scholarly journals Patient, Caregiver, and Provider Perspectives on Challenges and Solutions to Individualization of Care in Hemodialysis: A Qualitative Study

2020 ◽  
Vol 7 ◽  
pp. 205435812097071
Author(s):  
Rachelle Sass ◽  
Juli Finlay ◽  
Krista Rossum ◽  
Kaytlynn V. Soroka ◽  
Michael McCormick ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Focus Groups ◽  
Health Care Providers ◽  
Self Care ◽  
Well Being ◽  
Treatment Goals ◽  
Care Providers ◽  
Provider Perspectives ◽  
Set Up

Background: Clinical settings often make it challenging for patients with kidney failure to receive individualized hemodialysis (HD) care. Individualization refers to care that reflects an individual’s specific circumstances, values, and preferences. Objective: This study aimed to describe patient, caregiver, and health care professional perspectives regarding challenges and solutions to individualization of care in people receiving in-center HD. Design: In this multicentre qualitative study, we conducted focus groups with individuals receiving in-center HD and their caregivers and semi-structured interviews with health care providers from May 2017 to August 2018. Setting: Hemodialysis programs in 5 cities: Calgary, Edmonton, Winnipeg, Ottawa, and Halifax. Participants: Individuals receiving in-center HD for more than 6 months, aged 18 years or older, and able to communicate in English were eligible to participate, as well as their caregivers. Health care providers with HD experience were recruited using a purposive approach and snowball sampling. Methods: Two sequential methods of qualitative data collection were undertaken: (1) focus groups and interviews with HD patients and caregivers, which informed (2) individual interviews with health care providers. A qualitative descriptive methodology guided focus groups and interviews. Data from all focus groups and interviews were analyzed using conventional content analysis. Results: Among 82 patients/caregivers and 31 health care providers, we identified 4 main themes: session set-up, transportation and parking, socioeconomic and emotional well-being, and HD treatment location and scheduling. Particular challenges faced were as follows: (1) session set-up: lack of preferred supplies, machine and HD access set-up, call buttons, bed/chair discomfort, needling options, privacy in the unit, and self-care; (2) transportation and parking: lack of reliable/punctual service, and high costs; (3) socioeconomic and emotional well-being: employment aid, finances, nutrition, lack of support programs, and individualization of treatment goals; and (4) HD treatment location and scheduling: patient displacement from their usual spot, short notice of changes to dialysis time and location, lack of flexibility, and shortages of HD spots. Limitations: Uncertain applicability to non-English speaking individuals, those receiving HD outside large urban centers, and those residing outside of Canada. Conclusions: Participants identified challenges to individualization of in-center HD care, primarily regarding patient comfort and safety during HD sessions, affordable and reliable transportation to and from HD sessions, increased financial burden as a result of changes in functional and employment status with HD, individualization of treatment goals, and flexibility in treatment schedule and self-care. These findings will inform future studies aimed at improving patient-centered HD care.

scholarly journals Patient, Caregiver, and Provider Perspectives on Improving Information Delivery in Hemodialysis: A Qualitative Study

2021 ◽  
Vol 8 ◽  
pp. 205435812110460
Author(s):  
Priscila Ferreira da Silva ◽  
Melanie D. Talson ◽  
Juli Finlay ◽  
Krista Rossum ◽  
Kaytlynn V. Soroka ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Focus Groups ◽  
Peer Support ◽  
Health Care Providers ◽  
Information Transfer ◽  
Information Delivery ◽  
Technological Innovations ◽  
Care Providers ◽  
Provider Perspectives

