scholarly journals Understanding why patients request euthanasia when it is illegal: a qualitative study in palliative care units on the personal and practical impact of euthanasia requests

2022 ◽  
Vol 16 ◽  
pp. 263235242110669
Author(s):  
Danièle Leboul ◽  
Anne Bousquet ◽  
Aline Chassagne ◽  
Florence Mathieu-Nicot ◽  
Ashley Ridley ◽  
...  
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Care Providers ◽  
Palliative Care Setting ◽  
Palliative Care Units ◽  
The Relationship ◽  
Depth Interviews ◽  
Practical Impact

Context: Some patients in palliative care units request euthanasia regardless of legislation. Although studies have explored the reasons for these requests, little is known about the subjective, relational, and contextual repercussions for the patient. Objectives: The aim of this study is to understand the purpose of euthanasia requests from the patient’s viewpoint and their personal and practical impact. Methods: We conducted in-depth interviews with patients requesting euthanasia, their family members, and health care providers in 11 French palliative care units. A thematic analysis of the data was performed. Results: In total, 18 patients were interviewed within 48 h of the request being made; 1 week later, 9 patients were interviewed again. Five main themes emerged: assuming the possibility of transgressing the forbidden, a call for unbearable suffering to be recognized, encouragement to change clinical practice, reclaiming a sense of freedom over medical constraints, and imagining a desirable future for oneself. Conclusions: A request for euthanasia appears to be a willful means to remove oneself from the impasse of an existence paralyzed by suffering. It creates a space for discussion, which promotes negotiation with patients on care practices and therapeutics, and strengthens patients’ sense of autonomy. Investigating the relationship between the evolution of euthanasia requests within the palliative care setting could be beneficial. It is important to encourage health care professionals to adopt a readiness to listen by interacting with patients in a way that is not momentarily action-oriented but rather focused on proactive discussion.

Knowledge, Beliefs, and Behaviors Related to Palliative Care Delivery Among Pediatric Oncology Health Care Providers

2018 ◽  
Vol 35 (4) ◽  
pp. 247-256 ◽  
Author(s):  
Jessica L. Spruit ◽  
Cynthia J. Bell ◽  
Valerie B. Toly ◽  
Maryjo Prince-Paul
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Providers ◽  
Pediatric Oncology ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Advanced Practice ◽  
Care Providers ◽  
The Public ◽  
Patients With Cancer

The care of pediatric patients with cancer and their families is complex and rapidly evolving. Despite significant advances in outcomes, symptoms of the disease and complications of therapy continue to cause suffering that may improve with the involvement of pediatric palliative care (PPC) services. This descriptive study responds to the observation of great variability in PPC utilization within pediatric oncology. Data collected from 156 health care professionals (nurses, advanced practice professionals, and physicians) from a statewide hematology alliance evaluates the knowledge, beliefs, and perceived barriers to PPC involvement. Data analysis reveals significant variability when comparing respondents from professional roles and practice environments. Despite progress in PPC availability, care delivery remains incongruent with current recommendations. Knowledge gained from this study emphasizes the important role for all health care providers in advocating for support of PPC programs, educating the public, and committing to intentional involvement of PPC services while caring for pediatric oncology patients.

Monopoly and Power Implications for Trans Health Care Specialists Working in a Centralised Setting: A Qualitative Study

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Brogan L Geurts ◽  
Timo O Nieder
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Qualitative Content Analysis ◽  
Gender Recognition ◽  
Care Providers ◽  
Trans People ◽  
In Trans ◽  
The Relationship ◽  
Depth Interviews

<p>In the last decade, the range and number of people accessing trans health care has increased at a faster rate than previously. Globally trans health care is commonly used as a requirement for trans people to access legal gender recognition. In Europe, trans health care is often provided within centralised health systems by a limited number of specialist teams placed in monopoly positions. Through a qualitative study, we sought to understand the relationship and role these teams have with legal gender recognition. We conducted in-depth interviews with a team located in Central and Eastern Europe and consulted with local key informants working in trans health advocacy outside the team. After applying qualitative content analysis emerging themes comprised three sections: the team in context; conceptions of trans health care; and beyond the clinic.</p><p>Findings indicated that the team conceived trans identities and clinical needs in a medical framework that correlated with the process for legal gender recognition. This followed a similar historical progression across Europe. As the few respected specialists in the country, the team influenced care regulations within the ministry and held a monopoly position. While reform of some regulations was seen as needed, they were met with challenges within the health system and field. These challenges were, however, found to reflect trans health care globally rather than the team itself. Our findings suggest comparisons could be drawn to similar positioned teams throughout Europe regarding decision making, power, and influence. Increased transparency and cooperation between local trans communities and health care providers will be vital.</p>

