scholarly journals A Population-Based Investigation of Health-Care Needs and Preferences in American Adults With Multiple Sclerosis

2018 ◽  
Vol 7 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Chungyi Chiu ◽  
Malachy Bishop ◽  
Bradley McDaniels ◽  
Byung-Jin Kim ◽  
Lebogang Tiro
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Health Care Quality ◽  
Population Based ◽  
Care Quality ◽  
Care Providers ◽  
Care Needs ◽  
Research Committee

Background: Comprehensive and effective multiple sclerosis (MS) health care requires understanding of patients’ needs, preferences, and priorities. Objective: To evaluate priorities of patients with MS for their MS care. Methods: Participants included 3003 Americans with MS recruited through the National MS Society and the North American Research Committee on Multiple Sclerosis patient registry. Participants completed a comprehensive questionnaire on aspects of their health-care experiences. Results: Participants identified the top 3 health-care priorities as (1) the affordability of MS health care, (2) ensuring that non-MS health-care providers have more education about MS and how it can interact with other conditions, and (3) access to an MS center or specialized MS clinic with MS health-care professionals together in one place. Participants receiving care in an MS center rated the quality and their satisfaction with care higher than those receiving care in other settings. Although having the opportunity to evaluate their health-care quality was important to the participants, only 36.4% had been provided the opportunity in the past year. Conclusions: This study identifies health-care priorities and concerns for Americans with MS.

The Development of an Evacuation Protocol for Patients with Ventricular Assist Devices During a Disaster

2017 ◽  
Vol 32 (3) ◽  
pp. 333-338 ◽  
Author(s):  
Katherine J Davis ◽  
Joseph Suyama ◽  
Jennifer Lingler ◽  
Michael Beach
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Ventricular Assist Devices ◽  
Standards Of Care ◽  
Institute Of Medicine ◽  
Care Providers ◽  
Care Needs ◽  
Ventricular Assist ◽  
Assist Devices

AbstractIntroductionHealth care providers are on the forefront of delivering care and allocating resources during a disaster; however, very few are adequately trained to respond in these situations. Furthermore, there is a void in the literature regarding the specific care needs of patients with ventricular assist devices (VADs) in a disaster setting. This project aimed to develop an evidenced-based protocol to aid health care providers during the evacuation of patients with VADs during a disaster.MethodsThis is a qualitative study that used expert review, tabletop discussion, and a survey of health care professionals to develop and evaluate an evacuation protocol. The protocol was revised after each stage of review in order to reach a consensus document.ResultsThe project concluded with the finalization of a protocol which addresses evacuation and patient triage, and also includes an algorithm to determine which staff members should be evacuated with patients, transportation resources, evacuation documentation, and items patients need during evacuation. The protocol also addressed steps to be taken in the event that evacuation efforts fail and how to manage outpatient VAD patients seeking assistance.ConclusionsThis protocol provides guidance for the care of VAD patients in the event of a disaster and evacuation. Protocols such as this address difficult scenarios and should be created prior to a disaster to assist staff in making difficult decisions. These documents should be created using multi-disciplinary feedback via the consensus model as well as the Institute of Medicine (IOM; National Academy of Medicine; Washington, DC USA) “Crisis Standards of Care.”DavisKJ, SuyamaJ, LinglerJ, BeachM. The development of an evacuation protocol for patients with ventricular assist devices during a disaster. Prehosp Disaster Med. 2017;32(3):333–338.

scholarly journals Improving Behavioral Health Equity through Cultural Competence Training of Health Care Providers

2019 ◽  
Vol 29 (Supp2) ◽  
pp. 359-364 ◽  
Author(s):  
Brian McGregor ◽  
Allyson Belton ◽  
Tracey L. Henry ◽  
Glenda Wrenn ◽  
Kisha B. Holden
Keyword(s):  
Health Care ◽  
Cultural Competence ◽  
Integrated Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Ethnic Disparities ◽  
The United States ◽  
Care Providers ◽  
Care Needs

 Racial/ethnic disparities have long persisted in the United States despite concerted health system efforts to improve access and quality of care among African Americans and Latinos. Cultural competence in the health care setting has been recognized as an important feature of high-quality health care delivery for decades and will continue to be paramount as the society in which we live becomes increasingly culturally diverse. Unfortunately, there is limited empirical evidence of patient health benefits of a culturally competent health care workforce in integrated care, its feasibility of imple­mentation, and sustainability strategies. This article reviews the status of cultural competence education in health care, the merits of continued commitment to training health care providers in integrated care settings, and policy and practice strategies to ensure emerging health care professionals and those already in the field are prepared to meet the health care needs of racially and ethnically diverse populations. Ethn Dis. 2019;29(Supp 2):359-364. doi:10.18865/ed.29.S2.359

