scholarly journals GEROTRANSCENDENCE OF ALASKA NATIVE ELDERS AGING SUCCESSFULLY IN THE ALEUTIAN AND PRIBILOF ISLANDS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S517-S518
Author(s):  
Jordan P Lewis ◽  
Eric Wortman
Keyword(s):  
Health Care Providers ◽  
Alaska Native ◽  
Successful Aging ◽  
Care Providers ◽  
Emotional Wellbeing ◽  
Remote Communities ◽  
Healthcare Needs ◽  
Core Elements ◽  
Kleinman's Explanatory Model ◽  
Specific Health

Abstract Meeting the healthcare needs of Alaska Native (AN) Elders in remote communities is critical to support successful aging and this study allows AN Elders from the Aleutian region to share their experiences and define successful aging, supporting the limited research on AN successful aging. This study interviewed 19 Elders in two communities from the Aleutian region of Alaska. Using a 20-item questionnaire based on Kleinman’s explanatory model to explore successful aging and experiences of being an Elder. Thematic analysis was employed to identify the characteristics and activities of Elders coping and adapting to aging-related changes. This study identified 5 core elements of successful aging, 4 of which formed Lewis’s AN model of successful aging (2011): Mental and Emotional Wellbeing, Spirituality, Purposefulness, and Physical Health and Mobility, and the new element of Gerotranscendence. The unique finding of this study that expands Lewis’s model is the change in mindset Elders experience as they self-reflect. Elders describe being more intentional in their relationships and a stronger connection to traditional cultural and spiritual activities, described by Tornstam (2005) as gerotranscendence. This research will be used locally to develop community specific health promotion and prevention programs to improve Elder services. These findings can also be used by health care providers to help Elders find meaningful activities that promote health and teach individuals to cope with aging-related changes.

scholarly journals Health-related needs and barriers for forcibly displaced women: a systematic review

2019 ◽  
Author(s):  
Jenny Jesuthasan ◽  
Zara Witte ◽  
Sabine Oertelt-Prigione
Keyword(s):  
Health Care Providers ◽  
Cochrane Library ◽  
Care Providers ◽  
Culturally Sensitive Care ◽  
Barriers To Access ◽  
Innovative Methodology ◽  
Health Related ◽  
Unequal Access ◽  
Available Information ◽  
Specific Health

Abstract Introduction Women represent a large proportion of the currently internationally displaced individuals. Due to gender roles, care duty, educational and economic imbalance their experiences and vulnerability during flight and relocation differ from that of men and children. The currently available information about their specific health-related needs and barriers to access is scarce and scattered. Methods We searched PubMed, Medline, EMBASE, Cochrane Library and Scopus to identify publications that explored the unique experiences of female refugees between 1 January 2008 and 30 June 2018. Publications needed to address the health needs of refugees, asylum seekers or displaced individuals, include at least 50% women in their study and employ a user-centered perspective, i.e. focus on the perspective of displaced individuals themselves and not health care providers. A framework of themes was identified and applied to all publications. Results We identified 1945 publications of which 13 could be included in the present review. Twelve of these publications employed qualitative and/or innovative methodology (e.g. ethnographies, index cards, photovoice). We identified five broad categories of health-related needs (immediate healthcare, communication, sultural/spiritual, social, economic), which are further detailed. Conclusions A concerted action providing information and culturally-sensitive care, while supporting language acquisition and economic empowerment is essential to improving the health status of female refugees. Transformative interventions need to address multiple axes of unequal access for female refugees to increase participation and overall health.

scholarly journals Preventive Cardiology in the Digital and COVID-19 Era: A Brave New World within the Veterans Health Administration

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1623
Author(s):  
Sohil Khanna ◽  
Arash Harzand
Keyword(s):  
Cardiac Rehabilitation ◽  
Health Systems ◽  
Health Care Providers ◽  
The United States ◽  
Health Administration ◽  
Care Providers ◽  
Preventive Cardiology ◽  
Healthcare Needs ◽  
Cardiac Symptoms ◽  
Virtual Care

