scholarly journals Admission Decision-Making in Hospital Emergency Departments: The Role of the Accompanying Person

2020 ◽  
Vol 7 ◽  
pp. 233339362093002
Author(s):  
Susanna Rance ◽  
Debra Westlake ◽  
Heather Brant ◽  
Ingrid Holme ◽  
Ruth Endacott ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Emergency Departments ◽  
Participant Observation ◽  
Structured Interviews ◽  
Discharge Care ◽  
Conversational Skills ◽  
Hospital Emergency Departments

In resource-stretched emergency departments, people accompanying patients play key roles in patients’ care. This article presents analysis of the ways health professionals and accompanying persons talked about admission decisions and caring roles. The authors used an ethnographic case study design involving participant observation and semi-structured interviews with 13 patients, 17 accompanying persons and 26 health care professionals in four National Health Service hospitals in south-west England. Focused analysis of interactional data revealed that professionals’ standardization of the patient–carer relationship contrasted with accompanying persons’ varied connections with patients. Accompanying persons could directly or obliquely express willingness, ambivalence and resistance to supporting patients’ care. The drive to avoid admissions can lead health professionals to deploy conversational skills to enlist accompanying persons for discharge care without exploring the meanings of their particular relationship with the patients. Taking a relationship-centered approach could improve the attention to accompanying persons as co-producers of health care and participants in decision-making.

scholarly journals I don't leave my people; They need me: Qualitative research of local health care professionals' working motivations in Syria

2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Agneta Kallström ◽  
Orwa Al-Abdulla ◽  
Jan Parkki ◽  
Mikko Häkkinen ◽  
Hannu Juusola ◽  
...  
Keyword(s):  
Health Care ◽  
World War Ii ◽  
Health Care Workers ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Local Health ◽  
Structured Interviews ◽  
Care Workers ◽  
Local Health Care ◽  
Threatening Condition

Abstract Background The Syrian conflict has endured for a decade, causing one of the most significant humanitarian crises since World War II. The conflict has inflicted massive damage to civil infrastructure, and not even the health care sector has been spared. On the contrary, health care has been targeted, and as a result, many health professionals have left the country. Despite the life-threatening condition, many health professionals continued to work inside Syria even in the middle of the acute crisis. This qualitative study aims to determine the factors that have motivated Syrian health professionals to work in a conflict-affected country. Methods The research is based on 20 semi-structured interviews of Syrian health care workers. Interviews were conducted in 2016–2017 in Gaziantep, Turkey. A thematic inductive content analysis examined the motivational factors Syrian health care workers expressed for their work in the conflict area. Results Motivating factors for health care workers were intrinsic and extrinsic. Intrinsic reasons included humanitarian principles and medical ethics. Also, different ideological reasons, patriotic, political and religious, were mentioned. Economic and professional reasons were named as extrinsic reasons for continuing work in the war-torn country. Conclusions The study adds information on the effects of the Syrian crisis on health care—from healthcare workers' perspective. It provides a unique insight on motivations why health care workers are continuing their work in Syria. This research underlines that the health care system would collapse totally without local professionals and leave the population without adequate health care.

Body symbolics, obstetric practices, and the improvement of maternal health in Cambodia

2020 ◽  
pp. 450-471
Author(s):  
Clémence Schantz
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Professionals ◽  
Participant Observation ◽  
The Body ◽  
Clinical Settings ◽  
Mixed Method Research ◽  
Structured Interviews ◽  
Phnom Penh ◽  
Frequent Use

