scholarly journals Perspectives on Frailty Screening, Management and Its Implementation Among Acute Care Providers in Singapore: A Qualitative Study

2020 ◽  
Author(s):  
Xiao Liu ◽  
Vivienne Mai Khanh Le ◽  
Amber Lim Yew Chen ◽  
Emily Jiali Koh ◽  
Tu Nguyen ◽  
...  
Keyword(s):  
Public Health ◽  
Qualitative Study ◽  
Acute Care ◽  
Group Discussion ◽  
Functional Decline ◽  
Adverse Outcomes ◽  
Health Concern ◽  
Care Providers ◽  
Care Givers ◽  
Age Related

Abstract Background Frailty has emerged to be a public health concern among aging populations. COVID-19 pandemic has reminded how the frailest individuals are particularly exposed to adverse outcomes. It is important to identify and manage frailty to delay functional decline and reduce unnecessary health utilizations. Our study explored understanding on frailty and practice of frailty screening among different acute care professionals in Singapore, (2) identify barriers and facilitators concerning frailty screening, management and its implementation.Methods A qualitative study using focus group discussion among nurses and individual interviews among physicians from four departments (Accident & Emergency, Anaethesia, General Surgery, Orthopedics) in three acute hospitals from the three public health clusters in Singapore. Participants were recruited through a combination of purposive, convenience and snowball approach with a directed approach by using NVIVO 12.0 to analyse the data. Result Frailty was mainly but inadequately understood as a physical and age-related concept. Screening for frailty in acute care was considered necessary to reduce adverse health outcomes. Specific issues related to screening, management and implementation identified were: cooperation from patient/caregivers, acceptance from healthcare workers/hospital managers, need for dedicated resources, guidelines for follow-up management and consensus on the scope of measurement for different specialties. Conclusion Our findings indicated the need for 1) education program for patients/care givers and stakeholders 2) hospital wide push to adopt and develop a uniform frailty screening tool and process and 3) applying relevant guidelines, developing whole of hospital approach and process for the management of frail patients.

scholarly journals The bio-psycho-social frailty: a key to the integrate territorial and hospital care in Europe

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Roller-Winsberger
Keyword(s):  
Public Health ◽  
Good Practice ◽  
Functional Decline ◽  
Population Level ◽  
Adverse Outcomes ◽  
Healthy Ageing ◽  
Active And Healthy Ageing ◽  
Age Related ◽  
Practice Models ◽  
Health And Social Care

Abstract Demographic changes have forced communities and people themselves to reshape ageing concepts and approaches and try to develop actions towards Active and Healthy Ageing (AHA). The prevalence of frailty at population-level is expected to increase in Europe, changing the focus of Public Health. The European Innovation Partnership on Active and Healthy Ageing (EIPonAHA), a private public partnerships (PPP) launched by the European Commission (EC) is aimed at developing new solutions to facilitate AHA. The partnership combined the view on frailty coming from public health as well as the clinical management, and managed to overcome barriers between these two worlds. Bio-Psycho-Social frailty represents a synthetic indicator providing an effective basis to overcome a silos approach that is often performed by health and social professionals working in the field. The A3-Action Group on ' Lifespan Health Promotion & Prevention of Age-Related Frailty and Diseases” proposes good practice models to achieve and support the healthy ageing of European citizens using a bottom-up approach targeting the prevention of frailty and subsequent functional decline. Multiple factors were highlighted by the group as useful for healthcare planning: malnutrition, polypharmacy, impairment of physical function and social isolation were targeted to mitigate frailty and its consequences. Integrated health and social care is a key factors to affect ageing positively either in the field of prevention of functional decline and in the field of care. Studies focused on the management of frailty highlighted that tailored interventions can improve physical performance and reduce adverse outcomes. A crucial role is played by training of health personnel and education at population level in order to achieve a new awareness about AHA trajectory.

scholarly journals Barriers to weight management in pregnant mothers with obesity: a qualitative study on mothers with low socioeconomic background

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fahimeh Mehrabi ◽  
Najva Ahmaripour ◽  
Sara Jalali-Farahani ◽  
Parisa Amiri
Keyword(s):  
Public Health ◽  
Health Care ◽  
Qualitative Study ◽  
Pregnant Women ◽  
Weight Management ◽  
Socioeconomic Background ◽  
Theory Approach ◽  
Personal Factors ◽  
Care Providers ◽  
Low Socioeconomic

