scholarly journals Healthcare professionals’ perceptions of impacts of the Covid-19-pandemic on outpatient care in rural areas: a qualitative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Madlen Hoerold ◽  
Marc Gottschalk ◽  
Carla Maria Debbeler ◽  
Heike Heytens ◽  
Saskia Ehrentreich ◽  
...  
Keyword(s):  
Working Conditions ◽  
Rural Areas ◽  
Outpatient Care ◽  
Secondary Care ◽  
Healthcare Professionals ◽  
Family Physicians ◽  
Qualitative Interview Study ◽  
Health Related ◽  
Utilization Of Healthcare ◽  
The Impact

Abstract Background Measures to manage the COVID-19 pandemic have led to impacts on healthcare systems and providers worldwide. Outpatient healthcare professionals (HCPs) provide the majority of patient care. Insight into their experiences during a pandemic is rare. Therefore, we explored how primary and secondary care HCPs in a rural area in Germany experienced their work during the pandemic and what health-related outcomes they perceived in their patients. In this context, we also examined the impact on access to and utilization of healthcare and working conditions. Methods We conducted a qualitative interview study with outpatient HCPs. We recruited by e-mail, telephone, professional networks and personal contacts. Data were collected between August 2020 and January 2021. All interviews were audio recorded, transcribed, and analysed using qualitative content analysis. Results Our sample consisted of 28 HCPs (15 family physicians, 7 cardiologists, and 6 non-physician assistants, 12 female) from Saxony-Anhalt, Germany. HCPs experienced fewer consultations as well as cancellations by hospitals and secondary care physicians, especially at the beginning of the Covid-19-pandemic, while they continued throughout to provide outpatient care. They quickly adopted changes in practice organisation and healthcare provision. There was a shift towards telephone consultations, home visits as well as unconventional consultations e.g. through the practice window. Family physicians used personal relationships to support utilization of healthcare and to avoid health-related effects. Social tension and burden seemed to interact with a perceived lack of preparedness, the pandemic-related changes in their working condition as well as access to and utilization of healthcare. Chronic disease monitoring was postponed, which could have consequences in the course of disease of patients. HCPs experienced effects on patients’ psychological well-being. Conclusion Our study demonstrates the impacts of Covid-19-pandemic on outpatient care in rural areas and emphasizes its importance. HCPs experienced impacts on access to and utilization of healthcare, working conditions and health-related outcomes. Health policy should create a framework for healthcare to support outpatient care in rural areas with a looming undersupply of primary and secondary care in order to maintain healthcare and reduce pandemic impacts.

scholarly journals NEW TECHNOLOGIES IN AGRICULTURAL BUSINESS AND THEIR IMPACT ON EMPLOYMENT

2021 ◽  
Author(s):  
Pavlina Ivanova ◽  
Keyword(s):  
Working Conditions ◽  
Environmental Sustainability ◽  
Rural Areas ◽  
Agricultural Sector ◽  
New Technologies ◽  
Digital Technologies ◽  
Business Environment ◽  
Fast Pace ◽  
Agricultural Business ◽  
The Impact

The extremely fast pace with which digital technologies are developing and their entry into the agricultural sector is changing the business environment, working conditions and the composition of the workforce. This in turn creates an opportunity to increase the efficiency of farms, while improving the economic and environmental sustainability of the sector and rural areas. The aim of this report is to examine the impact that the application of digital technologies in agribusiness has on employment in the sector, the emergence of new occupations and changes in working conditions, as well as to identify the challenges to human resource management in the digital environment. agriculture.

scholarly journals Impact of rurality on processes and outcomes in melanoma care: results from a whole-Scotland melanoma cohort in primary and secondary care

