scholarly journals What happens to health professionals when the ill patient is the health care system? Understanding the experience of practising medicine in the Romanian socio-cultural context

2012 ◽  
Vol 18 (3) ◽  
pp. 663-679 ◽  
Author(s):  
Florina Spânu ◽  
Adriana Băban ◽  
Mara Bria ◽  
Dan L. Dumitrascu
2021 ◽  
Vol 11 (33) ◽  
pp. 14-26
Author(s):  
Teila Ceolin ◽  
Rita Maria Heck ◽  
Renata Menasche ◽  
Maria-Antonia Martorell-Poveda

O objetivo foi compreender o sistema de cuidado à saúde entre famílias rurais ao Sul do Rio Grande do Sul. Constituiu-se de uma pesquisa qualitativa, com orientação etnográfica, realizada em 2014, com 25 interlocutores, residentes em um território rural. Os dados foram analisados por meio de uma abordagem hermenêutica antropológica. As práticas de cuidado à saúde, para essas famílias rurais, envolvem diferentes saberes, tanto os oriundos do sistema formal, quanto do sistema informal de saúde. Essas práticas transitam pelo cuidado familiar, serviços biomédicos, religiosidade, não ocorrendo um fluxo único, mas utilizando-se dos diferentes espaços e serviços, de acordo com suas necessidades. Nesse sentido, para realização de um cuidado integral à saúde dos indivíduos e das suas famílias, os profissionais necessitam conhecer o contexto cultural da comunidade acompanhada, entender e valorizar as práticas e as dinâmicas de cuidado que integram seu sistema de cuidado à saúde.Descritores: População Rural, Família, Cultura, Enfermagem. Health care system of rural familiesAbstract: The aim was to comprehend the health care system of rural families in the south of Rio Grande do Sul. Qualitative research with etnographic orientation, developed in 2014, with 25 interlocutors, residents of a rural territory. Data were analyzed through antropological hermeneutic approach. Health care practices, for these rural families, involve different knowledge, those from the formal system and those from the informal system of health. These practices transit through family care, biomedical systems and services, religiosity, not a single flow, but using different spaces and services, according to their needs. Thus, the realization of an integral health care of the individuals and their families requires professionals that know the community’s cultural context, understand it and value practices and care dybamics that integrate their health care system.Descripstors: Rural Population, Family, Culture, Nursing. Sistema de atención de salud a familias ruralesResumen: El objetivo era comprender el sistema de atención de salud entre las familias rurales en el sur de Rio Grande do Sul. Consistió en una investigación cualitativa, con orientación etnográfica, realizada en 2014, con 25 interlocutores, residentes en un territorio rural. Los datos se analizaron utilizando un enfoque hermenéutico antropológico. Las prácticas de atención médica para estas familias rurales implican diferentes tipos de conocimiento, tanto de los sistemas de salud formales como informales. Estas prácticas se mueven a través de la atención familiar, los servicios biomédicos, la religiosidad, no un solo flujo, sino que utilizan diferentes espacios y servicios, de acuerdo con sus necesidades. En este sentido, para brindar atención médica integral a las personas y sus familias, los profesionales necesitan conocer el contexto cultural de la comunidad que se sigue, comprender y valorar las prácticas y dinámicas de atención que integran su sistema de atención de salud.Descriptores: Población Rural, Família, Cultura, Enfermería.


2020 ◽  
pp. 002076402094678
Author(s):  
Dana Alonzo ◽  
Dafne Aida Zapata Pratto

Background: Mental Health professionals often have to deal with at-risk individuals in crises and lack specialized training on suicide risk assessment and intervention. This study examined mental health professionals’ attitudes toward at-risk individuals and their perceptions of the quality of training and treatment available for assessing and intervening with this population. Methods: A total of 32 mental health professionals (13 psychiatrists, 16 psychologists, 2 psychiatric nurses; 1 social assistant) from highly vulnerable communities in Lima, Peru discussed their perceptions in four focus groups conducted by the authors. Results: Participants reported glaring deficiencies in all areas explored including training, knowledge and skills regarding suicide assessment and management. In addition, using ground theory analysis, three domains of findings emerged representing barriers and facilitators of treatment engagement, risk and protective factors of suicide and pros and cons of the current mental health care system including micro-, mezzo- and macro-level factors. The most frequently identified barrier was the perception that suicide is illegal; facilitator was family involvement; risk factor was poor parenting; protective factor was religious beliefs; pro of mental health care system was establishment of community-based services and con of mental health care system was lack of access to psychiatrists. Conclusion: The lack of specialized training available in the institutions that are designed to prepare mental health professionals for working with at-risk individuals is notable and has a direct and known impact self-identified by helping professionals. The need and desire for targeted training is palpable and essential to address growing rates of suicide, particularly among youth, in Peru.


2021 ◽  
pp. e20210013
Author(s):  
Charlie Davis ◽  
Corey W. Johnson ◽  
Ashley Flanagan ◽  
Washington Silk

Collective memory work allows participants to recall, examine, and analyze their memories and experiences within a broader cultural context to see how their individual experiences link to collective, shared experiences of similar and/or different groups. This study utilized collective memory work to engage six trans participants in an examination of their individual experiences with health care. During a four-hour focus group, participants engaged in this process of discourse analysis and came to collective agreements about the meaning of their stories, the intentions of the author, and the intentions of others in their shared lived experience. In this paper, we will provide a thorough and rich description of the participants’ memories and their collective analysis, which highlights the interconnection between perceptions of oneself and their experiences with the health-care system. Our analysis revealed participants felt they had a toxic relationship with the health-care system. In particular, they discussed how health-care professionals left trans people tremulously asking for services, uncertain if they would receive care, what the quality of the care would be, and whether they would be treated respectfully. When discussing positive health-care experiences, participants highlighted when fears and anxieties were not realized, but all instances reflected some inappropriate actions. The results from this study will contribute to research on trans health care by providing a nuanced understanding of how health-care experiences impact trans communities collectively, as well as the ways in which health practices can be improved.