Background: Patients with kidney failure are exposed to a surfeit of new information about their disease and treatment, often resulting in ineffective communication between patients and providers. Improving the amount, timing, and individualization of information received has been identified as a priority in in-center hemodialysis care. Objective: To describe and explicate patient, caregiver, and health care provider perspectives regarding challenges and solutions to information transfer in clinical hemodialysis care. Design: In this multicenter qualitative study, we gathered perspectives of patients, their caregivers, and health care providers conducted through focus groups and interviews. Setting: Five Canadian hemodialysis centers: Calgary, Edmonton, Winnipeg, Ottawa, and Halifax. Participants: English-speaking adults receiving in-center hemodialysis for longer than 6 months, their caregivers, and hemodialysis health care providers. Methods: Between May 24, 2017, and August 16, 2018, data collected through focus groups and interviews with hemodialysis patients and their caregivers subsequently informed semi-structured interviews with health care providers. For this secondary analysis, data were analyzed through an inductive thematic analysis using grounded theory, to examine the data more deeply for overarching themes. Results: Among 82 patients/caregivers and 31 healthcare providers, 6 main themes emerged. Themes identified from patients/caregivers were (1) overwhelmed at initiation of hemodialysis care, (2) need for peer support, and (3) improving comprehension of hemodialysis processes. Themes identified from providers were (1) time constraints with patients, (2) relevance of information provided, and (3) technological innovations to improve patient engagement. Limitations: Findings were limited to Canadian context, English speakers, and individuals receiving hemodialysis in urban centers. Conclusions: Participants identified challenges and potential solutions to improve the amount, timing, and individualization of information provided regarding in-center hemodialysis care, which included peer support, technological innovations, and improved knowledge translation activities. Findings may inform the development of interventions and strategies aimed at improving information delivery to facilitate patient-centered hemodialysis care.

scholarly journals “You Get Three Different Hats on and Try to Figure It Out:” Home-based Care Provision During a Disaster

2021 ◽  
Author(s):  
Sue Anne Bell ◽  
Sarah Dickey ◽  
Marie-Anne Rosemberg
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Focus Groups ◽  
Health Care Providers ◽  
Well Being ◽  
Home Health ◽  
Qualitative Inquiry ◽  
Care Providers ◽  
Home Based ◽  
Home Based Care

Abstract Background: Home-based care is a vital, and growing, part of the health care system that allows individuals to remain in their homes while still receiving health care. During a disaster, when normal health care systems are disrupted, home-based care remains a vital source of support for older adults. The purpose of this study was to describe the experiences of home-based care providers in providing care to older adults during a disaster in order to inform future disaster planning.Methods: Using qualitative inquiry informed by the social ecological model, five focus groups were conducted with home health nurses (n=25) in two settings affected by Hurricane Irma and Hurricane Harvey. An open-source database of home health agencies participating in Centers for Medicare and Medicaid Services programs was used to identify participants. Data were manually coded and larger themes were generated from recurring ideas and concepts using an abductive analysis approach. Results: Twenty five participants were included in one of five focus groups. Of the 22 who responded to the demographic survey, 65% were registered nurses, 20% were Licensed Vocational Nurses (LVN), and 15% were other types of health care providers. 12% of the sample was male and 88% was female. Seven themes were identified in the analysis: the importance of the community in preparedness and response, government and corporations were viewed as unreliable, disasters exacerbate inequalities, the role of the family bond, the breakdown of preparedness is at implementation, the tension between caring for self and family and caring for patients, and the resilience and adaptability of home based care providers.Conclusions: While home-based care providers faced multiple challenges to providing care during and after a disaster, the importance of community supports and existing nursing models of care in the immediate period after the disaster were emphasized. This study informs the growing body of evidence on the value of home-based care in promoting safety and well-being for older adults during a disaster.

scholarly journals Health care providers’ weight management practices for adolescent obesity and alignment with clinical practice guidelines: a multi-centre, qualitative study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
M. Kebbe ◽  
A. Perez ◽  
A. Buchholz ◽  
S. D. Scott ◽  
T.-L. F. McHugh ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Qualitative Study ◽  
Focus Groups ◽  
Weight Management ◽  
Health Care Providers ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Pediatric Obesity ◽  
Care Providers