Cambodia is one of the nine countries worldwide to have reduced its maternal mortality rate by more than 75 per cent between 1990 and 2015. Whilst prior to the 2000s, childbirth in Cambodia used to be a private event, it has now become a biomedical event for women and their families. This chapter describes the findings of mixed-method research challenging the idealized vision of the United Nations regarding maternal health in Cambodia by describing obstetrical practices on the ground, from an empirical study led in several clinical settings in Phnom Penh, through participant observation, semi-structured interviews with health-care professionals and patients, questionnaires with pregnant women, to the examination of medical records from four Phnom Penh maternity wards. The findings demonstrate that the biomedicalization of childbirth in Cambodia has been accompanied by technologized delivery with extremely frequent use of surgical practices. In order to understand the population’s adherence to these practices, the chapter draws out a number of anthropological and demographic arguments. These biomedical practices are part of a symbolism of the body where the body is conceived as a receptacle, where the body humours must be able to circulate appropriately, and where the hot/cold balance must be respected. Childbirth as an opening of the body represents a danger for women because it threatens this equilibrium.

scholarly journals Perspectives of Patients, Families, and Health Care Professionals on Decision-Making about Dialysis Modality—the Good, the Bad, and the Misunderstandings!

2013 ◽  
Vol 33 (3) ◽  
pp. 280-289 ◽  
Author(s):  
Konstadina Griva ◽  
Zhi Hui Li ◽  
Alden Yuanhong Lai ◽  
Meng Chan Choong ◽  
Marjorie Wai Yin Foo
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Professionals ◽  
Asian Population ◽  
Dialysis Modality ◽  
Subjective Experiences ◽  
Dialysis Patients ◽  
Structured Interviews ◽  
Learning Barriers ◽  
The Family

ObjectivesThis study explored the factors influencing decision-making about dialysis modality, integrating the perspectives of patients, their families, and health care professionals within an Asian population. The study further sought to understand the low penetration rate of peritoneal dialysis (PD) in Singapore.MethodsA sample of 59 participants comprising pre-dialysis patients, dialysis patients, caregivers, and health care professionals (HCPs) participated in semi-structured interviews to explore the decision-making process and their views about various dialysis modalities. Data were thematically analyzed using NVivo9 (QSR International, Doncaster, Australia) to explore barriers to and facilitators of various dialysis modalities and decisional support needs.ResultsFear of infection, daily commitment to PD, and misperceptions of PD emerged as barriers to PD. Side effects, distance to dialysis centers, and fear of needling and pain were barriers to hemodialysis (HD). The experiences of other patients, communicated informally or opportunistically, influenced the preferences and choices of patients and family members for a dialysis modality. Patients and families value input from HCPs and yet express strong needs to discuss subjective experiences of life on dialysis (PD or HD) with other patients before making a decision about dialysis modality.ConclusionsPre-dialysis education should expand its focus on the family as the unit of care and should provide opportunities for interaction with dialysis patients and for peer-led learning. Barriers to PD, especially misperceptions and misunderstandings, can be targeted to improve PD uptake.

scholarly journals Team Dynamics, Decision Making, and Attitudes Toward Multidisciplinary Cancer Meetings: Health Professionals' Perspectives

2010 ◽  
Vol 6 (6) ◽  
pp. e17-e20 ◽  
Author(s):  
Bianca Devitt ◽  
Jennifer Philip ◽  
Sue-Anne McLachlan
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Cancer Treatment ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Team Dynamics ◽  
Evidence Based ◽  
Patients With Cancer ◽  
Multidisciplinary Meetings ◽  
Evidence Based Guidelines

As the complexity of cancer treatment increases so too has the need for coordination between health care professionals. Multidisciplinary meetings are a useful tool in treating patients with cancer and are shown to improve survival and adherence to evidence based-guidelines.

scholarly journals Weighing up the costs of seeking health care for dengue symptoms: a grounded theory study of backpackers’ decision-making processes

2015 ◽  
Vol 21 (2) ◽  
pp. 245 ◽  
Author(s):  
Bálint Vajta ◽  
Mette Holberg ◽  
Jane Mills ◽  
William J. H. McBride
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Grounded Theory ◽  
Dengue Fever ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Public Health Issue ◽  
Structured Interviews ◽  
Australian Health ◽  
Core Category