2010 ◽  
Vol 6 (1) ◽  
pp. 85-107 ◽  
Author(s):  
Jui-Fen Rachel Lu ◽  
Tung-Liang Chiang

AbstractThis study aims to present an overview of the evolutionary policy process in reforming the health care system in Taiwan, through dissecting the forces of knowledge, social-cultural context, economic resources and political system. We further identify factors, which had a significant impact on health care reform policies in Taiwan through illustrative policy examples. One of the most illuminating examples highlighted is the design and implementation of a single-payer National Health Insurance (NHI) program in 1995, after nearly five years of planning efforts (1988–1993) and a two-year legislative marathon. The NHI is one of the most popular social programs ever undertaken in the history of Taiwan, which greatly enhances financial protection against unexpected medical expenses and assures access to health services. Nonetheless, health care reform still has an unfinished agenda. Despite high satisfaction ratings, Taiwan’s health care system today is encountering mounting pressure for new reforms as a result of its rapidly aging population, economic stagnation, and imbalanced NHI checkbook. Although there may exist some heterogeneous system characteristics and challenges among different health care systems around the world, Taiwan’s experiences in reforming its health care system for the past few decades may provide valuable lessons for countries going through rapid economic and political transition.


2020 ◽  
Author(s):  
Abera Mersha ◽  
Shitaye Shibiru ◽  
Meseret Girma ◽  
Gistane Ayele ◽  
Agegnehu Bante ◽  
...  

Abstract Background: Novel coronavirus is a global pandemic and killed many individuals, including health care professionals. It caused stress on the health care system of all countries. Presently, studies are emerging regarding the COVID-19 pandemic in different aspects. However, a few have explored militating factors that affecting the practice of preventive measures for the COVID-19. As such, the study aimed to fill these research gaps in the study setting.Methods: A semi-structured interview guide used to conduct this phenomenological study among 16 key informants. Key informants recruited by the purposive sampling method. The data analyzed inductively by using a thematic content analysis approach in NVivo 12 Pro software. Results: In this study, six main themes identified with the sub-themes. Overview of COVID-19 pandemic, consequences (with the two sub-theme), perceived practice (with four sub-theme), perceived militating factors (with four sub-theme), newfangled activities (with three sub-theme), and suggestion for improvement (with seven sub-theme) were the major themes. The participants perceived the influence of shortage of personal protective equipment and solutions for hand hygiene, negligence and ignorance, inadequate infrastructure, lack of training, and lack of attention and recognition for the staff on the practice of preventive measures. Conclusions: Conclusions: This study showed that there were gaps in the practice of preventive measures for the COVID-19 among health professionals in the health care system. Community influences, health care provider related factors, institutional factors, and lack of communication and support affect the practice. Hence, attention should give to fulfill the necessary supplies in the health facilities, improve the infrastructures, and equip health professionals by providing capacity-building activities. Besides, health care professionals must recognize, and credit should consider.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Tremblay

Abstract Canada's universal and publicly funded health-care system aims to promote universal and equitable access to care based on the needs of individuals, rather than on their capacity to pay for these services. Despite these principles, some groups, such as Indigenous peoples, experience significant and persistent social inequalities in health compared to the general population. This situation results from the continuing impacts of colonialism, which has an undeniable influence on social determinants of health, including access to care. This is surprising for many health professionals because it contradicts the democratic ideals of justice and equality that underlie the health-care system, as well as the rhetoric of their professional practice which asserts that 'everyone is treated the same'. Based on literature and on research findings, this presentation will demonstrate several ways in which a universal and homogeneous approach to health-care can contribute to creating social inequalities in health for Indigenous populations. First, health professionals tend to favor socially and culturally neutral practice, which can hinder the recognition of the influence of historical and socio-cultural factors on patients' health. This kind of practice may encourage a distorted reading of patients' issues and can lead to inappropriate responses. Second, a homogenous approach to care refers by default to health-care models and practices that are rooted in values and perspectives of the dominant culture, which contributes to the provision of culturally unsafe care for Indigenous patients. Finally, this type of approach overlooks the critical and specific needs of vulnerable groups, who often require more than the general population to achieve the same results. We will conclude by outlining some potential solutions, mainly how cultural safety as a transformative approach to care allows health professionals to better consider the needs and cultural identity of Indigenous patients.


2017 ◽  
Vol 14 (4) ◽  
pp. 271-282 ◽  
Author(s):  
Lisbeth Ørtenblad ◽  
Lucette Meillier ◽  
Alexandra R Jønsson

Objective The importance of everyday life when managing the burden of treatment is rarely studied. This article explores the burden of treatment among people with multi-morbidity by investigating the tension between everyday life and the health care system. Method This was an ethnographic study using individual interviews and participant-observations. An inductive analytical approach was applied, moving from observations and results to broader generalisations. Results People with multi-morbidity experience dilemmas related to their individual priorities in everyday life and the management of their treatment burdens. Dilemmas were identified within three domains: family and social life; work life; agendas and set goals in appointments with health professionals. Individual resources and priorities in everyday life play a dominant role in resolving dilemmas and navigating the tension between everyday life and the health care system. Discussion People with multi-morbidity are seldom supported by health professionals in resolving the dilemmas they must face. This study suggests an increased focus on patient-centredness and argues in favour of planning health care through cooperation between health professionals and people with multi-morbidity in a way that integrates both health and everyday life priorities.


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