Mothering Work and Perinatal Transfer: An Institutional Ethnographic Investigation

2019 ◽  
pp. 084456211988438 ◽  
Author(s):  
Catherine L. Ringham ◽  
Karen MacKinnon
Keyword(s):  
Health Care Providers ◽  
Ethnographic Study ◽  
Care Providers ◽  
Institutional Processes ◽  
Course Of Action ◽  
The Face ◽  
Health Complications ◽  
Childbearing Women ◽  
Purposive Sample ◽  
Infant Transfer

Background While maternal or infant transfer is generally the safest course of action when health complications arise, the process of shifting from one hospital to another is stressful for mothers and their infants. There is limited understanding of how institutional processes coordinate patient transfer in ways that increase tensions for women and their families who are trying to navigate the institutional systems during health crises. Methods This institutional ethnographic study explored womens’ experience of transfer. Interviews were conducted with a purposive sample of six childbearing women. The analysis highlights tensions and contradictions between patient care and institutional demands and shows how ordinary institutional decision-making practices impacted participants in unexpected ways. Results Women experienced uncertainty and stress when trying to convince health-care providers they needed care. Before, during, and after transfer, participants navigated home responsibilities, childcare, and getting care closer to home in difficult circumstances. Conclusion The effort and skill women need to care for their infants and families as they are transferred is extraordinary. This study offers insight into the resources and support childbearing women need to accomplish the work of caring for their families in the face of perinatal crisis and multiple transfers.

scholarly journals It Takes Two to Talk About Prostate Cancer

2012 ◽  
Vol 6 (6) ◽  
pp. 472-484 ◽  
Author(s):  
Daniela B. Friedman ◽  
Tracey L. Thomas ◽  
Otis L. Owens ◽  
James R. Hébert
Keyword(s):  
Prostate Cancer ◽  
Qualitative Research ◽  
South Carolina ◽  
Health Care Providers ◽  
Death Rate ◽  
European American ◽  
Care Providers ◽  
Men And Women ◽  
Research And Education ◽  
Purposive Sample

Prostate cancer (PrCA) is the most commonly diagnosed nonskin cancer among men. African American (AA) men in South Carolina have a PrCA death rate 150% higher than that of European American (EA) men. This in-depth qualitative research explored AA men’s and women’s current practices, barriers, and recommended strategies for PrCA communication. A purposive sample of 43 AA men and 38 AA spouses/female relatives participated in focus groups (11 male groups; 11 female groups). A 19-item discussion guide was developed. Coding and analyses were driven by the data; recurrent themes within and across groups were examined. Findings revealed AA men and women agreed on key barriers to discussing PrCA; however, they had differing perspectives on which of these were most important. Findings indicate that including AA women in PrCA research and education is needed to address barriers preventing AA men from effectively communicating about PrCA risk and screening with family and health care providers.

scholarly journals Experiences of Patients With COVID-19 Admitted to the Intensive Care Units: A Qualitative Study

2021 ◽  
Vol 8 ◽  
pp. 237437352110073
Author(s):  
Reza Norouzadeh ◽  
Mohammad Abbasinia ◽  
Zahra Tayebi ◽  
Ehsan Sharifipour ◽  
Alireza Koohpaei ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Health Care Providers ◽  
Spiritual Support ◽  
Care Providers ◽  
Structured Interviews ◽  
Icu Patients ◽  
Life Challenges ◽  
Care Models ◽  
The Face

This study aimed to describe the experiences of patients with COVID-19 admitted to the intensive care units (ICU). The data were analyzed by content analysis on 16 ICU patients with COVID-19. Data were collected by semi-structured interviews. Three categories were identified: (a) captured by a challenging incident with subcategories: perceived sudden and challenging death, fear of carelessness in overcrowding, worry about the family, and frustration with stigmatizing; (b) the flourishing of life with subcategories: spiritual-awakening, resilience in the face of life challenges, promoting health behaviors, and striving for recovery; and (c) honoring the blessings with subcategories: understanding the importance of nurses, realizing the value of family, and realizing the value of altruism. COVID-19 survivors experienced both positive and negative experiences. The results of this study could help health care providers identify the needs of ICU patients with COVID-19, including psychological, social, and spiritual support and design care models.

scholarly journals The lived experience of people with obesity: study protocol for a systematic review and synthesis of qualitative studies

