scholarly journals Shifting Boundaries in Professional Care

1996 ◽  
Vol 89 (7) ◽  
pp. 364-371 ◽  
Author(s):  
Anthony Hopkins ◽  
Juliet Solomon ◽  
Julia Abelson
Keyword(s):  
Health Care ◽  
Health Professionals ◽  
Modern Medicine ◽  
Organizational Complexity ◽  
Delivery Of Care ◽  
Professional Boundaries ◽  
Professional Care ◽  
Definition Of ◽  
Shifting Boundaries ◽  
Effective Health Care

The nature of the work undertaken by different health professionals and inter-professional boundaries are constantly shifting. The greater knowledge of users of health care, and the increasing technical and organizational complexity of modern medicine, have partly eroded the control of health professionals over the substance of their work. The definition of a field of work as lying within the province of any one profession is culturally rather than scientifically determined. It is evident that care of good quality should be delivered at the lowest possible cost. This might include delivery of care by a less trained person than heretofore, or by someone with limited but focused training. Sharing of skills is a more sensible subject for discussion than transfer of tasks. We review a number of studies which show the effectiveness of inter-professional substitution in various care settings, and also the effectiveness of substitution by those other than health professionals. The views of users of health services on inter-professional substitution need to be considered. Health professionals and others need to work together to devise innovative ways of delivering effective health care. The legal issues need clarification.

Assessment of Chronic Health Care through an Internet Consensus Tool

2016 ◽  
pp. 424-443 ◽  
Author(s):  
Josep Ma. Monguet ◽  
Alex Trejo ◽  
Tino Martí ◽  
Mireia Espallargues ◽  
Vicky Serra-Sutton ◽  
...  
Keyword(s):  
Health Care ◽  
Health Professionals ◽  
Chronic Care ◽  
Health Planning ◽  
Research Field ◽  
Consensus Method ◽  
Efficiency And Effectiveness ◽  
Professional Health ◽  
Participation Process ◽  
Definition Of

“Health Consensus for the Assessment of Chronic Care Programs” (HC-ACP) is an internet based application created to promote and facilitate the participation of health professionals in the definition of a set of indicators for the assessment of chronic care and management of areas of improvement in this field. The first prototype of the application has been applied twice, first in the region of Catalonia, and in a second project in the context of the whole Spanish Health System. HC-ACP has collected contributions from more than 800 health professionals from around Spain including profiles in the fields of management, health care professional, health planning and quality assessment, allowing sharing and aggregate knowledge and clinical experience from a wide range of points of view. After a process of literature review and panel meetings with professionals who proposed a wide list of indicators, the HC-ACP application was used to select a minimum set of indicators following a participative process based on Health Consensus, an online Real Time Delphi method. The first part of this chapter is devoted to expose paradigms that define the interdisciplinary research field of the method, the second part of the chapter presents the Health Consensus method, and finally the third part exposes a detailed description of the HC-ACP application and the followed process. Besides the relevance and utility of the Health Consensus method, the action-research conducted to build the application proves the efficiency and effectiveness of getting health professionals really involved in the processes of defining the models to assess the healthcare system. The online method proposed has been accepted by participants who have expressed high levels of satisfaction during the participation process.

scholarly journals Spirituality and Mental Health Care in a Religiously Homogeneous Country: Definitions, Opinions, and Practices Among Polish Mental Health Professionals

2019 ◽  
Vol 59 (1) ◽  
pp. 113-134 ◽  
Author(s):  
Edyta Charzyńska ◽  
Irena Heszen-Celińska
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Specific Context ◽  
Spirituality In Therapy ◽  
Definition Of ◽  
Insufficient Knowledge ◽  
Human Characteristic

Abstract This qualitative study involved a sample of 121 Polish mental health professionals who were interviewed about their definitions of spirituality and their opinions and practices concerning the inclusion of clients’ spirituality in therapy. Using inductive content analysis, we identified seven categories regarding the definitions of spirituality: (1) relationship, (2) transcendence, (3) dimension of functioning, (4) a specific human characteristic, (5) searching for the meaning of life, (6) value-based lifestyle, and (7) elusiveness and indefinability. The majority of respondents claimed to include elements of spirituality in therapy. However, some participants included spirituality only under certain circumstances or conditions, or did not include it at all, citing lack of need, lack of a clear definition of spirituality, their own insufficient knowledge, lack of experience, fear, or concern over ethical inappropriateness. Implicit techniques were primarily used when working on clients’ spirituality. This article deepens the knowledge on including spirituality in mental health care, with special consideration for a specific context of a highly religious and religiously homogenous culture.

