Determinants of influenza vaccination intention among Tunisian elderly

Abstract Background Influenza vaccination coverage among elderly remains unsatisfactory even in developed countries. Since attitudes are predictors of behavior, understanding factors influencing the intention to receive influenza vaccine (IV) among elderly may orientate interventions to increase vaccination rate. The aim of the current study was to identify factors associated to willingness to receive IV next season among Tunisian elderly. Methods During 2018 -2019 flu season a cross-sectional study was conducted among older persons aged 60 years and over with chronic disease attending primary and secondary health care facilities. The intention to get vaccinated against influenza was measured by means of a face to face questionnaire. Factors that affect willingness to receive IV were identified using a multiple logistic regression analysis. Results Of the 1191 older persons included, 19.4% [17.1-21.9] participants received IV in 2018-2019 flu season, 64.7% [61.9-67.3] expressed willingness to be vaccinated next season. Willingness to receive IV was more likely among persons with chronic pulmonary disease (ORa=2.6), those suffering from diabetes (ORa=1.6), those who received IV in 2018-2019 flu season (ORa=16.5), those who feel that they get enough information about vaccines and their safety (ORa=2.9) and persons who trust the advice of their health care providers (ORa=4.5). Conclusions Vaccination status was the most determinant factor associated to willingness to receive the vaccine. Therefore, sustainable efforts to promote IV may lead to cumulative increase of influenza vaccination coverage year by year. Doctors should be involved more in advocating IV and providing elderly with the necessary information about IV, but that could not be effective without a climate of trust between patients and health care providers. Key messages Positive self-experience of older persons with IV may change their perception about it and encourage them to adhere to the vaccine in the future. Elderly should be provided with the necessary information about IV in terms of effectiveness and safety.

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Vaccinate-or-mask: Ethical duties and rights of health care providers in obtaining or refusing the influenza vaccination

Clinical Ethics ◽

10.1177/1477750916657663 ◽

2016 ◽

Vol 11 (4) ◽

pp. 182-189 ◽

Cited By ~ 1

Author(s):

Stephanie Richardson ◽

Kathryn Weaver

Keyword(s):

Health Care ◽

Immanuel Kant ◽

Influenza Vaccination ◽

Health Care Providers ◽

Best Practice ◽

Well Being ◽

Health Providers ◽

Care Providers ◽

Health Institutions ◽

To Receive

There is much controversy over the effectiveness of the influenza vaccination; yet, globally, many health institutions are implementing policies that require health providers to either receive the influenza vaccination or wear a surgical mask. This vaccinate-or-mask policy has caused great hullabaloo among health care providers and the institutions wherein they work. In light of the limitations to best practice evidence, we conducted an analysis of the policy and its implications based first on the bioethical principles of beneficence, nonmaleficience, respect for autonomy, and justice and then on the ethical theories of Immanuel Kant and John Stuart Mill. The most important ethical issue was threat to patient safety and welfare in the event of receiving care from a health provider who chose to forego the influenza vaccination and surgical mask requirement. We concluded that policies requiring health care providers to receive the influenza vaccination or wear a surgical mask are only partially supported by the bioethical principle approach; however, they are clearly justified from a deontological standpoint. That is, Kant would argue the rightness of the policy as a moral imperative for health care providers to not impose a health risk to those they serve and for health care institutions to ensure professional care giver vaccination. In further considering the vaccinate-or-mask policy in terms of the utilitarian “greatest good for the greatest number”, we determined that Mill would argue that this type of policy is ethically right and just, but also that policies solely requiring immunization would be ethical as public well-being is promoted.

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Country-Level Assessment of Missed Opportunities for Vaccination in South Africa: Protocol for Multilevel Analysis (Preprint)

10.2196/preprints.16672 ◽

2019 ◽

Author(s):

Duduzile Ndwandwe ◽

Ntombenhle J Ngcobo ◽

Abdu A Adamu ◽

Chukwudi Nnaji ◽

Thandiwe Mashunye ◽

...

