scholarly journals Medical and psychological support of women with stillbirth in the perinatal period: a national study

2020 ◽  
Vol 14 (4) ◽  
pp. 176-184
Author(s):  
Yulya S. Mysovskaya ◽  
D. V. Marshalov ◽  
E. M. Shifman ◽  
N. V. Shindyapina

In the Russian Federation, the stillbirth rate in 2018 was 5.51 per 1000 live and dead births, which is almost twice the figure in the United States and Europe. This study aimed to conduct a rating analysis separately for each factor that influences the selection of techniques for the management of labor and the postpartum period in women with stillbirth. Material and methods. A questionnaire was developed, which consisted 23 questions in Russian. A total of 402 Russian-speaking medical workers took part in the survey. Results. In this study, 49.7% of the respondents seldom encounter patients with stillbirth. Moreover, 59.5% of the respondents find it easy to create a supportive communication with these patients, 70% believed that contact between the mother and her stillborn child has a negative influence on her psychoemotional state both at the time of delivery and in the long term, and only 27.7% found that mothers wanted to spend time with the child. As the optimal method of analgesia, 57.2% of the respondents chose epidural analgesia for stillbirth delivery. Furthermore, 57.7% believed that patients with stillbirth were satisfied with the quality of medical care, and 74.1% gave a positive assessment of the quality of medical care provided to patients with stillbirth in their medical institutions. Moreover, medical professionals (89.3%) consider it necessary to develop clinical recommendations on this problem. Conclusions. The results indicate that a unified technique of managing the peripartum period with stillbirth is still not established. Clinical guidelines on this problem are necessary.

2012 ◽  
Vol 188 (3) ◽  
pp. 769-774 ◽  
Author(s):  
Jamie Ritchey ◽  
E. Greer Gay ◽  
Benjamin A. Spencer ◽  
David C. Miller ◽  
Lauren P. Wallner ◽  
...  

2018 ◽  
Vol 13 (3) ◽  
pp. 107-119
Author(s):  
Patimat A. Bekshokova ◽  
Gayirbeg M. Abdurakhmanov ◽  
Kerim S. Bekshokov ◽  
Patimat I. Gabibova ◽  
Kazbek K. Bekshokov ◽  
...  

Aim.To carry out a comparative analysis of self-rated health, medical activity, and satisfaction with the quality of medical care in public health institutions by residents of rural settlements of the Untsukul district, Republic of Dagestan.Methods.The study was conducted by the method of questioning 2643 respondents, among them 1453 women and 1181 men.Results.According to the results of the survey, the majority of the interviewed residents of Untsukul district (68.2%) are satisfied with their health. Medical activity of the population at the time of the study was 60.6%. As to respondents who applied to the medical institutions of the Untsukul district during this period, 13.5% are not satisfied with the quality of medical care in public health institutions, 23.5% are fully satisfied, 30% are not fully satisfied.Conclusion.A social survey in the form of a questionnaire is one of the most effective methods of obtaining information about the self-rated health of the population. Timely analysis of medical activity of the population, its satisfaction with the quality of medical care will improve the efficiency of the health system.


2022 ◽  
Vol 8 (1) ◽  
pp. 114-121
Author(s):  
B. Niyazov ◽  
S. Niyazovа

Insufficient availability of emergency medical services to the rural population is noted. The dynamics of the growth of calls to emergency medical services testifies to the fact that emergency medical institutions have taken over part of inpatient services for the provision of emergency care to patients with chronic diseases and acute colds.