Leading through the ‘new normality’ of health care

2021 ◽  
Vol 34 (1) ◽  
pp. 47-52
Author(s):  
Federico Lega ◽  
Rocco Palumbo
Keyword(s):  
Health Care ◽  
Leadership Styles ◽  
Leadership Style ◽  
Health Professionals ◽  
Health Care Organizations ◽  
Delivery Of Care ◽  
Health Services Delivery ◽  
Services Delivery ◽  
Training Activities ◽  
New Challenges

Health care institutions are witnessing a ‘new normality’, which profoundly reshapes the strategic and management challenges faced by health professionals in their attempt to achieve excellence in the design and delivery of care. This ‘new normality’ triggers a transformation of conventional managing models and leadership styles, which have proved to be unfit with the changed attributes of the external and internal contexts of health care organizations. The ‘new normal’ leadership style relies on the ability of leaders to make sense out of the new challenges that are faced by health care organizations and on their capability to act managerially, sticking to an empowering approach which enables followers. However, the transformation of conventional leadership style is impossible if a rethinking of training activities and learning experiences delivered to health professionals is missing. The article provides an overview of the issues that health leaders and managers encounter in the ‘new normality’ of health care, identifying several unanswered questions which should be addressed to thrive in the changed landscape of health services’ delivery.

What is sober sex and how to achieve it?

2019 ◽  
Vol 19 (1) ◽  
pp. 29-35
Author(s):  
Remziye Kunelaki
Keyword(s):  
Health Care ◽  
Clinical Experience ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Design Methodology ◽  
Health Clinic ◽  
Clear Definition ◽  
Content Type ◽  
Sex With Men ◽  
Definition Of

Purpose The purpose of this paper is to provide the first definition of sober sex and recommendations for health care professionals who work therapeutically with patients who struggle with intimacy after experiencing chemsex. Design/methodology/approach The recommendations are based on the clinical experience of a psychosexual therapist working with men having sex with men (MSM) in a Sexual Health clinic in central London. Findings The paper concludes that having a clear definition of sober sex and specific tools, such as healthy masturbation exercise, could prove helpful for health professionals who work with this cohort of patients. Originality/value This paper provides the first definition of sober sex and a clear set of guidelines for health professionals based on the clinical experience of the author.

scholarly journals What is a health emergency? The difference in definition and understanding between patients and health professionals

2011 ◽  
Vol 35 (3) ◽  
pp. 284 ◽  
Author(s):  
Amee Morgans ◽  
Stephen J. Burgess
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Professionals ◽  
Health Resources ◽  
Healthcare Services ◽  
Continuous Variable ◽  
Emergency Health Care ◽  
Health Event ◽  
Definition Of ◽  
Emergency Health Services

