scholarly journals Patient, caregiver, and health care provider perspectives on barriers and facilitators to heart failure care in Kerala, India: A qualitative study

2021 ◽  
Vol 5 ◽  
pp. 250
Author(s):  
Prinu Jose ◽  
Ranjana Ravindranath ◽  
Linju M. Joseph ◽  
Elizabeth C. Rhodes ◽  
Sanjay Ganapathi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Focus Group ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Self Management ◽  
Care Providers ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
High Quality

Background: Deficits in quality of care for patients with heart failure (HF) contribute to high mortality in this population. This qualitative study aimed to understand the barriers and facilitators to high-quality HF care in Kerala, India. Methods: Semi-structured, in-depth interviews were conducted with a purposive sample of health care providers (n=13), patients and caregivers (n=14). Additionally, focus group discussions (n=3) were conducted with patients and their caregivers. All interviews and focus group discussions were transcribed verbatim. Textual data were analysed using thematic analysis. Results: Patients’ motivation to change their lifestyle behaviours after HF diagnosis and active follow-up calls from health care providers to check on patients’ health status were important enablers of high-quality care. Health care providers’ advice on substance use often motivated patients to stop smoking and consuming alcohol. Although patients expected support from their family members, the level of caregiver support for patients varied, with some patients receiving strong support from caregivers and others receiving minimal support. Emotional stress and lack of structured care plans for patients hindered patients’ self-management of their condition. Further, high patient loads often limited the time health care providers had to provide advice on self-management options. Nevertheless, the availability of experienced nursing staff to support patients improved care within health care facilities. Finally, initiation of guideline-directed medical therapy was perceived as complex by health care providers due to multiple coexisting chronic conditions in HF patients. Conclusions: Structured plans for self-management of HF and more time for patients and health care providers to interact during clinical visits may enable better clinical handover with patients and family members, and thereby improve adherence to self-care options. Quality improvement interventions should also address the stress and emotional concerns of HF patients.

scholarly journals Patient, caregiver, and health care provider perspectives on barriers and facilitators to heart failure care in Kerala, India: A qualitative study

2020 ◽  
Vol 5 ◽  
pp. 250
Author(s):  
Prinu Jose ◽  
Ranjana Ravindranath ◽  
Linju M. Joseph ◽  
Elizabeth C. Rhodes ◽  
Sanjay Ganapathi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Focus Group ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Self Management ◽  
Care Providers ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
High Quality

Background: Deficits in quality of care for patients with heart failure (HF) contribute to high mortality in this population. This qualitative study aims to understand the barriers and facilitators to high-quality HF care in Kerala, India. Methods: Semi-structured, in-depth interviews were conducted with a purposive sample of health care providers (n=13), patients and caregivers (n=14). Additionally, focus group discussions (n=3) were conducted with patients and their caregivers. All interviews and focus group discussions were transcribed verbatim. Textual data were analysed using thematic analysis. Results: Patients’ motivation to change their lifestyle behaviours after HF diagnosis and active follow-up calls from health care providers to check on patients’ health status were important enablers of high-quality care. Health care providers’ advice on substance use often motivated patients to stop smoking and consuming alcohol. Although patients expected support from their family members, the level of caregiver support for patients varied, with some patients receiving strong support from caregivers and others receiving minimal support. Emotional stress and lack of structured care plans for patients hindered patients’ self-management of their condition. Further, high patient loads often limited the time health care providers had to provide advice on self-management options. Nevertheless, the availability of experienced nursing staff to support patients improved care within health care facilities. Finally, initiation of guideline-directed medical therapy was perceived as complex by health care providers due to multiple coexisting chronic conditions in HF patients. Conclusions: Structured plans for self-management of HF and more time for patients and health care providers to interact during clinical visits may enable better clinical handover with patients and family members, and thereby improve adherence to self-care options. Quality improvement interventions should also address the stress and emotional concerns of HF patients.

scholarly journals Attitude and Perception of Physicians and Nurses Toward the Role of Clinical Pharmacists in Riyadh, Saudi Arabia: A Qualitative Study

2019 ◽  
Vol 5 ◽  
pp. 237796081988976
Author(s):  
Nada Alsuhebany ◽  
Lama Alfehaid ◽  
Hind Almodaimegh ◽  
Abdulkareem Albekairy ◽  
Shmeylan Alharbi
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Focus Group ◽  
Health Care Providers ◽  
Care Providers ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Clinical Pharmacists

Clinical pharmacists are responsible for guiding pharmacotherapy and ensuring medication safety along with other health-care providers. This study highlighted barriers that physicians and nurses encounter when interacting with clinical pharmacists. Twenty-seven physicians and nurses were randomly invited to participate in focus-group discussions. Five focus-group discussions were recorded and then transcribed, and the transcripts were reviewed and coded. Three major themes were identified, which were the role of clinical pharmacists, interprofessional communication, and competency. The greatest challenge reported in this study was lack of consistent understanding of the role of clinical pharmacists which to some extent caused communication deficiencies and affected the level of involvement with multidisciplinary teams. Despite that, majority of the participants perceived pharmacists as beneficial in optimizing pharmacotherapy and improving quality of care. Clinical pharmacy services are perceived positively in impacting quality of care as expressed by majority of the study participants. However, there is a lack of common understanding of the role of clinical pharmacists by other health-care providers.