Developing Rural Communities’ Capacity for Palliative Care: A Conceptual Model

2007 ◽  
Vol 23 (3) ◽  
pp. 143-153 ◽  
Author(s):  
Mary Lou Kelley
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Rural Communities ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Theoretical Perspective ◽  
Care Providers ◽  
Development Data ◽  
Palliative Care Services ◽  
Generalist Practice

The population in Canada and other developing countries is aging, increasing the need for palliative care services. In rural communities, care of dying people is normally provided by health care professionals as part of a generalist practice, not by palliative care specialists. Despite a lack of specialists and resources, some rural communities have developed local palliative care programs. The goal of this research was to conceptualize rural communities’ process of developing palliative care programs using a theoretical perspective of community capacity development. Data were from nine focus groups of interdisciplinary rural health care providers who provided palliative care in seven provinces/territories of Canada. The outcome is a theoretical model that conceptualizes the process of developing palliative care programs in four sequential phases: antecedent community conditions, a catalyst, creating the team, and growing the program. The activities of each phase are outlined. This research offers practical and theoretical knowledge to guide practitioners and planners seeking to develop palliative care programs in other rural communities.

Benefits, Challenges, and Social Impact of Health Care Providers’ Adoption of Social Media

2021 ◽  
pp. 089443932110257
Author(s):  
Md Irfanuzzaman Khan ◽  
Jennifer (M.I.) Loh
Keyword(s):  
Health Care ◽  
Social Media ◽  
Health Promotion ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Community Support ◽  
Care Providers ◽  
Australian Health ◽  
Actual Use ◽  
Use Of Social Media

With the advent of telecommunication technologies and social media, many health care professionals are using social media to communicate with their patients and to promote health. However, the literature reveals a lacuna in our understanding of health care professionals’ perception of their behavioral intentions to use innovations. Using the Unified Technology Acceptance Framework (unified theory of acceptance and use of technology), in-depth interviews were conducted with 16 Australian health care experts to uncover their intent and actual use of social media in their medical practices. Results revealed that social media tools offered five significant benefits such as (i) enhanced communication between health care professionals and their patients, (ii) community support, (iii) enabled e-learning, (iv) enhanced professional network, and (v) expedited health promotion. However, result also revealed barriers to social media usage including (i) inefficiency, (ii) privacy concerns, (iii) poor quality of information, (iv) lack of trust, and (v) blurred professional boundary. Peer influence and supporting conditions were also found to be determinants of social media adoption behaviors among health care professionals. This study has important implications for health care providers, patients, and policy makers on the responsible use of social media, health promotion, and health communication. This research is also among the very few studies that explore Australian health care professionals’ intent and actual use of innovations within a health care setting.

Reclaiming and Reshaping Life: Patterns of Reconstruction After the Suicide of a Loved One

2016 ◽  
Vol 27 (7) ◽  
pp. 994-1005 ◽  
Author(s):  
Dolores Angela Castelli Dransart
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Suicide Survivors ◽  
Loved One ◽  
Life Patterns ◽  
Survivors Of Suicide ◽  
And Coping ◽  
The Impact ◽  
Depth Interviews

The objective of this study is to identify patterns (components and processes) of reconstruction of suicide survivors. In-depth interviews were conducted with 50 survivors of suicide in Switzerland. Data were analyzed using ATLAS.ti and according to the Grounded Theory principles. Survivors of suicide face four major challenges: dealing with the impact of suicide, searching for meaning, clarifying responsibility, and finding a personal style of reaction and coping. The various ways in which survivors fare through the specific processes of the challenges result in various patterns of reconstruction: the vulnerability, transformation, commitment, and hard blow. The unique characteristics and dynamics of each of them are highlighted. Health care providers would benefit from an approach based on the dynamics of the various patterns of reconstruction in providing appropriate support to survivors of suicide.

scholarly journals Burnout Impact of COVID-19 Pandemic on Health-Care Professionals at Assiut University Hospitals, 2020

2021 ◽  
Vol 18 (10) ◽  
pp. 5368
Author(s):  
Shimaa A. Elghazally ◽  
Atef F. Alkarn ◽  
Hussein Elkhayat ◽  
Ahmed K. Ibrahim ◽  
Mariam Roshdy Elkhayat
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Emotional Exhaustion ◽  
Health Care Professionals ◽  
Maslach Burnout Inventory ◽  
Adverse Outcomes ◽  
Personal Accomplishment ◽  
Burnout Syndrome ◽  
Care Providers ◽  
University Hospitals