2016 ◽  
Author(s):  
Talya Miron-Shatz ◽  
Stefan Becker ◽  
Franklin Zaromb ◽  
Alexander Mertens ◽  
Avi Tsafrir

BACKGROUND Thank you letters to physicians and medical facilities are an untapped resource, providing an invaluable glimpse into what patients notice and appreciate in their care. OBJECTIVE The aim of this study was to analyze such thank you letters as posted on the Web by medical institutions to find what patients and families consider to be good care. In an age of patient-centered care, it is pivotal to see what metrics patients and families apply when assessing their care and whether they grasp specific versus general qualities in their care. METHODS Our exploratory inquiry covered 100 thank you letters posted on the Web by 26 medical facilities in the United States and the United Kingdom. We systematically coded and descriptively presented the aspects of care that patients and their families thanked doctors and medical facilities for. We relied on previous work outlining patient priorities and satisfaction (Anderson et al, 2007), to which we added a distinction between global and specific evaluations for each of the already existing categories with two additional categories: general praise and other, and several subcategories, such as treatment outcome, to the category of medical care. RESULTS In 73% of the letters (73/100), physicians were primarily thanked for their medical treatment. In 71% (71/100) of the letters, they were thanked for their personality and demeanor. In 52% cases (52/100), these two aspects were mentioned together, suggesting that from the perspective of patient as well as the family member, both are deemed necessary in positive evaluation of medical care. Only 8% (8/100) of the letters lacked reference to medical care, personality or demeanor, or communication. No statistically significant differences were observed in the number of letters that expressed gratitude for the personality or demeanor of medical care providers versus the quality of medical care (χ21, N=200=0.1, not statistically significant). Letters tended to express more specific praise for personality or demeanor, such as being supportive, understanding, humane and caring (48/71, 68%) but more general praise for medical care (χ21, N=424=63.9, P<.01). The most often mentioned specific quality of medical care were treatment outcomes (30/73, 41%), followed by technical competence (15/73, 21%) and treatment approach (14/73, 19%). A limitation of this inquiry is that we analyzed the letters that medical centers chose to post on the Web. These are not necessarily a representative sample of all thank you letters as are sent to health care institutions but are still indicative of what centers choose to showcase on the Web. CONCLUSIONS Physician demeanor and quality of interaction with patients are pivotal in how laymen perceive good care, no less so than medical care per se. This inquiry can inform care providers and medical curricula, leading to an improvement in the perceived quality of care.


Author(s):  
Vladimir Anatolievich Klimov

The problem of infectious safety is extremely urgent in modern medicine. To date, it is not possible to determine the reliable prevalence of nosocomial infections, since this indicator is significantly underestimated according to available statistical reporting. The development and implementation of a sanitary and hygienic monitoring system, organization of the work of the infection control commission is an important element in improving the quality of medical care by a general practitioner.


1997 ◽  
Vol 78 (6) ◽  
pp. 464-465
Author(s):  
E. V. Karpukhin

The main feature of the system of medical care for the rural population created in our country is its phased nature, starting from feldsher-midwife stations to regional, territorial and republican institutions. Due to the peculiarities of rural population settlement, large distances to medical institutions, poor roads, lack of regular transport communication, low technical availability of communication facilities, as well as a number of social, economic and geographical factors, there are problems in the organization of medical care for this contingent.


2020 ◽  
Vol 22 (3) ◽  
pp. 56-60
Author(s):  
O. N. Skryabin ◽  
K. N. Movchan ◽  
D. A. Tvorogov ◽  
V. V. Tatarkin ◽  
Yu. M. Morozov ◽  
...  

Abstract. This piece of work has evaluated the quality of medical care provided in 2015 to 1,158 patients with acute gastrointestinal bleeding in 11 medical institutions of Saint Petersburg that are licensed to provide in-patient examination and treatment for people with acute surgical diseases abdominal organs. The data on the possible correlative relationship of negative consequences for the implementation of the medical treatment and diagnostic process in cases of insufficient activity in terms of conducting clinical expert work on the profile of emergency abdominal surgery have been analysed in particular. It has been shown that providing medical care to patients with gastrointestinal bleeding is associated with defects in the medical diagnostic process in almost every second case. In the structure of inaccuracies, there prevailed cases of improper examination and treatment of patients (48 and 36%, respectively). Defects in making diagnosis and providing continuity comprise 13 and 3% respectively. The most significant drawback in providing medical care to patients with gastrointestinal bleeding was the use of low-effective anti-ulcer drug therapy schemes (16% of observation cases) and attempts to perform hemostasis by using outdated technologies of intraluminal endoscopy (16% of cases). It is noted that in cases of providing medical care to patients with acute gastrointestinal bleeding, a differentiated principle should be observed. It is proved that the proper quality of medical care for patients with acute gastrointestinal bleeding can be achieved by consistent, programmed provision of it with coordinated activities not only of surgeons directly involved in the treatment and diagnostic process, but also with their purposeful interaction with specialists of other medical fields.


