scholarly journals “They’re very passionate about making sure that women stay healthy”: a qualitative examination of women’s experiences participating in a community paramedicine program

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Laura M. Schwab-Reese ◽  
Lynette M. Renner ◽  
Hannah King ◽  
R. Paul Miller ◽  
Darren Forman ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Primary Care Providers ◽  
Holistic Health ◽  
Care Providers ◽  
Women’S Experiences ◽  
Early Motherhood ◽  
Women's Experiences ◽  
Community Paramedicine ◽  
Novel Approach ◽  
Physician Extenders

Abstract Background Community paramedicine programs (i.e., physician-directed preventive care by emergency medical services personnel embedded in communities) offer a novel approach to community-based health care. Project Swaddle, a community paramedicine program for mothers and their infants, seeks to address (directly or through referrals) the physical, mental, social, and economic needs of its participants. The objective of this process evaluation was to describe women’s experiences in Project Swaddle. By understanding their experiences, our work begins to build the foundation for similar programs and future examinations of the efficacy and effectiveness of these approaches. Methods We completed 21 interviews with women living in Indiana (July 2019–February 2020) who were currently participating in or had graduated from Project Swaddle. Interviews were audio-recorded, transcribed, and analyzed using a six-phase approach to thematic analysis. Results Program enrollment was influenced by the community paramedics’ experience and connections, as well as information received in the community from related clinics or organizations. Participants viewed the community paramedic as a trusted provider who supplied necessary health information and support and served as their advocate. In their role as physician extenders, the community paramedics enhanced patient care through monitoring critical situations, facilitating communication with other providers, and supporting routine healthcare. Women noted how community paramedics connected them to outside resources (i.e., other experts, tangible goods), which aimed to support their holistic health and wellbeing. Conclusions Results demonstrate Project Swaddle helped women connect with other healthcare providers, including increased access to mental health services. The community paramedics were able to help women establish care with primary care providers and pediatricians, then facilitate communication with these providers. Women were supported through their early motherhood experience, received education on parenting and taking control of their health, and gained access to resources that met their diverse needs.

scholarly journals “They’re very passionate about making sure that women stay healthy”: Women’s experiences participating in a community paramedicine program

2021 ◽  
Author(s):  
Laura Schwab-Reese ◽  
Lynette M Renner ◽  
Hannah King ◽  
R. Paul Miller ◽  
Darren Forman ◽  
...  
Keyword(s):  
Process Evaluation ◽  
Holistic Health ◽  
Women’S Experiences ◽  
Health And Wellbeing ◽  
Women's Experiences ◽  
Community Paramedicine ◽  
Novel Approach ◽  
Emergency Medical Services Personnel ◽  
Program Enrollment ◽  
Physician Extenders

Community paramedicine programs (i.e., physician-directed preventive care by emergency medical services personnel embedded in communities) offer a novel approach to community-based health care. Project Swaddle, a community paramedicine program for mothers and their infants, seeks to address (directly or through warm referrals) the physical, mental, social, and economic needs of its participants. The objective of this process evaluation was to describe women’s experiences in Project Swaddle. By understanding their experiences, our work begins to build the foundation for similar programs and future examinations of the efficacy and effectiveness of these approaches. We completed 21 interviews with women living in Indiana (July 2019 - February 2020) who were currently participating in or had graduated from Project Swaddle. Interviews were audio-recorded, transcribed, and analyzed using a six-phase approach to thematic analysis. Four emerging themes resulted: 1) Program enrollment was influenced by the community paramedics’ experience and connections; 2) Participating women view the community paramedics as a trusted provider who supplied necessary health information and support; 3) In their role as physician extenders, the community paramedics enhanced patient care through communication with other providers; 4) The program and its community paramedics connected participants to outside resources, which aimed to support their holistic health and wellbeing. The results of our process evaluation suggest Project Swaddle is a promising approach to improving the health and wellbeing of women and infants. Future outcome and impact evaluations are necessary to quantify the effect of Project Swaddle on its participants.

