scholarly journals Understanding what matters most to patients in acute care in seven countries, using the flash mob study design

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eva S. van den Ende ◽  
◽  
Bo Schouten ◽  
Marjolein N. T. Kremers ◽  
Tim Cooksley ◽  
...  

Abstract Background Truly patient-centred care needs to be aligned with what patients consider important, and is highly desirable in the first 24 h of an acute admission, as many decisions are made during this period. However, there is limited knowledge on what matters most to patients in this phase of their hospital stay. The objective of this study was to identify what mattered most to patients in acute care and to assess the patient perspective as to whether their treating doctors were aware of this. Methods This was a large-scale, qualitative, flash mob study, conducted simultaneously in sixty-six hospitals in seven countries, starting November 14th 2018, ending 50 h later. One thousand eight hundred fifty adults in the first 24 h of an acute medical admission were interviewed on what mattered most to them, why this mattered and whether they felt the treating doctor was aware of this. Results The most reported answers to “what matters most (and why)?” were ‘getting better or being in good health’ (why: to be with family/friends or pick-up life again), ‘getting home’ (why: more comfortable at home or to take care of someone) and ‘having a diagnosis’ (why: to feel less anxious or insecure). Of all patients, 51.9% felt the treating doctor did not know what mattered most to them. Conclusions The priorities for acutely admitted patients were ostensibly disease- and care-oriented and thus in line with the hospitals’ own priorities. However, answers to why these were important were diverse, more personal, and often related to psychological well-being and relations. A large group of patients felt their treating doctor did not know what mattered most to them. Explicitly asking patients what is important and why, could help healthcare professionals to get to know the person behind the patient, which is essential in delivering patient-centred care. Trial registration NTR (Netherlands Trial Register) NTR7538.

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Stephana J. Moss ◽  
Karla D. Krewulak ◽  
Henry T. Stelfox ◽  
Sofia B. Ahmed ◽  
Melanie C. Anglin ◽  
...  

Abstract Background Restricted visitation policies in acute care settings because of the COVID-19 pandemic have negative consequences. The objective of this scoping review is to identify impacts of restricted visitation policies in acute care settings, and describe perspectives and mitigation approaches among patients, families, and healthcare professionals. Methods We searched Medline, Embase, PsycINFO, Healthstar, CINAHL, Cochrane Central Register of Controlled Trials on January 01/2021, unrestricted, for published primary research records reporting any study design. We included secondary (e.g., reviews) and non-research records (e.g., commentaries), and performed manual searches in web-based resources. We excluded records that did not report primary data. Two reviewers independently abstracted data in duplicate. Results Of 7810 citations, we included 155 records. Sixty-six records (43%) were primary research; 29 (44%) case reports or case series, and 26 (39%) cohort studies; 21 (14%) were literature reviews and 8 (5%) were expert recommendations; 54 (35%) were commentary, editorial, or opinion pieces. Restricted visitation policies impacted coping and daily function (n = 31, 20%) and mental health outcomes (n = 29, 19%) of patients, families, and healthcare professionals. Participants described a need for coping and support (n = 107, 69%), connection and communication (n = 107, 69%), and awareness of state of well-being (n = 101, 65%). Eighty-seven approaches to mitigate impact of restricted visitation were identified, targeting families (n = 61, 70%), patients (n = 51, 59%), and healthcare professionals (n = 40, 46%). Conclusions Patients, families, and healthcare professionals were impacted by restricted visitation polices in acute care settings during COVID-19. The consequences of this approach on patients and families are understudied and warrant evaluation of approaches to mitigate their impact. Future pandemic policy development should include the perspectives of patients, families, and healthcare professionals. Trial registration: The review was registered on PROSPERO (CRD42020221662) and a protocol peer-reviewed prior to data extraction.