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Emma Farrell ◽  
Marta Bustillo ◽  
Carel W. le Roux ◽  
Joe Nadglowski ◽  
Eva Hollmann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lived Experience ◽  
Health Care Providers ◽  
Evidence Synthesis ◽  
Qualitative Studies ◽  
Qualitative Evidence Synthesis ◽  
Care Providers ◽  
Critical Appraisal Skills ◽  
Health Complications

Abstract Background Obesity is a prevalent, complex, progressive and relapsing chronic disease characterised by abnormal or excessive body fat that impairs health and quality of life. It affects more than 650 million adults worldwide and is associated with a range of health complications. Qualitative research plays a key role in understanding patient experiences and the factors that facilitate or hinder the effectiveness of health interventions. This review aims to systematically locate, assess and synthesise qualitative studies in order to develop a more comprehensive understanding of the lived experience of people with obesity. Methods This is a protocol for a qualitative evidence synthesis of the lived experience of people with obesity. A defined search strategy will be employed in conducting a comprehensive literature search of the following databases: PubMed, Embase, PsycInfo, PsycArticles and Dimensions (from 2011 onwards). Qualitative studies focusing on the lived experience of adults with obesity (BMI >30) will be included. Two reviewers will independently screen all citations, abstracts and full-text articles and abstract data. The quality of included studies will be appraised using the critical appraisal skills programme (CASP) criteria. Thematic synthesis will be conducted on all of the included studies. Confidence in the review findings will be assessed using GRADE CERQual. Discussion The findings from this synthesis will be used to inform the EU Innovative Medicines Initiative (IMI)-funded SOPHIA (Stratification of Obesity Phenotypes to Optimize Future Obesity Therapy) study. The objective of SOPHIA is to optimise future obesity treatment and stimulate a new narrative, understanding and vocabulary around obesity as a set of complex and chronic diseases. The findings will also be useful to health care providers and policy makers who seek to understand the experience of those with obesity. Systematic review registration PROSPERO CRD42020214560.

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.

scholarly journals Influencing Factors for Prevention of Postpartum Hemorrhage and Early Detection of Women at Risk in The Northern Province of Rwanda: Beneficiary and Health Worker Perspectives

2020 ◽  
Author(s):  
Oliva Bazirete ◽  
Manassé Nzayirambaho ◽  
Aline Umubyeyi ◽  
Marie Chantal Uwimana ◽  
Evans Marilyn
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Early Detection ◽  
Focus Groups ◽  
Health Care Providers ◽  
Health Workers ◽  
Northern Province ◽  
Care Providers ◽  
Factors Associated ◽  
Childbearing Women

Abstract Background: Reduction of maternal mortality and morbidity is a major global health priority. However, much remains unknown regarding factors associated with postpartum hemorrhage (PPH) among childbearing women in the Rwandan context. The aim of this study is to explore the influencing factors for prevention of PPH and early detection of women at risk as perceived by beneficiaries and health workers in the Northern Province of Rwanda. Methods: A qualitative descriptive exploratory study was drawn from a larger sequential exploratory‐mixed methods study. Semi‐structured interviews were conducted with 11 women who experienced PPH within the 6 months prior to interview. In addition, focus group discussions were conducted with: women’s partners or close relatives (2 focus groups), community health workers (CHWs) in charge of maternal health (2 focus groups) and health care providers (3 focus groups). A socio ecological model was used to develop interview guides to describe factors related to early detection and prevention of PPH in consideration of individual attributes, interpersonal, family and peer influences, intermediary determinants of health and structural determinants. The research protocol was approved by the University of Rwanda, College of Medicine and Health Sciences Institutional Ethics Review Board. Results: We generated four interrelated themes: (1) Meaning of PPH: beliefs, knowledge and understanding of PPH: (2) Organizational factors; (3) Caring and family involvement and (4) Perceived risk factors and barriers to PPH prevention. The findings from this study indicate that PPH was poorly understood by women and their partners. Family members and CHWs feel that their role for the prevention of PPH is to get the woman to the health facility on time. The main factors associated with PPH as described by participants were multiparty and retained placenta. Low socioeconomic status and delays to access health care were identified as the main barriers for the prevention of PPH. Conclusions: Addressing the identified factors could enhance early prevention of PPH among childbearing women. Placing emphasis on developing strategies for early detection of women at higher risk of developing PPH, continuous professional development of health care providers, developing educational materials for CHWs and family members could improve the prevention of PPH. Involvement of all levels of the health system was recommended for a proactive prevention of PPH. Further quantitative research, using case control design is warranted to develop a screening tool for early detection of PPH risk factors for a proactive prevention.

