scholarly journals Keeping one step ahead: A qualitative study among Norwegian health-care providers in hospitals involved in care coordination for patients with complex needs

2018 ◽  
Vol 21 (1-2) ◽  
pp. 15-25 ◽  
Author(s):  
Audhild Høyem ◽  
Deede Gammon ◽  
Gro Berntsen ◽  
Aslak Steinsbekk
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Care Coordination ◽  
Care Pathway ◽  
Clinical Pathways ◽  
Care Providers ◽  
Complex Needs ◽  
One Step

Introduction Various efforts aim to enhance continuity of care for patients with long-term health-care needs. Since 2012, Norwegian hospitals are mandated to appoint individual care coordinators for patients with complex needs to ensure continuity in the care pathway. New roles must meld with current practice. Implementation has been slow. This study investigates current care coordination across hospital contexts, from the perspective of health-care providers, a scarcely researched area. Methods A qualitative study using semi-structured individual, duo, and group interviews with 16 purposefully selected Norwegian health-care providers from different hospitals, departments, professions and with various roles. A thematic cross-case analysis using systematic text condensation was performed. Results Common for the interviewees’ care coordination experiences was to “keep one step ahead.” The scope of their coordination activities varied from diagnostics and treatment to orchestrating long-term, cross-sectional multidisciplinary care. This work was often performed without designated resources. The interviewees applied experience, knowledge, and sensitivity when defining the patients’ needs and searching for resources to orchestrate coordination work. They strived to balance the needs of patients with the resources available and adjusted the continuity ambitions on behalf of their patients to what they considered doable in the relevant contexts. However, many told of negotiating special solutions for selected patients with particularly complex needs. Discussion Care coordination for patients with complex needs emerged as diverse and context-sensitive. Acknowledgement of coordination activities that go beyond established workflow routines and clinical pathways, together with flexible leadership support and accessible infrastructural resources are needed.

scholarly journals Perspectives and experiences of compassion in long-term care facilities within Canada: a qualitative study of patients, family members and health care providers

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Lorraine Smith-MacDonald ◽  
Lorraine Venturato ◽  
Paulette Hunter ◽  
Sharon Kaasalainen ◽  
Tamara Sussman ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Long Term Care ◽  
Family Members ◽  
Care Providers ◽  
Term Care ◽  
Care Facilities

Patient Flow or the Patient’s Journey? Exploring Health Care Providers’ Experiences and Understandings of Implementing a Care Pathway to Improve the Quality of Transitional Care for Older People

2021 ◽  
pp. 104973232110038
Author(s):  
Cecilie Fromholt Olsen ◽  
Astrid Bergland ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Anne Gudrun Langaas
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Care Providers ◽  
Transitional Care ◽  
Care Pathway ◽  
Patient Flow ◽  
Care Pathways ◽  
Care Providers ◽  
Patient Centered ◽  
Care For Older People

Internationally, the implementation of care pathways is a common strategy for making transitional care for older people more effective and patient-centered. Previous research highlights inherent tensions in care pathways, particularly in relation to their patient-centered aspects, which may cause dilemmas for health care providers. Health care providers’ understandings and experiences of this, however, remain unclear. Our aim was to explore health care providers’ experiences and understandings of implementing a care pathway to improve transitional care for older people. We conducted semistructured interviews with 20 health care providers and three key persons, along with participant observations of 22 meetings, in a Norwegian quality improvement collaborative. Through a thematic analysis, we identified an understanding of the care pathway as both patient flow and the patient’s journey and a dilemma between the two, and we discuss how the negotiation of conflicting institutional logics is a central part of care pathway implementation.