2018 ◽  
Vol 68 (673) ◽  
pp. e566-e575 ◽  
Author(s):  
Peter Murchie ◽  
Rosalind Adam ◽  
Wei L Khor ◽  
Edwin A Raja ◽  
Lisa Iversen ◽  
...  
Keyword(s):  
Primary Care ◽  
Rural Areas ◽  
Secondary Care ◽  
Urban Areas ◽  
Proportional Hazards ◽  
Binary Logistic Regression ◽  
Small Towns ◽  
Cox Proportional Hazards ◽  
Current Evidence ◽  
The Impact

BackgroundThose living in rural areas have poorer cancer outcomes, but current evidence on how rurality impacts melanoma care and survival is contradictory.AimTo investigate the impact of rurality on setting of melanoma excision and mortality in a whole-nation cohort.Design and settingAnalysis of linked routine healthcare data comprising every individual in Scotland diagnosed with melanoma, January 2005–December 2013, in primary and secondary care.MethodMultivariate binary logistic regression was used to explore the relationship between rurality and setting of melanoma excision; Cox proportional hazards regression between rurality and mortality was used, with adjustments for key confounders.ResultsIn total 9519 patients were included (54.3% [n = 5167] female, mean age 60.2 years [SD 17.5]). Of melanomas where setting of excision was known, 90.3% (n = 8598) were in secondary care and 8.1% (n = 771) in primary care. Odds of primary care excision increased with increasing rurality/remoteness. Compared with those in urban areas, those in the most remote rural locations had almost twice the odds of melanoma excision in primary care (adjusted odds ratio [aOR] 1.92; 95% confidence interval [CI] = 1.33 to 2.77). No significant association was found between urban or rural residency and all-cause mortality. Melanoma-specific mortality was significantly lower in individuals residing in accessible small towns than in large urban areas (adjusted hazards ratio [HR] 0.53; 95% CI = 0.33 to 0.87) with no trend towards poorer survival with increasing rurality.ConclusionPatients in Scottish rural locations were more likely to have a melanoma excised in primary care. However, those in rural areas did not have significantly increased mortality from melanoma. Together these findings suggest that current UK melanoma management guidelines could be revised to be more realistic by recognising the role of primary care in the prompt diagnosis and treatment of those in rural locations.

Health and hygiene aspects affecting the development of the agricultural production environment

2020 ◽  
pp. 44-53
Author(s):  
Galina Aleksandrovna Bezrukova ◽  
Tamara Anatolievna Novikova ◽  
Anatoliy Nikolaevich Mikerov
Keyword(s):  
Working Conditions ◽  
Rural Areas ◽  
Agricultural Production ◽  
Agricultural Sector ◽  
Rural Settlements ◽  
Production Environment ◽  
The Sustainable Development ◽  
Active Population ◽  
Total Structure ◽  
The Impact

The results of a comprehensive multi-factor analysis of updated information about the demographic situation in rural settlements of the Russian Federation and working conditions in the agricultural sector of the economy are presented. It is shown that in the period from 2010 to 2018, stable population growth was registered only in 20.8 % of rural municipalities, while 79.2 % of settlements were characterized by a decrease in rural residents. Along with depopulation, critical for the sustainable development of rural areas is a prevailing explicit deformation of the age structure of the population and associated growth of demographic burden on the able-bodied rural population due to low birth rate and high death rate of men of working age, as well as the continuing migration outflow of the economically active population in the regional and Federal centers of Russia. The main place of employment in rural areas remains the production of agricultural products. Despite the differences characteristic of technological processes in certain types of agricultural activities, the specifics of labor in the agricultural sector have common aspects related to the impact of harmful factors of the production environment, the severity and intensity of the labor process. The number of people working in the agricultural sector in harmful and dangerous working conditions in the period from 2011 to 2017 decreased by 19.2 %, while the share of this category of people in the total structure of those employed in agricultural production decreased by 4.4 % to 29.4 % in 2017. According to the results of inspections of territorial bodies of Rospotrebnadzor in the period from 2011 to 2017, the share of jobs that do not meet sanitary and hygienic standards at agricultural enterprises decreased from 35.7 to 30.4 %, which indicates a trend of improvement in the sanitary and hygienic situation.

