Specialist Networks Influence Clinician Willingness to Treat Individuals with Special Needs

2021 ◽  
pp. 238008442110202
Author(s):  
M.A.W.T. Lim ◽  
S.A.C. Liberali ◽  
H. Calache ◽  
P. Parashos ◽  
G.L. Borromeo
Keyword(s):  
Special Needs ◽  
Health Professionals ◽  
Rural Areas ◽  
Dental Service ◽  
Aging Workforce ◽  
The South ◽  
Structured Interviews ◽  
Hub And Spoke ◽  
Barriers To Access ◽  
Patients With Special Needs

Background: The South Australian Dental Service’s Special Needs Network was established to support oral health professionals working within their statewide government-funded dental service to treat patients with special needs. This study aimed to investigate how a structured network relationship with specialists in special needs dentistry influenced the willingness of dentists to treat this group of patients. Methods: Semi-structured interviews were used to explore the views of specialists and dentists involved in the South Australian Dental Service’s Special Needs Network. Inductive thematic analysis identified emerging themes enabling completion of a SWOT (strengths, weaknesses, opportunities, threats) analysis. Results: Dentists felt that a strength of the Network was a greater sense of collegiality, particularly for those working in rural areas. Although the inability to get immediate advice was seen as a weakness, dentists felt a more structured relationship with specialists improved communication pathways and resulted in more timely care. The aging workforce, systemic barriers in the public dental system, such as productivity pressures and infrastructure, and the lack of support from other health professionals were seen as ongoing barriers and threats. Regardless, dentists identified the use of telehealth and visiting specialists as future opportunities. Specialists felt that the Network was a valuable resource but were skeptical about its effectiveness, feeling that a limitation was the ability of dentists to recognize the complexity of cases. Conclusions: Ongoing support from and communication with specialists in special needs dentistry through a structured network improved the perceived ability and willingness of dentists to treat patients with special needs. Knowledge Transfer Statement: This research suggests that providing support to dentists through a hub-and-spoke network that facilitates additional training, professional interaction, and improved communication with specialists in special needs dentistry may help overcome some of the current barriers to access to care experienced by individuals with special needs, particularly those associated with the willingness and capability of clinicians treat them.

scholarly journals EPIDEMIOLOGICAL ANALYSIS OF PATIENTS SERVED IN A PUBLIC DENTAL SERVICE FOR PATIENTS WITH SPECIAL NEEDS IN BELÉM

2021 ◽  
Vol 1 (06) ◽  
Author(s):  
Natalia Silva e Silva ◽  
Anete Brito Cartágenes ◽  
Leida Favacho ◽  
Ivone Almeida ◽  
Juliana De Borborema Garcia Pedreira ◽  
...  
Keyword(s):  
Periodontal Disease ◽  
Special Needs ◽  
Medical Records ◽  
Cross Sectional Study ◽  
Dental Service ◽  
Behavioral Disorder ◽  
Cross Sectional ◽  
Public Dental Service ◽  
Place Of Origin ◽  
Patients With Special Needs

Objective: In view of the scarcity of research aimed at patients with special needs in our region, this study aims to identify the pathologies, such as age, gender, place of origin and prevalence of caries and periodontal disease in patients enrolled in a public dental service in Belém aimed at the care of people with special needs. Method: Retrospective cross-sectional study, where the data collected in the medical records of the patients enrolled in SIDOPE-UFPA were analyzed. Results: At the end of the data collection, 219 medical records of patients eligible to participate in the study were divided into groups, such as Behavioral Disorder (27.85%), Non-Progressive Brain Encephalopathy (10.5%), Syndromes and malformations (8.7%), Intellective deficit (7.76%), among others. The prevalence of caries was 71.23% and Periodontal Disease was 23.7%; (61.6%) and Belém (62.5%) were the most prevalent place of origin. Conclusion: According to the research, most patients still need treatment, due to the high caries index found, and mainly preventive measures so that these numbers can be reduced in the future. It was also observed the complexity and variety of diseases in the patients enrolled, and the incidence of rare syndromes that should and should be studied more specifically, not only by dentistry, but also by professionals from other areas, emphasizing the importance of care multiprofessional approach to these patients.