Sexual and reproductive health in the time of COVID-19 in Latvia, qualitative research interviews and focus group discussions, 2020 (in Latvian)

2021 ◽  
Author(s):  
Gunta Lazdane ◽  
◽  
Dace Rezeberga ◽  
Ieva Briedite ◽  
Elizabete Pumpure ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Research ◽  
Focus Group ◽  
Reproductive Health ◽  
Pregnant Women ◽  
Sexual And Reproductive Health ◽  
People Living With Hiv ◽  
Care Providers ◽  
Focus Group Discussions ◽  
Group Discussions

Qualitative research is focused on the influence of COVID-19 pandemic and restriction measures on sexual and reproductive health in Latvia. Results of the anonymous online survey (I-SHARE) of 1173 people living in Latvia age 18 and over were used as a background in finalization the interview and the focus group discussion protocols ensuring better understanding of the influencing factors. Protocols included 9 parts (0.Introduction. 1. COVID-19 general influence, 2. SRH, 3. Communication with health professionals, 4.Access to SRH services, 5.Communication with population incl. three target groups 5.1. Pregnant women, 5.2. People with suspected STIs, 5.3.Women, who require abortion, 6. HIV/COVID-19, 7. External support, 8. Conclusions and recommendations. Data include audiorecords in Latvian of: 1) 11 semi-structures interviews with policy makers including representatives from governmental and non-governmental organizations involved in sexual and reproductive health, information and health service provision. 2) 12 focus group discussions with pregnant women (1), women in postpartum period (3) and their partners (3), people living with HIV (1), health care providers involved in maternal health care and emergency health care for women (4) (2021-02-18) Subject: Medicine, Health and Life Sciences Keywords: Sexual and reproductive health, COVID-19, access to services, Latvia

scholarly journals “I Like the Idea of It…But Probably Wouldn’t Use It” - Health Care Provider Perspectives on Heart Failure mHealth: Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Jennifer Dickman Portz ◽  
Kelsey Lynett Ford ◽  
Kira Elsbernd ◽  
Christopher E Knoepke ◽  
Kelsey Flint ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Qualitative Study ◽  
Real Time ◽  
Health Care Providers ◽  
Patient Reported Outcomes ◽  
Care Providers ◽  
Time Data ◽  
Patient Reported ◽  
Real Time Data

BACKGROUND Many mobile health (mHealth) technologies exist for patients with heart failure (HF). However, HF mhealth lacks evidence of efficacy, caregiver involvement, and clinically useful real-time data. OBJECTIVE We aim to capture health care providers’ perceived value of HF mHealth, particularly for pairing patient–caregiver-generated data with clinical intervention to inform the design of future HF mHealth. METHODS This study is a subanalysis of a larger qualitative study based on interviewing patients with HF, their caregivers, and health care providers. This analysis included interviews with health care providers (N=20), focusing on their perceived usefulness of HF mHealth tools and interventions. RESULTS A total of 5 themes emerged: (1) bio-psychosocial-spiritual monitoring, (2) use of sensors, (3) interoperability, (4) data sharing, and (5) usefulness of patient-reported outcomes in practice. Providers remain interested in mHealth technologies for HF patients and their caregivers. However, providers report being unconvinced of the clinical usefulness of robust real-time patient-reported outcomes. CONCLUSIONS The use of assessments, sensors, and real-time data collection could provide value in patient care. Future research must continually explore how to maximize the utility of mHealth for HF patients, their caregivers, and health care providers.

Perspectives from South African dietitians on infant and young child feeding regulations

2020 ◽  
Vol 24 (1) ◽  
pp. 169-181
Author(s):  
Megan Clarke ◽  
Nelene Koen ◽  
Lisanne du Plessis
Keyword(s):  
South Africa ◽  
Health Care ◽  
Health Care Providers ◽  
Knowledge Score ◽  
Care Providers ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Infant And Young Child

