Management of the actively dying patient

2015 ◽  
Author(s):  
Judith Lacey
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Practitioner ◽  
Care Providers ◽  
Care Needs ◽  
Dying Patients ◽  
Health Practitioners ◽  
Whole Person ◽  
Social Concerns ◽  
Dying Patient

The period leading to death is characterized by increasing prevalence and intensity of physical, psychological, existential, and social concerns, and it is often a challenging time for patients, their families, and health-care providers. This chapter specifically addresses the most prevalent symptoms and concerns encountered when managing the actively dying patient. Symptoms affecting dying patients’ comfort, including pain, dyspnoea, delirium, terminal secretions, and refractory symptoms and suffering require different clinical management as death approaches. Other topics included are recognizing the dying phase; communication with and preparation of patient, family, and staff; anticipating dying-advanced care planning and approach to resuscitation; addressing psychosocial and existential concerns; and approach to difficult end-of-life scenarios. This chapter aims to provide the health-care practitioner with a good overview and approach to the whole-person care needs of the dying patient and their family and carers to enable health practitioners to feel comfortable in providing this important care with confidence.

Needs assessment for gender sensitive reproductive health services for adolescents

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Fatemeh Rahmanian ◽  
Soheila Nazarpour ◽  
Masoumeh Simbar ◽  
Ali Ramezankhani ◽  
Farid Zayeri
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Health Services ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Providers ◽  
Reproductive Health Services ◽  
Care Needs ◽  
Reproductive Health Care ◽  
Care Services

AbstractBackgroundA dimension of reproductive health services that should be gender sensitive is reproductive health services for adolescents.ObjectiveThis study aims to assess needs for gender sensitive reproductive health care services for adolescents.MethodsThis was a descriptive cross-sectional study on 341 of health care providers for adolescents in health centers and hospitals affiliated to Shiraz University of Medical Sciences in Iran in 2016. The subjects of the study were recruited using a convenience sampling method. The tools for data collection were: (1) a demographic information questionnaire and; (2) a valid and reliable questionnaire to Assess the Needs of Gender-Sensitive Adolescents Reproductive Health Care Services (ANQ-GSARHS) including three sections; process, structure and policy making for the services. Data were analyzed using SPSS 21.ResultsThree hundred and forty-one health providers with an average working experience of 8.77 ± 5.39 [mean ± standard deviation (SD)] years participated in the study. The results demonstrated the highest scores for educational needs (92.96% ± 11.49%), supportive policies (92.71% ± 11.70%) and then care needs (92.37% ± 14.34%) of the services.ConclusionsProviding gender sensitive reproductive health care services for adolescents needs to be reformed as regards processes, structure and policies of the services. However, the gender appropriate educational and care needs as well as supportive policies are the priorities for reform of the services.

Pandemic Visitation Restrictions at the End of Life

2021 ◽  
Vol 46 (11) ◽  
pp. 3-4
Author(s):  
Molly Antone ◽  
Keyword(s):  
Health Care ◽  
End Of Life ◽  
Health Care Providers ◽  
Treatment Options ◽  
Care Providers ◽  
Medical Practices ◽  
Whole Person ◽  
Catholic Health Care

Dying today looks dramatically different than it did a century ago, largely due to wider treatment options and more specialized medical practices. Often missing from these advancements is the focus on factors relative to a patient’s total circumstances. Especially in light of the recent pandemic, it is incumbent upon Catholic health care providers to treat who whole person rather than simply focus on more utilitarian philosophies of care.

scholarly journals Queering whole person care in a pandemic

2022 ◽  
Vol 9 (1) ◽  
pp. 56-57
Author(s):  
Jane Shulman ◽  
David Kenneth Wright
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
The Past ◽  
Health Care Experiences ◽  
The People ◽  
Whole Person ◽  
Care Approach ◽  
The Face ◽  
Nursing Educator

How can health care providers (HCPs) working with 2SLGBTQ+ patients enact a whole person care approach during the SARS-CoV-2 pandemic and its aftermath, and in such desperate times, is it even reasonable to expect them to? In this presentation, a nurse/nursing educator and a health care researcher/frequent patient discuss their observations and experiences of whole person care during the SARS-CoV-2 pandemic. The conversation highlights that in the immediate chaos early on, and in the face of exhaustion, trauma, and burnout as the pandemic progressed, attending to the whole personhood of patients was/is paramount for HCPs and for the people they treat. The presenters reflect on the amplified significance of a whole person approach for 2SLGBTQ+ people who may have had negative health care experiences in the past, and may fear that they will not receive equitable care in the chaotic context of a pandemic. A whole person care approach is perhaps most necessary when it is also most difficult. In a period of such profound distress, a deeper sense of connectedness to patients may help HCPs manage feelings of helplessness they are likely to encounter, and surely helps the people they treat. The goal of this presentation is to begin a discussion about the ways that whole person approaches benefit 2SLGBTQ+ patients as well as their HCPs, with the hope that it will spark ideas for attendees to develop in their own practices.