Recent measles outbreaks in the United States: A look at the causes and responses

2019 ◽  
Vol 14 (10) ◽  
pp. 491-496
Author(s):  
Tracy Perron ◽  
Heather Larovere ◽  
Victoria Guerra ◽  
Kathleen Kilfeather ◽  
Nicole Pare ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care Providers ◽  
Personal Autonomy ◽  
Disease Outbreaks ◽  
The United States ◽  
Care Providers ◽  
Course Of Action ◽  
Public Health Officials ◽  
Measles Outbreaks

As measles cases continue to rise in the United States and elsewhere, public health officials, health care providers and elected officials alike are facing critical questions of how to protect the health of the public from current and future vaccine preventable disease outbreaks while still preserving the religious and personal autonomy of the populations they serve. As measles cases are being examined and carefully managed, public health officials are also tasked with revisiting vaccination policies and agendas to determine the best evidence-based interventions to control this epidemic. To determine the best course of action for the public's interest, research and current literature must be examined to protect and promote the health and wellbeing of those currently affected by the measles outbreak and those yet to be exposed.

scholarly journals A FRAMEWORK FOR CARE TRANSITIONS FOR OLDER ADULTS WITH COMPLEX HEALTH CONDITIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S687-S687
Author(s):  
Paul Stolee ◽  
Jacobi B Elliott ◽  
Kerry Byrne ◽  
Joanie Sims-Gould ◽  
Catherine Tong ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Health Care Providers ◽  
Service Use ◽  
Care Transitions ◽  
Ethnographic Study ◽  
System Level ◽  
Health Conditions ◽  
Care Providers ◽  
Framework Analysis

Abstract For older adults with complex health conditions, transitions between care settings are common and a major risk to quality of care and patient safety. Care transition interventions have shown positive impacts on continuity of care and health service use, however, most require additional human resources (e.g., transition coach), focus on one transition or “handoff”, and provide support for individual patients without addressing underlying challenges of health system integration. We sought to develop a framework for system-level enhancements to care transitions for older adults. We report a secondary framework analysis of an ethnographic investigation (the “InfoRehab” project) of care transitions for older persons who had experienced a hip fracture. The ethnographic study involved interviews, observations, and document reviews for 23 patients, 19 family caregivers, and 92 health care providers. Data were collected at each transition point (1-4/patient) along the care continuum, at three Canadian sites (large urban, mid-size urban, rural). Our framework analysis followed the approach described by Gale et al. (2013), using as cases 12 peer-reviewed papers which had reported InfoRehab results. Two researchers coded findings from each paper, then developed an analytical framework of eight themes by consensus; these include: patient involvement and choice, family caregiver involvement, patient complexity, health care provider coordination, information sharing, documentation, system constraints, and relationships. NVivo 11 was used to index findings into these themes and to generate a matrix. We are working with system stakeholders, including patients and caregivers, to apply this framework in the development of improved systems for care transitions.

User Fees for Health Care: Why a Bad Idea Keeps Coming Back (Or, What's Health Got to Do With It?)

1995 ◽  
Vol 14 (2) ◽  
pp. 360-390 ◽  
Author(s):  
Robert G. Evans ◽  
Morris L. Barer ◽  
Greg L. Stoddart
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care Costs ◽  
Health Care Providers ◽  
Final Analysis ◽  
User Fees ◽  
Care Providers ◽  
Positive Effects ◽  
The Face ◽  
Care Costs

ABSTRACTCalls for user fees in Canadian health care go back as far as the debate leading up to the establishment of Canada's national hospital insurance program in the late 1950s. Although the rationales have shifted around somewhat, some of the more consistent claims have been that user fees are necessary as a source of additional revenue for a badly underfunded system, that they are necessary to control runaway health care costs, and that they will deter unnecessary use (read abuse) of the system. But the real reasons that user fees have been such hardy survivors of the health policy wars, bear little relation to the claims commonly made for them. Their introduction in the financing of hospital or medical care in Canada would be to the benefit of a number of groups, and not just those one usually thinks of. We show that those who are healthy, and wealthy, would join health care providers (and possibly insurers) as net beneficiaries of a reintroduction of user fees for hospital and medical care in Canada. The flip side of this is that those who are indigent and ill will bear the brunt of the redistribution (for that is really what user fees are all about), and seniors feature prominently in those latter groups. Claims of other positive effects of user fees, such as reducing total health care costs, or improving appropriateness or accessibility, simply do not stand up in the face of the available evidence. In the final analysis, therefore, whether one is for or against user fees reduces to whether one is for or against the resulting income redistribution.