Pearls and pitfalls for prescribing opioids in a climate of increased provider scrutiny

2017 ◽  
Vol 52 (2) ◽  
pp. 190-195
Author(s):  
Joanna Gedzior ◽  
Arlen Kwong
Keyword(s):  
Primary Care ◽  
Healthcare Providers ◽  
Primary Care Providers ◽  
Opiate Addiction ◽  
Opioid Epidemic ◽  
Care Providers ◽  
Health Crisis ◽  
Surgeon General

In August 2016, U.S. Surgeon General Vivek Murthy, MD, MBA, issued a letter to healthcare providers requesting aid in addressing “an urgent health crisis facing America: the opioid epidemic.” In this article, we address some of the more poignant challenges that surface in treating patients with opiate addiction. We provide an outline of recommendations from the leading medical organizations to educate primary care providers on how to navigate patients to decreased or discontinued medication loads.

“From Hell to Healed” – A Qualitative Study on Women’s Experience of Recovery, Relationships and Sexuality after Severe Obstetric Perineal Injury

2020 ◽  
Author(s):  
Malin Huber ◽  
Katarina Tunon ◽  
Maria Lindqvist
Keyword(s):  
Sexual Function ◽  
Health Care Professionals ◽  
Qualitative Content Analysis ◽  
Pelvic Floor Dysfunction ◽  
Physical Symptoms ◽  
Care Providers ◽  
Women’S Experiences ◽  
Anal Sphincter Injury ◽  
Women's Experiences ◽  
The Right

Abstract Background: Few studies have investigated women’s experiences of daily life after childbirth complicated by obstetric anal sphincter injury (OASI). The aim of the present study was to explore experiences related to recovery, sexual function, relationships and coping strategies among women affected by OASI. Methods: In-depth interviews were conducted using a purposive sample of 11 women affected by OASI. Women were interviewed 1-2 years after their first childbirth. Inductive qualitative content analysis was applied.Results: The theme “From hell to healed” illustrates women’s experiences of recovery, relationships and sexual function after OASI. Three categories addressing women’s perceptions emerged: “Challenged to the core”, “At the mercy of the care provider” and “For better or for worse”. Support from partners and family and comprehensive care were important elements for the experiences of coping and healing from OASI. Elements that negatively influenced women’s experiences were the pain and physical symptoms of pelvic floor dysfunction, normalization of symptoms by heath care providers, and unrealistic expectations about how this period in life should be experienced.Conclusions: OASI greatly affects women’s experiences of their first years with their newborn child, relationships, social context and sexuality. For some women, OASI negatively affects everyday life for a long period after childbirth. However, others heal and cope quite quickly. Health care professionals need to identify and pay attention to women with persisting problems after OASI so that they can be directed to the right level of care.

scholarly journals Diabetes in Appalachia: providers’ perspectives

2020 ◽  
Vol 21 ◽  
Author(s):  
Elizabeth A. Beverly ◽  
Marilyn D. Ritholz ◽  
Karie Cook ◽  
Lesli K. Johnson ◽  
Anirudh Ruhil ◽  
...  
Keyword(s):  
Primary Care ◽  
Diabetes Care ◽  
Healthcare Providers ◽  
Primary Care Providers ◽  
Cultural Humility ◽  
Care Providers ◽  
Post Traumatic Stress ◽  
Appalachian Culture ◽  
Patients With Diabetes ◽  
Appalachian Ohio

Abstract Background: Southeastern Appalachian Ohio has more than double the national average of diabetes and a critical shortage of healthcare providers. Paradoxically, there is limited research focused on primary care providers’ experiences treating people with diabetes in this region. This study explored providers’ perceived barriers to and facilitators for treating patients with diabetes in southeastern Appalachian Ohio. Methods: We conducted in-depth interviews with healthcare providers who treat people with diabetes in rural southeastern Ohio. Interviews were transcribed, coded, and analyzed via content and thematic analyses using NVivo 12 software (QSR International, Chadstone, VIC, Australia). Results: Qualitative analysis revealed four themes: (1) patients’ diabetes fatalism and helplessness: providers recounted story after story of patients believing that their diabetes was inevitable and that they were helpless to prevent or delay diabetes complications. (2) Comorbid psychosocial issues: providers described high rates of depression, anxiety, incest, abuse, and post-traumatic stress disorder among people with diabetes in this region. (3) Inter-connected social determinants interfering with diabetes care: providers identified major barriers including lack of access to providers, lack of access to transportation, food insecurity, housing insecurity, and financial insecurity. (4) Providers’ cultural understanding and recommendations: providers emphasized the importance of understanding of the values central to Appalachian culture and gave culturally attuned clinical suggestions for how to use these values when working with this population. Conclusions: Evidence-based interventions tailored to Appalachian culture and training designed to increase the cultural competency and cultural humility of primary care providers may be effective approaches to reduce barriers to diabetes care in Appalachian Ohio.