scholarly journals Working in rural areas – the experiences of Umthombo Youth Development Foundation graduates

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Andrew J. Ross
Keyword(s):  
Professional Development ◽  
Life History ◽  
South African ◽  
Rural Area ◽  
Youth Development ◽  
Rural Areas ◽  
Healthcare Professionals ◽  
The World ◽  
The Impact ◽  
Life History Methodology

Background: Recruiting and retaining healthcare professionals (HCPs) for rural areas is challenging throughout the world. Although rural origin HCPs have been identified as being the most likely to work in rural areas, only a small number of rural-origin South African scholars are trained as HCPs each year and many do not return to work in rural areas.Aim: The aim of this article was to present the experiences of rural-origin HCPs who returned to work in a rural area after graduation.Setting: Umthombo Youth Development Foundation has been running an innovating rurally-based scholarship scheme since 1999. By December 2013, 184 students supported by the scheme had graduated and all had returned to work in a rural area for a period of time.Methods: This was a qualitative study using a life history methodology to explore the educational experience of six rural-origin HCPs working in rural areas.Results: The four themes that emerged from the data were: (1) contribution to service delivery; (2) professional development (3) the challenges and frustrations of working in rural hospitals; and (4) the impact of working as an HCP.Conclusion: Rural-origin HCPs are willing to return and work in rural areas. However, context and content factors need to be addressed if a work-back scholarship scheme is to be along-term strategy for the recruitment and retention of HCPs. 

scholarly journals How can we build and maintain the resilience of our health care professionals during COVID-19? Recommendations based on a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e043718
Author(s):  
Anja Rieckert ◽  
Ewoud Schuit ◽  
Nienke Bleijenberg ◽  
Debbie ten Cate ◽  
Wendela de Lange ◽  
...  
Keyword(s):  
Mental Health ◽  
Working Conditions ◽  
Scoping Review ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Psychosocial Support ◽  
Grey Literature ◽  
Hospital Setting ◽  
Physical And Mental Health ◽  
The Impact

ObjectiveTo explore how to build and maintain the resilience of frontline healthcare professionals exposed to COVID-19 outbreak working conditions.DesignScoping review supplemented with expert interviews to validate the findings.SettingHospitals.MethodsWe searched PubMed, Embase, PsycINFO, CINAHL, bioRxiv and medRxiv systematically and grey literature for articles focusing on the impact of COVID-19-like working conditions on the physical and/or mental health of healthcare professionals in a hospital setting. Articles using an empirical design about determinants or causes of physical and/or mental health and about interventions, measures and policies to preserve physical and/or mental health were included. Four experts were interviewed to reflect on the results from the scoping review.ResultsIn total, 4471 records were screened leading to an inclusion of 73 articles. Recommendations prior to the outbreak fostering resilience included optimal provision of education and training, resilience training and interventions to create a feeling of being prepared. Recommendations during the outbreak consisted of (1) enhancing resilience by proper provision of information, psychosocial support and treatment (eg, create enabling conditions such as forming a psychosocial support team), monitoring the health status of professionals and using various forms and content of psychosocial support (eg, encouraging peer support, sharing and celebrating successes), (2) tasks and responsibilities, in which attention should be paid to kind of tasks, task mix and responsibilities as well as the intensity and weight of these tasks and (3) work patterns and working conditions. Findings of the review were validated by experts.ConclusionsRecommendations were developed on how to build and maintain resilience of frontline healthcare professionals exposed to COVID-19 outbreak working conditions. These practical and easy to implement recommendations can be used by hospitals and other healthcare organisations to foster and preserve short-term and long-term physical and mental health and employability of their professionals.