The past year challenged patients, health care providers, and health systems alike to adapt and recalibrate to meet healthcare needs within pandemic constraints. The coronavirus 2019 (COVID-19) pandemic has radically interfered with the accessibility and delivery of cardiovascular care in the United States. With an emphasis on social distancing and stay-at-home orders in effect, many Americans delayed seeking routine medical care and treatment for acute cardiac symptoms due to fear of contracting the coronavirus. The COVID-19 pandemic compelled a rapid shift toward virtual care solutions across cardiovascular domains. The U.S Department of Veterans Affairs (VA) expanded virtual modalities, notably in specialty care and rehabilitation, which offered secure solutions to maintain treatment continuity. Within the VA and other health systems, virtual cardiac rehabilitation (CR) was embraced as an efficacious alternative to on-site cardiac rehabilitation that enabled patients to receive cardiac care remotely. Leveraging the infrastructure and lessons learned from the pandemic-induced expansion of virtual care carries enormous potential to refine virtual CR and revitalize future treatment paradigms for cardiovascular disease patients.

scholarly journals “Making Sense of a Disease That Makes No Sense”: Understanding Alzheimer’s Disease and Related Disorders Among Caregivers and Providers Within Alaska Native Communities

2020 ◽  
Author(s):  
Jordan P Lewis ◽  
Spero M Manson ◽  
Valarie B Jernigan ◽  
Carolyn Noonan
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Health Care ◽  
Support Groups ◽  
Health Care Providers ◽  
Alaska Native ◽  
Adult Population ◽  
Memory Loss ◽  
Cost Of Care ◽  
Care Providers

Abstract Background and Objectives With the rate of Alzheimer’s disease and related dementias (ADRD) increasing among Alaska Indian/Alaska Native (AI/AN) people, the Alaska Native Health system is ill-prepared to meet the challenges associated with the growing population at risk of ADRD. The high cost of care, inadequate training of health care providers, and lack of supportive services for caregivers are especially concerning. Research Design and Methods Interviews were conducted with 22 AN caregivers for ANs with ADRD and 12 ANs and non-Native health care providers in communities across Alaska. Interviews lasted approximately 60 min and were transcribed verbatim. We employed directed content analysis to examine the major agreements and disagreements between the participants’ understandings of ADRD in each of the domains of Kleinman’s Explanatory Model of Illness. Results Caregivers and health care providers expressed concerns about the lack of understanding, resources, and awareness of ADRD among ANs in rural and urban communities. Both caregivers and providers recognized the need to obtain an early diagnosis, blend Western and traditional medicines, promote lifestyle and dietary changes, and foster training for caregivers. Health care providers acknowledged their limited exposure to AN understanding of ADRD and wish to receive culturally relevant training to better serve AN. Discussion and Implications As the older AN adult population grows, the need for culturally responsive training and support services will continue to increase. We recommend establishing rural outreach and support groups for caregivers, developing an understanding of how ANs view ADRD to train and educate health care providers, and implement screening early for memory loss during routine medical examinations.

scholarly journals Reaching Perinatal Women Online: TheHealthy You, Healthy BabyWebsite and App

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Lydia Hearn ◽  
Margaret Miller ◽  
Leanne Lester
Keyword(s):  
Health Care Providers ◽  
Healthy Lifestyle ◽  
Online Resources ◽  
Online Information ◽  
Care Providers ◽  
Emotional Wellbeing ◽  
Close Link ◽  
Online Resource ◽  
Service Staff ◽  
Perinatal Women

Overwhelming evidence reveals the close link between unwarranted weight gain among childbearing women and childhood adiposity. Yet current barriers limit the capacity of perinatal health care providers (PHCPs) to offer healthy lifestyle counselling. In response, today’s Internet savvy women are turning to online resources to access health information, with the potential of revolutionising health services by enabling PHCPs to guide women to appropriate online resources. This paper presents the findings of a project designed to develop an online resource to promote healthy lifestyles during the perinatal period. The methodology involved focus groups and interviews with perinatal women and PHCPs to determine what online information was needed, in what form, and how best it should be presented. The outcome was the development of the Healthy You, Healthy Baby website and smartphone app. This clinically-endorsed, interactive online resource provides perinatal women with a personalised tool to track their weight, diet, physical activity, emotional wellbeing, and sleep patterns based on the developmental stage of their child with links to quality-assured information. One year since the launch of the online resource, data indicates it provides a low-cost intervention delivered across most geographic and socioeconomic strata without additional demands on health service staff.