scholarly journals Development of a Managed Clinical Network for Children’s Palliative Care – A Qualitative Evaluation

2021 ◽  
Author(s):  
Andrew Papworth ◽  
Lorna Fraser ◽  
Jo Taylor
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
Qualitative Evaluation ◽  
Governance Structure ◽  
Evidence Base ◽  
Care Staff ◽  
Successful Implementation ◽  
Structured Interviews ◽  
Clinical Network ◽  
Barriers To Access

Abstract Background Consistent evidence suggests that children’s palliative care is not equitable and managed clinical networks (MCNs) have been recommended as a solution. This study explored the perspectives of health professionals involved in the development of a children’s palliative care MCN, with an aim to identify barriers and enablers of successful implementation.Methods Thematic analysis of semi-structured interviews and focus groups with 45 healthcare staff with a role in developing the MCN or in the delivery of children’s palliative care (September 2019-March 2020). Results The study explored health professionals’ perceptions of the MCN features that had helped to formalise governance processes, establish training and networking opportunities, standardise practice, and improve collaboration between organisations. These include the funded MCN co-ordinator, committed individuals who lead the MCN, and a governance structure that fosters collaboration. However, the MCN’s development was impeded by cross-cutting barriers including limited funding for the MCN and children’s palliative care more generally, no shared technology, lack of standards and evidence-base for children’s palliative care, and shortage of palliative care staff. These barriers impacted on the MCN’s ability to improve and evaluate palliative care provision and affected member engagement. Competing organisational priorities and differences between NHS and non-NHS members also impeded progress. Training provision was well received, although barriers to access were identified. Conclusions Key features of children’s palliative care can act as barriers to developing a managed clinical network. Managing expectations and raising awareness, providing accessible and relevant training, and sharing early achievements through ongoing evaluation can help to sustain member engagement, which is crucial to a network’s success.

scholarly journals Two decades of changes in spatial distribution of retail and commercial services: Czech experience

2020 ◽  
Vol 69 (1) ◽  
pp. 41-55
Author(s):  
Zdeněk Šilhan ◽  
Josef Kunc
Keyword(s):  
Rural Areas ◽  
High Speed ◽  
Graphical Analysis ◽  
The South ◽  
Structured Interviews ◽  
Internet Service ◽  
The Public ◽  
Suburban Areas ◽  
Tax Relief ◽  
Red Tape

The aim of this paper is to introduce basic developmental consequences, changes, trends and the current situation in amenities through retail and commercial services in the rural areas of the Czech Republic. The example illustrated herein is the South Moravian Region. Methodically, the text is built on previous survey (2002), and on our own survey conducted in municipalities up to 3,000 inhabitants of the South Moravian Region in 2018 (n = 355). There are semi-structured interviews (n = 18) that link back to these surveys. The data obtained was processed by the methods of statistical and graphical analysis, comparison, interpretation and synthesis. The paper concludes that since 2002, commercial amenities have experienced remarkably negative development. The smaller municipalities in the periphery have encountered the greatest decline, but stagnation is also seen in the suburban areas of Brno. From among types of commercial amenities, the ones most weakened were specialized shops, which could no longer compete with large retail chains. Almost a fourth of municipalities support commercial trade and services, mainly through subsidies or lowered rent. The regions also provide subsidies. Even simplifying red tape or providing tax relief on the part of the public sector would support civic amenities. Another key may be retaining young and educated people in municipalities where they will live and work. Contributing to this could be not only developing infrastructure in municipalities, but also for example the next wave of digitalization and introduction of stable, high-speed Internet service in rural areas.

scholarly journals Development of a managed clinical network for children’s palliative care – a qualitative evaluation

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Andrew Papworth ◽  
Lorna Fraser ◽  
Jo Taylor
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
Qualitative Evaluation ◽  
Governance Structure ◽  
Evidence Base ◽  
Care Staff ◽  
Successful Implementation ◽  
Structured Interviews ◽  
Clinical Network ◽  
Barriers To Access