Students’ lack of knowledge regarding healthcare providers’ duties, and their preferences for information when selecting new providers

2015 ◽  
Vol 3 (1) ◽  
pp. 113 ◽  
Author(s):  
Evan Perrault
Keyword(s):  
College Students ◽  
Nurse Practitioners ◽  
Personal Information ◽  
Healthcare Providers ◽  
Physician Assistants ◽  
Primary Care Providers ◽  
Health Centers ◽  
Care Providers ◽  
Web Based ◽  
Midwestern Usa

Rationale, aims and objectives: When USA college students need medical care, their first destinations are usually campus health centers. Normally, staffed by a variety of care providers (e.g., nurse practitioners, physician assistants, physicians), students may be confused about who they may need to see and possibly hesitant to receive care. The present study sought to determine students’ knowledge about primary care providers and the qualities they would like to know about them prior to consultations. The goal of this paper is to improve the information campus health centers in terms of their ability to provide students health solutions when and where they need them. Methods: 534 USA college students from a large Midwestern USA university completed a web-based survey about their knowledge, attitudes and information preferences regarding their various care providers. They also viewed 3 experimentally manipulated biographies of providers and chose the provider they would want to visit. Results: The majority of students did not know the differences between physicians, physician assistants and nurse practitioners and the types of care that they could provide. About 9% stated they would not seek care and 16% would delay seeking care if unable to see a physician immediately. The most important pieces of information desired were providers’ philosophies of care, certifications, areas of specialization and length of time practising medicine. As students perceived greater similarities due to more personal information provided in the biographies, they viewed, uncertainty was reduced leading to higher levels of anticipated patient satisfaction and quality of care. Conclusions: USA college students need greater levels of education regarding the care that can be received from a variety of healthcare professionals. Information provided should also include more personal information about the providers to help reduce students’ uncertainty and to enable students to access services that are person-centered in their nature.

The ESCAPADE Study: Early supportive care for advanced cancer patients, assessing care delivery and provider engagement.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23142-e23142
Author(s):  
Oren Hannun Levine ◽  
Daryl Bainbridge ◽  
Gregory Russell Pond ◽  
Marissa Slaven ◽  
Sukhbinder K. Dhesy-Thind ◽  
...  
Keyword(s):  
Palliative Care ◽  
Disease Management ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Healthcare Providers ◽  
Primary Care Providers ◽  
Newly Diagnosed ◽  
Care Providers ◽  
Advanced Cancer Patients ◽  
Gi Cancer

e23142 Background: Advanced cancer patients benefit from early integration of palliative care (EIPC) with usual care. A proposed model of EIPC reserves specialized palliative care (SPC) for complex patients, while primary care providers (PCP) and oncologists oversee basic palliative care (PC). We studied the attitudes among patients and their healthcare providers regarding delivery of EIPC. Methods: A cross-sectional study at a tertiary cancer centre in Ontario. Patients with newly diagnosed incurable gastrointestinal (GI) cancer were surveyed using a study specific instrument for the outcomes of interest: importance of and preferences for accessing support across 8 domains of PC (disease management, physical, psychological, social, spiritual, practical, end of life care, loss and grief). Healthcare providers within the circle of care completed a parallel survey for each recruited patient. Primary analysis involved use of descriptive statistics to summarize survey results and concordance between patient and provider responses. Results: From Oct 2017 - Nov 2018, 67 patients were surveyed (median age 69, 34% female). 90% had an identified medical oncologist, and 19% had SPC. 97% had a PCP, but only 42% listed a PCP as part of the care team. Median time from first oncology assessment for advanced cancer to patient survey completion was 52.5 days. 85 providers responded (oncologist = 59, PCP = 20, SPC = 6; response rate 92%; 1-3 physician responses per patient). Disease management and physical concerns were most important to patients. In these domains, 67% and 81% of patients endorsed receiving care from the preferred provider, but concordance between patient and physician responses regarding most responsible provider was only 58% and 38%. For all other domains, 87 – 100% of patients attributed primary responsibility to self or family rather than any healthcare provider. Conclusions: Respondents did not assign responsibility to physicians early in the disease trajectory for many domains of PC. Our findings suggest that incorporating patient activation and empowerment into EIPC requires further study. PCPs appeared to have limited involvement in PC for newly diagnosed advanced GI cancer patients.