Caring for adolescents in Guatemala: provider perspectives

2017 ◽  
Vol 0 (0) ◽  
Author(s):  
Areej Hassan ◽  
Juan Carlos Reyes Maza ◽  
Hayley G. Teich ◽  
Erwin H. Calgua Guerra
Keyword(s):  
Health Care ◽  
Adolescent Health ◽  
Health Care Providers ◽  
Strong Support ◽  
Comfort Level ◽  
Care Providers ◽  
Framework Analysis ◽  
Provider Perspectives ◽  
Healthcare Needs ◽  
Medical Education And Training

AbstractPurposeToday’s generation of adolescents is the largest in history, creating a major challenge for low and middle income countries faced with the necessity of addressing their growing healthcare needs. Our objective was to assess the extent to which health care providers in Guatemala are trained, knowledgeable and feel comfortable providing services to adolescents.MethodsA sample of 20 medical providers were recruited from the School of Medicine at San Carlos University and its affiliated hospitals. Providers were interviewed face-to-face for 30–40 min using a semi-structured guide exploring their training, knowledge, skills and experience in adolescent health care. Recruitment continued until thematic saturation was reached. Interviews were recorded and transcribed verbatim, and then analyzed for emergent themes using principles of framework analysis.ResultsThe provider’s mean age was 33.7 years [standard deviation (SD) = 10.2]. Most were female (65%) and practiced medicine in a metropolitan location. Results revealed the presence of five major themes: (1) Need for dedicated adolescent health services; (2) Presence of a multitude of barriers to providing adolescent health care; (3) Perceived comfort level in communicating with adolescents; (4) Limited knowledge of current adolescent specific services, programs, and guidelines; and (5) Gaps in medical education and training.ConclusionProviders recognize the need for increased and dedicated adolescent health care services. There is strong support for the creation of a credentialed national adolescent health training program.

scholarly journals Gerotranscendence and Alaska Native Successful Aging in the Aleutian Pribilof Islands, Alaska

2021 ◽  
Vol 36 (1) ◽  
pp. 43-67
Author(s):  
Erik S. Wortman ◽  
Jordan P. Lewis
Keyword(s):  
Psychosocial Development ◽  
Alaska Native ◽  
Personal Growth ◽  
Successful Aging ◽  
Healthy Aging ◽  
The United States ◽  
Emotional Wellbeing ◽  
Theories Of Aging ◽  
And Behaviors ◽  
Pribilof Islands