Recruiting Underrepresented Students for Nursing Schools

2021 ◽  
Vol 27 (1) ◽  
pp. 40-45
Author(s):  
Vernell P. DeWitty ◽  
David A. Byrd
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Nursing Student ◽  
Educational Institution ◽  
Underrepresented Students ◽  
Recruitment Strategy ◽  
Cultural Humility ◽  
Care Providers ◽  
Care Needs

Preparing a richly diverse nursing student population is essential to improving health outcomes for the nation and achieving a robust supply of health-care providers who better reflect the society we serve. As the U.S. population becomes more diverse, cultural competence is necessary among health-care professionals in order to practice with cultural humility. Cultural humility refers to a commitment and active engagement in a lifelong learning process that allows individuals to better meet the complex health-care needs of patients, communities, and colleagues. The design of an effective recruitment strategy should be driven by the mission of the educational institution and aligned to reflect the targeted population of potential students. Recruitment efforts and activities should be designed to improve the ability to attract a diverse population and more firmly establish a continuing pipeline of possible students. This article presents strategies such as building relationships and partnerships with 2-year community colleges with upper division nursing programs, and employing technology solutions to enhance recruitment and admissions of a diverse pool of applicants. Technology solutions can help manage large applicant pools, help staff coordinate a communication campaign so there is frequent contact with prospects, and capture notes throughout the recruitment process that can be utilized in a holistic admission strategy. Recruitment is the first step; to address retention, students must be welcomed into an inclusive learning environment where they can successfully advance, in order to achieve the goal of a more diverse nursing workforce.

scholarly journals Perspectives on marijuana use and effectiveness

2017 ◽  
Vol 7 (4) ◽  
pp. 333-343 ◽  
Author(s):  
Stacey S. Cofield ◽  
Amber Salter ◽  
Tuula Tyry ◽  
Christina Crowe ◽  
Gary R. Cutter ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Research Committee ◽  
The North ◽  
Current Usage ◽  
Before And After ◽  
History Of ◽  
Potential Benefits

AbstractBackground:Interest in and use of marijuana by persons with multiple sclerosis (MS) has increased. While potential benefits have been reported, so have concerns about potential risks. Few large studies have been conducted about the perceptions and current usage of marijuana and medical cannabinoids in persons with MS.Methods:Participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) registry were surveyed in 2014 regarding legality and history of marijuana usage, both before and after diagnosis with MS.Results:A total of 5,481 participants responded, with 78.2% female, 90% relapsing disease at onset, and a current mean age of 55.5 (10.2) years. Sixty-four percent had tried marijuana prior to their MS diagnosis, 47% have considered using for their MS, 26% have used for their MS, 20% have spoken with their physician about use, and 16% are currently using marijuana. Ninety-one percent think marijuana should be legal in some form. Men, those with higher disability, current and past nicotine smokers, and younger age were associated with a higher likelihood of current use.Conclusions:The majority of responders favor legalization and report high interest in the use of marijuana for treatment of MS symptoms, but may be reluctant to discuss this with health care providers. Health care providers should systematically inquire about use of marijuana.

scholarly journals Multiple Sclerosis and Pregnancy: A Comparison Study

2013 ◽  
Vol 40 (4) ◽  
pp. 590-596 ◽  
Author(s):  
Sura Alwan ◽  
Magdalena Dybalski ◽  
Irene M. Yee ◽  
Talitha M. Greenwood ◽  
Elaine Roger ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Systems ◽  
Care Program ◽  
Care Providers ◽  
Research Committee ◽  
The North ◽  
Reproductive Decision Making ◽  
Care Systems

Abstract:Objective:To determine whether different health care systems may affect reproductive decision-making among patients with Multiple Sclerosis (MS), we describe the reproductive practices and attitudes of Canadian MS patients ascertained from the multidisciplinary MS Clinic at Hôpital Notre-Dame in Montreal, Quebec (NDMSC), in comparison to those of matched American selfregistrants from the database of the North American Research Committee on Multiple Sclerosis (NARCOMS).Methods:A total of 665 self-administered questionnaires on reproductive practices were sent out to eligible attendees attending the NDMSC. The short questionnaires were completed and returned to the authors in an anonymous format for analysis.Results:A total of 459 completed questionnaires were returned. The majority of NDMSC respondents (72.5%) and NARCOMS subset (75.2% females), did not encounter a pregnancy following diagnosis of MS. The most common MS-related reason for this decision was “symptoms interfering with parenting” (75.0% for the NDMSC, 72.6% for the NARCOMS). The most commonly reported non-MS-related reason was “a completed family” by the time of diagnosis in both the NDMSC and NARCOMS subset (58.0%, 40.4%, respectively). Concerns about financial issues both related and unrelated to MS were also commonly reported by males and females in both cohorts but significantly more so among the NARCOMS participants.Conclusion:These results indicate that reproductive decisions of MS patients are highly affected by their illness and its associated disability, regardless of the available health care program. Health care providers should discuss their patients' reproductive needs and perceptions to help them make more informed decisions.

