persistence ◽  
Factors Associated ◽  
Insured Patients

Background: Persistence with medication-assisted therapy among patients with opioid use disorder has been associated with reduced likelihood of illicit opioid use. Objective: We aimed to describe treatment persistence and identify factors associated with 1-year persistence among insured patients newly initiating buprenorphine-containing pharmacotherapy. Methods: The retrospective observational cohort included employer-sponsored and managed Medicaid patients newly started on buprenorphine-containing therapy between June 30, 2010, and January 1, 2015. Persistence was measured as both a continuous and dichotomous variable (proportion of patients persistent for 1 year). Multivariable logistic regression analysis was used to identify factors associated with 1-year persistence. Results: A total of 302 patients met inclusion criteria. The median [range] number of treatment episodes was 1 [1-4]. Mean number of days on therapy during the first episode was 206 (SD = 152) days, with 40.4% (n = 122) of patients persisting for 1 year. Presence of concomitant fills of prescription opioid analgesics (odds ratio [OR] = 0.25; 95% CI = 0.12-0.51), being in care of an addiction specialist (OR = 0.40; 95% CI = 0.21-0.76), and Medicaid insurance coverage (OR = 0.33; 95% CI = 0.13-0.84) were significantly and negatively associated with 1-year persistence. There was also a strong inverse relationship between persistence and inpatient hospitalization (OR = 0.30; 95% CI = 0.12-0.76). Conclusions: Several health care delivery and use variables were significantly associated with nonpersistence. Concomitant use of prescription opioids is the most easily modifiable risk factor that health care providers and policy makers may act on to improve treatment continuation.

Understanding the Use of Antiretroviral Drugs in the Aging Patient

2017 ◽  
Author(s):  
Brandon H. Samson ◽  
James D. Scott
Keyword(s):  
Health Care ◽  
Drug Interactions ◽  
Health Care Providers ◽  
Bone Health ◽  
Older Patients ◽  
Viral Suppression ◽  
Antiretroviral Drugs ◽  
Care Providers ◽  
Negative Effects ◽  
Positive Effects

The prevalence of HIV infection is increasing in the older population. Because of other comorbidities, older patients infected with HIV may be taking multiple medications, which increases the risk of drug–drug interactions. Treatment of HIV in aging patients is based on the consideration of adverse effects associated by antiretroviral therapy (ART) with regard to renal, hepatic, cardiovascular, metabolic, and bone health, as well as the potential for increased drug–drug interactions. Because ART is associated with both beneficial and deleterious effects, health care providers should weigh the negative effects against the positive effects of viral suppression. Health care providers should routinely review patients’ medication lists to search for significant drug–drug interactions and perform drug interaction checks using available resources.

scholarly journals Knowledge, attitudes and practices on influenza vaccination during pregnancy in Quito, Ecuador

2020 ◽  
Author(s):  
Carlos E. Erazo ◽  
Carlos V. Erazo ◽  
Mario J. Grijalva ◽  
Ana L. Moncayo
Keyword(s):  
Health Care ◽  
Antenatal Care ◽  
Influenza Vaccination ◽  
Pregnant Women ◽  
Health Care Providers ◽  
Influenza Viruses ◽  
Care Providers ◽  
Factors Associated ◽  
Attitudes And Practices ◽  
Knowledge Attitudes And Practices

Abstract Background: Vaccination is the most effective way to prevent infection and severe outcomes caused by influenza viruses in pregnant women and their children. In Ecuador, the coverage of seasonal influenza vaccination in pregnant women is low. The aim of this study was to assess the knowledge, attitudes, and practices (KAP) of pregnant women toward influenza vaccination in Quito-Ecuador.Methods: A cross-sectional study enrolled 842 women who delivered at three main public gynecological-obstetric units of the Metropolitan District of Quito. A questionnaire regarding demographics, antenatal care, risk conditions and knowledge, attitudes and practices related to influenza vaccination was administered. We examined factors associated with vaccination using log-binomial regression models.Results: A low vaccination rate (36.6%) against influenza was observed among pregnant women. The factors associated with vaccination included the recommendations from health providers (adjusted PR: 15.84; CI 95% 9.62-26.10), belief in the safety of the influenza vaccine (adjusted PR: 1.53; CI 95% 1.03-2.37) and antenatal care (adjusted PR: 1.21; CI 95% 1.01-1.47). The most common reasons for not vaccinating included the lack of recommendation from health care providers (73.9%) and lack of access to vaccine (9.0%).Conclusions: Health educational programs aimed at pregnant women and antenatal care providers have the most potential to increase influenza vaccination rates. Further studies are needed to understand the barriers of health care providers regarding influenza vaccination in Ecuador.