Introduction to the “Evaluating the Impact of Structural Policies on Health Inequalities and Their Social Determinants and Fostering Change” (SOPHIE) Project

2016 ◽  
Vol 47 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Carme Borrell ◽  
Davide Malmusi ◽  
Carles Muntaner
Keyword(s):  
Labor Market ◽  
Health Inequalities ◽  
Working Conditions ◽  
Health Inequality ◽  
Social Determinants ◽  
Social Stratification ◽  
Structural Determinants ◽  
Health Related ◽  
The Impact ◽  
Specific Health

The SOPHIE Project (acronym for Structural Policies for Health Inequalities Evaluation) has focused on evaluating the impact of structural policies on health equity, considering as such all those policies that exert a powerful influence on the structural determinants of health (e.g., patterns of social stratification, living and working conditions) and thus on health-related exposures through intermediary determinants. In these sections of the International Journal of Health Services, we present some of the main findings of the SOPHIE Project. We include both articles that summarize all the evidence already published in the project on a thematic area (such as labor market, gender, or housing) and articles that present new, unpublished evidence on a specific health inequality or policy.

scholarly journals Exploring public perspectives of anti-diabetic drugs: a qualitative content analysis of Twitter posts (Preprint)

2020 ◽  
Author(s):  
Su Golder ◽  
Millie Bach ◽  
Karen O'Connor ◽  
Robert Gross ◽  
Sean Hennessy ◽  
...  
Keyword(s):  
Content Analysis ◽  
Public Perception ◽  
Healthcare Professionals ◽  
Qualitative Content Analysis ◽  
Real Life ◽  
Self Management ◽  
Public Health Issue ◽  
Global Public Health ◽  
Health Related ◽  
The Impact

BACKGROUND Diabetes mellitus is a major global public health issue where self-management is critical to reducing disease burden. Social media has been a powerful tool to understand public perceptions. Public perception of drugs used to treat the disease may be useful for orienting interventions to increase adherence. OBJECTIVE To explore the perceptions of anti-diabetic drugs (ADDs) through the analysis of health-related tweets mentioning such medications. METHODS 4000 tweets from 1st January to 1st October 2019 containing key terms related to ADDs were coded using qualitative content analysis. Tweets were coded for whether they were truly about an ADD, and then whether they were health-related. Health-related tweets were further coded based on who was tweeting, which ADD was being tweeted about, and the content discussed in the tweet. The main outcome of the analysis was the themes identified by analyzing the content of health-related tweets on ADDs. RESULTS 1664 health-related tweets about 33 ADDs were identified. A quarter (415/1664 of tweets were confirmed to have come from people with diabetes, 18% (298/1664) from people posting about someone else, and 3% (45/1664) from healthcare professionals. However, the role of the tweeter was unidentifiable from two-thirds of the tweets. 13 themes were identified, with the health consequences of the cost of ADDs being the most extensively discussed, followed by the efficacy and availability. We also identified issues patients may conceal from healthcare professionals, such as purchasing medications from unofficial sources. CONCLUSIONS This study is the first to use Twitter to explore perceptions exclusively related to ADDs. This analysis gives an insight into the real-life issues individual’s face when taking ADDs, and such findings may be incorporated into health policies to improve compliance and efficacy. This study suggests there is a fear of not having access to ADDs, whether due to cost or physical availability and also highlights the impact of the sacrifices made to access ADDs. Alongside screening for diabetes-related health issues, healthcare professionals should also ask their patients about any non-health concerns with their ADDs. The positive tweets about dietary changes indicate that people with type 2 diabetes may be more open to self-management than healthcare professionals believe.

scholarly journals The health impact of an innovative summer camp for older adults: a pilot study using an interdisciplinary collaborative approach

BMC Nursing ◽  
2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Mei-Hua Yeh ◽  
Cheng-Hsien Huang ◽  
Yu-Chih Lin ◽  
Tung-Jung Huang ◽  
Mei-Yen Chen
Keyword(s):  
Older Adults ◽  
Pilot Study ◽  
Rural Areas ◽  
Healthy Aging ◽  
Summer Camp ◽  
Lifestyle Changes ◽  
Collaborative Approach ◽  
Health Related ◽  
The Impact ◽  
Health Related Fitness

