scholarly journals Multiple burdens of stigma for prisoners participating in opioid antagonist treatment (OAT) programmes in Indonesian prisons: a qualitative study

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Rita Komalasari ◽  
Sarah Wilson ◽  
Sudirman Nasir ◽  
Sally Haw
Keyword(s):  
Health Care ◽  
Drug Use ◽  
Care Staff ◽  
Opioid Antagonist ◽  
Health Care Staff ◽  
Prison Staff ◽  
Content Type ◽  
Effective Strategies ◽  
Programme Participation

Purpose In spite of the effectiveness of opioid antagonist treatment (OAT) in reducing injecting drug use and needle sharing, programmes in prison continue to be largely stigmatised. This affects programme participation and the quality of programmes delivered. This study aims to explore how Indonesian prison staff and prisoners perceived and experienced stigma relating to prison OAT programmes and identify potential strategies to alleviate this stigma. Design/methodology/approach Three prisons in Indonesia were selected as part of a qualitative case study. Two of the prisons provided OAT, in the form of methadone maintenance treatment (MMT). Purposive and snowball sampling were used to recruit study participants. In total, 57 semi-structured interviews were conducted with prison governors, health-care staff, prison officers and prisoners. Prisoners included both participants and non-participants in methadone programmes. The data were analysed thematically. Findings MMT programme participants were perceived by both prison staff and other prisoners to be engaged in illicit drug use, and as lazy, poor, dirty and unproductive people. They were also presumed to be HIV-positive. These multi-layered, intersectional sources of (inter-personal) stigma amplified the effects on prisoners affecting not only their quality of life and mental health but also their access to prison parole programmes, and therefore the possibility of early release. In addition, organisational factors – notably non-confidential programme delivery and lack of both family and institutional supports for methadone prisoners – exacerbated the stigmatisation of MMT programme participants. Practical implications Effective strategies to alleviate stigma surrounding OAT programmes such as MMT programmes are urgently needed to ensure participation in and the quality of programmes in prisons. Originality/value Many prisoners reported experiencing stigma relating to their participation in MMT programmes in both the methadone prisons studied. They often emphasised the ways that this stigmatisation was amplified by the ways that MMT programme participation was associated with drug use and HIV infection. However, these intersecting experiences and concerns were not recognised by health-care staff or other prison staff. Effective strategies to alleviate stigma surrounding OAT programmes such as MMT programmes are urgently needed to ensure participation in and the quality of programmes in prisons.

Factors influencing the quality of care learning disabled patients receive in hospital

2020 ◽  
Vol 25 (2) ◽  
pp. 83-92
Author(s):  
Alice Durrant
Keyword(s):  
Health Care ◽  
Learning Disabilities ◽  
Quality Of Care ◽  
General Hospital ◽  
Learning Disabled ◽  
Care Staff ◽  
Content Type ◽  
Increased Risk ◽  
Disabled Patients

Purpose In total, 40% of the deaths of patients with learning disabilities have been classed as avoidable, and there is a known increased risk of harm while inpatients in hospital. This paper aims to look at the current experiences and treatment of people with learning disabilities within a general hospital setting to examine factors that affect their care. Design/methodology/approach A comprehensive literature search was conducted of primary research between 2013 and 2019 to evaluate what is known about the quality of care and treatment that learning disabled patients experience within a general hospital. Findings The research suggests that people with learning disabilities receive haphazard care in hospital settings, with inconsistent implementation of reasonable adjustments, insufficient arrangements to support family and other carer input, and poor knowledge of learning disability amongst hospital staff. Originality/value Previously, reviews focussing on hospital care have mainly focussed on access to health care rather than its delivery. This review has found evidence of significant failings in delivering care to this patient group, identifying a gap of knowledge in this field regardless of policies and laws already in place. There should be stricter monitoring of the Equality Act’s enforcement, along with improved and mandatory training for all general health-care staff. It is crucial that health-care professionals learn from mistakes to improve the care and experiences of learning disabled inpatients.

scholarly journals Physician perceptions of the types of roles interpreters play in limited English proficient pediatric encounters and how they evaluate the quality of interpretation

2019 ◽  
Vol 20 ◽  
Author(s):  
Rebecca J. Schwei ◽  
Natalie Guerrero ◽  
Alissa L. Small ◽  
Elizabeth A. Jacobs
Keyword(s):  
Health Care ◽  
Limited English Proficient ◽  
Health Care Systems ◽  
Care Staff ◽  
Health Care Staff ◽  
Structured Interviews ◽  
Team Members ◽  
Medical Interpreters ◽  
Care Systems