Background. Investigations into ‘inappropriate’ use of emergency health services are limited by the lack of definition of what constitutes a health emergency. Position papers from Australian and international sources emphasise the patient’s right to access emergency healthcare, and the responsibility of emergency health care workers to provide treatment to all patients. However, discordance between the two perspectives remain, with literature labelling patient use of emergency health services as ‘inappropriate’. Objective. To define a ‘health emergency’ and compare patient and health professionals perspectives. Method. A sample of 600 emergency department (ED) patients were surveyed about a recent health experience and asked to rate their perceived urgency. This rating was compared to their triage score allocated at the hospital ED. Results. No significant relationship was found between the two ratings of urgency (P = 0.51). Conclusions. Differing definitions of a ‘health emergency’ may explain patient help-seeking behaviour when accessing emergency health resources including hospital ED and ambulance services. A new definition of health emergency that encapsulates the health professional and patient perspectives is proposed. An agreed definition of when emergency health resources should be used has the potential to improve emergency health services demand and patient flow issues, and optimise emergency health resource allocation. What is known about the topic? Although many patients’ access emergency healthcare services in an emergency, many patients’ access emergency healthcare services when their condition is non-urgent, and avoid using emergency health care when their condition requires. What does this paper add? This paper identifies that health professionals and patients have different perspectives on what constitutes an emergency and when emergency health resources should be used.This paper also provides a review of literature and triage policy papers that identify key differences in the assessment of a health event, and shows that health professionals base their assessment on knowledge and physiological measures, whereas patients used socio-emotional cues to identify medical urgency. What are the implications for practitioners? Practitioners cannot expect their patients to be able to accurately evaluate the urgency of a health event. An emergency is difficult to define as health conditions are dynamic, and may change in urgency over time, and relative urgency is a continuous variable, rather than a dichotomous ‘health emergency’ v. ‘not a health emergency’.

Re-visioning Clinical Research: Gender and the Ethics of Experimental Design

Hypatia ◽  
1989 ◽  
Vol 4 (2) ◽  
pp. 125-139 ◽  
Author(s):  
Sue V. Rosser
Keyword(s):  
United States ◽  
Health Care ◽  
Experimental Design ◽  
Clinical Research ◽  
Medical Research ◽  
Ethical Dilemmas ◽  
The United States ◽  
Modern Medicine ◽  
Ethical Problems ◽  
Definition Of

Since modern medicine is based substantially in clinical medical research, the flaws and ethical problems that arise in this research as it is conceived and practiced in the United States are likely to be reflected to some extent in current medicine and its practice. This paper explores some of the ways in which clinical research has suffered from an androcentric focus in its choice and definition of problems studied, approaches and methods used in design and interpretation of experiments, and theories and conclusions drawn from the research. Some examples of re-visioned research hint at solutions to the ethical dilemmas created by this biased focus; an increased number of feminists involved in clinical research may provide avenues for additional changes that would lead to improved health care for all.

E-health developments in the system of health services in Hungary and the European Union

2014 ◽  
Vol 155 (21) ◽  
pp. 822-827
Author(s):  
Ágnes Váradi
Keyword(s):  
Health Care ◽  
European Union ◽  
Public Discourse ◽  
Action Plan ◽  
Fundamental Rights ◽  
Public Health Care ◽  
The European Union ◽  
Contemporary Issue ◽  
Definition Of ◽  
Basic Features

The question of electronic solutions in public health care has become a contemporary issue at the European Union level since the action plan of the Commission on the e-health developments of the period between 2012 and 2020 has been published. In Hungary this issue has been placed into the centre of attention after a draft on modifications of regulations in health-care has been released for public discourse, which – if accepted – would lay down the basics of an electronic heath-service system. The aim of this paper is to review the basic features of e-health solutions in Hungary and the European Union with the help of the most important pieces of legislation, documents of the European Union institutions and sources from secondary literature. When examining the definition of the basic goals and instruments of the development, differences between the European Union and national approaches can be detected. Examination of recent developmental programs and existing models seem to reveal difficulties in creating interoperability and financing such projects. Finally, the review is completed by the aspects of jurisdiction and fundamental rights. It is concluded that these issues are mandatory to delineate the legislative, economic and technological framework for the development of the e-health systems. Orv. Hetil., 2014, 155(21), 822–827.

Oral health diseases among the older people: a general health perspective

2020 ◽  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Oral Health ◽  
Older People ◽  
Health Professionals ◽  
General Health ◽  
Oral Health Care ◽  
Oral Diseases ◽  
Public Health Professionals ◽  
The Relationship