Abstract Background Healthy aging with dignity and aging in place are important for Taiwanese individuals. Although Taiwan did not experience COVID-19 outbreaks prior to May 2021, many older adults have been encouraged to stay at home since the beginning of the global pandemic in January 2020. Such shelter-in-place recommendations have resulted in significant lifestyle changes, limiting activities associated with aging with dignity such as exercise and community engagement. Few studies have explored how to promote or maintain holistic health practices and physical fitness in older adults residing in rural communities during the COVID-19 pandemic. This pilot study aimed to establish an interdisciplinary collaboration with community care workers (CCWs) and evaluate the impact of an innovative summer camp (ISC) program for older adults residing in rural areas. Methods A quasi-experimental pre-post-test design with an interdisciplinary collaborative approach was implemented. The ISC program was based on a standardized protocol of modified Baduanjin exercise combined with three recreational breathing games. Participants were recruited from three community centers around the western coastal region of Yunlin County between June and August 2020. The ISC program was designed and executed by a nurse-led health promotion research team that collaborated with trained CCWs for 90 min per day, five days per week, for 12 weeks. Participants and CCWs wore facemasks during all activities. Paired t-test was used to measure changes in physical biomarkers, pulmonary lung function, and health-related fitness changes. Results Sixty-eight participants completed the ISC program. The ISC program significantly improved the participants’ physiological biomarkers and health-related fitness, including reduced body weight, waistline, and systolic blood pressure, and increased forced vital capacity, biceps arm flexion, and ability to sit and stand from a chair, step with a knee up in situ, and stand on one foot with eyes open. Most participants reported that they felt happy, satisfied, and hoped that this program would be continued in their community center. Conclusions This interdisciplinary, collaborative ISC program improved physical biomarkers and health-related fitness in older adults. Despite limitations, results strongly suggested that primary healthcare providers and CCWs can employ the described ISC program to promote wellness in older adults.

scholarly journals Homelessness at discharge and its impact on psychiatric readmission and physician follow-up: a population-based cohort study

2019 ◽  
Vol 29 ◽  
Author(s):  
V. Laliberté ◽  
V. Stergiopoulos ◽  
B. Jacob ◽  
P. Kurdyak
Keyword(s):  
Mental Health ◽  
Cohort Study ◽  
Outpatient Care ◽  
Service Use ◽  
Significant Proportion ◽  
Population Based ◽  
Psychiatric Hospitalisation ◽  
Health Related ◽  
Ed Visits ◽  
The Impact

Abstract Aims A significant proportion of adults who are admitted to psychiatric hospitals are homeless, yet little is known about their outcomes after a psychiatric hospitalisation discharge. The aim of this study was to assess the impact of being homeless at the time of psychiatric hospitalisation discharge on psychiatric hospital readmission, mental health-related emergency department (ED) visits and physician-based outpatient care. Methods This was a population-based cohort study using health administrative databases. All patients discharged from a psychiatric hospitalisation in Ontario, Canada, between 1 April 2011 and 31 March 2014 (N = 91 028) were included and categorised as homeless or non-homeless at the time of discharge. Psychiatric hospitalisation readmission rates, mental health-related ED visits and physician-based outpatient care were measured within 30 days following hospital discharge. Results There were 2052 (2.3%) adults identified as homeless at discharge. Homeless individuals at discharge were significantly more likely to have a readmission within 30 days following discharge (17.1 v. 9.8%; aHR = 1.43 (95% CI 1.26–1.63)) and to have an ED visit (27.2 v. 11.6%; aHR = 1.87 (95% CI 1.68–2.0)). Homeless individuals were also over 50% less likely to have a psychiatrist visit (aHR = 0.46 (95% CI 0.40–0.53)). Conclusion Homeless adults are at higher risk of readmission and ED visits following discharge. They are also much less likely to receive post-discharge physician care. Efforts to improve access to services for this vulnerable population are required to reduce acute care service use and improve care continuity.

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