AbstractPurposeThe purpose of this study is to understand different roles that interpreters play in a pediatric, limited English proficient (LEP) health care encounter and to describe what factors within each role inform physicians’ assessment of the overall quality of interpretation.BackgroundLanguage barriers contribute to lower quality of care in LEP pediatric patients compared to their English-speaking counterparts. Use of professional medical interpreters has been shown to improve communication and decrease medical errors in pediatric LEP patients. In addition, in many pediatric encounters, interpreters take on roles beyond that of a pure language conduit.MethodsWe conducted 11 semi-structured interviews with pediatricians and family medicine physicians in one health system. Transcripts were audio-recorded and transcribed verbatim. We analyzed our data using directed content analysis. Two study team members coded all transcripts, reviewed agreement, and resolved discrepancies.FindingsPhysicians described four different interpreter roles: language conduit, flow manager, relationship builder, and cultural insider. Within each role, physicians described components of quality that informed their assessment of the overall quality of interpretation during a pediatric encounter. We found that for many physicians, a high-quality interpreted encounter involves multiple roles beyond language transmission. It is important for health care systems to understand how health care staff conceptualize these relationships so that they can develop appropriate expectations and trainings for medical interpreters in order to improve health outcomes in pediatric LEP patients.

Commentary on “Factors influencing the quality of care learning disabled patients receive in hospital”

2020 ◽  
Vol 25 (2) ◽  
pp. 93-96
Author(s):  
Tricia Handley
Keyword(s):  
Quality Of Care ◽  
Design Methodology ◽  
Learning Disabled ◽  
Care Staff ◽  
Health Care Staff ◽  
Content Type ◽  
Factors Influencing ◽  
Acute Hospitals ◽  
Disabled Patients

Purpose The purpose of this paper is to provide a commentary on Durrant’s paper “Factors influencing the quality of care learning disabled patients receive in hospital”. Design/methodology/approach The commentary identifies examples of practice in acute hospital provision consistent with the themes outlined in Durrant’s paper. Findings The themes identified in Durrant’s paper are easily recognisable. At the same time, there is a need to more fully understand the complexity of acute hospitals and to involve mainstream health-care staff in development and delivery of training on learning disability. Consideration should be given to the development of new specialist roles. Originality/value The commentary provides a practice perspective arising from wide clinical experience.

scholarly journals Building health system responsiveness to noncommunicable diseases for Gweru District adults, Zimbabwe: a case study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Blender Muzvondiwa ◽  
Roy Batterham
Keyword(s):  
Health Care ◽  
Lived Experience ◽  
Health Systems ◽  
Grey Literature ◽  
Care Staff ◽  
Noncommunicable Diseases ◽  
Health Care Staff ◽  
Local Health ◽  
Content Type ◽  
Local Health Care

PurposeGweru District, Zimbabwe faces a major challenge of noncommunicable diseases (NCDs). Globally, health systems have not responded successfully to problems in prevention and management of NCDs. Despite numerous initiatives, reorienting health services has been slow in many countries. Gweru District has similar challenges. The purpose of this paper is to explore what the health systems in Zimbabwe have done, and are doing to respond to increasing numbers of NCD cases in adults in the nation, especially in the district of GweruDesign/methodology/approachThe study employed a descriptive narrative review of the academic and grey literature, supplemented by semi-structured key informant interviews with 14 health care staff and 30 adults living with a disease or caring for an adult with a disease in Gweru District.FindingsRespondents identified many limitations to the response in Gweru. Respondents said that screening and diagnosis cease to be helpful when it is difficult securing medications. Nearly all community respondents reported not understanding why they are not freed of the diseases, showing poor understanding of NCDs. The escalating costs and scarcity of medications have led people to lose trust in services. Government and NGO activities include diagnosis and screening, provision of health education and some medication. Health personnel mentioned gaps in transport, medication shortages, poor equipment and poor community engagement. Suggestions include: training of nurses for a greater role in screening and management of NCDs, greater resourcing, outreach activities/satellite clinics and better integration of diverse NCD policies.Research limitations/implicationsParticipant responses were greatly influenced by the current political and economic situation in Zimbabwe, so responses may reflect short-term crises rather than long-term trends.Originality/valueThis research offers an understanding of NCD strategies and their limitations from the bottom-up, lived experience perspective of local health care workers and community members.