Abstract Background Consistent evidence suggests that children’s palliative care is not equitable and managed clinical networks (MCNs) have been recommended as a solution. This study explored the perspectives of health professionals involved in the development of a children’s palliative care MCN, with an aim to identify barriers and enablers of successful implementation. Methods Thematic analysis of semi-structured interviews and focus groups with 45 healthcare staff with a role in developing the MCN or in the delivery of children’s palliative care (September 2019–March 2020). Results The study explored health professionals’ perceptions of the MCN features that had helped to formalise governance processes, establish training and networking opportunities, standardise practice, and improve collaboration between organisations. These include the funded MCN co-ordinator, committed individuals who lead the MCN, and a governance structure that fosters collaboration. However, the MCN’s development was impeded by cross-cutting barriers including limited funding for the MCN and children’s palliative care more generally, no shared technology, lack of standards and evidence base for children’s palliative care, and shortage of palliative care staff. These barriers impacted on the MCN’s ability to improve and evaluate palliative care provision and affected member engagement. Competing organisational priorities and differences between NHS and non-NHS members also impeded progress. Training provision was well received, although barriers to access were identified. Conclusions Key features of children’s palliative care can act as barriers to developing a managed clinical network. Managing expectations and raising awareness, providing accessible and relevant training, and sharing early achievements through ongoing evaluation can help to sustain member engagement, which is crucial to a network’s success.

scholarly journals Development of a Managed Clinical Network for Children’s Palliative Care – A Qualitative Evaluation

2020 ◽  
Author(s):  
Andrew Papworth ◽  
Lorna Fraser ◽  
Jo Taylor
Keyword(s):  
Palliative Care ◽  
Health Professionals ◽  
Qualitative Evaluation ◽  
Governance Structure ◽  
Evidence Base ◽  
Care Staff ◽  
Successful Implementation ◽  
Structured Interviews ◽  
Clinical Network ◽  
Barriers To Access

Abstract BackgroundConsistent evidence suggests that children’s palliative care is not equitable and managed clinical networks (MCNs) have been recommended as a solution. This study explored the perspectives of health professionals involved in the development of a children’s palliative care MCN, with an aim to identify barriers and enablers of successful implementation.MethodsThematic analysis of semi-structured interviews and focus groups with 45 healthcare staff with a role in developing the MCN or in the delivery of children’s palliative care (September 2019-March 2020). ResultsThe study explored health professionals’ perceptions of the MCN features that helped to formalise governance processes, establish training and networking opportunities, standardise practice, and improve collaboration between organisations. These include the funded MCN co-ordinator, committed individuals who lead the MCN, and a governance structure that fosters collaboration. However, the MCN’s development was impeded by cross-cutting barriers including limited funding for the MCN and children’s palliative care more generally, no shared technology, lack of standards and evidence-base for children’s palliative care, and shortage of palliative care staff. These barriers impacted on the MCN’s ability to improve and evaluate palliative care provision and affected member engagement. Competing organisational priorities and differences between NHS and non-NHS members also impeded progress. Training provision was well received, although barriers to access were identified. ConclusionsKey features of children’s palliative care can act as barriers to developing a managed clinical network. Managing expectations and raising awareness, providing accessible and relevant training, and sharing early achievements through ongoing evaluation can help to sustain member engagement, which is crucial to a network’s success.

Water and sanitation policies for improving health in South Africa: overcoming the institutional legacy of apartheid

Water Policy ◽  
2005 ◽  
Vol 7 (6) ◽  
pp. 627-642 ◽  
Author(s):  
Edina Sinanovic ◽  
Sandi Mbatsha ◽  
Stephen Gundry ◽  
Jim Wright ◽  
Clas Rehnberg
Keyword(s):  
South Africa ◽  
Rural Areas ◽  
Integrated Approach ◽  
The South ◽  
Financing System ◽  
Water And Sanitation ◽  
Sanitation Services ◽  
Sanitation And Hygiene ◽  
Access To Water ◽  
New Policies

