scholarly journals Evidence use as sociomaterial practice? A qualitative study of decision-making on introducing service innovations in health care

2021 ◽  
pp. 1-25
Author(s):  
Simon Turner ◽  
Danielle D´Lima ◽  
Jessica Sheringham ◽  
Nick Swart ◽  
Emma Hudson ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Qualitative Study ◽  
Evidence Use

scholarly journals Lack of autonomy in facility-based births makes women become absentees of maternity services in Somaliland fragile contexts - a qualitative study

2021 ◽  
Author(s):  
Jama Ali Egal ◽  
Amina Essa ◽  
Rahma Yusuf ◽  
Fadumo Osman ◽  
Marie Klingberg- Allvin ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Qualitative Study ◽  
Healthcare Providers ◽  
Medical Knowledge ◽  
Care Seeking ◽  
Place Of Birth ◽  
Maternity Services ◽  
Risk Pregnancy ◽  
Respectful Care

Abstract ObjectiveSomaliland has high levels of both maternal and infant mortality. This has been attributed, in part, to the fact that nearly 80% of births in the country take place at home, with women assisted by Traditional Birth Attendants (TBA) who have limited medical knowledge when it comes to obstetric complications. In this study we aim to capture multipara women’s decision-making when choosing the place of birth, illuminated by their experiences of maternity services in SomalilandDesignAn explorative qualitative approach using individual interviews conducted in Somaliland with 25 multiparous women who had experience of both a home and facility-based birth within the last three years.FindingsThe main finding of this study was the description of how valuable autonomy and respectful care were for Somaliland women. Respectful care and the cost of maternity services were vital parts of women’s autonomous decision-making when choosing a place of birth. Disrespectful care in maternity services made low-risk pregnancy women chose homebirth instead of a health facility birth. Women who had previous high-risk pregnancies that suggested they should be returnees to facility-based antenatal care, were still planning for a homebirth as their first choice.Key conclusionThis qualitative study was conducted in the fragile context of Somaliland and suggest a need to transform maternal and child health clinics into midwifery-led birthing centers that promote natural birth. It is further important to create new roles and responsibilities for TBAs that link them to the formal health system assuring timely health care seeking during pregnancy and in relation to delivery. There is a need to conduct a country-wide study on the availability and distribution of healthcare providers and to construct a long-term sustainable plan to assure quality and equal access to maternal health care in the country.

scholarly journals Social and Health System Complexities Impacting on Decision-Making for Utilization of Oncology and Palliative Care in an African Context: A Qualitative Study

2019 ◽  
Vol 35 (3) ◽  
pp. 185-191 ◽  
Author(s):  
David A. Agom ◽  
Stuart Allen ◽  
Sarah Neill ◽  
Judith Sixsmith ◽  
Helen Poole ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Palliative Care ◽  
Qualitative Study ◽  
Health Care System ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Semistructured Interview ◽  
Design Data ◽  
Care System

Background: There is a dearth of research focusing on identifying the social complexities impacting on oncology and palliative care (PC), and no study has explored how the health-care system in Nigeria or other African contexts may be influencing utilization of these services. Aim: This study explored how social complexities and the organization of health-care influenced the decision-making process for the utilization of oncology and PC in a Nigerian hospital. Methods: This qualitative study used an interpretive descriptive design. Data were collected using semistructured interview guides with 40 participants, comprising health-care professionals, patients, and their families. Thematic analysis was conducted to generate and analyze patterns within the data. Findings: Three themes were identified: dysfunctional structural organization of the health-care delivery system, service-users’ economic status, and the influence of social networks. The interrelationship between the themes result in patients and their family members decisions either to present late to the hospital, miss their clinical appointments, or not to seek oncological health care and PC. Conclusion: This article offers insights into the role of the health-care system, as organized currently in Nigeria, as “autoinhibitory” and not adequately prepared to address the increasing burden of cancer. We therefore argue that there is a need to restructure the Nigerian health-care system to better meet the needs of patients with cancer and their families as failure to do so will strengthen the existing inequalities, discourage usage, and increase mortality.

scholarly journals A Triangulated Qualitative Study of Veteran Decision-Making to Seek Care During Heart Failure Exacerbation: Implications of Dual Health System Use

2018 ◽  
Vol 55 ◽  
pp. 004695801775150
Author(s):  
Charlene A. Pope ◽  
Boyd H. Davis ◽  
Leticia Wine ◽  
Lynne S. Nemeth ◽  
Robert N. Axon
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Decision Making ◽  
Qualitative Study ◽  
Emergency Department Visits ◽  
Care Utilization ◽  
Health Administration ◽  
Dual Use ◽  
Primary Specialty ◽  
System Use

Among Veterans, heart failure (HF) contributes to frequent emergency department visits and hospitalization. Dual health care system use (dual use) occurs when Veterans Health Administration (VA) enrollees also receive care from non-VA sources. Mounting evidence suggests that dual use decreases efficiency and patient safety. This qualitative study used constructivist grounded theory and content analysis to examine decision making among 25 Veterans with HF, for similarities and differences between all-VA users and dual users. In general, all-VA users praised specific VA providers, called services helpful, and expressed positive capacity for managing HF. In addition, several Veterans who described inadvertent one-time non-VA health care utilization in emergent situations more closely mirrored all-VA users. By contrast, committed dual users more often reported unmet needs, nonresponse to VA requests, and faster services in non-VA facilities. However, a primary trigger for dual use was VA telephone referral for escalating symptoms, instead of care coordination or primary/specialty care problem-solving.

