scholarly journals Antenatal Doppler ultrasound implementation in a rural sub-Saharan African setting: exploring the perspectives of women and healthcare providers

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Sam Ali ◽  
Olive Kabajaasi ◽  
Michael G. Kawooya ◽  
Josaphat Byamugisha ◽  
David Zakus ◽  
...  
Keyword(s):  
Doppler Ultrasound ◽  
Qualitative Content Analysis ◽  
Healthcare Providers ◽  
World Health ◽  
Structured Interviews ◽  
Long Distance ◽  
Local Staff ◽  
Provider Perspectives ◽  
Ultrasound Technology ◽  
Western Uganda

Abstract Background The World Health Organization recommends research to evaluate the effects of a single third trimester Doppler ultrasound examination on preventable deaths in unselected-risk pregnancies, particularly in low- and middle-income countries (LMICs) where the evidence base is scarce. While evaluating such technologies, researchers often ignore women and health care provider perspectives. This study explored the views and experiences of women and healthcare providers regarding the use of advanced ultrasound technology to optimize the health of mothers and their babies in a rural community in mid-western Uganda. Methods We enrolled 53 mothers and 10 healthcare providers, and captured data on their perceptions, barriers, and facilitators to the use of Doppler ultrasound technology using focus group discussions, semi-structured interviews and observations. Using qualitative content analysis, we inductively coded the transcripts in ATLAS.ti 8.0, detecting emerging themes. Results Women were afraid that ultrasound would harm them or their fetuses and many of them had never seen an ultrasound scan. The majority of the women found their partners supportive to attend antenatal care and use ultrasound services. Healthcare providers in Kagadi Hospital were unfamiliar with Doppler technology and using it to guide clinical decisions. Other barriers to the implementation of Doppler ultrasound included shortage of trained local staff, insufficient equipment, long distance to and from the hospital, and frequent power cuts. Conclusions We found limited exposure to Doppler ultrasound technology among women and healthcare providers in mid-western Uganda. Engaging male partners may potentially influence the likelihood of accepting and using it to improve the health of women and their fetuses while wide spread myths and misconceptions about it may be changed by community engagement. Healthcare workers experienced difficulties in offering follow-up care to mothers detected with complications and Doppler ultrasound required a high level of training. While introducing advanced ultrasound machines to weak health systems, it is important to adequately train healthcare providers to avoid inappropriate interventions based on misinterpretation of the findings, consider where it is likely to be most beneficial, and embed it with realistic clinical practice guidelines.

scholarly journals Exploring the experiences related to postpartum changes: perspectives of mothers and healthcare providers in Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mahboobeh Asadi ◽  
Mahnaz Noroozi ◽  
Mousa Alavi
Keyword(s):  
Postpartum Period ◽  
Qualitative Content Analysis ◽  
Healthcare Providers ◽  
Educational Interventions ◽  
Psychological State ◽  
Structured Interviews ◽  
Childbearing Age ◽  
New Period ◽  
Women's Lives ◽  
Field Notes

Abstract Background Numerous changes occur in different aspects of women’s lives in the postpartum period. Women’s adjusting with problems and taking advantage of this opportunity can develop their personality. In this regard, accurate knowledge of their experiences and feelings is necessary to help them to benefit from this period. Therefore, the present study aimed to explore the experiences related to postpartum changes in women. Methods In the present qualitative study, 23 participants, including women of childbearing age who gave birth and healthcare providers (midwives and obstetricians) in Isfahan, Iran were selected using purposive sampling with a maximum variation strategy. Data were collected through in-depth semi structured interviews, field notes, and daily notes, and simultaneously analyzed using the conventional qualitative content analysis. Results The data analysis results led to the extraction of three main categories including “feeling of decreased female attractiveness” (with two sub-categories of “ feeling of decreased beauty” and “feeling of decreased sexual function”), “feeling of insolvency and helplessness” (with two sub-categories of “physical burnout”, and “mental preoccupations”) and “beginning a new period in life” (with three sub-categories of “changing the meaning of life”, “feeling of maturity” and “deepening the communication”). Conclusions Findings of this study can provide a good context for designing interventions to improve the women’s quality of life by explaining and highlighting their experiences in the postpartum period. In this regard, providing sufficient empathy, social and psychological support from family members (especially husband), performing appropriate educational interventions and also regular assessment of women’s psychological state by healthcare providers in postpartum period can reduce their concerns and help to improve their health.

