scholarly journals Factitious Disorders and Cardiothoracic Surgery: The Ongoing Multidisciplinary Challenges of a Complex Case

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Michael S. Firstenberg ◽  
John H. Sirak ◽  
Benjamin Sun ◽  
David P. Kasick
Keyword(s):  
Health Care ◽  
Great Distance ◽  
Cardiothoracic Surgery ◽  
Complex Case ◽  
Factitious Disorder ◽  
Access To Information ◽  
Factitious Disorders ◽  
Seek Health Care ◽  
Surgical Emergencies ◽  
Timely Access

Chronic factitious disorder, Munchausen's syndrome, can be challenging to manage—particularly when complaints and symptoms suggest medical or surgical emergencies. We present a patient whose problems have spanned many years and a great distance. Hopefully, with a greater awareness of this disease, as this patient continues to seek health care in many different hospitals, the implications of timely access to information, good histories and physical exams, and an index of suspicion can assist in potentially avoiding unnecessary, expensive, and invasive evaluations.

Barriers in Case Managers’ Roles: A Qualitative Systematic Review

2017 ◽  
Vol 40 (10) ◽  
pp. 1522-1542 ◽  
Author(s):  
Jee Young Joo ◽  
Diane L. Huber
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Case Management ◽  
Health Care Providers ◽  
Management Practices ◽  
Case Managers ◽  
Qualitative Studies ◽  
Complex Case ◽  
Bibliographic Databases ◽  
Care Providers

The challenges faced by case managers when implementing case management have received little focus. Several qualitative studies have been published that may be able to shed light on those challenges. This study is a systematic review of qualitative literature to identify barriers case managers have when implementing case management. Five electronic bibliographic databases were systematically searched, and 10 qualitative studies were identified for inclusion in the review which were published from 2007 to 2016. Through thematic synthesis of findings, five themes were identified as barriers to case management implementation: unclear scope of practice, diverse and complex case management activities, insufficient training, poor collaboration with other health-care providers, and client relationship challenges. This review study suggested that standardized evidence-based practical protocols and certification programs may help overcome case managers’ barriers and improve case management practices. Health policymakers, case management associations, and health-care management researchers should develop educational and practical supports for case managers.

Referral Criteria for Assessment and Treatment: In an Ambulatory Dysphagia Clinic

2012 ◽  
Vol 73 (4) ◽  
pp. 189-194
Author(s):  
Klara Lorinczi ◽  
Vanessa Denheyer ◽  
Amanda Pickard ◽  
Alice Lee ◽  
Diana R. Mager
Keyword(s):  
Health Care ◽  
Retrospective Chart Review ◽  
Wait Times ◽  
Health Care Teams ◽  
Treatment Services ◽  
Referral Criteria ◽  
Assessment And Treatment ◽  
Timely Access ◽  
Interdisciplinary Health Care Teams ◽  
Interdisciplinary Health Care

Dysphagia is highly prevalent in patients with chronic neurological disorders and can increase the risk for comorbidities such as aspiration pneumonia and malnutrition. Treatment includes timely access to interdisciplinary health care teams with specialized skills in dysphagia management. A retrospective chart review (n=99 of 125 charts screened) was conducted to evaluate the effectiveness of referral criteria to identify and triage patients with suspected dysphagia to an ambulatory dysphagia clinic. Variables collected included demographic information (age), anthropometric information (body mass index [BMI], each patient’s sex), reason for referral, primary medical diagnosis, symptomatology (e.g., pneumonia, chest congestion), nutrition and swallowing interventions, clinic wait times, missed/cancelled appointments, and referring health care professional. The mean age and mean BMI ± standard deviation of patients reviewed were 68.7 years ± 18.4 years and 25.2 kg/m2 ± 6.7 kg/m2, respectively. Average clinic wait times were 158 days (13 to 368 days) for routine and 52 days (0 to 344 days) for urgent assessments (p<0.001). The most common reason(s) for referral was/were related to dysphagia (n=83), surgery (n=50), and/or gastrointestinal symptomatology (n=28); 80% to 90% of patients received varying diagnostic and treatment services for dysphagia. Development of effective referral criteria is critical to ensure that clients with dysphagia receive timely diagnostic, treatment, and nutrition interventions by interdisciplinary health care teams specializing in dysphagia.

scholarly journals Predictors of Health Seeking Behaviours for Common Childhood Illnesses in Poor Resource Settings in Zambia, A Community Cross Sectional Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Golden Apuleni ◽  
Choolwe Jacobs ◽  
Patrick Musonda
Keyword(s):  
Health Care ◽  
Marital Status ◽  
Cross Sectional Study ◽  
Education Level ◽  
Child Health Services ◽  
Sectional Study ◽  
Health Seeking ◽  
Cross Sectional ◽  
Seek Health Care ◽  
Childhood Illnesses