scholarly journals A Hepatitis C Educational Needs Assessment of Canadian Healthcare Providers

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Reza Naghdi ◽  
Karen Seto ◽  
Carolyn Klassen ◽  
Didi Emokpare ◽  
Brian Conway ◽  
...  
Keyword(s):  
Primary Care ◽  
Hepatitis C ◽  
Needs Assessment ◽  
Primary Care Physicians ◽  
Healthcare Providers ◽  
Public Health Problem ◽  
Primary Care Providers ◽  
Educational Needs ◽  
Major Public Health Problem ◽  
Care Providers

Background and Aim. Despite advances in the treatment of chronic hepatitis C infection (CHC), it remains a major public health problem in Canada and globally. The knowledge of healthcare providers (HCPs) is critical to improve the care of CHC in Canada. To assess the current knowledge and educational needs of healthcare providers (HCPs) in the area of CHC management a national online survey was conducted. Method. An interprofessional steering committee designed a 29-question survey distributed through various direct and electronic routes. The survey assessed several domains (e.g., participant and practice demographics, access to resources, knowledge of new treatments, and educational preferences). Results. A total of 163 HCPs responded to the survey. All hepatologists and 8% of primary care providers (PCPs) reported involvement in treatment of CHC. Physicians most frequently screened patients who had abnormal liver enzymes, while nurses tended to screen based on lifestyle factors. More than 70% of PCPs were not aware of new medications and their mechanisms. Conclusion. Overall, the needs assessment demonstrated that there was a need for further education, particularly for primary care physicians, to maximize the role that they can play in screening, testing, and treatment of hepatitis C in Canada.

Evaluation of an Inter-Professional Educational Intervention to Improve the Use of Arthritis Best Practices in Primary Care

2011 ◽  
Vol 38 (5) ◽  
pp. 931-937 ◽  
Author(s):  
SYDNEY C. LINEKER ◽  
MARY J. BELL ◽  
ELIZABETH M. BADLEY
Keyword(s):  
Primary Care ◽  
Best Practices ◽  
Nurse Practitioners ◽  
Professional Education ◽  
Best Practice ◽  
Healthcare Providers ◽  
Primary Care Providers ◽  
Care Providers ◽  
Rehabilitation Professionals ◽  
Knee Oa

Objective.To describe the evaluation of a community-based continuing health education program designed to improve the management of rheumatoid arthritis (RA) and osteoarthritis (OA), and to examine the results by discipline.Methods.The Getting a Grip on Arthritis©program was based on clinical practice guidelines adapted for the primary care environment (best practices). The program consisted of an accredited inter-professional workshop and 6 months of activities to reinforce the learning. Analyses compared best practice scores derived from responses to 3 standardized case scenarios (early and late RA; moderate knee OA) at baseline and 6 months post-workshop using the ACREU Primary Care Survey.Results.In total, 553 primary care providers (nurses/licensed practical nurses 30.9%, rehabilitation professionals 22.5%, physicians 22.5%, nurse practitioners 10.9%, other healthcare providers/non-clinical staff/students 13.1%) attended one of 27 workshops across Canada; 275 (49.7%) completed followup surveys. Best practice scores varied by discipline at baseline (p < 0.05) and improved for all 3 case scenarios, with nurse practitioners and rehabilitation therapists improving the most (p ≤ 0.05).Conclusion.Results suggest that inter-professional education may be an effective method for dissemination of guidelines and has potential to improve the delivery of arthritis care, particularly when nurse practitioners and rehabilitation therapists are involved in the care of patients.

scholarly journals Exploration of the Pregnant Women's Experiences During COVID-19 Disease Crisis: A Qualitative Study