Keyword(s):

South Africa ◽

Health Care ◽

South African ◽

Health Care Providers ◽

Vaccination Coverage ◽

Health Survey ◽

Health Care Facilities ◽

Ethical Review ◽

Care Providers ◽

Missed Opportunities

BACKGROUND Vaccination is one of the greatest public health interventions of all time. Vaccination coverage in South Africa has shown a steady improvement in reaching the national target. However, while there is progress nationally, there are districts within the country that are below the set target for vaccination coverage. One of the main drivers of suboptimal vaccination coverage is thought to be missed opportunities for vaccination. OBJECTIVE This study aims to understand the magnitude and determinants of missed opportunities for vaccination in South Africa. METHODS The 2016 South African Demographic and Health Survey will be used to conduct multilevel regression analyses to determine individual and contextual factors associated with missed opportunities for vaccination in South Africa. The perspectives of parents attending health care facilities in South Africa will be explored through exit interviews and focus group discussions. Similarly, perspectives of the health care providers will be sought to understand enablers and barriers to vaccination coverage at the facility level. Insights to such factors will aid in designing tailor-made interventions to improve vaccination coverage in South Africa. RESULTS Ethical review submission is planned for October 2020. Data collection is expected to be underway in January 2021. CONCLUSIONS The extent of missed opportunities in South Africa coupled with the associated factors presents an opportunity for efforts to increase uptake in districts where vaccination coverage is below the national target. Population-level data such as those from the 2016 South African Demographic Health Survey will provide an idea of the magnitude of missed opportunities for vaccination in South Africa at the national and subnational levels. The findings of the study will inform national and subnational policy implementation on vaccinations and help to find context-specific interventions to improve vaccination coverage. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/16672

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Country-Level Assessment of Missed Opportunities for Vaccination in South Africa: Protocol for Multilevel Analysis

JMIR Research Protocols ◽

10.2196/16672 ◽

2020 ◽

Vol 9 (9) ◽

pp. e16672

Author(s):

Duduzile Ndwandwe ◽

Ntombenhle J Ngcobo ◽

Abdu A Adamu ◽

Chukwudi Nnaji ◽

Thandiwe Mashunye ◽

...

Keyword(s):

South Africa ◽

Health Care ◽

South African ◽

Health Care Providers ◽

Vaccination Coverage ◽

Health Survey ◽

Health Care Facilities ◽

Ethical Review ◽

Care Providers ◽

Missed Opportunities

Background Vaccination is one of the greatest public health interventions of all time. Vaccination coverage in South Africa has shown a steady improvement in reaching the national target. However, while there is progress nationally, there are districts within the country that are below the set target for vaccination coverage. One of the main drivers of suboptimal vaccination coverage is thought to be missed opportunities for vaccination. Objective This study aims to understand the magnitude and determinants of missed opportunities for vaccination in South Africa. Methods The 2016 South African Demographic and Health Survey will be used to conduct multilevel regression analyses to determine individual and contextual factors associated with missed opportunities for vaccination in South Africa. The perspectives of parents attending health care facilities in South Africa will be explored through exit interviews and focus group discussions. Similarly, perspectives of the health care providers will be sought to understand enablers and barriers to vaccination coverage at the facility level. Insights to such factors will aid in designing tailor-made interventions to improve vaccination coverage in South Africa. Results Ethical review submission is planned for October 2020. Data collection is expected to be underway in January 2021. Conclusions The extent of missed opportunities in South Africa coupled with the associated factors presents an opportunity for efforts to increase uptake in districts where vaccination coverage is below the national target. Population-level data such as those from the 2016 South African Demographic Health Survey will provide an idea of the magnitude of missed opportunities for vaccination in South Africa at the national and subnational levels. The findings of the study will inform national and subnational policy implementation on vaccinations and help to find context-specific interventions to improve vaccination coverage. International Registered Report Identifier (IRRID) PRR1-10.2196/16672

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Prevalence and Correlates of Depression in Elderly Persons

Psychological Reports ◽

10.2466/pr0.1980.47.3f.1055 ◽

1980 ◽

Vol 47 (3_suppl) ◽

pp. 1055-1061 ◽

Cited By ~ 9

Author(s):

Edward F. Raymond ◽

Timothy J. Michals ◽

Robert A. Steer

Keyword(s):

Health Care ◽

Regression Analysis ◽

Health Care Providers ◽

Older Persons ◽

Stepwise Regression ◽

The Elderly ◽

Elderly Persons ◽

Care Providers ◽

Self Assessment ◽

Psychiatric Intervention

A sample of 504 elderly persons living within a metropolitan area were questioned about their socio-medical characteristics and administered the Wakefield Self-assessment Depression Inventory. The distribution of depression scores indicated that 34.5% were depressed. Stepwise regression analysis was next used to examine the relationships between the characteristics and depression scores. Total number of self-reported symptoms and being partially housebound were positively associated with depression. Recommendations were made that health care providers for the elderly be alerted that older persons with physical complaints and those who are partially restricted to their homes may tend to develop levels of depression which might require psychiatric intervention.