Background: Developing countries, including Zambia, account for larger share of child morbidities and mortalities due to common childhood illnesses. Studies on wider determinants of behaviour pertaining to treatment seeking for childhood febrile illnesses in poor resource settings are limited. This study investigated health seeking behaviours of mothers in poor resource settings of Zambia and identified associated factors.Methods: Secondary data from a community cross sectional study design from the Health for the Poorest Population (HPP) Project was analysed between March and May 2019. Data was collected between May and August, 2013. It was collected by means of administering a structured questionnaire from the mothers of under-five children. The survey took place in Samfya and Chiengi of Luapula province while in Northern Province, Luwingu and Mungwi were settled for. A total of 1 653 mothers of under 5 years who had an episode of diarrhoea, malaria, pneumonia or a combination of any of them not more than 14 days before the interview were included in the study. A sample size was arrived at using A Lot Quality Assurance Sampling (LQAS) method. In order to determine the associations between respondent's demographic characteristics and health seeking behaviour, chi square test of independence was carried out. Multivariable logistic regression was also done to identify predictors of health seeking behaviours for common childhood illnesses in children aged &lt;5 years old in poor resource settings.Results: Among the mothers interviewed, 64.6% were married while 35.4% were unmarried. Their mean age was 32 years. Mothers who took their sick children to the health facilities for the purpose of seeking health care for their child for either of the illnesses accounted for 75.2%, [95% CI: 0.62–0.96], while 24.8% did not seek health care for their sick child. Factors typically associated with health seeking behaviours were mothers' marital status [aOR = 0.74; 95% CI: 0.58–0.94], and mothers ‘education level [aOR = 1.47; 95% CI: 1.13–1.92].Conclusion: It was established in this study that health care seeking behaviours for these common childhood illnesses in poor resource settings was relatively high and could be predicted by mother's education level and mothers' marital status. Integrating interventions targeted at increasing utilisation of maternal and child health services with basic education to women and moral support counselling to families may potentially maximise health seeking behaviours in marginalised communities.

Does it matter why heartburn sufferers seek health care?

2000 ◽  
Vol 118 (4) ◽  
pp. A209 ◽  
Author(s):  
Joseph A. Crawley ◽  
Bernard Hamelin ◽  
Eileen Gallagher
Keyword(s):  
Health Care ◽  
Seek Health Care

Health Care for Children of Migrant Families

PEDIATRICS ◽  
1989 ◽  
Vol 84 (4) ◽  
pp. 739-740
Author(s):  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Migrant Worker ◽  
Migrant Health ◽  
Farm Workers ◽  
Poverty Level ◽  
Health Maintenance ◽  
Seek Health Care ◽  
Migrant Families ◽  
Seasonal Farm Workers

Migrant and seasonal/farm workers constitute a major portion of the labor force in the American food industry. By harvesting and processing farm crops, they contribute positively to agricultural communities and the American economy. Currently, the office of Migrant Health estimates that nationwide there are between 3 and 5 million migrant and seasonal farm workers and dependents. The average annual income for migrant and seasonal farm workers is well below the poverty level (US Dept of Health and Human Services, unpublished data, 1988). Because health care insurance is invariably beyond the reach of migrant family budgets, and employers of farm workers rarely provide health care benefits for their employees, these families are usually uninsured. In some cases, these families lack US citizenship or are in this country illegally, which complicates obtaining health care for their children. Medicaid enrollment is also complicated by migration because aliens must meet eligibility requirements in each state to which they migrate, and only US citizens are eligible. Because of their income and mobile life-style, migrant worker families often find that comprehensive child health care (health maintenance, anticipatory guidance, and preventive medicine) essentially is not available. Migrating families must seek health care whenever it is available. This results in a pattern of service that usually is fragmented and ad hoc. Migration not only interrupts continuity of care but it also contributes to a lack of knowledge about a community's health services and/or jeopardizes eligibility for these services by conflicting with residency requirements. Other problems that delay or prevent access to health care for the children of migrant families include language barriers and differences in culture.

scholarly journals Scaling-up health insurance through community- based health insurance schemes in rural sub- Saharan African communities

2013 ◽  
Vol 3 (1) ◽  
pp. 14 ◽  
Author(s):  
Ufuoma John Ejughemre
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Rural Communities ◽  
Care Delivery ◽  
Sub Saharan Africa ◽  
Community Based ◽  
Seek Health Care ◽  
Community Based Health Insurance ◽  
The Poor ◽  
Sub Saharan