“Recognize Our Humanity”: Immigrant Youth Voices on Health Care in Arizona’s Restrictive Political Environment

2018 ◽  
Vol 29 (4) ◽  
pp. 498-509 ◽  
Author(s):  
Sofía Gómez ◽  
Heide Castañeda
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Immigrant Youth ◽  
Lessons Learned ◽  
Research Approach ◽  
Policy Recommendations ◽  
Care Providers ◽  
Care Needs ◽  
Action Research Approach ◽  
Important Position

The “DACAmented Voices in Healthcare” project examined the intersection of restrictive immigration policies and health care via photovoice, a participatory action research approach, with immigrant youth living in Arizona, who were recipients of the Deferred Action for Childhood Arrivals (DACA) program. These “DACAmented” youth took part in nine photovoice sessions exploring their health care experiences and accessibility to care using documentary photography and narratives. They poignantly illustrated their experiences through images identifying their main health concerns and strengths, facilitating the development of health policy recommendations. This article illustrates the thematic findings and discusses policy recommendations and lessons learned from presentations to policy makers and health care providers. Findings suggest that immigrant youth are knowledgeable of their family’s health care needs and hold a unique and important position within mixed-status households. Health care providers can benefit from the proposed recommendations by building bridges to care to address health equity in immigrant communities.

Which sorts of pharmacies provide more patient counselling?

2002 ◽  
Vol 7 (1_suppl) ◽  
pp. 23-28 ◽  
Author(s):  
Pauline Norris
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Census Data ◽  
Social Deprivation ◽  
Statistical Significance ◽  
Negative Relationship ◽  
Care Providers ◽  
Care Needs ◽  
Patient Counselling ◽  
Large Town

Objective This paper investigates the characteristics of pharmacies that are associated with the degree of counselling provided to customers purchasing medicines. Methods Twelve ‘mystery shoppers’ (research assistants posing as normal customers) purchased restricted medicines at 180 pharmacies around New Zealand. One drug (diclofenac) and one class of drugs (vaginal antifungals) were purchased. The amount of counselling provided was recorded, and linked to profile data on the pharmacies, obtained through a questionnaire, from Census data, and from direct observations of pharmacies. Results Location within a city, a large town, or strip shopping did not affect the level of counselling pharmacies provided. Pharmacies adjacent to medical centres gave significantly less counselling to diclofenac purchasers than other pharmacies. No consistent relationship was found between pharmacy size and the level of counselling provided. There were large differences between areas of the country. A strong negative relationship was found between the amount of counselling given about thrush, and the proportion of Pacific Island people in the population around the pharmacy. Although only some results reached statistical significance, there seems to have been a similar trend for pharmacies to provide less counselling in areas with more Maori people and with higher levels of social deprivation. Conclusions Regional variation in the provision of pharmacy services, and in particular the tendency for pharmacies to provide less counselling in areas that are likely to have higher health care needs, must be addressed if pharmacies are to fulfil their potential as health care providers.

Competence

2017 ◽  
Author(s):  
Lisa Freitag
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Care Needs ◽  
Medical Problems ◽  
Special Health Care ◽  
Level Of Knowledge ◽  
High Level ◽  
Work Done

Parents caring for children with special health care needs or long-term disabilities are called to a new level of competence as medical caregivers, often as soon as the child is discharged from the hospital. There is no accepted measure for success with this task, though failure can be met with repeated hospitalization or removal of the child from the home. This chapter evaluates, through parent narratives, how parents obtain and view their competence. Some parents perform in-depth research into their child’s medical problems and achieve a surprisingly high level of knowledge. This is often discounted by both the parents and health care providers. The moral work done in this area is significant. Parents must change their priorities and re-align their expectations for their child’s success. They must adapt to a slower developmental pace, and create for the child a safe haven where the child’s disability becomes the accepted norm.

The Development of an Evacuation Protocol for Patients with Ventricular Assist Devices During a Disaster

2017 ◽  
Vol 32 (3) ◽  
pp. 333-338 ◽  
Author(s):  
Katherine J Davis ◽  
Joseph Suyama ◽  
Jennifer Lingler ◽  
Michael Beach
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Ventricular Assist Devices ◽  
Standards Of Care ◽  
Institute Of Medicine ◽  
Care Providers ◽  
Care Needs ◽  
Ventricular Assist ◽  
Assist Devices

AbstractIntroductionHealth care providers are on the forefront of delivering care and allocating resources during a disaster; however, very few are adequately trained to respond in these situations. Furthermore, there is a void in the literature regarding the specific care needs of patients with ventricular assist devices (VADs) in a disaster setting. This project aimed to develop an evidenced-based protocol to aid health care providers during the evacuation of patients with VADs during a disaster.MethodsThis is a qualitative study that used expert review, tabletop discussion, and a survey of health care professionals to develop and evaluate an evacuation protocol. The protocol was revised after each stage of review in order to reach a consensus document.ResultsThe project concluded with the finalization of a protocol which addresses evacuation and patient triage, and also includes an algorithm to determine which staff members should be evacuated with patients, transportation resources, evacuation documentation, and items patients need during evacuation. The protocol also addressed steps to be taken in the event that evacuation efforts fail and how to manage outpatient VAD patients seeking assistance.ConclusionsThis protocol provides guidance for the care of VAD patients in the event of a disaster and evacuation. Protocols such as this address difficult scenarios and should be created prior to a disaster to assist staff in making difficult decisions. These documents should be created using multi-disciplinary feedback via the consensus model as well as the Institute of Medicine (IOM; National Academy of Medicine; Washington, DC USA) “Crisis Standards of Care.”DavisKJ, SuyamaJ, LinglerJ, BeachM. The development of an evacuation protocol for patients with ventricular assist devices during a disaster. Prehosp Disaster Med. 2017;32(3):333–338.