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Experiences of homosexual patients’ access to primary health care services in Umlazi, KwaZulu-Natal

Curationis ◽

10.4102/curationis.v38i2.1522 ◽

2015 ◽

Vol 38 (2) ◽

Cited By ~ 6

Author(s):

Nokulunga H. Cele ◽

Maureen N. Sibiya ◽

Dudu G. Sokhela

Keyword(s):

Health Care ◽

Primary Health Care ◽

Nursing Education ◽

Health Care Providers ◽

Health Care Services ◽

Health Care Facilities ◽

Easy Access ◽

Care Providers ◽

Care Services ◽

Primary Health

Background: Homosexual patients are affected by social factors in their environment, and as a result may not have easy access to existing health care services. Prejudice against homosexuality and homosexual patients remains a barrier to them seeking appropriate healthcare. The concern is that lesbians and gays might delay or avoid seeking health care when they need it because of past discrimination or perceived homophobia within the health care thereby putting their health at risk.Aim of the study: The aim of the study was to explore and describe the experiences of homosexual patients utilising primary health care (PHC) services in Umlazi in the province ofKwaZulu-Natal (KZN).Method: A qualitative, exploratory, descriptive study was conducted which was contextual innature. Semi-structured interviews were conducted with 12 participants. The findings of this study were analysed using content analysis.Results: Two major themes emerged from the data analysis, namely, prejudice against homosexual patients by health care providers and other patients at the primary health care facilities, and, homophobic behaviour from primary health care personnel.Conclusion: Participants experienced prejudice and homophobic behaviour in the course of utilising PHC clinics in Umlazi, which created a barrier to their utilisation of health services located there. Nursing education institutions, in collaboration with the National Department of Health, should introduce homosexuality and anti-homophobia education programmes during the pre-service and in-service education period. Such programmes will help to familiarise health care providers with the health care needs of homosexual patients and may decrease homophobic attitudes.

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Tomorrow's Challenges –Today's Realities Making the Leap: 2002 Ryley-Jeffs Memorial Lecture

Canadian Journal of Dietetic Practice and Research ◽

10.3148/63.3.2002.134 ◽

2002 ◽

Vol 63 (3) ◽

pp. 134-139

Author(s):

Kathleen M. Martin

Keyword(s):

Health Care ◽

Health Care Providers ◽

Health Care Services ◽

Structural Changes ◽

Health Care Facilities ◽

Memorial Lecture ◽

Institute Of Medicine ◽

Care Providers ◽

Quality Health Care ◽

Canadian Health Care System

The premise of the presentation is a challenge to health care providers to examine the quality of services currently provided in health care facilities across the country. While the Canadian health care system is under scrutiny with numerous reviews and commissions, the underlying question is: are the structural changes making a difference? We need to consider the recommendations in the latest report from the Institute of Medicine, Crossing the Quality Chasm. The report calls for a sweeping redesign and suggests a set of ten new rules to guide patient/clinician relationships. Dietitians must take the lead on implementation of systematic changes, model the way and get involved in the necessary changes. As the report suggests, the gap between where we are and where we need to go in providing quality health care services is not just a crack; it is in fact a chasm.

