scholarly journals Response to language barriers with patients from refugee background in general practice in Australia: findings from the OPTIMISE study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shoko Saito ◽  
Mark F Harris ◽  
Katrina M Long ◽  
Virginia Lewis ◽  
Sue Casey ◽  
...  
Keyword(s):  
Randomised Trial ◽  
Family Members ◽  
Cluster Randomised Trial ◽  
Practice Facilitation ◽  
Major Barrier ◽  
Extra Time ◽  
General Practices ◽  
The Government ◽  
Time Required

Abstract Background Language is a barrier to many patients from refugee backgrounds accessing and receiving quality primary health care. This paper examines the way general practices address these barriers and how this changed following a practice facilitation intervention. Methods The OPTIMISE study was a stepped wedge cluster randomised trial set within 31 general practices in three urban regions in Australia with high refugee settlement. It involved a practice facilitation intervention addressing interpreter engagement as one of four core intervention areas. This paper analysed quantitative and qualitative data from the practices and 55 general practitioners from these, collected at baseline and after 6 months during which only those assigned to the early group received the intervention. Results Many practices (71 %) had at least one GP who spoke a language spoken by recent humanitarian entrants. At baseline, 48 % of practices reported using the government funded Translating and Interpreting Service (TIS). The role of reception staff in assessing and recording the language and interpreter needs of patients was well defined. However, they lacked effective systems to share the information with clinicians. After the intervention, the number of practices using the TIS increased. However, family members and friends continued to be used to interpret with GPs reporting patients preferred this approach. The extra time required to arrange and use interpreting services remained a major barrier. Conclusions In this study a whole of practice facilitation intervention resulted in improvements in procedures for and engagement of interpreters. However, there were barriers such as the extra time required, and family members continued to be used. Based on these findings, further effort is needed to reduce the administrative burden and GP’s opportunity cost needed to engage interpreters, to provide training for all staff on when and how to work with interpreters and discuss and respond to patient concerns about interpreting services.

scholarly journals Exploring the independent prescribing role of the community pharmacists in Wales

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i35-i35
Author(s):  
S S Alghamdi ◽  
R Deslandes ◽  
S White ◽  
K Hodson ◽  
A Mackridge ◽  
...  
Keyword(s):  
Community Pharmacy ◽  
Community Pharmacists ◽  
Community Pharmacies ◽  
Committee Report ◽  
Independent Prescribing ◽  
General Practices ◽  
The Government ◽  
Clinical Records ◽  
The Impact

Abstract Introduction Since 2019, the role of independent pharmacist prescribers (IPPs) in primary care has extended to community pharmacies in Wales [1]. This was in response to a Welsh Pharmaceutical Committee report in 2019 that outlined a plan to include an IPP in each community pharmacy in Wales by 2030. This aimed to relieve pressure on general practices, enhance patient care and reduce referral and admission rates to secondary care [2]. As funding was provided by the Government, the number of community pharmacists completing the independent prescribing course increased and many have implemented their prescribing role. Aim To explore the views of community IPPs regarding their prescribing role within community pharmacies in Wales. Methods Semi-structured face-to-face and telephone interviews were conducted with community IPPs from all seven health boards (HBs) in Wales. Ethical approval was obtained from the School of Pharmacy and Pharmaceutical Sciences at Cardiff University and the School of Pharmacy and Bioengineering at Keele University. Purposive sampling was used to identify potential participants. Gatekeepers (HB community pharmacy leads and directors of IPP courses in Wales) sent invitation emails, participant information sheet and consent form to potential participants. Written consent was obtained. Interviews were audio-recorded and transcribed ad verbatim. Thematic analysis was used to analyse the data. Results Thirteen community IPPs across Wales participated. Six themes were identified, including the utilisation of their role as community IPPs, their experiences with their independent prescribing training, motivation to obtain their prescribing qualification and utilise it, the impact, barriers and facilitators to implement and utilise their role. Participants practised as IPPs in the management of minor ailments and some other conditions, such as respiratory and sexual health. The course and training for community IPPs was helpful, but there was a need to focus more on therapeutic and clinical examination skills. The main impact of the role was that it helped to improve communication between community pharmacies and general practices and relieved some pressure on general practices. The main barriers were the lack of appropriate funding by the Government to develop the role, lack of access to patients’ medical records, lack of support and high workload. “One of the areas identified as high risk is for pharmacy prescribers is the lack of access to clinical records. How can you [as community IPPs] make any sensible decisions with half the information?” IPP6 Facilitators included that some services were already in place and the drive from the 2030 vision. Conclusion This is the first study that explored the views of community IPPs regarding their prescribing role in community pharmacies in Wales. It provided an insight into this new role that can be considered by the Welsh Government to achieve the 2030 vision for this role. A limitation to this study was that the role is still new in community pharmacies, which may affect the views of the community IPPs. Many of them have obtained their prescribing qualification but have not started to utilise it yet. Further work is needed to explore a wider population of community IPPs’ experiences as the role develops. References 1. Wickware, C. 2019. All community pharmacies in Wales to have an independent prescriber as part of long-term plan for Welsh pharmacy. Available at: https://www.pharmaceutical-journal.com/news-and-analysis/news/all-community-pharmacies. 2. Welsh Pharmaceutical Committee. 2019. Pharmacy: Delivering a Healthier Wales. Available at: https://www.rpharms.com/Portals/0/RPS%2.