scholarly journals Connected diagnostics to improve accurate diagnosis, treatment, and conditional payment of malaria services in Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shannen M. C. van Duijn ◽  
Angela K. Siteyi ◽  
Sherzel Smith ◽  
Emmanuel Milimo ◽  
Leon Stijvers ◽  
...  
Keyword(s):  
Clinical Performance ◽  
Healthcare Providers ◽  
Malaria Treatment ◽  
Sub Saharan Africa ◽  
Structured Interviews ◽  
National Guidelines ◽  
Private Providers ◽  
Provider Perspectives ◽  
Treatment Data ◽  
Sub Saharan

Abstract Background In sub-Saharan Africa, the material and human capacity to diagnose patients reporting with fever to healthcare providers is largely insufficient. Febrile patients are typically treated presumptively with antimalarials and/or antibiotics. Such over-prescription can lead to drug resistance and involves unnecessary costs to the health system. International funding for malaria is currently not sufficient to control malaria. Transition to domestic funding is challenged by UHC efforts and recent COVID-19 outbreak. Herewith we present a digital approach to improve efficiencies in diagnosis and treatment of malaria in endemic Kisumu, Kenya: Connected Diagnostics. The objective of this study is to evaluate the feasibility, user experience and clinical performance of this approach in Kisumu. Methods Our intervention was performed Oct 2017–Dec 2018 across five private providers in Kisumu. Patients were enrolled on M-TIBA platform, diagnostic test results digitized, and only positive patients were digitally entitled to malaria treatment. Data on socio-demographics, healthcare transactions and medical outcomes were analysed using standard descriptive quantitative statistics. Provider perspectives were gathered by 19 semi-structured interviews. Results In total 11,689 febrile patients were digitally tested through five private providers. Malaria positivity ranged from 7.4 to 30.2% between providers, significantly more amongst the poor (p < 0.05). Prescription of antimalarials was substantially aberrant from National Guidelines, with 28% over-prescription (4.6–63.3% per provider) and prescription of branded versus generic antimalarials differing amongst facilities and correlating with the socioeconomic status of clients. Challenges were encountered transitioning from microscopy to RDT. Conclusion We provide full proof-of-concept of innovative Connected Diagnostics to use digitized malaria diagnostics to earmark digital entitlements for correct malaria treatment of patients. This approach has large cost-saving and quality improvement potential.

scholarly journals Barriers to Self-care Among Patients with Heart Failure: A Qualitative Study

2020 ◽  
Author(s):  
Reza Negarandeh ◽  
Ali Aghajanloo ◽  
Khatereh Seylani
Keyword(s):  
Heart Failure ◽  
Content Analysis ◽  
Qualitative Content Analysis ◽  
Healthcare Providers ◽  
Self Care ◽  
The Body ◽  
Financial Strain ◽  
Personal Factors ◽  
Structured Interviews ◽  
Patients With Heart Failure

Introduction: Heart failure is the most prevalent cardiovascular disease. It is the end stage of most cardiovascular diseases and is characterized by the reduced ability of the heart to pump enough blood to fulfill the metabolic needs of the body. Self-care is the basis of the management of chronic diseases such as heart failure. The aim of this study was to explore the barriers to self-care among patients with heart failure. Methods: This was a qualitative content analysis. Participants were fourteen patients with heart failure and three healthcare providers who were purposively recruited from cardiac care centers in Zanjan, Iran. Data were collected through in-depth semi-structured interviews and were analyzed through the conventional qualitative content analysis approach proposed by Elo and Kyngäs. Results: Self-care barriers -care among patients with HF were categorized into three main categories, namely personal factors, disease burden, and inefficient support system. Each category had three subcategories which were respectively lack of self-care knowledge, heart failure-related negative emotions, the difficulty of changing habits, progressive physical decline, comorbid conditions, financial strain, inadequate social support, healthcare providers’ inattention to self-care, and limited access to healthcare providers. Conclusion: Patients with heart failure face different personal, disease-related, and supportrelated barriers to self-care. Based on these barriers, healthcare providers can develop interventions for promoting self-care among patients with heart failure.

scholarly journals Experiences of Telemental Health Providers and Support Staff Serving Indigenous Patients of Northern Canada

2020 ◽  
Author(s):  
Zhida Shang ◽  
Antonia Arnaert ◽  
Yvonne Hindle ◽  
Zoumanan Debe ◽  
Geneviève Côté-Leblanc ◽  
...  
Keyword(s):  
Mental Health ◽  
Patient Care ◽  
Healthcare Providers ◽  
Indigenous Communities ◽  
Support Staff ◽  
Inpatient Unit ◽  
Telemental Health ◽  
Health Providers ◽  
Structured Interviews ◽  
Local Staff