AbstractObjective:This study aimed to determine the knowledge, perceptions and practices of dietitians in South Africa regarding the Regulations Relating to Foodstuffs for Infants and Young Children (R991).Design:A mixed methods, cross-sectional design was used.Setting:Quantitative data were collected using an online survey (n 282) and qualitative data by means of two focus group discussions (n 12).Participants:Participants were dietitians registered with the Health Professions Council of South Africa.Results:Dietitians’ average knowledge score was 64·8 % ± 12·5. Those working in infant and young child feeding had a 5 % higher knowledge score (95 % CI 1·4, 8·6, P = 0·01). Perceptions towards the Regulations were generally positive, and the majority of practices were compliant. Positive perceptions seemed to correlate with compliant practices. The most frequently selected enabler to the implementation of the Regulations was ‘Increase in other initiatives which support, protect and promote breastfeeding’, and the most frequently selected barrier was ‘Lack of awareness of the Regulation among health care providers’. The major themes from the focus group discussions comprised: less knowledge among dietitians and mothers about products controlled under the Regulations, non-compliance of other health care providers, the dietitians’ role in support and enforcement, the discrepancy between practice in private and public sectors and a lack of enforcement.Conclusions:South Africa has taken a bold step in legislating the International Code of Marketing of Breast-milk Substitutes and should upscale programmes to ensure consistent monitoring and enforcing of the Regulations.

scholarly journals A Patient-Centered Mobile Phone App (iHeartU) With a Virtual Human Assistant for Self-Management of Heart Failure: Protocol for a Usability Assessment Study (Preprint)

2019 ◽  
Author(s):  
Lingling Zhang ◽  
Sabarish V Babu ◽  
Meenu Jindal ◽  
Joel E Williams ◽  
Ronald W Gimbel
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Health Care Providers ◽  
Low Income ◽  
Virtual Human ◽  
Self Management ◽  
Care Providers ◽  
Patient Centered ◽  
Usability Assessment ◽  
User Centric

BACKGROUND Heart failure (HF) causes significant economic and humanistic burden for patients and their families, especially those with a low income, partly due to high hospital readmission rates. Optimal self-care is considered an important nonpharmacological aspect of HF management that can improve health outcomes. Emerging evidence suggests that self-management assisted by smartphone apps may reduce rehospitalization rates and improve the quality of life of patients. We developed a virtual human–assisted, patient-centered mobile health app (iHeartU) for patients with HF to enhance their engagement in self-management and improve their communication with health care providers and family caregivers. iHeartU may help patients with HF in self-management to reduce the technical knowledge and usability barrier while maintaining a low cost and natural, effective social interaction with the user. OBJECTIVE With a standardized systematic usability assessment, this study had two objectives: (1) to determine the obstacles to effective and efficient use of iHeartU in patients with HF and (2) to evaluate of HF patients’ adoption, satisfaction, and engagement with regard to the of iHeartU app. METHODS The basic methodology to develop iHeartU systems consists of a user-centric design, development, and mixed methods formative evaluation. The iterative design and evaluation are based on the guidelines of the American College of Cardiology Foundation and American Heart Association for the management of heart failure and the validated “Information, Motivation, and Behavioral skills” behavior change model. Our hypothesis is that this method of a user-centric design will generate a more usable, useful, and easy-to-use mobile health system for patients, caregivers, and practitioners. RESULTS The prototype of iHeartU has been developed. It is currently undergoing usability testing. As of September 2018, the first round of usability testing data have been collected. The final data collection and analysis are expected to be completed by the end of 2019. CONCLUSIONS The main contribution of this project is the development of a patient-centered self-management system, which may support HF patients’ self-care at home and aid in the communication between patients and their health care providers in a more effective and efficient way. Widely available mobile phones serve as care coordination and “no-cost” continuum of care. For low-income patients with HF, a mobile self-management tool will expand their accessibility to care and reduce the cost incurred due to emergency visits or readmissions. The user-centered design will improve the level of engagement of patients and ultimately lead to better health outcomes. Developing and testing a novel mobile system for patients with HF that incorporates chronic disease management is critical for advancing research and clinical practice of care for them. This research fills in the gap in user-centric design and lays the groundwork for a large-scale population study in the next phase. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/13502

scholarly journals Community and Health Care Providers Perception on Quality of Private Sector Outpatient Malaria Care in North West Ethiopia: A Qualitative Study

2020 ◽  
Author(s):  
Mesele Damte Argaw ◽  
Thandisizwe Redford Mavundla ◽  
Kassa Daka Gidebo
Keyword(s):  
Focus Group ◽  
Private Sector ◽  
Health Care Providers ◽  
Service Providers ◽  
Good Governance ◽  
Health Workers ◽  
Care Providers ◽  
Focus Group Discussions ◽  
Group Discussions