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Dignity and palliative end-of-life care

10.1093/med/9780199656097.003.0106 ◽

2015 ◽

Cited By ~ 1

Author(s):

Harvey Max Chochinov ◽

Susan E. McClement ◽

Maia S. Kredentser

Keyword(s):

Health Care ◽

End Of Life ◽

Health Care Providers ◽

End Of Life Care ◽

Vulnerable Groups ◽

Clinical Settings ◽

Life Care ◽

Care Providers ◽

Key Aspects ◽

To Receive

The concept of dignity continues to receive attention in health care, with particular implications for end-of-life care. This chapter reviews current conceptualizations of dignity, integrating medical, philosophical, and ontological perspectives. The centrality of dignity to palliative care is discussed, exploring empirical findings, which examine what dignity means to patients and families in the context of illness and end-of-life care. The chapter provides an overview of validated tools, evidence-based therapies, and practical ‘everyday’ communication skills that health-care providers in diverse clinical settings can use to enhance patient dignity. Suggestions are provided for extending existing research into the notion of dignity as it relates to vulnerable groups, and how interventions aimed at supporting patient dignity can impact family members. Dignity subsumes many key aspects of comprehensive care, which can guide health-care providers towards improving end-of-life experiences for patients and families.

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Direct-to-Consumer Genetic Testing

Journal of Information Technology Research ◽

10.4018/jitr.2012010103 ◽

2012 ◽

Vol 5 (1) ◽

pp. 35-67 ◽

Cited By ~ 1

Author(s):

Richard A. Stein

Keyword(s):

Health Care ◽

Genetic Testing ◽

Health Care Providers ◽

Double Helix ◽

Health Care Facilities ◽

Past Century ◽

Care Providers ◽

Genetic Tests ◽

Direct To Consumer ◽

Dna Double Helix

Genetics has fascinated societies since ancient times, and references to traits or behaviors that appear to be shared or different among related individuals have permeated legends, literature, and popular culture. Biomedical advances from the past century, and particularly the discovery of the DNA double helix, the increasing numbers of links that were established between mutations and medical conditions or phenotypes, and technological advances that facilitated the sequencing of the human genome, catalyzed the development of genetic testing. Genetic tests were initially performed in health care facilities, interpreted by health care providers, and included the availability of counseling. Recent years have seen an increased availability of genetic tests that are offered by companies directly to consumers, a phenomenon that became known as direct-to-consumer genetic testing. Tests offered in this setting range from the ones that are also provided in health care establishments to tests known as ‘recreational genomics,’ and consumers directly receive the test results. In addition, testing in this context often does not involve the availability of counseling and, when this is provided, it frequently occurs on-line or over the phone. As a field situated at the interface between biotechnology, biomedical research, and social sciences, direct-to-consumer genetic testing opens multiple challenges that can be appropriately addressed only by developing a complex, inter-disciplinary framework.

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Bilio-pancreatic endoscopy during COVID-19 pandemic

Therapeutic Advances in Gastroenterology ◽

10.1177/1756284820935187 ◽

2020 ◽

Vol 13 ◽

pp. 175628482093518

Author(s):

Vincenzo Bove ◽

Tommaso Schepis ◽

Ivo Boškoski ◽

Rosario Landi ◽

Beatrice Orlandini ◽

...

Keyword(s):

Health Care ◽

Health Care Providers ◽

Physical Distance ◽

Health Care Facilities ◽

Standards Of Care ◽

Unknown Etiology ◽

Care Providers ◽

The Public ◽

Frequent Exchange ◽

High Standards

On 31 December 2019, the WHO China Country Office was informed of cases of pneumonia of unknown etiology detected in Wuhan (Hubei Province of China). In January 2020, a new coronavirus named SARS-CoV2 was isolated and, since that time, SARS-CoV2 related disease (COVID-19) rapidly spread all over the world becoming pandemic in March 2020. The COVID-19 outbreak dramatically affected the public-health and the health-care facilities organization. Bilio-pancreatic endoscopy is considered a high-risk procedure for cross-contamination and, even though it is not directly involved in COVID-19 diagnosis and management, its reorganization is crucial to guarantee high standards of care minimizing the risk of SARS-CoV2 transmission among patients and health-care providers. Bilio-pancreatic endoscopic procedures often require a short physical distance between the endoscopist and the patient for a long period of time, a frequent exchange of devices, the involvement of a large number of personnel, the use of complex endoscopes difficult to reprocess. On this basis, endoscopic units should take precautions with adjusted management of bilio-pancreatic endoscopy. The aim of this article is to discuss the approach to bilio-pancreatic endoscopy in the COVID-19 era with focus on diagnostic algorithms, indications, management of the endoscopic room, proper use of Personal Protective Equipment and correct reprocessing of instrumentation.

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