scholarly journals What Do Patients Say About Doctors Online? A Systematic Review of Studies on Patient Online Reviews (Preprint)

2018 ◽  
Author(s):  
Y Alicia Hong ◽  
Chen Liang ◽  
Tiffany A Radcliff ◽  
Lisa T Wigfall ◽  
Richard L Street
Keyword(s):  
Machine Learning ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Quality ◽  
Online Reviews ◽  
The United States ◽  
Care Quality ◽  
Small Sample ◽  
Care Providers ◽  
Study Characteristics

BACKGROUND The number of patient online reviews (PORs) has grown significantly, and PORs have played an increasingly important role in patients’ choice of health care providers. OBJECTIVE The objective of our study was to systematically review studies on PORs, summarize the major findings and study characteristics, identify literature gaps, and make recommendations for future research. METHODS A major database search was completed in January 2019. Studies were included if they (1) focused on PORs of physicians and hospitals, (2) reported qualitative or quantitative results from analysis of PORs, and (3) peer-reviewed empirical studies. Study characteristics and major findings were synthesized using predesigned tables. RESULTS A total of 63 studies (69 articles) that met the above criteria were included in the review. Most studies (n=48) were conducted in the United States, including Puerto Rico, and the remaining were from Europe, Australia, and China. Earlier studies (published before 2010) used content analysis with small sample sizes; more recent studies retrieved and analyzed larger datasets using machine learning technologies. The number of PORs ranged from fewer than 200 to over 700,000. About 90% of the studies were focused on clinicians, typically specialists such as surgeons; 27% covered health care organizations, typically hospitals; and some studied both. A majority of PORs were positive and patients’ comments on their providers were favorable. Although most studies were descriptive, some compared PORs with traditional surveys of patient experience and found a high degree of correlation and some compared PORs with clinical outcomes but found a low level of correlation. CONCLUSIONS PORs contain valuable information that can generate insights into quality of care and patient-provider relationship, but it has not been systematically used for studies of health care quality. With the advancement of machine learning and data analysis tools, we anticipate more research on PORs based on testable hypotheses and rigorous analytic methods. CLINICALTRIAL International Prospective Register of Systematic Reviews (PROSPERO) CRD42018085057; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=85057 (Archived by WebCite at http://www.webcitation.org/76ddvTZ1C)

scholarly journals Sources of Occupational Stress and their Relationship with Personal and Occupational Factors in Nurses of Rasht Teaching Hospitals in 2016

2020 ◽  
Author(s):  
Khadijeh Mobasher –Amini ◽  
Behrooz Rezaei ◽  
Mohammad Esmaeilpour- Bandboni
Keyword(s):  
Health Care ◽  
Occupational Stress ◽  
Job Stress ◽  
Health Care Providers ◽  
Health Care Quality ◽  
Pearson Correlation ◽  
Care Quality ◽  
Teaching Hospitals ◽  
Care Providers ◽  
Occupational Factors

Introduction: Nurses experience more stress than other health care providers due to the nature of their job. Job stress has significant effects on the performance of nurses and health care organizations; it also endangers the health care quality and patients' safety. The purpose of this study was to identify the sources of occupational stress and their relationship with personal and occupational factors among nurses in teaching hospitals of Rasht, a city in north of Iran in 2016. Methods: This cross-sectional and analytical study was conducted among nurses in the teaching hospitals in Rasht City in 2016. The sample size was estimated based on the Cochran formula. The study population included 250 nurses selected via stratified randomly from the clinical wards in seven hospitals.  Data were collected by demographic questionnaire and Toft - Anderson nurses' stress scale including 34 questions in seven domains of nurses' stressors. Data were analysed with independent t, ANOVA, and Pearson correlation coefficient tests using SPSS   V21.0 software (Significance level <0.05). Results: The mean score of job stress (72.46 ± 12.47) was evaluated at the sever level. Based on the findings, 77.8% of the nurses reported that their stress was at the sever level and 21.7% reported a moderate level of stress. The most frequently mentioned sources of stress were related to "uncertainty in treatment", "suffering and death of patients", and "high workload". However, the least source of stress was related to "lack of support resources". Job stress had no significant correlation with personal and occupational characteristics (p> 0.05). Conclusion: Given the high levels of nurses' job stress, continuous interventions are needed to decrease the nurses' stress at the individual and organizational levels, especially in the highest sources of stress including "uncertainty about treatment" and "workload". In this regard, we recommend the following interventions at primary (related to reducing stressors), secondary (aimed at reducing nurses' response to stressors), and tertiary (focusing on specific assistance to nurses with high levels of stress) levels.