Abstract Malaria is one of the most important public health problems in Ethiopia contributing to significant patient morbidity and mortality. Prompt diagnosis and effective malaria case management-through public, private and community health facilities has been one of the key malaria prevention, control and elimination strategies. The objective of this study was to evaluate perceptions of adult malaria patients and healthcare provider on quality of malaria management at private sector outpatient facilities. An exploratory, descriptive, contextual, qualitative research methodology was conducted with 101 participants (i.e. 33 in-depth interviews and ten Focus Group Discussions with 68 discussants). All interview and Focus Group Discussions were audio recorded, transcribed verbatim and analysed using eight steps of Tesch (1990). During data analysis a single theme, two categories and six sub categories were emerged, namely (1) Perceived quality of malaria management at outpatient facilities; (a) essential resources ; (a1) safe outpatient services; (a2) antimalarial drugs and supplies; (a3) health workers; (b) factors influencing service utilization ; (b1) Physical accessibility; (b2) “Art of care’’; and (b3) efficient malaria diagnosis and treatment services. Finally, enhancing good governance and stewardship of the public sector to tap the potential of private sector, build the service providers capacity and empowering the community on seeking early medical and safety were recommended.

scholarly journals “I Like the Idea of It…But Probably Wouldn’t Use It” - Health Care Provider Perspectives on Heart Failure mHealth: Qualitative Study

JMIR Cardio ◽  
10.2196/18101 ◽  
2020 ◽  
Vol 4 (1) ◽  
pp. e18101
Author(s):  
Jennifer Dickman Portz ◽  
Kelsey Lynett Ford ◽  
Kira Elsbernd ◽  
Christopher E Knoepke ◽  
Kelsey Flint ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Qualitative Study ◽  
Real Time ◽  
Health Care Providers ◽  
Patient Reported Outcomes ◽  
Care Providers ◽  
Time Data ◽  
Patient Reported ◽  
Real Time Data

Background Many mobile health (mHealth) technologies exist for patients with heart failure (HF). However, HF mhealth lacks evidence of efficacy, caregiver involvement, and clinically useful real-time data. Objective We aim to capture health care providers’ perceived value of HF mHealth, particularly for pairing patient–caregiver-generated data with clinical intervention to inform the design of future HF mHealth. Methods This study is a subanalysis of a larger qualitative study based on interviewing patients with HF, their caregivers, and health care providers. This analysis included interviews with health care providers (N=20), focusing on their perceived usefulness of HF mHealth tools and interventions. Results A total of 5 themes emerged: (1) bio-psychosocial-spiritual monitoring, (2) use of sensors, (3) interoperability, (4) data sharing, and (5) usefulness of patient-reported outcomes in practice. Providers remain interested in mHealth technologies for HF patients and their caregivers. However, providers report being unconvinced of the clinical usefulness of robust real-time patient-reported outcomes. Conclusions The use of assessments, sensors, and real-time data collection could provide value in patient care. Future research must continually explore how to maximize the utility of mHealth for HF patients, their caregivers, and health care providers.

scholarly journals Perceptions and Experiences of Inequity in The Provision and Utilization of Maternal, Newborn, and Child Health Services in Tigray, Ethiopia: A Qualitative Exploratory Study

2021 ◽  
Author(s):  
Alem Desta Wuneh ◽  
Afework Mulugeta Bezabih ◽  
Lars Åke Persson ◽  
Yemisrach Behailu Okwaraji ◽  
Araya Abrha Medhanyie
Keyword(s):  
Focus Group ◽  
Child Health ◽  
Health Services ◽  
Health Care Providers ◽  
Child Health Services ◽  
Care Providers ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Newborn And Child Health ◽  
And Child Health

Abstract Background In earlier studies, we could show that rural Ethiopian maternal health services were distributed pro-rich, while child immunization coverage was equitably distributed. Hence, this study aimed at exploring rural Ethiopian mothers’ and primary healthcare workers’ perceptions of inequities and their causes in the provision and utilization of maternal, newborn, and child health services. Methods The study was conducted from August to December 2019 in two rural districts in Tigray, Ethiopia. We performed 22 in-depth interviews and three focus group discussions with mothers who had given birth the last year before the survey. We also interviewed women’s development group leaders, health extension workers at health posts, and health workers at health centers. The final sample was determined based on the concept of saturation. The interviews and focus group discussions were audiotaped, transcribed, translated, coded, and analyzed using thematic analysis. Results Mothers perceived the provision and utilization of antenatal care, facility-based delivery, and care-seeking for sick children inequitably distributed, while immunization was seen as an equitable service. The inequity in providing and utilizing maternal and child health services was linked to the economy, distance, social and cultural norms, health systems, maternal age, and education. Poor implementation of the Government’s equity-oriented policies, such as community-based health insurance, was perceived to result in health inequities. Conclusions Mothers and primary health care providers in rural Ethiopia indicated weaknesses in delivering equitable services and reasons for inequitable utilization. The narratives could inform efforts to provide universal health coverage for mothers, newborns, and children. These problems require multisectoral actions to address the identified sources of inequities.

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