Dengue fever, a mosquito-borne virus, is an ongoing public health issue in North Queensland. Importation of dengue fever by travellers visiting or returning to Australia can lead to epidemics. The mosquito can acquire the virus in the symptomatic viraemic phase, so timely recognition of cases is important to prevent epidemics. There is a gap in the literature about backpackers’ knowledge of dengue fever and the decision-making process they use when considering utilising the Australian health-care system. This study uses grounded theory methods to construct a theory that explains the process backpackers use when seeking health care. Fifty semi-structured interviews with backpackers, hostel receptionists, travel agents and pharmacists were analysed, resulting in identification of a core category: ‘weighing up the costs of seeking health care’. This core category has three subcategories: ‘self-assessment of health status’, ‘wait-and-see’ and ‘seek direction’. Findings from this study identified key areas where health promotion material and increased access to health-care professionals could reduce the risk of backpackers spreading dengue fever.

scholarly journals Real time location systems: Is it big brother or a big opportunity for professional practice?

2020 ◽  
Vol 10 (11) ◽  
pp. 67
Author(s):  
Jacqueline Limoges ◽  
Sara Lankshear ◽  
Joseph Church
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Real Time ◽  
Professional Practice ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Care Providers ◽  
Location Systems

Purpose: Real Time Location Systems (RTLS) is an emerging health care technology with the potential to capture data that can be used to improve professional practice and patient outcomes. However, there is a paucity of literature in this area to guide health professionals and leaders in both the implementation and use of RTLS data. To address this gap in the literature, this qualitative study was designed to explore how staff perceive and experience RTLS, and how health care providers anticipate using RTLS data for professional practice and clinical decision making.Results: Interviews and focus groups were conducted with 31 health care professionals who work in a community hospital in Canada. There was variation between the participants in terms of the experience of being monitored, the intensity of emotions related to RTLS and being monitored, the degree to which RTLS influenced clinical decision making and reflection, and the perceptions of usefulness of RTLS data for  professional practice. Three key themes emerged from the data: (1) the experience of being monitored, (2) anticipating using the data and (3) claiming the data for professional practice.Conclusions: Supports are vital to the successful adoption of RTLS and to enable health care professionals to claim and use RTLS data for professional practice and clinical decision making. During the implementation and use of RTLS data, it is crucial to recognize that RTLS data only represent the time spent in a location, and not the professional or knowledge-based practice of health professionals. Further research is required to understand the leadership strategies to guide the use of RTLS data.

Forms of trust and polypharmacy among older adults

2020 ◽  
pp. 1-16
Author(s):  
Alison Ross ◽  
James Gillett
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Decision Making ◽  
Social Networks ◽  
Health Care Professionals ◽  
Communicative Action ◽  
Medication Use ◽  
Modern Society ◽  
Structured Interviews ◽  
Life World

Abstract This article examines how older adults make decisions about their medications through interconnected axes of trust that operate across social networks. Trust is negotiated by older adults enrolled in a deprescribing programme which guides them through the process of reducing medications to mitigate risks associated with polypharmacy. Habermas’ work on the significance of communicative action in negotiating trust within social relationships informs our analysis, specifically in-depth semi-structured interviews with older adults about their medication use and the role of social networks in managing their health. Participants were age 70+ and experiencing polypharmacy. Our analysis discusses the social nature of medication practices and the importance of social networks for older adults’ decision-making. Their perspective reflects the critique of late-modern society put forward by Habermas. Negotiating trust in pharmaceutical decision-making requires navigating tensions across and between system networks (health-care professionals) and life-world networks (family and friends). This study contributes to our knowledge of how distinct forms of trust operate in different social spheres, setting the context for the way health-care decisions are made across social networks. Our analysis reinforces the need for older adults to engage meaningfully in health-care decision-making such that a convergence between system-world and life-world structures is encouraged. This would improve deprescribing programmes’ efficacy as older adults optimise their medication use and improve overall quality of life.

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