Fair Testing: The Science And Politics Of Effective Health Care

Abstract Background Depression is often underdiagnosed by treating health professionals. This is a situation in Malawi where there is no routine screening of depression at antenatal clinics. Recently, a Screening Protocol for Antenatal Depression (SPADe) that can be used by midwives to screen for antenatal depression was developed in Blantyre District. SPADe proposes multistage screening of antenatal depression by midwives which may enable early detection and treatment of pregnant women with depression. Proper treatment of antenatal depression can assist in achieving Sustainable Development Goals (SDGs). However, utilisation of SPADe in clinical practice to screening for depression in antenatal clinics has not been established yet. Therefore, the primary aim of this study is to assess feasibility of screening for depression by midwives using SPADe in antenatal clinics in Blantyre District. The secondary aim was to assess acceptability and fidelity of screening for depression by midwives using SPADe in antenatal clinics in Blantyre District. Methods This will be a feasibility study which will consist of scientific investigations that will support movement of evidence-based, effective health care approach, SPADe, from the clinical knowledge base into routine use. This study will consist three phases: phase 1 will introduce SPADe in antenatal clinics in Blantyre District where screening of depression is almost none existent; phase 2 will implement screening of depression using SPADe in antenatal clinics in Blantyre District; and phase 3 will evaluate the screening of antenatal depression using SPADe to establish its feasibility, acceptability and fidelity in antenatal clinics in Blantyre District. Discussion This study will establish and document feasibility, acceptability and fidelity of screening for depression by midwives using SPADe in antenatal clinics in Blantyre District. It is expected that midwives will develop more confidence in detecting and dealing with antenatal depression. Consequently, there will be increased numbers of pregnant women detected with depression by midwives and increased accessibility to mental health care by pregnant women in antenatal clinics.

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Clinical Evidence: A Compendium of the Best Available Evidence for Effective Health Care

Annals of Internal Medicine ◽

10.7326/0003-4819-131-11-199912070-00021 ◽

1999 ◽

Vol 131 (11) ◽

pp. 872

Author(s):

Lawrence G. Smith

Keyword(s):

Health Care ◽

Clinical Evidence ◽

Effective Health Care

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Transformation of Mental Health Care for U.S. Soldiers and Families During the Iraq and Afghanistan Wars: Where Science and Politics Intersect

American Journal of Psychiatry ◽

10.1176/appi.ajp.2015.15040553 ◽

2016 ◽

Vol 173 (4) ◽

pp. 334-343 ◽

Cited By ~ 22

Author(s):

Charles W. Hoge ◽

Christopher G. Ivany ◽

Edward A. Brusher ◽

Millard D. Brown ◽

John C. Shero ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Science And Politics

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(Re)Introducing communication competence to the health professions

Journal of Public Health Research ◽

10.4081/jphr.2013.e23 ◽

2013 ◽

Vol 2 (3) ◽

pp. 23 ◽

Cited By ~ 18

Author(s):

Brian H. Spitzberg

Keyword(s):

Health Care ◽

Communication Skills ◽

Care Delivery ◽

Communication Competence ◽

Health Professions ◽

Theoretical Background ◽

Integrative Model ◽

Individual Motivation ◽

Error Disclosure ◽

Effective Health Care

<p>Despite the central role that communication skills play in contemporary accounts of effective health care delivery in general, and the communication of medical error specifically, there is no common or consensual core in the health professions regarding the nature of such skills. This lack of consensus reflects, in part, the tendency for disciplines to reinvent concepts and measures without first situating such development in disciplines with more cognate specialization in such concepts. In this essay, an integrative model of communication competence is introduced, along with its theoretical background and rationale. Communication competence is defined as an impression of appropriateness and effectiveness, which is functionally related to individual motivation, knowledge, skills, and contextual facilitators and constraints. Within this conceptualization, error disclosure contexts are utilized to illustrate the heuristic value of the theory, and implications for assessment are suggested.</p>

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How to measure innovation in radiotherapy: an application of the Delphi method

Journal of Hospital Administration ◽

10.5430/jha.v4n4p14 ◽

2015 ◽

Vol 4 (4) ◽

pp. 14

Author(s):

Maria Jacobs ◽

Liesbeth Boersma ◽

Andre Dekker ◽

Mark Govers ◽

Philippe Lambin ◽

...

Keyword(s):

Health Care ◽

Delphi Method ◽

Delphi Study ◽

Cost Effective ◽

Specific Product ◽

Radical Innovations ◽

Medical Physicists ◽

Successful Innovation ◽

Effective Health Care

Objective: Innovation is an important driver for improving the quality of health care, yet a tension exists between innovation and providing cost-effective health care. To develop strategies that promote innovation, parameters are needed that are indicative of innovation. However, no recognised indicators of innovation in radiotherapy are currently available. The aim of this study is to fill that gap by providing a framework for measuring innovation. This should facilitate future multi-centric studies on strategies aimed at promoting innovation in radiotherapy.Methods: We applied the Delphi method in four rounds. The chairpersons of all Dutch radiotherapy departments were asked to suggest indicators. The resulting inventory was assessed by a number of Dutch radiation oncologists, medical physicists and managers. After implementig a cut-off score on suitability and measurability, we asked Dutch professors on innovation to assess the remaining indicators. Finally, the chairpersons reached consensus.Results: On the basis of the Delphi study, we derived 13 indicators in four categories, more specific product innovation, technology innovation, market innovation and organisational innovation, for measuring both incremental and radical innovations in radiotherapy; these indicators are also suitable for measuring the generation and adoption of innovations.Conclusions: We were successful in reaching consensus amongst the experts on indicators that measure innovations in radiotherapy. The developed tool will be used to investigate the relation between innovation and possible factors inhibiting or stimulating successful innovation and between the level of innovation and its effects.

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