2020 ◽  
Author(s):  
Fatemeh Bakouei ◽  
Maryam Nikpour ◽  
Hajar Adib Rad ◽  
zahra abadi marzoni
Keyword(s):  
Qualitative Study ◽  
Pregnant Women ◽  
Healthcare Providers ◽  
Pregnancy Care ◽  
Women’S Experiences ◽  
Individual Interviews ◽  
Women's Experiences ◽  
Data Saturation ◽  
North Of Iran ◽  
And Control

Abstract Background: Prevention and control of COVID-19 disease in pregnant women has become a major concern. Healthcare providers should be aware that restriction of the routine prenatal care may have adverse effects. A qualitative approach can be helpful in understanding the pregnant women's experience and perspective in crisis. The study was conducted to explain the pregnant women's experiences during COVID-19 disease crisis.Methods: The qualitative study was conducted with conventional content analysis. Pregnant women selected with purposive sampling from six urban health centers in Babol (North of Iran). The semi structured individual interviews were done by telephone from May 03 to June 10, 2020. The systematic thematic analysis was used to identify and organize themes into clusters and categories across interviews.Result: We recruited twelve pregnant women until data saturation. Three theme categories extracted from data analysis. The first was "unpleasant feelings during pregnancy", the pregnant women stated feelings in this crisis such as worry, fear, obsession, boredom, nervousness, discouragement, and the like, which led them to have no positive pregnancy experience. The second category was "adjusted lifestyle". They experienced changes in lifestyle with the aim of preventing COVID-19 disease. The third category was “safe pregnancy care”. The pregnant women, while paying attention to the importance of pregnancy care, were forced to limit, delay, or modify some cares in order to be safe. Conclusion: The pregnant women experienced unpleasant feelings in this crisis; therefore, they should receive the necessary consulting to maintain mental health. All pregnant women reported some changes in their lifestyle and pregnancy care in order to health considerations to prevent the disease. Regular training for all pregnant women is necessary to manage this important pregnancy period while maintaining the maternal and fetal health in crisis.

scholarly journals Patients’ perspectives on BETTER 2 prevention and screening: qualitative findings from Newfoundland & Labrador

BJGP Open ◽  
2017 ◽  
Vol 1 (3) ◽  
pp. bjgpopen17X101037
Author(s):  
Nicolette Sopcak ◽  
Carolina Aguilar ◽  
Candace I J Nykiforuk ◽  
Mary Ann O’Brien ◽  
Kris Aubrey-Bassler ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Disease Prevention ◽  
Primary Care Providers ◽  
Chronic Disease Prevention ◽  
Qualitative Description ◽  
Preventative Care ◽  
Care Providers ◽  
Rural And Remote ◽  
Novel Approach

BackgroundChronic disease prevention and screening (CDPS) has been identified as a top priority in primary care. However, primary care providers often lack time, evidence-based tools, and consistent guidelines to effectively address CDPS. Building on Existing Tools to Improve Chronic Disease Prevention and Screening in Primary Care (BETTER) is a novel approach that introduces a new role, that of the prevention practitioner; the prevention practitioner meets with patients, one on one, to undertake a personalised CDPS visit. Understanding patients’ perspectives is important for clinicians and other stakeholders aiming to address and integrate CDPS.AimTo describe patients’ perspectives regarding visits with a prevention practitioner in BETTER 2, an implementation study that was carried out after the BETTER trial and featured a higher proportion of patients in rural and remote locations.Design & settingQualitative description based on patient feedback surveys, completed by patients in three primary care clinics (urban, rural, and remote) in Newfoundland and Labrador, Canada.MethodPatients’ perspectives were assessed based on responses from 91 feedback forms. In total, 154 patients (aged 40–65 years) received ≥1 prevention visit(s) from a prevention practitioner and were asked to provide written feedback. In addition to demographics, patients were asked what they liked about their visit(s), what they would have liked to be different, and invited to make any other comments. Qualitative description was used to analyse the data.ResultsFour main themes emerged from patients’ feedback: value of visit (patients appreciated the visit with a prevention practitioner); visit characteristics (the visit was personalised, comprehensive, and sufficiently long); prevention practitioners' characteristics (professionalism and interpersonal skills); and patients’ concerns (termination of the programme and access to preventative care).ConclusionPatients appreciated the visits they received with a prevention practitioner and expressed their desire to receive sustained CDPS in primary care.

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