Abstract Background: It is known that there is a high mental health burden among Indigenous communities in Northern Quebec. The use of telemental health (TMH) may be a potential solution in addressing this burden, but its use in the Northern Quebec context has never been studied. Methods: A purposive sample of eight healthcare providers and support staff comprising of an entire TMH clinic serving Indigenous patients in Northern Quebec was recruited. A qualitative descriptive approach was adopted, and semi-structured interviews were conducted, concurrent with thematic data analysis.Results: Overall, the TMH staff have a very strong sense of communication, which allows them to diligently serve the Indigenous communities, and reflect upon their own practice. On the other hand, Northern patient care at the inpatient unit is seen as a work in progress, as there exists further potential for culturally sensitive Indigenous patient care. Both the TMH clinic and the inpatient unit address the mental health gap in Northern Quebec, where local staff turnover is adversely affecting patient care. As for the delivery of the mental health care, the in-person and videoconferencing consultations have a synergistic effect, since they allow for the TMH psychiatrists to maintain both an insider and outsider identity. Finally, a comprehensive electronic medical record and further administrative reforms are desperately needed, which would increase the efficiency of all components of the TMH clinic. Conclusions: TMH is an indispensable component of Northern patient care, but there is room for further improvements, especially with regards to the inpatient unit and documentation methods. This study may have implications towards the development and improvement of telemental health in Northern Quebec.

scholarly journals Provider perspectives on demand creation for maternal vaccines in Kenya

2018 ◽  
Vol 2 ◽  
pp. 34 ◽  
Author(s):  
Irina Bergenfeld ◽  
Stacy W. Nganga ◽  
Courtni A. Andrews ◽  
Vincent L. Fenimore ◽  
Nancy A. Otieno ◽  
...  
Keyword(s):  
Patient Education ◽  
Healthcare Providers ◽  
Immunization Coverage ◽  
Provider Education ◽  
Structured Interviews ◽  
Maternal Immunization ◽  
Provider Perspectives ◽  
Demand Creation ◽  
Print Materials ◽  
Cultural Leaders

Background. Expansion of maternal immunization, which offers some of the most effective protection against morbidity and mortality in pregnant women and neonates, requires broad acceptance by healthcare providers and their patients. We aimed to describe issues surrounding acceptance and demand creation for maternal vaccines in Kenya from a provider perspective. Methods. Nurses and clinical officers were recruited for semi-structured interviews covering resources for vaccine delivery, patient education, knowledge and attitudes surrounding maternal vaccines, and opportunities for demand creation for new vaccines. Interviews were conducted in English and Swahili, transcribed verbatim from audio recordings, and analyzed using codes developed from interview guide questions and emergent themes. Results. Providers expressed favorable attitudes about currently available maternal immunizations and introduction of additional vaccines, viewing themselves as primarily responsible for vaccine promotion and patient education.  The importance of educational resources for both patients and providers to maintain high levels of maternal immunization coverage was a common theme. Most identified barriers to vaccine acceptance and delivery were cultural and systematic in nature. Suggestions for improvement included improved patient and provider education, including material resources, and community engagement through religious and cultural leaders. Conclusions. The distribution of standardized, evidence-based print materials for patient education may reduce provider overwork and facilitate in-clinic efforts to inform women about maternal vaccines. Continuing education for providers should address communication surrounding current vaccines and those under consideration for introduction into routine schedules. Engagement of religious and community leaders, as well as male decision-makers in the household, will enhance future acceptance of maternal vaccines.

scholarly journals Connected Diagnostics to Improve Accurate Diagnosis, Treatment, and Conditional Payment of Malaria Services in Kenya.

2020 ◽  
Author(s):  
Shannen Van Duijn ◽  
Angela Siteyi ◽  
Sherzel Smith ◽  
Emmanuel Milimo ◽  
Leon Stijvers ◽  
...  
Keyword(s):  
Clinical Performance ◽  
Healthcare Providers ◽  
Malaria Treatment ◽  
Sub Saharan Africa ◽  
Structured Interviews ◽  
Medical Outcomes ◽  
Provider Perspectives ◽  
Treatment Data ◽  
Sub Saharan ◽  
Quantitative Statistics