scholarly journals Hiking

2016 ◽  
Vol 12 (4) ◽  
pp. 302-310 ◽  
Author(s):  
Denise Mitten ◽  
Jillisa R. Overholt ◽  
Francis I. Haynes ◽  
Chiara C. D’Amore ◽  
Janet C. Ady
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Emotional Health ◽  
World Health ◽  
Health Care Practitioner ◽  
Federal State ◽  
Care Providers ◽  
Increased Risk

Research has connected sedentary lifestyles with numerous negative health outcomes, including a significant increased risk for mortality. Many health care professionals seek ways to help clients meet physical activity guidelines recommended by the Office of Disease Prevention and Health Promotion, the World Health Organization, and the American College of Sports Medicine in order to promote active lifestyles and improve overall wellness. Hiking is a cost-effective intervention that encourages people to be physically active while spending time in nature. Time in nature can lead to health benefits through contact with the natural elements, participation in physical activity, restoration of mental and emotional health, and time with social contacts. Benefits may be immediate, such as decreased blood pressure, decreased stress levels, enhanced immune system functioning, and restored attention, or transpire over time, such as weight loss, decreased depression, and overall wellness. Health care providers are ideally positioned to recommend and prescribe hiking to clients. Federal, state, and local natural resource agencies are beginning to partner with health care professionals to promote outdoor nature-related activities. Examples of successful doctor and other health care practitioner partnership programs are described, along with tips for getting started.

scholarly journals Living large: the experiences of large-bodied women when accessing general practice services

2013 ◽  
Vol 5 (3) ◽  
pp. 199 ◽  
Author(s):  
Nicola Russell ◽  
Jenny Carryer
Keyword(s):  
Health Care ◽  
General Practice ◽  
Health Care Providers ◽  
Health Care Services ◽  
Point Of Care ◽  
Social Stigma ◽  
Care Providers ◽  
Care Needs ◽  
Care Services ◽  
Verbal Insults

INTRODUCTION: Numerous studies report high levels of stigma and discrimination experienced by obese/overweight women within the health care system and society at large. Despite general practice being the most utilised point of access for health care services, there is very little international or national exploration of the experiences of large-bodied women (LBW) accessing these services. The aim of this study was to explore LBW’s experiences of accessing general practice services in New Zealand. METHODS: This is a qualitative, descriptive, feminist study. Local advertising for participants resulted in eight self-identified, large-bodied women being interviewed. A post-structural feminist lens was applied to the data during thematic analysis. FINDINGS: The women in this study provided examples of verbal insults, inappropriate humour, negative body language, unmet health care needs and breaches of dignity from health care providers in general practice. Seven themes were identified: early experiences of body perception, confronting social stereotypes, contending with feminine beauty ideals, perceptions of health, pursuing health, respecting the whole person, and feeling safe to access care. CONCLUSION: Pressure for body size vigilance has, in effect, excluded the women in this study from the very locations of health that they are ‘encouraged’ to attend – including socialising and exercising in public, screening opportunities that require bodily exposure, and accessing first point of care health services. KEYWORDS: General practice; obesity; primary health care; social stigma; women

scholarly journals Improving Behavioral Health Equity through Cultural Competence Training of Health Care Providers

2019 ◽  
Vol 29 (Supp2) ◽  
pp. 359-364 ◽  
Author(s):  
Brian McGregor ◽  
Allyson Belton ◽  
Tracey L. Henry ◽  
Glenda Wrenn ◽  
Kisha B. Holden
Keyword(s):  
Health Care ◽  
Cultural Competence ◽  
Integrated Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Ethnic Disparities ◽  
The United States ◽  
Care Providers ◽  
Care Needs

 Racial/ethnic disparities have long persisted in the United States despite concerted health system efforts to improve access and quality of care among African Americans and Latinos. Cultural competence in the health care setting has been recognized as an important feature of high-quality health care delivery for decades and will continue to be paramount as the society in which we live becomes increasingly culturally diverse. Unfortunately, there is limited empirical evidence of patient health benefits of a culturally competent health care workforce in integrated care, its feasibility of imple­mentation, and sustainability strategies. This article reviews the status of cultural competence education in health care, the merits of continued commitment to training health care providers in integrated care settings, and policy and practice strategies to ensure emerging health care professionals and those already in the field are prepared to meet the health care needs of racially and ethnically diverse populations. Ethn Dis. 2019;29(Supp 2):359-364. doi:10.18865/ed.29.S2.359

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