Background: burnout syndrome is a serious and growing problem among medical staff. Its adverse outcomes not only affect health-care providers’ health, but also extend to their patients, resulting in bad-quality care. The COVID-19 pandemic puts frontline health-care providers at greater risk of psychological stress and burnout syndrome. Objectives: this study aimed to identify the levels of burnout among health-care professionals currently working at Assiut University hospitals during the COVID-19 pandemic. Methods: the current study adopted an online cross-sectional design using the SurveyMonkey® website for data collection. A total of 201 physicians were included and the Maslach Burnout Inventory (MBI) scale was used to assess the three burnout syndrome dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. Results: about one-third, two-thirds, and one-quarter of the respondents had high emotional exhaustion, high depersonalization, and low personal accomplishment, respectively. Younger, resident, and single physicians reported higher burnout scores. The personal accomplishment score was significantly higher among males. Those working more than eight hours/day and dealing with COVID-19 patients had significantly higher scores. Conclusion: during the COVID-19 pandemic, a high prevalence of burnout was recorded among physicians. Age, job title, working duration, and working hours/day were significant predictors for burnout syndrome subscale results. Preventive and interventive programs should be applied in health-care organizations during pandemics.

scholarly journals Concerns of Patients With Cancer on Accessing Cannabis Products in a State With Restrictive Medical Marijuana Laws: A Survey Study

2019 ◽  
Vol 15 (10) ◽  
pp. 531-538 ◽  
Author(s):  
Vinita Singh ◽  
Ali J. Zarrabi ◽  
Kimberly A. Curseen ◽  
Roman Sniecinski ◽  
Justine W. Welsh ◽  
...  
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Providers ◽  
Medical Marijuana ◽  
Survey Study ◽  
Care Practice ◽  
Care Providers ◽  
Patients With Cancer ◽  
Medical Marijuana Laws ◽  
Source Of Information

PURPOSE: Several states, particularly in the Southeast, have restrictive medical marijuana laws that permit qualified patients to use specific cannabis products. The majority of these states, however, do not provide avenues for accessing cannabis products such as in-state dispensaries. METHODS: We conducted a survey of patients registered for medical marijuana (low tetrahydrocannabinol [THC] oil cards) in an ambulatory palliative care practice in Georgia (one of the states with restrictive medical marijuana laws). RESULTS: We had a total of 101 responses. Among our sample of patients who use cannabis as part of a state-approved low THC oil program, 56% were male and 64% were older than age 50 years. Advanced cancer was the most common reason (76%) for granting the patients access to a low THC oil card. Although patients reported cannabis products as being extremely helpful for reducing pain, they expressed considerable concerns about the legality issues (64%) and ability to obtain THC (68%). Several respondents were using unapproved formulations of cannabis products. For 48% of the patients, their physician was the source of information regarding marijuana-related products. Furthermore, they believed that their health care providers and family members were supportive of their use of cannabis (62% and 79%, respectively). CONCLUSION: Patients on Georgia’s medical marijuana program are most concerned about the legality of the product and their ability to obtain marijuana-related products. Therefore, we recommend that states with medical marijuana laws should provide safe and reliable access to cannabis products for qualifying patients.

scholarly journals Preferences and Perceptions of Patients Attending Emergency Departments with Low Acuity Problems in Hong Kong

2009 ◽  
Vol 16 (3) ◽  
pp. 148-154 ◽  
Author(s):  
CA Graham ◽  
WO Kwok ◽  
YL Tsang ◽  
TH Rainer
Keyword(s):  
Health Care ◽  
Hong Kong ◽  
Health Care Providers ◽  
Waiting Time ◽  
Health Care Professionals ◽  
Waiting Times ◽  
Medical Advice ◽  
Care Providers ◽  
Convenience Sample ◽  
Waiting Area