AbstractThe population of the United States is aging and by 2045 it is projected that approximately 1 in every 6 Alaskans will be 65+. Delivering healthcare and meeting the needs of older Alaskans in their community is critical to supporting healthy aging and community sustainability. Alaska Native (AN) Elders are underserved with very few studies providing an emic perspective on their experience aging. This research opens the door and allows us a glimpse of the AN Elder experience of aging: the values, beliefs, and behaviors that allow them to age well. This study highlights the characteristics and activities of AN Elders in the Aleutian and Pribilof Islands to further develop the model of AN successful aging. There are many theories of aging and this study explores a cross-cultural understanding of gerotranscendence - the personal and interpersonal changes that result from successful aging or achieving Eldership. This study interviewed Elders in two communities of the Aleutian and Pribilof Islands region. Using 22 standardized questions based on the explanatory model, researchers facilitated discussion of what it means to be an Elder and age successfully. Employing thematic analysis, interview transcripts were analyzed for themes to organize the data. Themes were organized into 5 core elements of successful aging with specific emphasis on values, beliefs, and behaviors that were protective and helped them adapt to aging-related changes. Interview content, meaning, and themes support the four elements of the AN model of successful aging developed by Lewis (The Gerontologist, 51(4), 540-549, 2011): Mental and Emotional Wellbeing, Spirituality, Purposefulness and Engagement, and Physical Health. Elders’ stories highlight the importance of reflection, personal growth, and psychosocial development. Elders who more strongly identified with their role in the community described how their perspective had changed and they shared stories that emphasized culture, connection to the land, and enjoyment of daily activities that resulted in increased life satisfaction. Elders provided clear evidence that they experienced aspects of gerotranscendence, which Tornstam (Journal of Aging Studies, 11(2), 143-154, 1997) categorized as the cosmic dimension, the self, and social and personal relationships. Elders adapting to aging-related changes and embracing their role as an Elder provided the greatest evidence of gerotranscendence - they developed new perspectives on life, took on new roles within the community, and experienced a shift in mindset that reinforced the importance of culture, tradition, and the Native Way of Life. This research allowed AN Elders to share their experiences, define successful aging, and expand the concept of Eldership to include changes in mindset, values, and relationships with themselves and others. The study is a framework to help us better understand the experiences of AN Elders aging successfully and the wisdom they wish to impart to others to help them learn to live healthy and meaningful lives.

scholarly journals Advance Care Planning in Healthy Older Adults

2011 ◽  
Vol 9 (2) ◽  
pp. 6-14 ◽  
Author(s):  
Karen Van Leuven
Keyword(s):  
Older Adults ◽  
End Of Life ◽  
Advance Directives ◽  
Health Care Providers ◽  
Successful Aging ◽  
Care Planning ◽  
Advanced Care Planning ◽  
Care Providers ◽  
Healthy Older Adults ◽  
Medical Diagnoses

This article reports the secondary analysis of a qualitative study that examined the beliefs, values, lifestyles and health status of adults at least 75 years old (N=18). An unanticipated finding was that all participants who self-identified as healthy (N=14) had in place advance directives which dictated their end-of-life wishes. In contrast, participants who self-identified as fair or poor health (N=4) did not have advance directives (N=4). These "healthy" older adults also differed substantially from their counterparts in the degree in which they were socially engaged in their community and family, but varied little related to their actual medical diagnoses or health problems. The self-described healthy group approached advanced care planning as part of health promotion; they simultaneously planned for end-of-life while engaging in activities to maintain optimum health. In contrast, those who evaluated their health as fair or poor perceived advanced care planning as something to be avoided. Planning for end-of-life may be a form of ongoing engagement as it requires dialogue with health care providers, and thoughtful consideration of experiences and wishes. It may also be a manifestation of successful aging in that death is recognized as the culmination of a good life rather than something to be feared.

Conscience, Compromise, and Complicity

2018 ◽  
Vol 92 ◽  
pp. 161-174 ◽  
Author(s):  
Jason T. Eberl ◽  
Christopher Ostertag ◽  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Intrinsic Value ◽  
Legal Services ◽  
Care Providers ◽  
Faith Based ◽  
Care Services ◽  
Catholic Health Care ◽  
Specific Health

Debate over whether health care institutions or individual providers should have a legally protected right to conscientiously refuse to offer legal services to patients who request them has grown exponentially due to the increasing legalization of morally contested services. This debate is particularly acute for Catholic health care providers. We elucidate Catholic teaching regarding the nature of conscience and the intrinsic value of being free to act in accord with one’s conscience. We then outline the primary positions defended in this debate and respond to critics of Catholic teaching. In so doing, we show how Catholic health care providers’ claims to conscientiously refuse to offer specific health care services are not essentially faith-based, but are founded upon publicly defensible reasons. We also address the question of whether conscientiously refusing health care providers may become complicit in moral wrongdoing or potentially cause scandal by means of disclosure or referral to another provider.