The burden of water-related disease is closely related to both the socio-economic situation and public health issues like access to clean water, sanitation and hygiene services. Poverty eradication, through improved access to water and sanitation, is the South African government's major priority. This is partly achieved through subsidising the cost of water and sanitation provision to the poor in rural areas. Whilst the new policies have made a remarkable impact on improved access to water and sanitation services, a general problem since the new approach in 1994 has been the lack of integration of policies for water and sanitation and health. This paper analyses the policies concerning rural water supply and sanitation in South Africa. It considers the structure of institutions, the division of responsibilities and legislated and financial capacity of the South Africa's water sector. A more integrated approach for the policies aiming at water access, sanitation and health is needed. In addition, as the local government's capacity to implement different programmes is limited, a review of the financing system is necessary.

scholarly journals Post-stroke fatigue: an exploratory study with patients and health professionals to develop a patient-reported outcome measure

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Ingrid Johansen Skogestad ◽  
Marit Kirkevold ◽  
Petra Larsson ◽  
Christine Råheim Borge ◽  
Bent Indredavik ◽  
...  
Keyword(s):  
Future Development ◽  
Health Professionals ◽  
Outcome Measure ◽  
Patient Reported Outcome ◽  
Stroke Survivors ◽  
Structured Interviews ◽  
Post Stroke ◽  
Patient Reported Outcome Measure ◽  
Patient Reported ◽  
Initial Hospital

Abstract Background Post-stroke fatigue (PSF) is commonly reported and described as disabling by patients recovering from stroke. However, a major challenge is how to accurately diagnose and assess PSF. Therefore, the aim of this study was to explore PSF as it is experienced by stroke survivors and described by health professionals to guide future development of a PSF-specific PROM. Methods Individual semi-structured interviews were conducted with stroke survivors experiencing PSF (n = 9) and three focus groups were conducted with health professionals (n = 16). Data were analyzed through inductive content analysis. Results The analysis revealed four themes illustrating the experience and descriptions of PSF: 1) PSF characteristics, 2) interfering and aggravating factors, 3) management, and 4) PSF awareness, which refers to stroke survivors first becoming aware of PSF after their initial hospital admission. Conclusion This study highlights the complexity and multidimensionality of PSF. The results from this study will guide future development of a PSF-PROM and support its content validity.

scholarly journals POS0160-HPR THE CARE PROCESS OF HIP AND KNEE OSTEOARTHRITIS: GIVING AN ACCOUNT OF PATIENTS’ EXPERIENCE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 292.2-293
Author(s):  
S. Battista ◽  
M. Manoni ◽  
A. Dell’isola ◽  
M. Englund ◽  
A. Palese ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Health Professionals ◽  
Emotional Experience ◽  
Functional Limitations ◽  
Care Quality ◽  
Care Process ◽  
Exact Science ◽  
Structured Interviews ◽  
Patients Experience

Background:The care process is often a complex and intimate process experienced by patients. Osteoarthritis (OA) care is usually characterised by multimodal interventions that consider the broader array of symptoms and functional limitations and often require a high level of patients’ compliance. Despite efforts to improve the quality of care of patients suffering from OA, and the publication of state-of-the-art clinical practice guidelines [1], the quality of the care process, as experienced by patients, seems to be suboptimal [2]. Hence, it is essential to investigate how patients experience this process to highlight potential elements that can enhance or spoil it to optimise the care quality.Objectives:To explore the patients’ experience of the received OA care process.Methods:Qualitative study, 10 semi-structured interviews were performed. The interview guide was created by a pool of healthcare professionals (physiotherapists, psychologists, nurses) and expert patients. It investigated the emotional experience, beliefs, expectations, perceived barriers and facilitators towards conservative treatments perceived by patients suffering from OA. The interviews lasted approximately one hour, were transcribed verbatim and analysed independently by two authors, who labelled their core parts to find categories and subcategories. A theme-based analysis was performed following an ecological paradigm, naturalistic epistemology, philosophy of phenomenological research.Results:Our analysis revealed 7 main categories with several subcategories (Fig. 1). 1) Uncertainty as some patients perceived treatment choice not to be based on medical evidence “there is an almost religious way of thinking on how to deal with the pathology. It is not an exact science when you choose the physicians you choose the treatment”. 2) Relationship with the self and the others as some patients did not feel understood or even shameful and hopeless about their condition. 3) Patients’ and Health Professionals’ beliefs about the pathology management where common thoughts were the perceived (ab)use of passive therapies, the movement as something dangerous and that OA is “something that you try to resist to, but (surgery) is your destiny”. 4) facilitators and 5) barriers of the adherence to therapeutic exercise that revolve around the cost of the therapy, the time needed and the willingness to change life habits. 6) Patients’ attitudes towards pathology in which the oldest patients perceive OA as “something I have to accept since I am getting old” and the youngest as “Something I have to fight”. 7) Relationship with food in which diet is seen as something that “you force yourself to follow” which is useful only to lose weight and not to preserve a high health status and where overeating is used “to eat your feelings”.Figure 1.Categories and Subcategories stemmed from the analysis of the patients’ interviewsConclusion:Patients suffering from hip and knee OA seem to experience an uncertain care process. The lack of clear explanations and the attitude towards conservative treatment, which is considered as “a pastime while waiting for surgery,” fosters the importance of providing patients with adequate information about the treatment, to shift their beliefs and improve their awareness. This will enhance a patient-centred and shared decision-making treatments.References:[1]Fernandes L, Hagen KB, Bijlsma JWJ, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann. Rheum. Dis. 2013;72:1125–35.[2]Basedow M, Esterman A. Assessing appropriateness of osteoarthritis care using quality indicators: a systematic review. J Eval Clin Pract 2015;21:782–9.Acknowledgements:This work is part of the project funded by EULAR Health Professionals Research Grant 2020.Disclosure of Interests:None declared