scholarly journals Missed opportunities: are residents prepared to care for transgender patients? A study of family medicine, psychiatry, endocrinology, and urology residents

2018 ◽  
Vol 9 (3) ◽  
pp. e41-55 ◽  
Author(s):  
Alexandre Coutin ◽  
Sarah Wright ◽  
Christine Li ◽  
Raymond Fung
Keyword(s):  
Health Care ◽  
Family Medicine ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Clinical Care ◽  
Care Providers ◽  
Care Needs ◽  
Missed Opportunities ◽  
Clinical Exposure ◽  
Care Education

Background: The transgender (trans) population faces multiple barriers in accessing health care, with knowledge deficits of health care providers contributing substantially. Trans patients report having to teach health care professionals about their own health needs.We compared perceptions of trans-care education and training across family medicine, psychiatry, endocrinology, and urology residency training programs at the University of Toronto.             Methods: We surveyed residents to assess their perceptions of and attitudes towards trans-care, exposure to trans patients, knowledge of trans-specific clinical care, and the state of trans-care education within their training. We used Likert scale data to identify patterns across residency programs. We collected open-ended responses to further explain quantitative findings where appropriate.Results: Of 556 residents approached, 319 participated (response rate = 57.4%). Nearly all endocrinology and psychiatry residents agreed that trans-care falls within their scope of practice, while only 71% and 50% of family medicine and urology residents did, respectively. Though participants were at different stages of their postgraduate training when surveyed, only 17% of all participants predicted they would feel competent to provide specialty-specific trans-care by the end of their residency and only 12% felt that their training was adequate to care for this population.Conclusion: Though the study revealed a willingness to serve this population, there was a lack of clinical exposure and trans-related teaching within postgraduate curricula resulting in feelings of unpreparedness to meet the health care needs of this underserved population. 

Pharmaceutical Manufacturers and Self-Regulation of Drug Advertising and Promotion

1992 ◽  
Vol 22 (2) ◽  
pp. 235-243 ◽  
Author(s):  
Gerald J. Mossinghoff
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Health Care Costs ◽  
Health Care Providers ◽  
Health Care Quality ◽  
Government Regulation ◽  
Care Quality ◽  
Care Providers ◽  
Care Costs ◽  
Advertising And Promotion

Contrary to critics' contentions that pharmaceutical promotion and advertising hurts medical care and raises health care costs, the opposite is true. Advertising and promotion improves health care quality by keeping health care providers up to date about the best medicines for preventing, treating and curing diseases. This knowledge reduces the need for more expensive medical care and helps restore good health, which lowers overall health care costs. The article cites a number of instances in which advertising and promotional efforts by pharmaceutical companies have increased awareness of health problems amenable to pharmaceutical intervention, with positive results. Pharmaceutical company support of medical journals and continuing medical education has been an important resource for the dissemination of new medical knowledge. Government regulation of pharmaceutical advertising and promotion is strict. The research-based pharmaceutical industry has adopted guidelines that prohibit many of the activities critics have referred to as abuses. Further government regulation would be unnecessary and unwise.

scholarly journals Patient Attitudes about Patient Portal Functions

2017 ◽  
Author(s):  
Tamara Sequeira
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Providers ◽  
Financial Incentives ◽  
Health Care Quality ◽  
Primary Care Patient ◽  
Meaningful Use ◽  
Care Quality ◽  
Patient Portal ◽  
Care Providers

As part the U.S. government’s ongoing efforts to improve health care quality, the Electronic Health Records (EHR) Incentive Program from the Centers for Medicare and Medicaid (CMS) offers financial incentives to eligible health care providers (EP) who adopt, implement, improve, and demonstrate meaningful use of EHR. Beginning 2014, the Stage 2 Meaningful Use core objectives included the ability of patients to use online patient portals to view, download and transmit their health information. As a result, many EP offer a patient portal and encourage sign up, yet not all patients have done so. How patients perceive the patient portal, whether positively or negatively, may affect their adoption and use of the portal. A survey collected attitudes and beliefs about the patient portal from adult, female, primary care patients (n=257). The beliefs of patients who signed up, along with those who had not, were considered within the framework of the theory of planned behavior (TPB) to identify methods to increase patient use of the portal. The TPB correctly predicted portal sign up behavior in attitude (p<0.05) and intention (p<0.05) subscales. Overall, patients viewed portal characteristics as useful, but patients who had signed up identified them as significantly (p<0.01) more useful, and also, were found to have significantly (p<0.05) more education than those who did not sign up. Few methods to increase patient sign up were identified apart from targeted education to promote the portal’s usability and utility. More research is needed to identify potential methods health care providers can use to increase portal use in primary care patient populations. Implications for advanced public health nurse practice, training, policy, and research were identified and recommendations given.

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