Depression: A Long-Term Illness

1994 ◽  
Vol 165 (S26) ◽  
pp. 9-15 ◽  
Author(s):  
Martin B. Keller
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Maintenance Treatment ◽  
Depressive Disorders ◽  
Care Providers ◽  
Serious Illness ◽  
Antidepressant Treatments ◽  
Continued Education ◽  
Low Levels

The realisation that major depression is often both chronic and recurrent has slowly begun to change the way that depression is diagnosed and treated. In particular, the need for continuation and maintenance treatment is an issue that now deserves increased attention, especially with the availability of new classes of antidepressant treatments, which have excellent efficacy and more favourable side-effect profiles. Although the serious consequences of depressive disorders clearly indicate the need for effective and prompt intervention on the part of clinicians, the results of several studies indicate that patients with depression consistently receive no or low levels of antidepressant therapy. It is hoped that, through continued education of health care providers and patients about the consequences of depression, the issue of undertreatment of this serious illness will be resolved.

scholarly journals “Take the treatment and be brave”: Care experiences of pregnant women with rifampicin-resistant tuberculosis

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242604
Author(s):  
Marian Loveday ◽  
Sindisiwe Hlangu ◽  
Jennifer Furin
Keyword(s):  
Health Care ◽  
Pregnant Women ◽  
Health Care System ◽  
Health Care Providers ◽  
Physical Symptoms ◽  
Coding System ◽  
Care Providers ◽  
Convenience Sample ◽  
Care System

Background There are few data on the on the care experiences of pregnant women with rifampicin-resistant TB. Objective To describe the treatment journeys of pregnant women with RR-TB—including how their care experiences shape their identities—and identify areas in which tailored interventions are needed. Methods In this qualitative study in-depth interviews were conducted among a convenience sample from a population of pregnant women receiving treatment for RR-TB. This paper follows COREQ guidelines. A thematic network analysis using an inductive approach was performed to analyze the interview transcripts and notes. The analysis was iterative and a coding system developed which focused on the care experiences of the women and how these experiences affected their perceptions of themselves, their children, and the health care system in which treatment was received. Results Seventeen women were interviewed. The women described multiple challenges in their treatment journeys which required them to demonstrate sustained resilience (i.e. to “be brave”). Care experiences required them to negotiate seemingly contradictory identities as both new mothers—“givers of life”—and RR-TB patients facing a complicated and potentially deadly disease. In terms of their “pregnancy identity” and “RR-TB patient identity” that emerged as part of their care experiences, four key themes were identified that appeared to have elements that were contradictory to one another (contradictory areas). These included: 1) the experience of physical symptoms or changes; 2) the experience of the “mothering” and “patient” roles; 3) the experience of the care they received for their pregnancy and their RR-TB; and 4) the experience of community engagement. There were also three areas that overlapped with both roles and during which identity was negotiated/reinforced and they included: 1) faith; 2) socioeconomic issues; and 3) long-term concerns over the child’s health. At times, the health care system exacerbated these challenges as the women were not given the support they needed by health care providers who were ill-informed or angry and treated the women in a discriminatory fashion. Left to negotiate this confusing time period, the women turned to faith, their own mothers, and the fathers of their unborn children. Conclusion The care experiences of the women who participated in this study highlight several gaps in the current health care system that must be better addressed in both TB and perinatal services in order to improve the therapeutic journeys for pregnant women with RR-TB and their children. Suggestions for optimizing care include the provision of integrated services, including specialized counseling as well as training for health care providers; engagement of peer support networks; provision of socioeconomic support; long-term medical care/follow-up for children born to women who were treated for RR-TB; and inclusion of faith-based services in the provision of care.

scholarly journals Health care providers and HIV

2021 ◽  
Author(s):  
Anne C. Wagner
Keyword(s):  
Health Care ◽  
Factor Analysis ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Hiv Stigma ◽  
People Living With Hiv ◽  
Care Providers ◽  
Related Stigma ◽  
Convergent And Divergent Validity ◽  
Living With Hiv

The current investigation seeks to examine the attitudes and beliefs of health care providers in Canada about people living with HIV. The line of research consists of three studies. Study 1 was a qualitative study conducted with a critical lens. The critical lens was used in a series of four focus groups when qualitatively soliciting opinions about the range of attitudes, behaviours and cognitions health care providers may have towards people living with HIV. Study 2 used the information gathered from Study 1 to develop a scale to assess HIV stigma in health care providers. Items were created from examples and themes found in the qualitative study, and were tested via exploratory factor analysis, confirmatory factor analysis, test-retest reliability analysis, and assessed for convergent and divergent validity. Study 3 examined the newly developed scale’s relationship to proposed overlapping stigmas and attitudes, and tested the adapted intersectional model of HIV-related stigma with health care trainees using the newly developed HIV stigma scale as an outcome measure. The line of research found that HIV stigma continues to be a significant problem in the health care system. The scale developed in Study 2 demonstrates that HIV stigma can be conceptualized and assessed as a tripartite model of discrimination, stereotyping and prejudice, and that this conceptualization of HIV stigma supports an intersectional model of overlapping stigmas with homophobia, racism, stigma against injection drug use and stigma against sex work.