Abstract Background Clinical practice guidelines (CPGs) include evidence-based recommendations for managing obesity in adolescents. However, information on how health care providers (HCPs) implement these recommendations in day-to-day practice is limited. Our objectives were to explore how HCPs deliver weight management health services to adolescents with obesity and describe the extent to which their reported practices align with recent CPGs for managing pediatric obesity. Methods From July 2017 to January 2018, we conducted a qualitative study that used purposeful sampling to recruit HCPs with experience in adolescent weight management from multidisciplinary, pediatric weight management clinics in Edmonton and Ottawa, Canada. Data were collected using audio-recorded focus groups (4–6 participants/group; 60–90 min in length). We applied inductive, semantic thematic analysis and the congruent methodological approach to analyze our data, which included transcripts, field notes, and memos. Qualitative data were compared to recent CPGs for pediatric obesity that were published by the Endocrine Society in 2017. Of the 12 obesity ‘treatment-related’ recommendations, four were directly relevant to the current study. Results Data were collected through three focus groups with 16 HCPs (n = 10 Edmonton; n = 6 Ottawa; 94% female; 100% Caucasian), including dietitians, exercise specialists, nurses, pediatricians, psychologists, and social workers. We identified three main themes that we later compared with CPG recommendations, including: (i) discuss realistic expectations regarding weight management (e.g., shift focus from weight to health; explore family cohesiveness; foster delayed vs instant gratification), (ii) personalize weight management (e.g., address personal barriers to change; consider developmental readiness), and (iii) exhibit non-biased attitudes and practices (e.g., de-emphasize individual causes of obesity; avoid making assumptions about lifestyle behaviors based on weight). Based on these qualitative findings, HCPs applied all four CPG recommendations in their practices. Conclusions HCPs provided practical insights into what and how they delivered weight management for adolescents, which included operationalizing relevant CPG recommendations in their practices.

scholarly journals Psychological impact of COVID-19 pandemic on nurses: A qualitative study

2021 ◽  
pp. 48-55
Author(s):  
Farzana Danial ◽  
Irfan Ullah Khattak
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Qualitative Study ◽  
Social Isolation ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Tertiary Care ◽  
Psychological Impact ◽  
Self Care ◽  
Care Providers

Coronavirus disease is a serious infectious disease that spread very rapidly. Coronavirus not only impacts the general population but also a thread for health care providers. Besides, it psychologically impacts health care professionals especially nurses. Objectives. To explore the psychological impact of the COVID-19 pandemic on nurses working in corona isolation units. Methodology. A qualitative study was conducted using a phenomenological study design. Overall, data were collected from 15 nurses working in tertiary care hospitals of district Nowshera. The study was carried from 1st April 2020 to 20th May 2020. Permission was granted from the District Health Officer of District Nowshera. Keeping the spread of the coronavirus in view, data was collected through semi-structured in-depth telephonic interviews. Electronic consent was also granted from all the concerned participants before data collection. Data were analyzed using Colaizzi’s 7-step method. Results. A total of three themes were generated from the data; Stress, social isolation, and Coping and Self-Care Styles. Nurses working in COVID-19 units experience stress due to constant duty change, fatigue, change in duty placement, and work overload. Also, they experience social isolation due to the fear of getting infected and the disease transmission to their family and other population. Coping and self-care styles such as exercise, physical activity, facing the reality and religious beliefs are important for the nurses to maintain their mental health. Conclusions. The outbreak of COVID-19 psychologically impacts the nurses. Besides, the nurses experience stress and social isolation. The nurses also need coping and self-care styles to maintain their mental health. The role of the health department is very important to highlight this issue and provide proper assistance to the nurses.

Self-care advice for health-care providers during COVID-19

2020 ◽  
Author(s):  
Helen L. Coons ◽  
Steven Berkowitz ◽  
Rachel Davis
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Self Care ◽  
Care Providers

Covid-19 and its financial effects on the dental fraternity and health-care workers: A literature review

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 628-631
Author(s):  
Devangi Agrawal ◽  
Namisha Khara ◽  
Bhushan Mundada ◽  
Nitin Bhola ◽  
Rajiv Borle
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Workers ◽  
Care Providers ◽  
Dental Procedures ◽  
Care Workers ◽  
Dental Practices ◽  
Precautionary Measures ◽  
The Government ◽  
Set Up