scholarly journals KlebSeq, a Diagnostic Tool for Surveillance, Detection, and Monitoring of Klebsiella pneumoniae

2016 ◽  
Vol 54 (10) ◽  
pp. 2582-2596 ◽  
Author(s):  
Jolene R. Bowers ◽  
Darrin Lemmer ◽  
Jason W. Sahl ◽  
Talima Pearson ◽  
Elizabeth M. Driebe ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Klebsiella Pneumoniae ◽  
Group Identification ◽  
Amplicon Sequencing ◽  
Multidrug Resistant ◽  
Care Staff ◽  
Health Care Staff ◽  
Health Crisis ◽  
Content Type

Health care-acquired infections (HAIs) kill tens of thousands of people each year and add significantly to health care costs. Multidrug-resistant and epidemic strains are a large proportion of HAI agents, and multidrug-resistant strains ofKlebsiella pneumoniae, a leading HAI agent, have caused an urgent public health crisis. In the health care environment, patient colonization byK. pneumoniaeprecedes infection, and transmission via colonization leads to outbreaks. Periodic patient screening forK. pneumoniaecolonization has the potential to curb the number of HAIs. In this report, we describe the design and validation of KlebSeq, a highly informative screening tool that detectsKlebsiellaspecies and identifies clinically important strains and characteristics by using highly multiplexed amplicon sequencing without a live-culturing step. We demonstrate the utility of this tool on several complex specimen types, including urine, wound swabs and tissue, and several types of respiratory and fecal specimens, showingK. pneumoniaespecies and clonal group identification and antimicrobial resistance and virulence profiling, including capsule typing. Use of this amplicon sequencing tool to screen patients forKlebsiellacarriage could inform health care staff of the risk of infection and outbreak potential. KlebSeq also serves as a model for next-generation molecular tools for public health and health care, as expansion of this tool can be used for several other HAI agents or applications.

scholarly journals Experiences of Older Persons in Seeking Care at a Private Hospital in Urban India

2020 ◽  
Vol 6 ◽  
pp. 233372142091063
Author(s):  
Sachin Ganorkar ◽  
Zarina Nahar Kabir ◽  
Nasreen Rustomfram ◽  
Harshad Thakur
Keyword(s):  
Health Care ◽  
Older Persons ◽  
Private Hospital ◽  
Care Staff ◽  
Health Care Staff ◽  
Structured Interviews ◽  
Urban India ◽  
Complex Health Problems ◽  
Payment Mechanisms

Objective: The study aims to describe the experiences of older persons in seeking health care in a private hospital in urban India. Methods: Semi-structured interviews were conducted with 50 older persons admitted in or visiting a private hospital in Hyderabad city in India between the period November 2017 and April 2018. The data were analyzed using Content Analysis. Results: Dimensions related to payment mechanisms, quality of health care staff, and hospital quality were reported to be important for the older persons. Payment mechanisms were related to discounts, insurance support, and reducing out-of-pocket expenditure. Quality of care was related to optimizing hospital operational processes like discharge time, standard of treatment, and trustworthiness of the medical staff. Discussion: Payment mechanism can be made friendly for the older persons. Quality of hospital including its staff can be enhanced by developing geriatric-specific competencies which can help them to understand and treat complex health problems specific for the older population.

scholarly journals Mindfulness for Healthcare Professionals

2020 ◽  
Vol 12 (1) ◽  
pp. 33
Author(s):  
Mita Mistry
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Potential Role ◽  
Working Environment ◽  
Good News ◽  
Care Staff ◽  
Health Care Staff ◽  
Number Of Patients ◽  
Reducing Stress

Heavy demands on health care staff include dealing with a large number of patients, long hours, restricted control over the working environment and ongoing organisational changes. Such conditions have been directly associated with growing stress levels and symptoms of burnout amongst health care professionals, and consequently, affecting the quality of care delivered to patients. 1 The good news is that this is now increasingly recognised and is indeed a catalyst for change in the development of awareness aimed at building self-care skills for clinicians. In particular, there is a growing body of evidence in Mindfulness-based interventions, which have a potential role in reducing stress and burnout.

scholarly journals Quality of Obstetric Services: Perspectives of Patients, Obstetricians, and Midwives