Context: The knotty and monumental problem of health inequality and the high burden of diseases in sub-Saharan Africa bothers on the poor state of health of many of its citizens particularly in rural communities. These issues are further exacerbated by the harrowing conditions of health care delivery and the poor financing of health services in many of these communities. Against these backdrops, health policy makers in the region are not just concerned with improving peoples’ health but with protecting them against the financial costs of illness. What is important is the need to support more robust strategies for healthcare financing in these communities in sub-Saharan Africa. Objective: This review assesses the evidence of the extent to which community-based health insurance (CBHI) is a more viable option for health care financing amongst other health insurance schemes in rural communities in sub-Saharan Africa. Patterns of health insurance in sub-Saharan Africa: Theoretically, the basis for health insurance is that it allows for risk pooling and therefore ensures that resources follow sick individuals to seek health care when needed. As it were, there are different models such as social, private and CBHI schemes which could come to bear in different settings in the region. However, not all insurance schemes will come to bear in rural settings in the region. Community based health insurance: CBHI is now recognized as a community-initiative that is community friendly and has a wide reach in the informal sector especially if well designed. Experience from Rwanda, parts of Nigeria and other settings in the region indicate high acceptability but the challenge is that these schemes are still very new in the region. Recommendations and conclusion: Governments and international development partners in the region should collect- ively develop CBHI as it will help in strengthening health systems and efforts geared towards achieving the millennium development goals. This is because it is inextricably linked to the health care needs of the poor. 

Integrative oncology in palliative medicine

2015 ◽  
Author(s):  
Gary Deng ◽  
Barrie Cassileth
Keyword(s):  
Health Care ◽  
Palliative Medicine ◽  
Complementary Therapies ◽  
Symptom Burden ◽  
Integrative Oncology ◽  
Seek Health Care ◽  
Health Care Practices ◽  
Alternative Approaches ◽  
Current Health Care System ◽  
Complementary And Alternative

Patients under palliative care, facing poor prognoses and a heavy symptom burden, often seek health-care practices and agents outside of mainstream medicine. Collectively these modalities often are termed ‘complementary and alternative medicine’ (CAM), to describe a diverse group of therapies that range from unproved alternative ‘cures’ offering false hope, to adjunctive complementary therapies that provide legitimate supportive care and that comprise integrative oncology. Although complementary therapies and alternative approaches are sometimes discussed under the single umbrella of CAM, it is clinically and conceptually necessary to distinguish between complementary and ‘alternative’ because they are profoundly different, and because there are no viable ‘alternatives’ to mainstream cancer care. The acronym is an easy but incorrect and counterproductive conflation of two unrelated approaches. This chapter summarizes the state of integrative medicine and medical oncology in the current health-care system. It discusses helpful complementary therapies applicable to palliative medicine and also describes the unproven alternatives that are widely proffered to patients and families internationally.

Blood Pressure Screenings Through Community Nursing Health Fairs: Motivating Individuals to Seek Health Care Follow-Up

2011 ◽  
Vol 28 (3) ◽  
pp. 119-129 ◽  
Author(s):  
Daniel Lucky ◽  
Barbara Turner ◽  
Melissa Hall ◽  
Scott Lefaver ◽  
Art de Werk
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Community Nursing ◽  
Seek Health Care ◽  
Health Fairs ◽  
Nursing Health

Impact of Sex and Gender on Irritable Bowel Syndrome

2003 ◽  
Vol 5 (1) ◽  
pp. 56-65 ◽  
Author(s):  
Margaret Heitkemper ◽  
Monica Jarrett ◽  
Eleanor F. Bond ◽  
Lin Chang
Keyword(s):  
Health Care ◽  
Irritable Bowel Syndrome ◽  
Visceral Pain ◽  
Partial Agonist ◽  
The United States ◽  
Care Seeking ◽  
Sex And Gender ◽  
Seek Health Care ◽  
And Gender ◽  
Irritable Bowel

Irritable bowel syndrome (IBS) is a common functional bowel disorder characterized by abdominal pain and change in defecation pattern. This review addresses the topic of possible sex (genetic, biological) and gender (experiential, perceptual) differences in individuals with and without IBS. Several observations make the topic important. First, there is a predominance of women as compared to men who seek health care services for IBS in the United States and other industrialized societies. Second, menstrual cycle-linked differences are observed in IBS symptom reports. Third, women with IBS tend to report greater problems with constipation and nongastrointestinal complaints associated with IBS. Fourth, serotonin (5-HT3) receptor antagonist and 5-HT4 partial agonist drugs appear to more effectively diminish reports of bowel pattern disruption in women with IBS as compared to men. This review examines sex and gender modulation of gastrointestinal motility and transit, visceral pain sensitivity, autonomic nervous system function, serotonin biochemistry, and differences in health care-seeking behavior for IBS.

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