scholarly journals Preferences and Perceptions of Patients Attending Emergency Departments with Low Acuity Problems in Hong Kong

2009 ◽  
Vol 16 (3) ◽  
pp. 148-154 ◽  
Author(s):  
CA Graham ◽  
WO Kwok ◽  
YL Tsang ◽  
TH Rainer

Objective To explore why patients in Hong Kong seek medical advice from the emergency department (ED) and to identify the methods by which patients would prefer to be updated on the likely waiting time for medical consultation in the ED. Methods The study recruited 249 semi-urgent and non-urgent patients in the ED of Prince of Wales Hospital from 26th September 2005 to 30th September 2005 inclusive. A convenience sample of subjects aged ≥15 years old in triage categories 4 or 5 were verbally consented and interviewed by research nurses using a standardized questionnaire. Results From 1715 potential patients, 249 were recruited ad hoc (mean age 44 years [SD18]; 123 females). About 63% indicated that an acceptable ED waiting time was less than or equal to two hours, and 88% felt that having individual number cards and using a number allocation screen in the ED waiting area would be useful. Perceived reasons for attending the ED rather than other health care providers such as primary health care or the general outpatient clinic (GOPC) included: a desire for more detailed investigations (56%); a perception that more professional medical advice was given in the ED (35%); patients were under the continuing care of the hospital (19%); and patients were referred to the ED by other health care professionals (11%). Notably, 26% of participants had considered attending the GOPC prior to attending the ED. Patients educated to tertiary level expected a shorter waiting time than those educated to lesser degrees (p=0.026, Kruskal-Wallis test). Suggestions were made on how to provide a more pleasant ED environment for the wait for consultations, which included the provision of a television screen with sound in the waiting area (43%), more comfortable chairs (37%) and health care promotion programs (32%). Conclusion Patients chose ED services because they believed they would receive more detailed investigations and more professional medical advice than available alternatives. Clear notification of the likely waiting times and enhancement of comfort before consultation are considered desirable by patients. Enhanced public education about the role of the ED and making alternatives to ED care more accessible may be useful in reducing inappropriate ED attendances in Hong Kong.

2021 ◽  
Author(s):  
Timothy Ryan Smith ◽  
Russell McCulloh ◽  
Minh-Thuy Bui ◽  
Natalie Sollo ◽  
Carolyn R. Ahlers-Schmidt ◽  
...  

Abstract BackgroundClinical trials are the gold standard for assessing the effectiveness and safety of treatments. The objective of the current study was to assess provider opinions regarding implementing pediatric clinical trials in various practice settings across Kansas. MethodsThe study was completed within the Sunflower Pediatric Clinical Trials Research Extension (SPeCTRE), an affiliate of the IDeA States Pediatric Clinical Trials Network (ISPCTN). A cross-sectional, 36-item survey was administered to a state-wide convenience sample targeting health care providers and clinic staff. ResultsA total of 119 health care providers and clinic staff completed surveys; 31% were physicians. Physicians were more likely than other clinic staff to have experience with clinical trials (correlation coefficient [CC]=0.270, p=0.004). When compared to urban respondents, rural providers were less supportive of recruitment for clinical trials in their practices (CC=-0.251, p=0.008) and more likely to feel comfortable referring patients for clinical trials involving treatments that their insurance did not cover (CC=0.302, p=0.001).ConclusionA range of rural and urban health care professionals support the performance of pediatric clinical trials but identify several barriers as well. These results will support future pediatric clinical trials across the country including Kansas.TRIAL REGISTRATION: NA


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
David Ebbevi ◽  
Henna Hasson ◽  
Knut Lönnroth ◽  
Hanna Augustsson

Abstract Background Access to health care is an essential health policy issue. In several countries, waiting time guarantees mandate set time limits for assessment and treatment. High-quality waiting time data are necessary to evaluate and improve waiting times. This study’s aim was to investigate health care providers and administrative management professionals’ perceptions of validity and usefulness of waiting time reporting in specialist care. Methods Semi-structured interviews (n = 28) were conducted with administrative management and care professionals (line managers and care providers) in specialized clinics in the Stockholm Region, Sweden. Clinic-specific data from the waiting time registry was used in the care provider interviews to assess face validity. Clinics were purposefully sampled for maximum variation in complexity of care, volume of production, geographical location, private or public ownership, and local waiting times. Thematic analysis was used. Results The waiting time registry was perceived to have low validity and usefulness. Perceived validity and usefulness were interconnected, with mechanisms that reinforced the connection. Structural and cognitive barriers to validity included technical and procedural errors, errors caused by role division, misinterpretation of guidelines, diverging interpretations of nonregulated cases and extensive willful manipulation of data. Conclusions We identify four misconceptions underpinning the current waiting time reporting system: passive dissemination of guidelines is sufficient as implemented, cognitive load of care providers to report waiting times is negligible, soft-law regulation and presentation of outcome data is sufficient to drive improvement, and self-reported data linked to incentives poses a low risk of data corruption. To counter low validity and usefulness, we propose the following for policy makers and administrative management when developing and implementing waiting time monitoring: communicate guidelines with instructions for operationalization, address barriers to implementation, ensure quality through monitoring of implementation and adherence to guidelines, develop IT ontology together with professionals, avoid parallel measurement infrastructures, ensure waiting times are presented to suit management needs, provide timely waiting time data, enable the study of single cases, minimize manual data entry, and perform spot-checks or external validity checks. Several of these strategies should be transferable to waiting time monitoring in other contexts.