scholarly journals Alaska Native Patient and Provider Perspectives on the Multitarget Stool DNA Test Compared With Colonoscopy for Colorectal Cancer Screening

2019 ◽  
Vol 10 ◽  
pp. 215013271988429
Author(s):  
Diana G. Redwood ◽  
Ian D. Blake ◽  
Ellen M. Provost ◽  
John B. Kisiel ◽  
Frank D. Sacco ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Care ◽  
Health Care Providers ◽  
Alaska Native ◽  
Response Rate ◽  
Care Providers ◽  
Younger Patients ◽  
Dna Test ◽  
Crc Screening ◽  
Stool Dna

Objective: Alaska Native (AN) people have among the world’s highest rate of colorectal cancer (CRC). We assessed perceptions of AN people and their health care providers of a new take-home multitarget stool DNA test (MT-sDNA; Cologuard) relative to colonoscopy. Methods: Cross-sectional surveys of AN people aged 40 to 75 years (mailed) and providers (online). Results: Participants included 1616 AN patients (19% response rate) and 87 providers (26% response rate; 57% AN people). Over half (58%) of patients preferred colonoscopy for CRC screening, while 36% preferred MT-sDNA. Unscreened patients were significantly more likely to state a preference for MT-sDNA than previously screened patients (42% vs 31%, P < .05) as were younger patients (<60 years old) compared with older patients (40% vs 30%, P < .05). Most providers thought that MT-sDNA would improve screening rates (69%), would recommend if available (79%), and be implementable (79%). Perceived barriers differed substantially between patients and providers in both type and magnitude. Leading colonoscopy barriers reported by patients were travel (44%) and bowel preparation (40%), while providers thought that fear of pain (92%) and invasiveness of the test (87%) were the primary barriers. For MT-sDNA, patients’ belief that colonoscopy was better (56%) and not knowing how to do the test (40%) were primary barriers, while providers thought stool collection (67%) and having a stool sample in their home (63%) were leading barriers. Conclusions: This study found that MT-sDNA has potential acceptability among AN people and their health care providers. Both groups reported a willingness to use MT-sDNA and did not perceive major barriers to its use. This preference was especially true of unscreened and younger patients. The majority of providers indicated they would use MT-sDNA if available and that it would improve CRC screening rates. In this population, where colonoscopy access is limited, MT-sDNA has the potential to improve CRC screening adherence.

scholarly journals Feasibility of a voice-enabled medical diary app (SpeakHealth) with caregivers of children with special healthcare needs and healthcare providers: A mixed methods study (Preprint)

2020 ◽  
Author(s):  
Emre Sezgin ◽  
Garey Noritz ◽  
Simon Lin ◽  
Yungui Huang
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Information And Communication Technologies ◽  
Health Care Providers ◽  
Technology Use ◽  
Care Management ◽  
Communication Technologies ◽  
Care Providers ◽  
Healthcare Needs ◽  
Interview Session

UNSTRUCTURED Children with special health care needs (CSHCN) require more than the usual care management and coordination efforts from caregivers and health care providers (HCP). Health information and communication technologies can potentially facilitate these efforts in order to increase the quality of care received by CSHCN. In this study, we assessed the feasibility of a voice-enabled medical diary app (SpeakHealth). Following a mixed methods approach, caregivers of CSHCN were interviewed (n=10) and surveyed (n=86) about their care management and communication technology use. Only interviewed participants were introduced to SpeakHealth app prototype, and they tested the app during the interview session. In addition, we interviewed complex care HCPs (n=15) to understand their perception of the value of a home medical diary like SpeakHealth app. Overall, the findings demonstrated the needs and challenges for caregivers of CSHCN and opportunities of voice interactive medical diary apps in care management and coordination. We also reported the themes for enablers and barriers in care communication and communication technologies. We believe the perspectives of caregiver and providers suggested both benefits and challenges in using SpeakHealth app for medical note taking and health events tracking at home. We believe the findings could inform researchers and developers about development and use of a voice-enabled medical diary app.

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