Objective To explore why patients in Hong Kong seek medical advice from the emergency department (ED) and to identify the methods by which patients would prefer to be updated on the likely waiting time for medical consultation in the ED. Methods The study recruited 249 semi-urgent and non-urgent patients in the ED of Prince of Wales Hospital from 26th September 2005 to 30th September 2005 inclusive. A convenience sample of subjects aged ≥15 years old in triage categories 4 or 5 were verbally consented and interviewed by research nurses using a standardized questionnaire. Results From 1715 potential patients, 249 were recruited ad hoc (mean age 44 years [SD18]; 123 females). About 63% indicated that an acceptable ED waiting time was less than or equal to two hours, and 88% felt that having individual number cards and using a number allocation screen in the ED waiting area would be useful. Perceived reasons for attending the ED rather than other health care providers such as primary health care or the general outpatient clinic (GOPC) included: a desire for more detailed investigations (56%); a perception that more professional medical advice was given in the ED (35%); patients were under the continuing care of the hospital (19%); and patients were referred to the ED by other health care professionals (11%). Notably, 26% of participants had considered attending the GOPC prior to attending the ED. Patients educated to tertiary level expected a shorter waiting time than those educated to lesser degrees (p=0.026, Kruskal-Wallis test). Suggestions were made on how to provide a more pleasant ED environment for the wait for consultations, which included the provision of a television screen with sound in the waiting area (43%), more comfortable chairs (37%) and health care promotion programs (32%). Conclusion Patients chose ED services because they believed they would receive more detailed investigations and more professional medical advice than available alternatives. Clear notification of the likely waiting times and enhancement of comfort before consultation are considered desirable by patients. Enhanced public education about the role of the ED and making alternatives to ED care more accessible may be useful in reducing inappropriate ED attendances in Hong Kong.

The Use of and Attitude Towards Telehealth in Rural Communities

2007 ◽  
Vol 13 (3) ◽  
pp. 29 ◽  
Author(s):  
Emily Mauldon
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Routine Practice ◽  
Care Providers ◽  
Urban Hospital ◽  
Primary Health ◽  
The Impact ◽  
Rural Patients

This paper reports on the attitudes of a sample of health care providers towards the use of telehealth to support rural patients and integrate rural primary health and urban hospital care. Telehealth and other information technologies hold the promise of improving the quality of care for people in rural and remote areas and for supporting rural primary health care providers. While seemingly beneficial for rural patients, study participants believed that telehealth remains underused and poorly integrated into their practice. In general, participants thought that telehealth is potentially beneficial but places constraints on their activities, and few actually used it. Published literature usually reports either on the success of telehealth pilot projects or initiatives that are well resourced and do not reflect the constraints of routine practice, or has an international focus limiting its relevance to the Australian context. Because of the paucity of systematic and generalisable research into the effects of the routine use of telehealth to support rural patients, it is unclear why health care professionals choose to provide such services or the costs and benefits they incur in doing so. Research and policy initiatives continue to be needed to identify the impact of telehealth within the context of Australian primary health care and to develop strategies to support its use.

Exploring Psychosocial Determinants of Diversity Sensitive Task Perception and Behavioural Intentions in a Health Care Student Population: Recommendations for Diversity Education in Health Care

2021 ◽  
Author(s):  
Laura Van Raemdonck ◽  
Stijn Schelfhout ◽  
Wendelien Vantieghem ◽  
Riya George ◽  
Stéphanie De Maesschalck ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Student Population ◽  
Diversity Education ◽  
Care Providers ◽  
Psychosocial Determinants ◽  
Health Care Students ◽  
Behavioural Intentions ◽  
Task Perception ◽  
The Relationship

Abstract Background: Diversity sensitive task perception and diversity sensitive behavioural intentions are strong predictors of diversity sensitive care. Nevertheless, it has been less clear which psychosocial determinants are affecting these concepts in health care providers. This article also explores whether there are differences in relationships between these concepts, and how these concepts are interrelated. The study focussed on the following psychosocial determinants: (a) ethnocentric attitudes and (b) intercultural capabilities. The latter concept is drawn from the four-dimensional construct of intercultural intelligence. Methods: A survey was conducted in a health care student population (N = 364). In addition to classic survey questions, behavioural intentions were measured through the use of eight vignettes comprising situations characterised by diversity in health care. Results: Regression analyses show that ethnocentric attitudes were negatively associated with diversity sensitive task perception and behavioural intentions. Interestingly, we found no significant relationship between cognitive intercultural capabilities (IC) and diversity sensitivity. Motivational- and behavioural intercultural capabilities were significantly associated with diversity sensitive task perception and behavioural intentions. Motivational IC had a stronger relationship with task perception. Behavioural IC had a stronger relationship with behavioural intentions. Adding diversity sensitive task perception in a supplementary regression model as an independent variable on behavioural intentions caused a shift in associations. The significant association between motivational IC and behavioural intentions disappeared, and a significant association between diversity sensitive task perception and diversity sensitive behavioural intention appeared. Conclusion: Diversity education should increasingly focus on diminishing ethnocentric attitudes and encouraging behavioural IC and motivational IC in health care students. The paper also suggests two theoretical hypothesises. Firstly, metacognitive IC is a concept strongly related to two IC: motivational IC and behavioural IC. Secondly, the relationship between motivational IC and behavioural intentions is fully mediated by diversity sensitive task perception. Further research that substantiate these theoretical hypothesises is recommended.

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