2021 ◽  
pp. 089443932110257
Author(s):  
Md Irfanuzzaman Khan ◽  
Jennifer (M.I.) Loh

With the advent of telecommunication technologies and social media, many health care professionals are using social media to communicate with their patients and to promote health. However, the literature reveals a lacuna in our understanding of health care professionals’ perception of their behavioral intentions to use innovations. Using the Unified Technology Acceptance Framework (unified theory of acceptance and use of technology), in-depth interviews were conducted with 16 Australian health care experts to uncover their intent and actual use of social media in their medical practices. Results revealed that social media tools offered five significant benefits such as (i) enhanced communication between health care professionals and their patients, (ii) community support, (iii) enabled e-learning, (iv) enhanced professional network, and (v) expedited health promotion. However, result also revealed barriers to social media usage including (i) inefficiency, (ii) privacy concerns, (iii) poor quality of information, (iv) lack of trust, and (v) blurred professional boundary. Peer influence and supporting conditions were also found to be determinants of social media adoption behaviors among health care professionals. This study has important implications for health care providers, patients, and policy makers on the responsible use of social media, health promotion, and health communication. This research is also among the very few studies that explore Australian health care professionals’ intent and actual use of innovations within a health care setting.


Author(s):  
Shimaa A. Elghazally ◽  
Atef F. Alkarn ◽  
Hussein Elkhayat ◽  
Ahmed K. Ibrahim ◽  
Mariam Roshdy Elkhayat

Background: burnout syndrome is a serious and growing problem among medical staff. Its adverse outcomes not only affect health-care providers’ health, but also extend to their patients, resulting in bad-quality care. The COVID-19 pandemic puts frontline health-care providers at greater risk of psychological stress and burnout syndrome. Objectives: this study aimed to identify the levels of burnout among health-care professionals currently working at Assiut University hospitals during the COVID-19 pandemic. Methods: the current study adopted an online cross-sectional design using the SurveyMonkey® website for data collection. A total of 201 physicians were included and the Maslach Burnout Inventory (MBI) scale was used to assess the three burnout syndrome dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. Results: about one-third, two-thirds, and one-quarter of the respondents had high emotional exhaustion, high depersonalization, and low personal accomplishment, respectively. Younger, resident, and single physicians reported higher burnout scores. The personal accomplishment score was significantly higher among males. Those working more than eight hours/day and dealing with COVID-19 patients had significantly higher scores. Conclusion: during the COVID-19 pandemic, a high prevalence of burnout was recorded among physicians. Age, job title, working duration, and working hours/day were significant predictors for burnout syndrome subscale results. Preventive and interventive programs should be applied in health-care organizations during pandemics.


2007 ◽  
Vol 13 (3) ◽  
pp. 29 ◽  
Author(s):  
Emily Mauldon

This paper reports on the attitudes of a sample of health care providers towards the use of telehealth to support rural patients and integrate rural primary health and urban hospital care. Telehealth and other information technologies hold the promise of improving the quality of care for people in rural and remote areas and for supporting rural primary health care providers. While seemingly beneficial for rural patients, study participants believed that telehealth remains underused and poorly integrated into their practice. In general, participants thought that telehealth is potentially beneficial but places constraints on their activities, and few actually used it. Published literature usually reports either on the success of telehealth pilot projects or initiatives that are well resourced and do not reflect the constraints of routine practice, or has an international focus limiting its relevance to the Australian context. Because of the paucity of systematic and generalisable research into the effects of the routine use of telehealth to support rural patients, it is unclear why health care professionals choose to provide such services or the costs and benefits they incur in doing so. Research and policy initiatives continue to be needed to identify the impact of telehealth within the context of Australian primary health care and to develop strategies to support its use.