Fathers and Child Health Care Decision Making: A Qualitative Study of Parental Identity Conjointness

2006 ◽  
Author(s):  
Anthony J. Isacco ◽  
Craig F. Garfield ◽  
Rechelle R. Paranal
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Child Health ◽  
Qualitative Study ◽  
Child Health Care ◽  
Health Care Decision ◽  
Parental Identity ◽  
And Child Health ◽  
Care Decision

Participation in health care priority-setting through the eyes of the participants

2002 ◽  
Vol 7 (4) ◽  
pp. 222-229 ◽  
Author(s):  
Douglas Martin ◽  
Julia Abelson ◽  
Peter Singer
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Qualitative Study ◽  
Priority Setting ◽  
Decision Makers ◽  
Medical Specialist ◽  
Committee Chair ◽  
The Public ◽  
Health Care Priority Setting ◽  
Patient Representative

Objectives: The literature on participation in priority-setting has three key gaps: it focuses on techniques for obtaining public input into priority-setting that are consultative mechanisms and do not involve the public directly in decision-making; it focuses primarily on the public's role in priority-setting, not on all potential participants; and the range of roles that various participants play in a group making priority decisions has not been described. To begin addressing these gaps, we interviewed individuals who participated on two priority-setting committees to identify key insights from participants about participation. Methods: A qualitative study consisting of interviews with decision-makers, including patients and members of the public. Results: Members of the public can contribute directly to important aspects of priority-setting. The participants described six specific priority-setting roles: committee chair, administrator, medical specialist, medical generalist, public representative and patient representative. They also described the contributions of each role to priority-setting. Conclusions: Using the insights from decision-makers, we have described lessons related to direct involvement of members of the public and patients in priority-setting, and have identified six roles and the contributions of each role.

scholarly journals Barriers to shared decision making in mental health care: qualitative study of the Joint Crisis Plan for psychosis

2015 ◽  
Vol 19 (2) ◽  
pp. 448-458 ◽  
Author(s):  
Simone Farrelly ◽  
Helen Lester ◽  
Diana Rose ◽  
Max Birchwood ◽  
Max Marshall ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Decision Making ◽  
Qualitative Study ◽  
Mental Health Care ◽  
Shared Decision Making ◽  
Shared Decision ◽  
Joint Crisis Plan ◽  
Crisis Plan

scholarly journals Multimorbidity, clinical decision making and health care delivery in New Zealand Primary care: a qualitative study

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Tim Stokes ◽  
Emma Tumilty ◽  
Fiona Doolan-Noble ◽  
Robin Gauld
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Decision Making ◽  
New Zealand ◽  
Qualitative Study ◽  
Health Care Delivery ◽  
Clinical Decision Making ◽  
Care Delivery ◽  
Clinical Decision

Paternal Reports of Health Care Decision Making: A Qualitative Study

2007 ◽  
Author(s):  
Anthony Isacco ◽  
Craig F. Garfield ◽  
Timothy E. Rogers
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Qualitative Study ◽  
Health Care Decision ◽  
Care Decision

Maternal health care decision-making process at the family level in Geita Region, Tanzania: A qualitative study

2020 ◽  
Author(s):  
Thecla W. Kohi ◽  
Jasintha S. Boniphace ◽  
Justine Dol
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Maternal Health ◽  
Qualitative Study ◽  
Maternal Health Care ◽  
Health Care Facilities ◽  
Decision Making Process ◽  
Obstetric Danger Signs ◽  
Danger Signs ◽  
Family Level

Abstract Background : Most maternal deaths are preventable if a woman is able to identity danger signs and seek obstetric health care without delay. However, lack of knowledge on obstetric danger signs and a prolonged decision-making process at family level may contribute to the high maternal mortality. Currently, there is little known on how the process of decision-making at family level in seeking obstetric care is being made in Tanzania. Therefore, this study aimed to describe the process on decision-making at family level in seeking maternal health care during pregnancy, delivery and postpartum period in the Geita Region, Tanzania. Methods : A qualitative study using in-depth semi-structured interview was conducted at Chato District Hospital in the Geita Region with seven fathers and seven mothers who were attending the Reproductive Child Health Clinic.Participants were recruited using purposeful sampling and interviews were analyzed using content analysis. Results: Three themes emerged from this study, including recognition of danger signs, decision-making process, and perceived influencers for seeking maternal health care. Almost all participants were aware of obstetric danger signs, yet some gaps remained among husbands. The process of decision-making starts with the woman herself who then communicates to others for discussion but the final decision-making in seeking care is dominated by husbands, parents, or neighbors, rather than mothers alone. Observing danger signs and perceived quality of care available from the health facilities were the most predominate influencers for seeking maternal health care. Conclusion: While the process of decision-making in every family starts with the woman herself, others are consulted for discussion prior to reaching a decision about seeking maternal health care, resulting in delays in accessing care. It is positive that most of the decision makers had good understanding of obstetric danger signs and that observation of those danger signs encourage access of maternal health care. However, continued education on obstetric danger signs in the community is needed as well as quality care needs to be available and known to be provided at health care facilities to encourage early seeking of maternal health care. Keywords : maternal health; decision-making; Tanzania

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