scholarly journals FRONTLINE HEALTH PROVIDER'S PERSPECTIVE IN REDUCING CHILD DEATHS DUE TO MALNUTRITION IN A TRIBAL DISTRICT OF MAHARASHTRA: A QUALITATIVE STUDY

2021 ◽  
pp. 246-249
Author(s):  
Lalit Sankhe ◽  
Chhaya Rajguru ◽  
Monali Kadam
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Service Providers ◽  
Health Workers ◽  
Health Care Service ◽  
Care Providers ◽  
Child Deaths ◽  
Primary Health ◽  
Refresher Training

Background: Malnutrition is a complex problem with double burden of undernutrition and overweight. India is no exception to it but there is a higher level of malnutrition in tribal blocks and to curb this situation,various activities have been undertaken but the slow pace of decline in malnutrition is a concern.The role of frontline health workers is crucial in strengthening primary health care.They serve as the bridge between the formal government health-care system and the community.The present study helps to seek the perception of primary health care service providers and challenges faced by them in reducing child deaths due to malnutrition. Method: A descriptive cross sectional qualitative study was conducted during August 2019 - February 2020 in three talukas of a tribal district. Focus group discussions (FGD) for each service providers Auxiliary Nurse midwife (ANM), Anganwadi worker (AWW) and Accredited Social Health activist (ASHA) were conducted. All the FGDs were audio recorded and transcripts were prepared,a thematic analysis framework was used for doing the analysis. Results: Most of the service providers were aware regarding their roles and responsibilities in implementation of schemes/ services related to malnutrition. The important factors influencing their performance were superstitions, more reliance on health seeking from unqualified health care providers and faith healers, poor road connectivity, network issues,lack of refresher training,overburdening with work,poor incentives. Conclusion: Specific training programs to tackle malnutrition along with frequent refresher training of the service providers,better infrastructure and human resources will help in achieving the desired results in future in dealing with child malnutrition.

scholarly journals Understanding How to Support Family Caregivers of Seniors with Complex Needs

2017 ◽  
Vol 20 (2) ◽  
pp. 75-84 ◽  
Author(s):  
Lesley Charles ◽  
Suzette Brémault-Phillips ◽  
Jasneet Parmar ◽  
Melissa Johnson ◽  
Lori-Ann Sacrey
Keyword(s):  
Health Care ◽  
Family Caregivers ◽  
Health Care Providers ◽  
Research Priorities ◽  
Care Providers ◽  
Community Based ◽  
Caregiver Support ◽  
Complex Needs ◽  
Participant Engagement

Purpose of the StudyThe purpose of this study was to describe the experiences and challenges of supporting family caregivers of seniors with complex needs and to outline support strategies and research priorities aimed at supporting them.Design and MethodsA CIHR-funded, two-day conference entitled “Supporting Family Caregivers of Seniors: Improving Care and Caregiver Outcomes” was held. An integrated knowledge translation approach guided this planning conference. Day 1 included presentations of research evidence, followed by participant engagement Qualitative data was collected regarding facilitators, barriers/gaps, and recommendations for the provisionof caregiver supports. Day 2 focused on determination of research priorities.ResultsIdentified facilitators to the provision of caregiver support included accessibility of health-care and community-based resources, availability of well-intended health-care providers, and recognition of caregivers by the system. Barriers/gaps related to challenges with communication, access to information, knowledge of what is needed, system navigation, access to financial resources, and current policies. Recommendations regarding caregiver services and research revolved around assisting caregivers to self-identify and seek support, formalizing caregiver supports, centralizing resources, making system navigation available, and preparing the next generation for caregiving.Implication A better understanding of the needs of family caregivers and ways to support them is critical to seniors’ health services redesign.

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