2020 ◽  
Vol 22 (1) ◽  
pp. 53-59
Author(s):  
K N Movchan ◽  
K E Chernov ◽  
B S Artyushin ◽  
A V Zharkov ◽  
V V Tatarkin ◽  
...  

Despite the successes in the examination and treatment of patients with prostate cancer, the problems associated with the organization of medical care for patients suffering from this disease remain. Defects in the verification of oncological diseases of the prostate often cause a decrease in parameters reflecting the quality and life expectancy of men. The data on the clinical case presented in the work demonstrate the difficulties of verifying a disease of a patient with prostate cancer, despite the involvement of many specialists of several medical institutions in the diagnostic process. With significant amounts of medical measures, the quality of the medical care provided at all stages can be considered inappropriate, primarily due to a violation of continuity in the management of the patient. Health care resources were used irrationally despite the fact that attempts were made to save the patient’s life at all levels and stages of medical care. Probably, defects in the provision of medical care could have been prevented by applying unified approaches in the diagnostic and treatment process using the advantages of information technology in modern computer databases of medical institutions, which make it possible to monitor the stages and volume of medical care provided to patients individually. In addition, the proper organization of medical care, as well as the targeted routing of patient flows should be provided not so much by clinicians as health managers. In the absence of opportunities in the treatment and prevention facilities, where patients are sometimes unplanned in urgent cases, the possibilities for carrying out diagnostic and treatment procedures, the healthcare organizers, together with the clinicians, must find reserves for referring patients to specialized medical organizations, in which examination and treatment of patients can be guaranteed. At the same time, the role, importance and effectiveness of the activities of health managers in the examination of the quality of medical care in each case should be evaluated separately.


1978 ◽  
Vol 6 (4) ◽  
pp. 317-339
Author(s):  
Richard C. Boutwell

The rising costs of medical care and the training of medical professionals has brought about circumstances which threatens the acceptable quality of medical care in the United States. Fewer medical schools and a drop in the rate of enrolled medical students are but two indicators reflecting the issue between cost versus quality of medical training. One of the medical communities responses to this crisis has been the introduction of educational technology and instructional design processes in the training of medical professionals. This paper discusses the background of the problem and offers an instructional design model which has applied success.


Author(s):  
I. A. Shmelyov ◽  
Oleg E. Konovalov

Introduction. Process of reforming of health care causes the need of the use of medico-sociological methods for the analysis of efficiency of medical care and search of ways of its improvement. There are presented data of Estimation of Parental Valuation of the quality and availability of the out-patient and polyclinic care for children. Materials and methods. The questionnaire survey of 478 lawful representatives of minor patients (residents of the samara region) was performed. Results. Respondents in general were established to give a positive assessment to the assurance of the quality of medical care for their children: relationships with the doctor were characterized by high degree of trust, attentive and respect, full understanding of problems of the patient from the medical personnel. Among the positive aspects the survey participants pointed out the possibility of obtaining expert assistance, free care, and certain availability, the possibility of the contact with a doctor as needed. The lack of a variety of specialists, safeguarding the confidentiality of the information, scarcity of medicines, and poor organization of rehabilitation are negatively perceived by parents. Parents see the achieving high quality of care in the improvement in working conditions for medical staff (including financial stimulation of employees) and increasing of the professionalism of doctors. Conclusion. Primary out-patient and polyclinic care for the children’s population in general is highly appreciated by parents enough as quite corresponds to individual needs of patients and in most cases helps to cope with their problems. Inconstancy of the level of satisfaction characterizing the quality of medical care determines the need of its regular monitoring. Information on the quality and availability of the out-patient and polyclinic care can be used in forming regional programs of the prevention of noninfectious diseases among the children’s population.


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