In the wake of the current outbreak of novel Covid-19, which is now declared as a 'pandemic' by the WHO, people around the globe have been dealing with a lot of difficulties. This virus had come into light in December 2019 and since then has only grown exponentially. Amongst the most affected are the ones who have been working extremely hard to eradicate it, which includes the hospitals, dental fraternity and the health-care workers. These people are financially burdened due to limited practise. In the case of dentistry, to avoid the spread of the virus, only emergency treatments are being approved, and the rest of the standard procedures have been put on hold. In some cases, as the number of covid cases is rising, many countries are even trying to eliminate the emergency dental procedures to divert the finances towards the treatment of covid suffering patients. What we need to realise is that this is probably not the last time that we are facing such a situation. Instead of going down, we should set up guidelines with appropriate precautionary measures together with the use of standardised PPEs. The government should also establish specific policies to support dental practices and other health-care providers. Together, we can fight this pandemic and come out stronger.

scholarly journals Depression and Suicidality in Gay Men: Implications for Health Care Providers

2017 ◽  
Vol 11 (4) ◽  
pp. 910-919 ◽  
Author(s):  
Carrie Lee ◽  
John L. Oliffe ◽  
Mary T. Kelly ◽  
Olivier Ferlatte
Keyword(s):  
Health Care ◽  
Gay Men ◽  
Health Care Providers ◽  
Help Seeking ◽  
Adult Population ◽  
Well Being ◽  
Sexual Practices ◽  
Care Providers ◽  
Physical And Mental Health ◽  
Prevalence Of Depression

Gay men are a subgroup vulnerable to depression and suicidality. The prevalence of depression among gay men is three times higher than the general adult population. Because depression is a known risk factor for suicide, gay men are also at high risk for suicidality. Despite the high prevalence of depression and suicidality, health researchers and health care providers have tended to focus on sexual health issues, most often human immunodeficiency virus in gay men. Related to this, gay men’s health has often been defined by sexual practices, and poorly understood are the intersections of gay men’s physical and mental health with social determinants of health including ethnicity, locale, education level, and socioeconomic status. In the current article summated is literature addressing risk factors for depression and suicidality among gay men including family acceptance of their sexual identities, social cohesion and belonging, internalized stigma, and victimization. Barriers to gay men’s help seeking are also discussed in detailing how health care providers might advance the well-being of this underserved subgroup by effectively addressing depression and suicidality.

Creating Comics to Address Well-Being and Resilience During the COVID-19 Pandemic

2021 ◽  
pp. 152483992110654
Author(s):  
Kathryn West ◽  
Karen R. Jackson ◽  
Tobias L. Spears ◽  
Brian Callender
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Case Series ◽  
Narrative Medicine ◽  
Well Being ◽  
Small Scale ◽  
Care Providers ◽  
Graphic Medicine ◽  
Racial Injustice ◽  
Pilot Implementation

In this descriptive case series, we detail the theoretical basis, methodology, and impact of a small-scale pilot implementation of graphic medicine workshops as an innovative approach to well-being and resilience in the age of COVID-19 and increasing awareness of racial injustice. The data provided in this article are anecdotal and based on participation in the workshops. Images created during the workshops are also shared as examples of the types of reflection that graphic medicine can enable. The workshops themselves were designed collaboratively and are based on the theoretical principles of graphic medicine, narrative medicine, and racial and social justice. They were conducted as part of a larger wellness initiative and were offered to health care-focused faculty at our academic medical institution. Our findings suggest that this was a beneficial activity which helped participants to reflect and reconsider their experiences with the COVID-19 pandemic and surging awareness of racial injustice. Reflections also showed that drawings were correlated with ProQOL scores and may, in larger numbers, also help to mitigate or bring attention to issues of burnout in frontline providers. Drawings shared show the tremendous impact of COVID-19 and the simultaneous chaos and emptiness of practicing during dual pandemics. Our workshops engaged about 20 frontline health care providers and other health care faculty and highlight the utility of graphic medicine as a tool for building resilience and encouraging self-reflection. Further study is necessary, as is more rigorous analysis of the relationship between the graphics created and the ability to recognize and mitigate burnout.

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