From Vulnerable Health Habitus to Tough Health Habitus Against Covid-19 in Inang-Inang at The Traditional Markets in Medan, Indonesia

2021 ◽  
Vol 12 (1) ◽  
pp. 111-111
Author(s):  
Hadriana Marhaeni Munthe ◽  
Lina Sudarwati
Keyword(s):  
Family Members ◽  
Economic Resilience ◽  
Health Security ◽  
Traditional Markets ◽  
Urban Markets ◽  
The People ◽  
Traditional Market ◽  
Strategic Role ◽  
The Government

The term, 'inang-inang pasar' is referred to Bataknese market female vendors who sell basic commodities in the traditional urban markets. They have the image of hard working and tough vendors who fight against poverty in towns. Their activities as vendors in traditional markets indicate their strategic role of women as the agents of economic resilience and the agents of health security in their families. Here, their toughness in supporting their families by being vendors at Sembada traditional market, Medan. However, their toughness becomes a dilemma caused by Covid-19 pandemic. In this case, the government implement prokes (health protocol) from 3Ms to 5 Ms (wearing masks, washing hands, doing social distancing, avoiding crowd, and staying home), including in the area of the traditional markets where they sell their merchandise. The Prokes of Covid-19 in traditional markets have caused various responses from them. The reality is that they have not been ready to practice the policy on this 5 M Prokes since most of them lack of awareness of adhering to it due to the vulnerable of their health habitus. It seems that they can become the carriers and local transmitters of Covid-19. This situation worsens their condition and the people surrounding them such as their own family members. Keywords: Habitus, Covid-19, Inang-Inang, Traditional Market

Management of COPD in Australian general practices: experiences from a cluster randomised trial

2017 ◽  
Author(s):  
Jenifer Liang ◽  
Michael Abramson ◽  
Nicholas Zwar ◽  
Grant Russell ◽  
Anne Holland ◽  
...  
Keyword(s):  
Randomised Trial ◽  
Cluster Randomised Trial ◽  
Cluster Randomised ◽  
General Practices

scholarly journals “家庭共決”保障脆弱人群的倫理限度及困境

2013 ◽  
Vol 11 (2) ◽  
pp. 45-50
Author(s):  
Junrong LIU
Keyword(s):  
Family Members ◽  
Vulnerable Groups ◽  
Digital Commons ◽  
The Family ◽  
The Government

LANGUAGE NOTE | Document text in Chinese; abstract in English only.The role of the family as “the first guarantee” of vulnerable groups is extremely limited and not always effective. When disagreements arise between patients and their family members, family co-determination can do nothing to help. Respecting patients’ autonomy should be taken as the premise of family co-determination; the government and society undertake more important responsibilities in the protection of vulnerable groups.DOWNLOAD HISTORY | This article has been downloaded 52 times in Digital Commons before migrating into this platform.

scholarly journals Family networks and healthy behaviour: evidence from Nepal

2018 ◽  
Vol 14 (2) ◽  
pp. 231-248 ◽  
Author(s):  
Jolene Skordis ◽  
Noemi Pace ◽  
Marcos Vera-Hernandez ◽  
Imran Rasul ◽  
Emla Fitzsimons ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Knowledge ◽  
Nuclear Family ◽  
Randomised Trial ◽  
Cluster Randomised Trial ◽  
Health Seeking Behaviour ◽  
Health Seeking ◽  
Family Networks ◽  
Ability To Act

AbstractModels of household decision-making commonly focus on nuclear family members as primary decision-makers. If extended families shape the objectives and constraints of households, then neglecting the role of this network may lead to an incomplete understanding of health-seeking behaviour. Understanding the decision-making processes behind care-seeking may improve behaviour change interventions, better intervention targeting and support health-related development goals. This paper uses data from a cluster randomised trial of a participatory learning and action cycle (PLA) through women’s groups, to assess the role of extended family networks as a determinant of gains in health knowledge and health practice. We estimate three models along a continuum of health-seeking behaviour: one that explores access to PLA groups as a conduit of knowledge, another measuring whether women’s health knowledge improves after exposure to the PLA groups and a third exploring the determinants of their ability to act on knowledge gained. We find that, in this context, a larger network of family is not associated with women’s likelihood of attending groups or acquiring new knowledge, but a larger network of husband’s family is negatively associated with the ability to act on that knowledge during pregnancy and the postpartum period.

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