2018 ◽  
Vol 12 (2) ◽  
pp. 5-10
Author(s):  
Chanda Karki Bhandari ◽  
Gehanath Baral

Aims: The aim of the review is to understand the concept of abuse in health care in general and its various forms. It includes- review what is meant by healthcare and health care abuse; identify its various forms and to recognize who may be the most potential victims; find out the reasons of abuse by health care providers; and know the role of  ethical guidelines and institutional policy in confronting abuse in health care.Methods: Literatures and publications on the subject were searched in order to identify research studies investigating abuse in health care that were studied, analyzed and presented.  Results: Abuse in health care today is an emerging concept in need of a clear analysis and definition. At the same time, boundaries to the related concepts are not demarcated. Medical professionals and institutions are being targeted worldwide today for negligence and the medical litigation has become a huge challenge. Throughout history, health care professionals have been trusted because of their competency and caring abilities. However, the disturbing reality is that physical and psychological maltreatment of patients do occur in the health care settings throughout the world. The abuse can vary from treating someone with disrespect in a way which significantly affects the person's quality of life, to causing actual physical suffering. Differently able and dependent people are more susceptible to such abuse. Work overload, Staff burnout, lack of information and instructions were also indicated to underlie instances of abuse in health care.Conclusions: We in the healthcare facility should first accept that abuse in health care does occur and causes distress. This change needs to occur at individual, cultural and structural level. Next step will be for the staffs to be aware of abuse in health care when it happens and recognize it as such. It is always better to create a situation where we could prevent abuse from happening at health centers. Hospital personnel must implement a change in workplace culture to stop abusive behaviors wherever they occur. Each and every health care facility should be client friendly and respecting their rights. Effective ethical guidelines were needed to minimize abuse as existing ethical codes were found to be ineffective and above all there was a lack of awareness of the contents of the relevant ethical documents.


2017 ◽  
Vol 22 (4) ◽  
pp. 851-855 ◽  
Author(s):  
Virginia S. Cowen ◽  
Robin Streit Miccio ◽  
Bijal Parikh

Massage offers cancer patients general quality of life benefits as well as alleviation of cancer-related symptoms/cancer-treatment–related symptoms including pain, anxiety, and fatigue. Little is known about whether massage is accessible to cancer patients who receive treatment in the outpatient setting and how massage is incorporated into the overall cancer treatment plan. Outpatient cancer centers (n = 78) in a single metropolitan area were included this mixed-methods project that included a systematic analysis of website information and a telephone survey. Massage was offered at only 40 centers (51.3% of total). A range of massage modalities were represented, with energy-based therapies (Reiki and Therapeutic Touch) most frequently provided. Although massage therapists are licensed health care providers in the states included in this analysis, massage was also provided by nurses, physical therapists, and other health care professionals.


2011 ◽  
Vol 16 (1) ◽  
Author(s):  
Norah L. Katende-Kyenda ◽  
Martie Lubbe ◽  
Juan H.P. Serfontein ◽  
Ilse Truter

Current antiretroviral treatment (ART) guidelines recommend different combinations that have led to major improvements in the management of HIV and AIDS in the developed and developing world. With the rapid approval of many agents, health care providers may not be able to familiarise themselves with them all. This lack of knowledge leads to increased risk of dose- prescribing errors, especially by non-HIV and AIDS specialists. The purpose of this retrospective non-experimental, quantitative drug utilisation study was to evaluate if antiretrovirals (ARVs) are prescribed according to the recommended prescribed daily doses (PDDs) in a section of the private health care sector in South Africa (SA). Analysed ARV prescriptions (49995, 81096 and 88988) for HIV and AIDS patients were claimed from a national medicine claims database for the period 1 January 2005 through to 31 December 2007. ARV prescriptions prescribed by general practitioners (GPs) with PDDs not according to the recommended ARV dosing increased dramatically, from 12.33% in 2005 to 24.26% in 2007. Those prescribed by specialists (SPs) increased from 15.46% in 2005 to 35.20% in 2006 and decreased to 33.16% in 2007. The highest percentage of ARV prescriptions with PDDs not according to recommended ARV dosing guidelines was identified in ARV regimens with lopinavir−ritonavir at a PDD of 1066.4/264 mg and efavirenz at a PDD of 600 mg prescribed to patients in the age group of Group 3 (19 years > age ≤ 45 years). These regimens were mostly prescribed by GPs rather than SPs. There is a need for more education for all health care professionals and/or providers in the private health care sector in SA on recommended ARV doses, to avoid treatment failures, development of resistance, drug-related adverse effects and drug interactions.OpsommingHuidige riglyne vir behandeling met antiretrovirale middels beveel verskillende kombinasies aan wat tot groot verbetering in die beheer van MIV en VIGS in die ontwikkelde en ontwikkelende wêreld gelei het. Met die vinnige goedkeuring van talle nuwe middels kan dit gebeur dat verskaffers van gesondheidsorg nie kan bybly om hulle hiermee op hoogte te hou nie. Hierdie gebrek aan kennis lei tot ‘n hoër risiko vir foute in die voorgeskrewe dosis en veral deur persone wat nie spesialiste in MIV en VIGS is nie. Die doel van hierdie nie-eksperimentele, retrospektiewe, kwantitatiewe studie van die gebruik van geneesmiddels was om te bepaal of antiretrovirale middels in ‘n deel van die privaat gesondheidsorgsektor in Suid-Afrika (SA) volgens die aanbevole voorgeskrewe daaglikse dosisse (VDD) voorgeskryf word. Voorskrifte van antiretrovirale middels (49995, 81096 en 88988) aan pasiënte met MIV en VIGS wat in die periode van 1 Januarie 2005 tot 31 Desember 2007 van ‘n nasionale medisyne databasis geëis is, is ontleed. Voorskrifte van antiretrovirale middels deur algemene praktisyns (APs) met VDDs wat nie volgens die aanbevole dosisse vir antiretrovirale middels was nie, het dramaties van 12.33% in 2005 tot 24.26% in 2007 toegeneem. Die wat deur spesialiste (SPs) voorgeskryf is, het van 15.46% in 2005 tot 35.20% in 2006 toegeneem en in 2007 tot 33.16% gedaal. Die hoogste persentasie van voorskrifte vir antiretrovirale middels met VDDs wat nie volgens die riglyne was nie, was in die regimens met lopinavir−ritonavir met ‘n VDD van 1066.4/264 mg en efavirens met ‘n VDD van 600 mg wat aan pasiënte in die ouderdomsgroep van ouer as 19 tot en met 45 jaar voorgeskryf is. Hierdie regimens is meer deur APs as deur SPs voorgeskryf. Daar is ‘n behoefte aan nog opleiding van alle gesondheidsprofessies en/of voersieners in die privaat gesondheidsorgsektor in SA oor die aanbevole antiretrovirale middel-dosisse om mislukking van behandeling, ontwikkeling van weerstand, nadelige effekte vanweë geneesmiddels en geneesmiddel interaksies te voorkom.