Abstract Background: In sub-Saharan Africa, the material and human capacity to diagnose patients reporting with fever to healthcare providers is largely insufficient. Febrile patients are typically treated presumptively with antimalarials and/or antibiotics. Such over-prescription can lead to drug resistance and involves unnecessary costs to the health system. International funding for malaria is decreasing and transition to domestic funding is challenged by UHC efforts and recent COVID-19 outbreak. Herewith we present a digital approach to markedly improve efficiencies in diagnosis and treatment of malaria in endemic Kisumu, Kenya. The objective of this study is to evaluate feasibility, user experience, clinical performance and of Connected Diagnostics in Kisumu and to assess over-prescription of antimalarials. Methods: Our intervention was performed Oct 2017 – Dec 2018 across seven providers in Kisumu. Patients were enrolled on M-TIBA platform, diagnostic test results digitized, and only positive patients were digitally entitled for malaria treatment. Data on socio-demographics, healthcare transactions and medical outcomes were analysed using standard descriptive quantitative statistics. Provider perspectives were gathered by 19 semi-structured interviews. Results: In total 11,689 febrile patients were tested. Malaria positivity rates ranged from 7.4% to 30.2% between providers, with significantly more positive cases amongst the poor (p< 0.05). Over-prescription of antimalarials was 28%, fluctuating between 4.6% to 63.3% per provider. Prescription of branded versus generic antimalarials was dichotomous. Challenges were encountered transitioning from microscopy to RDT. Conclusion: We provide full proof-of-concept of innovative Connected Diagnostics to use digitized malaria diagnostics to earmark digital entitlements for correct malaria treatment of patients. This approach has large cost-saving and quality improving potential.

Exploring the Barriers Related to the Healthcare System and Healthcare Professionals in Implementing Quality Intravenous Chemotherapy: A Qualitative Study

2021 ◽  
Author(s):  
shahin salarvand ◽  
Masoumeh Sadat Mousavi ◽  
Mohammad Almasian
Keyword(s):  
Cancer Patients ◽  
Family Caregivers ◽  
Healthcare System ◽  
Healthcare Professionals ◽  
Qualitative Content Analysis ◽  
Healthcare Providers ◽  
Routine Care ◽  
Structured Interviews ◽  
Intravenous Chemotherapy ◽  
Individualized Care

Abstract Purpose: This study aimed to explore barriers related to the healthcare system (HCS) and healthcare providers (HCPs) in implementing quality intravenous (IV) chemotherapy (CT) from the perspectives of cancer patients, family caregivers, and healthcare professionals.Methods: Using an explanatory descriptive qualitative method, this study was conducted in 2019. Forty-one participants (6 patients, 5 family caregivers, 12 oncologists, and 18 nurses) were selected through purposive sampling. In-depth semi-structured interviews were conducted to collect the data, which were analyzed using qualitative content analysis. Lincoln and Guba’s criteria of rigor were employed to ensure the trustworthiness of the study.Results: Data analysis showed two categories, each with three subcategories: Barriers related to HCPs that contains “educational and communication barriers”, “failure to establish trust” and “unskilled healthcare professionals”; Barriers related to the HCS, which consists of “inadequate physical and care infrastructures to provide services”, “lack of support in the disease trajectory from diagnosis to rehabilitation” and “mismanagement of CT wards/procedures”.Conclusion: The identification and removal of the barriers related to HCPs and HCS from routine care are crucial. Education of and communication with cancer patients and their family caregivers are two important pillars in the quality of intravenous chemotherapy (IV CT) and this education and communication should be based on individualized care and tailored to the unique needs of each patient.

scholarly journals Cyberincivility Experience of Korean Clinical Nurses in the Workplace: A Qualitative Content Analysis

2020 ◽  
Vol 17 (23) ◽  
pp. 9052
Author(s):  
Sang Suk Kim ◽  
Ho Jeong Song ◽  
Jung Jae Lee
Keyword(s):  
Content Analysis ◽  
Qualitative Content Analysis ◽  
Healthcare Providers ◽  
Online Communication ◽  
Public Hospitals ◽  
Structured Interviews ◽  
Clinical Nurses ◽  
Health Related ◽  
Private And Public ◽  
Hierarchical Communication

Although clinical nurses use online platforms to acquire health-related information and communicate with other healthcare providers, there are increasing reports on their incivility exposure in cyberspace. However, an in-depth understanding of their cyberincivility experience is lacking. This study aimed to identify Korean clinical nurses’ perception and experience of cyberincivility. A qualitative study was conducted. Twenty clinical nurses from seven private and public hospitals in the Seoul metropolitan area were recruited using purposive sampling. Individual semi-structured interviews were conducted with the nurses from June to September 2019. Conventional content analysis was applied for the interview data analysis. Clinical nurses perceived cyberincivility as disrespectful and condemning behavior as users hide under the shield of anonymity to persecute others without fear of retribution. Four themes regarding participants’ cyberincivility experience emerged: unprofessional behavior, hierarchical communication, lack of respect and morality, and forming an inefficient work environment. The results of this study provide an understanding regarding clinical nurses’ experience of cyberincivility that goes beyond that of previous studies, which mainly focused on students. These results could increase awareness of cyberincivility among clinical nurses, and provide key information for the design of cybercivility educational programs and guidelines to curb cyberincivility, nurture professional online communication, and consequently improve quality of care.

scholarly journals Connected Diagnostics to improve accurate diagnosis, treatment, and conditional payment of malaria services in Kenya.