Background: The relationship between oral health and general health is gaining interest in geriatric research; however, a lack of studies dealing with this issue from a general perspective makes it somewhat inaccessible to non-clinical public health professionals. Purpose: The purpose of this review is to describe the relationship between oral health and general health of the elderly on the basis of literature review, and to give non-clinical medical professionals and public health professionals an overview of this discipline. Methods: This study was based on an in-depth review of the literature pertaining to the relationship between oral health and general health among the older people. The tools commonly used to evaluate dental health and the academic researches of male elderly people were also reviewed. And future research directions were summarized. Results: Dental caries, periodontal disease, edentulism, and xerostomia are common oral diseases among the older people. Dental caries and periodontal diseases are the leading causes of missing teeth and edentulism. Xerostomia, similar to dry mouth, is another common oral health disease in the older people. No clear correlation exists between the subjective feeling of dryness and an objective decrease of saliva. Rather, both conditions can be explained by changes in saliva. The General Oral Health Assessment Index (GOHAI) and the Oral Health Impact Profile (OHIP) are the main assessment tools used to examine oral health and quality of life in the older people. The GOHAI tends to be more sensitive to objective values pertaining to oral function. In addition, oral health studies in male elderly people are population-based cohort or cross-sectional studies, involving masticatory function, oral prevention, frailty problems, cardiovascular disease risk, and cognitive status. Conclusion: It is possible to reduce the incidence of certain oral diseases, even among individuals who take oral health care seriously. Oral health care should be based on the viewpoint of comprehensive treatment, including adequate nutrition, good life and psychology, and correct oral health care methods. In the future, researchers could combine the results of meta-analysis with the clinical experience of doctors to provide a more in-depth and broader discussion on oral health research topics concerning the older people.

Testing Consultation Recordings in a Clinical Setting With the SecondEars Smartphone App: Mixed Methods Implementation Study (Preprint)

2019 ◽  
Author(s):  
Amelia Hyatt ◽  
Ruby Lipson-Smith ◽  
Bryce Morkunas ◽  
Meinir Krishnasamy ◽  
Michael Jefford ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Health Professional ◽  
Clinical Setting ◽  
Health Professionals ◽  
Implementation Strategy ◽  
Smartphone App ◽  
Implementation Study ◽  
Pilot Testing ◽  
Effective Implementation

BACKGROUND Health care systems are increasingly looking to mobile device technologies (mobile health) to improve patient experience and health outcomes. SecondEars is a smartphone app designed to allow patients to audio-record medical consultations to improve recall, understanding, and health care self-management. Novel health interventions such as SecondEars often fail to be implemented post pilot-testing owing to inadequate user experience (UX) assessment, a key component of a comprehensive implementation strategy. OBJECTIVE This study aimed to pilot the SecondEars app within an active clinical setting to identify factors necessary for optimal implementation. Objectives were to (1) investigate patient UX and acceptability, utility, and satisfaction with the SecondEars app, and (2) understand health professional perspectives on issues, solutions, and strategies for effective implementation of SecondEars. METHODS A mixed methods implementation study was employed. Patients were invited to test the app to record consultations with participating oncology health professionals. Follow-up interviews were conducted with all participating patients (or carers) and health professionals, regarding uptake and extent of app use. Responses to the Mobile App Rating Scale (MARS) were also collected. Interviews were analyzed using interpretive descriptive methodology; all quantitative data were analyzed descriptively. RESULTS A total of 24 patients used SecondEars to record consultations with 10 multidisciplinary health professionals. In all, 22 of these patients used SecondEars to listen to all or part of the recording, either alone or with family. All 100% of patient participants reported in the MARS that they would use SecondEars again and recommend it to others. A total of 3 themes were identified from the patient interviews relating to the UX of SecondEars: empowerment, facilitating support in cancer care, and usability. Further, 5 themes were identified from the health professional interviews relating to implementation of SecondEars: changing hospital culture, mitigating medico-legal concerns, improving patient care, communication, and practical implementation solutions. CONCLUSIONS Data collected during pilot testing regarding recording use, UX, and health professional and patient perspectives will be important for designing an effective implementation strategy for SecondEars. Those testing the app found it useful and felt that it could facilitate the benefits of consultation recordings, along with providing patient empowerment and support. Potential issues regarding implementation were discussed, and solutions were generated. CLINICALTRIAL Australia and New Zealand Clinical Trials Registry ACTRN12618000730202; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373915&isClinicalTrial=False

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