2019 ◽  
Vol 2 (3) ◽  
pp. 36
Author(s):  
Karin Dam Eikhof

Background: The aim was to gain insight into how patients with chronic obstructive pulmonary disease (COPD) experience being acutely admitted to an emergency department in Denmark. The Department is characterized by a large number of acute patients, which means that the focal point for the healthcare professionals may be to ensure vacant beds. This may be at the expense of caring for the patients sufficiently due to their individual needs. Focus on the flow culture may be contrary to the need for e.g. silence, safety, continuity in care and time with the healthcare professionals. Methods:  This study has a qualitative design with a phenomenological hermeneutic approach. The empirics consist of qualitative semi-structured interviews with fourteen patients admitted to an emergency department in Denmark. The data has been analysed through the four steps about meaning condensation and meaning interpretation as described by Kvale and Brinkmann. Results: The preliminary analyses indicated that patients being admitted to the Emergency Department experience a strong need for getting help to breathe and rest. They have struggled with their breathing when they were at home and therefore feel extremely tired. Thus, the chaos that often exists in the Emergency Department may affect the patients’ well-being. In addition, the healthcare professionals’ way of communicating with the patients has a great impact on patient´s feeling safe and comfortable. Conclusion: By focusing on the patients´ individual fundamental care needs in a busy department, it may qualify continuity of care for patients with COPD.


Author(s):  
Ramakanta Satapathy ◽  
Bikram Kumar Das

<p>Right to health is recognized by the constitution of India. The Constitution of World Health Organization states that, “Health is a State of Complete physical, mental and social well being and not merely the absence of diseases or infirmity.” Right to health presupposes that, “ it is the duty of the State to raise the level of nutrition and standard of living of the people for good health. The apex court of India declared that Right to health is a fundamental right coming within Article 21 of the Indian Constitution. Right to health and health care needs multi-disciplinary services to monitor health condition of life. It is a huge task requires effective management and organized action.  In this article an attempt is made to introspect the right to health within the constitutional parameters, international provisions and judicial decisions of Supreme Court. In this work doctrinal method is adopted to draw the conclusion. </p>


2019 ◽  
Vol 17 (5) ◽  
pp. 561-568 ◽  
Author(s):  
Susanne Lind ◽  
Lars Wallin ◽  
Carl Johan Fürst ◽  
Ingela Beck

AbstractObjectiveImplementation of patient-reported outcome measures for patients with palliative care needs is characterized by both enablers and barriers. The ways in which healthcare professionals experience the use of assessment tools is important. Our aims were to explore factors contributing to or hindering patients with palliative care needs in assessing their symptoms with the Integrated Palliative Care Outcome Scale (IPOS) and to explore healthcare professionals’ experiences of the use of IPOS in acute care settings.MethodData were collected as a part of the evaluation of the feasibility of an implementation strategy for introducing IPOS. Data from three participating acute care units were included. We used descriptive and analytical statistics; a qualitative content analysis was also performed.ResultA total of 309 patients were eligible to be offered assessment of symptoms with IPOS. Of these 69 (22%) had completed IPOS. A significant positive association was found between healthcare professionals’ participation in training sessions and completed IPOS. The experiences of IPOS were split into two categories: “IPOS acting as a facilitator” and “barriers to the use of IPOS.” The use of IPOS was described as contributing to person-centered care of patients with palliative care needs and inspiration to improved routines. Healthcare professionals’ feelings of uncertainty about how to approach severely ill patients and their family members appear to have hindered their use of IPOS.Significance of resultsWe found an association between healthcare professionals’ participation in training sessions and patients who completed IPOS, indicating the need for a high degree of attendance at the training to achieve successful implementation. The healthcare professionals expressed feelings of insecurity concerning the use of IPOS indicating a need for further education and clinical support in its use of IPOS. Nevertheless, use of IPOS was considered to contribute to improved care of patients with palliative care needs.


2020 ◽  
pp. 105477382095811
Author(s):  
Ayşe Arikan Dönmez ◽  
Nilgün Kuru Alici ◽  
Pınar Borman

This descriptive phenomenological study was conducted to explore the lived experiences for supportive care needs of women with breast cancer-related lymphedema. Purposive sampling was used to recruit participants. In-depth, semi-structured interviews were conducted to collect data. Thematic analysis method was used for data analysis. Data saturation was achieved after interviewing 19 participants. The study was divided into four main themes and nine subthemes: physical (caused by difficulties in performing household chores, limitations in performing self-care activities, and challenges in shopping), psychosocial (being addicted to someone else in daily life, uncertainty about the future, social, and religious support), healthcare systems and information (attention from healthcare professionals, education and lifestyle advices, and access to healthcare sources), and financial supportive care needs. Women experience various SCNs in their daily lives. Provision of supportive care from both family members or others and healthcare professionals could ease the daily lives, improve physical, and psychosocial well-being.