Using the Church to maximize the potential of learners with special needs

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Gina C. Obiakor ◽  
Kristen E. Obiakor ◽  
Festus E. Obiakor ◽  
Kevin Jones
Keyword(s):  
Special Education ◽  
Special Needs ◽  
Behavioral Problems ◽  
Health Professionals ◽  
Emotional And Behavioral Problems ◽  
Social Emotional ◽  
Educational Activities ◽  
The Church

Abstract Learners with special needs experience myriad problems in general and special education. These problems range from minor academic, social, emotional, and behavioral problems to major disenfranchisements, disadvantages, and disillusionments. In addition, these problems can be very intense. As a result, they call for innovative and creative techniques that include using the Church as a spiritual tool in educational activities. As educators and health professionals who are also Christians, we believe using the Church can assist in remediating the plights of these learners with special needs and in maximizing their fullest potential in school and in life. This is the focus of this article.

scholarly journals Loneliness Among the Elderly in Rural Contexts: A Mixed-Method Study Protocol

2021 ◽  
Vol 20 ◽  
pp. 160940692199686
Author(s):  
Borja Rivero Jiménez ◽  
David Conde-Caballero ◽  
Lorenzo Mariano Juárez
Keyword(s):  
Data Collection ◽  
Mixed Method ◽  
Rural Areas ◽  
Population Group ◽  
The Elderly ◽  
Interaction Patterns ◽  
Structured Interviews ◽  
Strict Adherence ◽  
Data Collection And Analysis ◽  
Technological Tools

Loneliness among the elderly has become a pressing issue in Western societies. In the Spanish context, the problem of the so-called “empty” Spain disproportionately affects this population group—elderly individuals living in rural areas with low population density, and therefore at higher risk of social exclusion and isolation. We introduce here a mixed-method, quantitative-qualitative research protocol, triangulated with technological tools, designed to improve both data acquisition and subsequent data analysis and interpretation. This study will take place in a rural locality in the Extremadura region (Spain), chosen according to a particular socio-demographic profile. The De Jong Gierveld Loneliness Scale will be used on a cohort of 80 people over 65 years old. Within this cohort, a smaller sample of 20–30 individuals will be selected for semi-structured interviews about their beliefs and experiences of loneliness. Finally, data gathered from technological tools (smartbands, Bluetooth sensors) will allow us to monitor social interactions and to map daily loneliness/interaction patterns. Data will be triangulated by analyzing and comparing the empirical material gathered through these different methods and tools. Strict adherence to ethical standards for data protection and handling will be essential through data collection and analysis. As well as providing insights into the phenomenon of loneliness in old age, the use of different methods and tools for data collection will provide the basis for an epistemological reflection on the scope and limits of each one of these methods.

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