Medicina ◽  
2011 ◽  
Vol 47 (2) ◽  
pp. 17
Author(s):  
Rosita Aniulienė ◽  
Aurelija Blaževičienė ◽  
Olga Riklikienė
Keyword(s):  
Health Care ◽  
Care Staff ◽  
Quality Of Services ◽  
Health Care Staff ◽  
Technical Quality ◽  
Professional Relationship ◽  
Functional Quality ◽  
Obstetric Services ◽  
Better Than

Objective. The aim of this study was to compare the perspectives of patients and health care staff on the quality of obstetric services in an obstetric department. Material and Methods. This study was carried out at the Department of Obstetrics, Hospital of Lithuanian University of Health Sciences, where 68 obstetricians and midwives and 334 female patients completed anonymous questionnaires. Two different versions of the questionnaire for patients and health care staff were prepared with the aim to compare the results of both groups. Results. Patients evaluated technical quality of services significantly better than health care staff. Other items were showed to have no significant differences with the exception of sterility of equipment and premises and appearance of physicians. Patients and health care staff had similar opinions about professional relationship between patients and physicians: patients can expect representation of their interests and evaluation of treatment progress. Evaluation of external efficiency revealed that respondents were satisfied with health care and would recommend the current health care institution to their friends and relatives or would use it again when needed. Conclusions. Patients evaluated technical quality of services significantly better than health care staff. The different perceptions of patients and health care staff about functional quality and external effectiveness of services in most aspects were insignificant.

The recognition and management of delirium superimposed on dementia

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Margaret Robertson
Keyword(s):  
Health Care ◽  
Professional Practice ◽  
Critical Discussion ◽  
Care Staff ◽  
Health Care Staff ◽  
Training And Education ◽  
Content Type ◽  
The University ◽  
Practical Implications ◽  
Delirium Superimposed On Dementia

Purpose This essay was written as a university assignment for an expert dementia practice module as part of the Masters in Applied Professional Practice. This paper aims to provide a critical discussion of the recognition and management of delirium superimposed on dementia. Design/methodology/approach The findings of this paper showed that the recognition of delirium superimposed of dementia is not well recognized, but early intervention and management can result in preferential outcomes. This requires the use of appropriate recognition tools and for all health-care staff to have specific training within this area. Findings Education is imperative to improving delirium recognition. Research limitations/implications Education is imperative to improving awareness. Practical implications The research implications of this paper demonstrate that appropriate training and education of health-care staff is imperative for the timely recognition of delirium and the improvement of care. Originality/value This paper was undertaken as an assignment for the University of Highlands and Islands.

Bringing an entrepreneurial mindset to health-care: a new tool for better outcomes

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Laurence Murray Gillin ◽  
Lois Marjorie Hazelton
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Professional Practice ◽  
Health Care Industry ◽  
Care Staff ◽  
Health Care Staff ◽  
Content Type ◽  
Care Industry ◽  
Entrepreneurial Behaviour

Purpose The purpose of this paper is to consider the value of an industry ecosystem in providing context for both identifying and evaluating organisation opportunities and related entrepreneurial behaviour for future strategic growth by reference to a case study in the health-care industry. Using a validated entrepreneurship mindset audit instrument, an assessment is made of the leadership, decision-making, behaviour and awareness dimensions of professional practice health-care staff to create the internal culture that fosters an entrepreneurial orientated organisation that can deliver effective innovation for satisfied users of health-care services. Design/methodology/approach This case study examines the distinctive dimensions of entrepreneurial mindset – leadership, decision-making, behaviour and awareness – within a practice-based health-care (nursing) ecosystem and how these dimensions impact organisation performance throughout the health-care industry. Findings This study validates research findings that entrepreneurial leadership encourages entrepreneurial behaviour and an entrepreneurial culture supports the development of innovations. Opportunities for such cultural behaviour are best understood by measuring the staff’s and leaders’ “entrepreneurial mindset”. Research limitations/implications Generalising results from this case study requires caution. The positive outcome from the professional practice examples, and their strong association with impactful entrepreneurial mindset values on service delivery, requires further evaluation. Practical implications Using an entrepreneurial mindset audit to assess organisation’s cultural behaviour enables management to identify factors fostering or inhibiting entrepreneurial activity and to devise interventions to improve strategic direction. Originality/value Entrepreneurial mindset is not a new concept, but adding the critical significance of spiritual awareness to creative entrepreneur behaviour, together with a visioning map, adds both value and understanding to enhance organisation performance.

Sign in / Sign up

Export Citation Format

Share Document