Author(s):  
Sanne J. Kuipers ◽  
Anna P. Nieboer ◽  
Jane M. Cramm

Background: Primary care delivery for multimorbid patients is complex, due to single disease–oriented guidelines, complex care needs, time constraints and the involvement of multiple healthcare professionals. Co-creation of care, based on the quality of communication and relationships between healthcare professionals and patients, may therefore be valuable. This longitudinal study investigates the relationships of co-creation of care to physical and social well-being and satisfaction with care among multimorbid patients in primary care. Methods: In 2017 and 2018, longitudinal surveys were conducted among multimorbid patients from seven primary care practices in Noord-Brabant, the Netherlands (n = 138, age = 73.50 ± 9.99). Paired sample t-tests and multivariate regression analyses were performed. (3) Results: Co-creation of care improved significantly over time (t = 2.25, p = 0.026), as did social well-being (t = 2.31, p = 0.022) and physical well-being (t = 2.72, p = 0.007) but not satisfaction with care (t = 0.18, p = 0.858). Improvements in co-creation of care from T0 to T1 were associated with social well-being (B = 0.157, p = 0.002), physical well-being (B = 0.216, p = 0.000) and satisfaction with care (B = 0.240, p = 0.000). (4) Conclusions: Thus, investment in co-creation of care by primary care practices may lead to better outcomes for multimorbid patients.


2013 ◽  
Vol 22 (1) ◽  
pp. 87-95 ◽  
Author(s):  
Sanna Sintonen ◽  
Aini Pehkonen

2013 ◽  
Vol 18 (3) ◽  
pp. 158-168 ◽  
Author(s):  
Emily Frankenberg ◽  
Katharina Kupper ◽  
Ruth Wagner ◽  
Stephan Bongard

This paper reviews research on young migrants in Germany. Particular attention is given to the question of how Germany’s history of migration, immigration policies, and public attitude toward migrants influence the transcultural adaptation of children and adolescents from different ethnic backgrounds. We combine past research with the results of new empirical studies in order to shed light on migrants’ psychological and sociocultural adaptation. Studies comparing young migrants and their German peers in terms of psychological well-being, life satisfaction, and mental health outcome suggest higher rates of emotional and behavioral problems among migrants of most age groups. With regard to adolescent populations between the ages of 14 and 17 years, however, the existence of differences between migrants and natives appears to be less clear. Research has also yielded inconsistent findings regarding the time trajectory of transcultural adaptation among adolescents. The coincidence of acculturation and age-related change is discussed as a possible source of these inconsistencies. Further, we provide an overview of risk and protective factors such as conflicting role expectations and ethnic discrimination, which may cause heightened vulnerability to adverse adaptation outcomes in some groups. Large-scale studies have repeatedly shown migrants of all age groups to be less successful within the German school system, indicating poor sociocultural adaptation. Possible explanations, such as the idiosyncrasies of the German school system, are presented. Our own studies contribute to the understanding of young migrants’ adaptation process by showing that it is their orientation to German culture, rather than the acculturation strategy of integration, that leads to the most positive psychological and sociocultural outcomes. The paper concludes by discussing implications for future cross-cultural research on young migrants and by suggesting recommendations for multicultural policies.


Author(s):  
Deborah Carr ◽  
Vera K. Tsenkova

The body weight of U.S. adults and children has risen markedly over the past three decades. The physical health consequences of obesity are widely documented, and emerging research from the Midlife in the United States study and other large-scale surveys reveals the harmful impact of obesity on adults’ psychosocial and interpersonal well-being. This chapter synthesizes recent research on the psychosocial implications of body weight, with attention to explanatory mechanisms and subgroup differences in these patterns. A brief statistical portrait of body weight is provided, documenting rates and correlates of obesity, with a focus on race, gender, and socioeconomic status disparities. The consequences of body weight for three main outcomes are described: institutional and everyday discrimination, interpersonal relationships, and psychological well-being. The chapter concludes with a discussion of the ways that recent integrative health research on the psychosocial consequences of overweight and obesity inform our understanding of population health.


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