scholarly journals Falls prevention at GP practices: a description of daily practice

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Wytske M. A. Meekes ◽  
Chantal J. Leemrijse ◽  
Yvette M. Weesie ◽  
Ien A. M. van de Goor ◽  
Gé A. Donker ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Providers ◽  
Preventive Care ◽  
Fall Risk ◽  
Older Patients ◽  
Daily Practice ◽  
Falls Prevention ◽  
Care Providers ◽  
Mobility Limitations

Abstract Background General practitioners (GPs) can be considered the designated professionals to identify high fall risk and to guide older people to fall preventive care. Currently it is not exactly known how GPs treat this risk. This study aims to investigate GPs’ daily practice regarding fall preventive care for frail older patients. Methods Sixty-five GPs from 32 Dutch practices participated in this study for a period of 12 months. When a GP entered specific International Classification of Primary Care-codes related to frailty and/or high fall risk in their Electronic Health Records, a pop-up appeared asking “Is this patient frail?”. If the GP confirmed this, the GP completed a short questionnaire about patient’s fall history and fear of falling (FOF), and the fall preventive care provided. Results The GPs completed questionnaires regarding 1394 frail older patients aged ≥75. Of 20% of these patients, the GPs did not know whether they had experienced a fall or not. The GPs did not know whether a FOF existed in even more patients (29%). Of the patients with a fall history and/or a FOF (N = 726), 37% (N = 271) received fall preventive care. Two main reasons for not offering fall preventive care to these patients were: I) the patient finds treatment too intensive or too much of a hassle (37%), and II) the GP identified a high fall risk but the patient did not acknowledge this (14%). When patients were treated for high fall risk, the GP and the physiotherapist were the most frequently involved health care providers. The involved health care providers most often treated mobility limitations, cardiovascular risk factors, and FOF. Conclusions The results from this study show that GPs were frequently not aware of their frail patient’s fall history and/or FOF and that the majority of the frail older patients with a fall history and/or FOF did not receive fall preventive care. Developing systematic screening strategies for the primary care setting enhancing the identification of high fall risk and the provision of fall preventive care may improve patients’ quality of life and reduce health care costs.

scholarly journals Prevalence and factors associated with burnout among frontline primary health care providers in low- and middle-income countries: A systematic review

2018 ◽  
Vol 2 ◽  
pp. 4 ◽  
Author(s):  
Sagar Dugani ◽  
Henrietta Afari ◽  
Lisa R. Hirschhorn ◽  
Hannah Ratcliffe ◽  
Jeremy Veillard ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Emotional Exhaustion ◽  
Care Providers ◽  
Middle Income ◽  
Factors Associated ◽  
Middle Income Countries ◽  
Primary Health

Background: Primary health care (PHC) systems require motivated and well-trained frontline providers, but are increasingly challenged by the growing global shortage of health care workers. Burnout, defined as emotional exhaustion, depersonalization, and low personal achievement, negatively impacts motivation and may further decrease productivity of already limited workforces. The objective of this review was to analyze the prevalence of and factors associated with provider burnout in low and middle-income countries (LMICs). Methods: We performed a systematic review of articles on outpatient provider burnout in LMICs published up to 2016 in three electronic databases (EMBASE, MEDLINE, and CAB). Articles were reviewed to identify prevalence of and risk factors associated with provider burnout. Results: A total of 6,182 articles were identified, with 20 meeting eligibility criteria. We found heterogeneity in definition and prevalence of burnout. Most studies assessed burnout using the Maslach Burnout Inventory. All three dimensions of burnout were seen across multiple cadres (physicians, nurses, community health workers, and pharmacists). Frontline nurses in South Africa had the highest prevalence of high emotional exhaustion and depersonalization, while PHC providers in Lebanon had the highest reported prevalence of low personal achievement. Higher provider burnout was associated with high job stress, high time pressure and workload, and lack of organizational support. Conclusions: Our comprehensive review of published literature showed that provider burnout is an important problem across various health care providers in LMICs. Further studies are required to better measure the prevalence, causes and consequences of burnout, and guide the development of effective interventions to reduce or prevent burnout.

Sign in / Sign up

Export Citation Format

Share Document