2020 ◽  
Author(s):  
Shannen Van Duijn ◽  
Angela Siteyi ◽  
Sherzel Smith ◽  
Emmanuel Milimo ◽  
Leon Stijvers ◽  
...  
Keyword(s):  
Clinical Performance ◽  
Healthcare Providers ◽  
Malaria Treatment ◽  
Sub Saharan Africa ◽  
Structured Interviews ◽  
National Guidelines ◽  
Private Providers ◽  
Provider Perspectives ◽  
Treatment Data ◽  
Sub Saharan

Abstract Background: In sub-Saharan Africa, the material and human capacity to diagnose patients reporting with fever to healthcare providers is largely insufficient. Febrile patients are typically treated presumptively with antimalarials and/or antibiotics. Such over-prescription can lead to drug resistance and involves unnecessary costs to the health system. International funding for malaria is currently not sufficient to control malaria. Transition to domestic funding is challenged by UHC efforts and recent COVID-19 outbreak. Herewith we present a digital approach to improve efficiencies in diagnosis and treatment of malaria in endemic Kisumu, Kenya: Connected Diagnostics. The objective of this study is to evaluate the feasibility, user experience and clinical performance of this approach in Kisumu.Methods: Our intervention was performed Oct 2017 – Dec 2018 across five private providers in Kisumu. Patients were enrolled on M-TIBA platform, diagnostic test results digitized, and only positive patients were digitally entitled to malaria treatment. Data on socio-demographics, healthcare transactions and medical outcomes were analysed using standard descriptive quantitative statistics. Provider perspectives were gathered by 19 semi-structured interviews.Results: In total 11,689 febrile patients were digitally tested through five private providers. Malaria positivity ranged from 7.4% to 30.2% between providers, significantly more amongst the poor (p< 0.05). Prescription of antimalarials was substantially aberrant from National Guidelines, with 28% over-prescription (4.6%-63.3% per provider) and prescription of branded versus generic antimalarials differing amongst facilities and correlating with the socioeconomic status of clients. Challenges were encountered transitioning from microscopy to RDT.Conclusion: We provide full proof-of-concept of innovative Connected Diagnostics to use digitized malaria diagnostics to earmark digital entitlements for correct malaria treatment of patients. This approach has large cost-saving and quality improvement potential.

scholarly journals The Perceived Social Support by Iranian Women with Breast Cancer: A Qualitative Study

2021 ◽  
Author(s):  
Leila Mokhtari ◽  
Abdollah Khorami Markani ◽  
Hamid Reza Khalkhali ◽  
Aram Feizi
Keyword(s):  
Breast Cancer ◽  
Social Support ◽  
Qualitative Study ◽  
Lived Experience ◽  
Qualitative Content Analysis ◽  
Healthcare Providers ◽  
Well Being ◽  
Medical Sciences ◽  
Structured Interviews ◽  
The Family

Abstract Background: Social support has an importnat role in improving health outcomes and is considered as one of the crucial aspects of the modern care in cancer patients. Therefore this article aims at discovering and describing the dimensions of social support based on the lived experience of women suffering from breast cancer.Methods: In this qualitative study, 22 women with breast cancer were selected through purposive sampling from 7 hospitals affiliated to Urmia University of Medical Sciences. The data were collected through semi-structured interviews and were analyzed by the Conventional Qualitative Content Analysis and Graneheim’s and Lundman’s (2004) approach, using MAXQDA software, version 10.Results: After completion of the analyzing process, 6 categories were appeared including “creating an empathic atmosphere by family and community”, “creating a safe communication network for the patient”, “adaption to disease”, “giving meaning to life”, “the feeling of satisfaction with the healthcare providers for fulfilling their role”, and “accepting the support and help of family and friends in fighting the disease”. Conclusion: According to the findings, good social support during the illness can result in the spiritual, mental, and physical well-being of the patients and is one of the most effective factors in fighting the disease and feeling of recovery. The findings of this study can be used to develop plans to help the patients to achieve more support from the family, healthcare providers and the community and even providing the required supportive care for this group of women.

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