Medicina ◽  
2007 ◽  
Vol 43 (6) ◽  
pp. 441 ◽  
Author(s):  
Donatas Stakišaitis ◽  
Indrė Špokienė ◽  
Jonas Juškevičius ◽  
Konstantinas Valuckas ◽  
Paola Baiardi

Currently in Europe, approximately 30 million people suffer from rare diseases, and a major problem is that many patients do not have access to quality healthcare for their disorders. Moreover, there is also a lack of quality information and a networking system aimed at supporting interaction among patients, clinicians, researchers, pharmaceutical industries, and governmental bodies. The purpose of this article is to inform physicians, public health care professionals, and other health care providers about EuOrphan service, the aim of which is to ensure easier access to quality information on rare diseases and their treatment. A set of web-based services is available at www.euorphan.com where information for target-users on treatments and products available worldwide for rare disease care as well as indications about healthcare centers are provided. Moreover, the service aims at providing consultancies for pharmaceutical companies to ultimately support the European legislation in bringing new drugs of a high ethical standard to the market and to exert a positive impact on the large population of patients suffering from rare diseases in Europe. The services provided by EuOrphan can facilitate concrete networking among patients, patient associations, doctors, and companies and also support the organization of clinical trials. In this perspective, EuOrphan could become a very valuable tool for globalizing the information about the availability of treatment (authorized or under development) of orphan patients.


2018 ◽  
Author(s):  
Yasmine L Konheim-Kalkstein ◽  
Talya Miron-Shatz ◽  
Leah Jenny Israel

BACKGROUND Birth stories provide an intimate glimpse into women’s birth experiences in their own words. Understanding the emotions elicited in women by certain types of behaviors during labor and delivery could help those in the health care community provide better emotional care for women in labor. OBJECTIVE The aim of this study was to understand which supportive reactions and behaviors contributed to negative or positive emotions among women with regard to their labor and delivery experience. METHODS We sampled 10 women’s stories from a popular blog that described births that strayed from the plan. Overall, 90 challenging events that occurred during labor and delivery were identified. Each challenge had an emotionally positive, negative, or neutral evaluation by the woman. We classified supportive and unsupportive behaviors in response to these challenges and examined their association with the woman’s emotional appraisal of the challenges. RESULTS Overall, 4 types of behaviors were identified: informational inclusion, decisional inclusion (mostly by health care providers), practical support, and emotional support (mostly by partners). Supportive reactions were not associated with emotional appraisal; however, unsupportive reactions were associated with women appraising the challenge negatively (Fisher exact test, P=.02). CONCLUSIONS Although supportive behaviors did not elicit any particular emotion, unsupportive behaviors did cause women to view challenges negatively. It is worthwhile conducting a larger scale investigation to observe what happens when patients express their needs, particularly when challenges present themselves during labor, and health care professionals strive to cater to them.


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