scholarly journals The magnitude and associated Factors of Postoperative Trichiasis among adults who underwent Trachomatous Trichiasis Surgery in Ambassel District, North-East Ethiopia

2020 ◽  
Author(s):  
Abdu Tabor Yimam ◽  
Gizachew Tadesse Wassie ◽  
Getu Degu Alene
Keyword(s):  
Health Care Providers ◽  
Associated Factors ◽  
Sampling Technique ◽  
Fiscal Year ◽  
High Recurrence Rate ◽  
Care Providers ◽  
Cross Sectional ◽  
North East ◽  
The Face ◽  
Trachomatous Trichiasis

Abstract Background In Trachoma endemic countries, many people who underwent Trichiasis surgery faced a recurrence of the disease. Postoperative Trichiasis is a significant problem for patients and health care providers because it puts the eye at renewed risk of sight loss. Despite the low utilization of Trachomatous Trichiasis (TT) surgery and high recurrence rate, evidences that elucidate why TT recurs after surgery are limited. This study was aimed to assess the magnitude and associated factors of postoperative Trichiasis among 18 years and above individuals who underwent Trachomatous Trichiasis surgery between 2006 and 2011 Ethiopian Fiscal year in Ambassel District, North-East Ethiopia, 2020. Methods The community-based cross-sectional study design was conducted from March 10 to March 23/2020 in selected kebeles of Ambassel District. The required sample size was calculated using EPI-INFO Version 7. A multi-stage sampling technique was used to employ a total of 506 individuals. Data were collected through the interviewer-administered structured pre-tested questionnaire and entered into EpiData version 3.1 and then exported to SPSS version 23.0. Bi-variable and multivariable logistic regression models were fitted to identify associated factors of Trachomatous Trichiasis recurrence. Results Four hundred ninety two individuals participated in this study with response rate of 97.2%. In Ambassel district the prevalence of postoperative Trichiasis was 23.8% (95%CI = 19.9–27.8). Among associated factors of postoperative Trichiasis age 50–59 AOR = 3.34 (CI = 1.38–8.1), 60–69 AOR = 3.24(CI = 1.38–7.61), ≥ 70 years AOR = 6.04 (CI = 2.23–16.41), duration since surgery AOR = 1.7(CI = 1.35–2.14), complication AOR = 2.98(CI = 1.24–7.2), washing the face two times AOR = 0.25(CI = 0.13–0.47), washing the face three and more times AOR = 0.1(CI = 0.41 − 0.25), taking Azithromycin following surgery AOR = 0.19(CI = 0.09–0.41), pre-operative epilation history AOR = 2.11, (CI = 1.14, 3.9)and having a knowledge about TrachomaTtrichiasis AOR = 0.21(CI = 0.08–0.58) showed a statistical significant association. Conclusions The prevalence of postoperative Trichiasis in Ambassel District was higher than most Ethiopian studies. Age, frequency of face washing, medication following surgery, duration since the last surgery, knowledge about trachoma, pre-operative epilation history and complication after surgery were identified to be independent factors. To minimize postoperative Trichiasis stakeholders need to consider health education for patients, provision of Azithromycin after surgery and proper training for IECWs.

The Use of Vacuum-Assisted Closure Therapy for the Treatment of a Large Infected Facial Wound

2006 ◽  
Vol 72 (2) ◽  
pp. 129-131 ◽  
Author(s):  
Rob Schuster ◽  
Arash Moradzadeh ◽  
Kenneth Waxman
Keyword(s):  
Health Care Providers ◽  
Granulation Tissue ◽  
Chronic Wounds ◽  
Care Providers ◽  
Vacuum Assisted Closure ◽  
Vac Therapy ◽  
First Case ◽  
Facial Wound ◽  
The Face ◽  
New Treatment

Chronic wounds in difficult locations pose constant challenges to health care providers. Negative-pressure wound therapy is a relatively new treatment to promote wound healing. Laboratory and clinical studies have shown that the vacuum-assisted closure (VAC) therapy increases wound blood flow, granulation tissue formation, and decreases accumulation of fluid and bacteria. VAC therapy has been shown to hasten wound closure and formation of granulation tissue in a variety of settings. Accepted indications for VAC therapy include the infected sternum, open abdomen, chronic, nonhealing extremity wounds and decubitus ulcers. We report the first case of VAC therapy successfully used on a large infected wound to the face to promote healing.

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