Abstract Background Maternal obesity is a public health issue that could affect both women’s and children’s health. This qualitative study aimed to identify barriers to weight management of pregnant women with obesity and low socioeconomic backgrounds. Methods The current qualitative study has been conducted using a grounded theory approach by analyzing data collected from in-depth interviews with clients of Tehran’s public health care centers for prenatal care. The criteria for selecting participants were excessive weight gain during the first two trimesters of pregnancy, low socioeconomic status, and willingness to share their experiences. A semi-structured guide consisting of open-ended questions was asked in a private room. Open, axial, and selective coding were applied to the data. Findings Four main themes emerged from data, each of which has some subcategories: 1) personal factors (unpleasant emotions and feelings, personal tastes/hobbies, workload and responsibilities, and history of diseases), 2) pregnancy status (unintended and high-risk pregnancy), 3) interpersonal relationships and support (lack of a spouse’s support and unhealthy role modeling of relatives), 4) socio-cultural factors/influences (social norms and values, lack of access to health services, and unreliable information channels). Conclusions This study provides an overview of the barriers to the weight management of pregnant women from low socioeconomic backgrounds. The results could help develop appropriate health strategies for low socioeconomic women with obesity. Also, health care providers for this group of women could use these findings as a guide to consider their conditions and background.

Addressing Food Insecurity and Overweight/Obesity in Hospitalized Low-Income Latino Patients

2019 ◽  
Vol 25 (3) ◽  
pp. 241-248
Author(s):  
Trina Lorraine Gipson-Jones ◽  
Bertha L. Davis ◽  
Ché Matthew Harris
Keyword(s):  
Public Health ◽  
Type 2 Diabetes ◽  
Food Insecurity ◽  
Low Income ◽  
Adverse Outcomes ◽  
Hospital Utilization ◽  
Health Concern ◽  
Public Health Concern ◽  
Disease Risks

Food insecurity (FI), the limited or unreliable availability of safe and nutritious food, is a pressing public health concern affecting millions of U.S. citizens. Unfortunately, FI tends to impact those who are most vulnerable (e.g., low-income minorities) and potentially increases obesity risks, diet-sensitive disease risks (e.g., hypertension and type 2 diabetes), and hospital utilization. Low-income Latino patients may be particularly sensitive to adverse outcomes based on unaddressed socioeconomic needs. Nurses are in a prime position to assess and address FI in these patients. Our article will discuss how nurses can be advocates in combating FI in Latino patients with overweight/obesity.

scholarly journals Extended-spectrum beta-lactamase and ampicillin Class C beta lactamase-producing Escherichia coli from food animals: A review

2019 ◽  
pp. 65-75 ◽  
Author(s):  
Asinamai Athliamai Bitrus ◽  
Peter Anjili Mshelia ◽  
Iliya Dauda Kwoji ◽  
Mohammed Dauda Goni ◽  
Saleh Mohammed Jajere
Keyword(s):  
Public Health ◽  
Escherichia Coli ◽  
Health Concern ◽  
Resistant Bacteria ◽  
Beta Lactamase ◽  
Care Providers ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Class C

Antimicrobial resistance has gained global notoriety due to its public health concern, the emergence of multiple drug-resistant bacteria, and lack of new antimicrobials. Extended-spectrum beta-lactamase (ESBL)/ampicillin Class C (AmpC)- producing Escherichia coli and other zoonotic pathogens can be transmitted to humans from animals either through the food chain, direct contact or contamination of shared environments. There is a surge in the rate of resistance to medically important antibiotics such as carbapenem, ESBL, aminoglycosides, and fluoroquinolones among bacteria of zoonotic importance. Factors that may facilitate the occurrence, persistence and dissemination of ESBL/AmpC-Producing E. coli in humans and animal includes; 1). o ral administration of antimicrobials to humans primarily (by physician and health care providers) and secondarily to animals, 2). importation of parent stock and day-old chickens, 3). farm management practice and lack of water acidification in poultry, 4). contamination of feed, water and environment, 5). contamination of plants with feces of animals. Understanding these key factors will help reduce the level of resistance, thereby boosting the therapeutic effectiveness of antimicrobial agents in the treatment of animal and human infections. This review highlights the occurrence, risk factors, and public health importance of ESBL/AmpC-beta-lactamase producing E. coli isolated from livestock.

Discrimination and mental health among lesbian, gay and bisexual adults

2017 ◽  
Vol 41 (S1) ◽  
pp. S734-S734
Author(s):  
M.A. Dos Santos
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Health Care ◽  
Health Care Providers ◽  
Public Health Problem ◽  
Health Concern ◽  
Health Issues ◽  
Care Providers ◽  
Mental Health Issues ◽  
And Bisexual

IntroductionMental health care is indispensable, has an essential role in development, but mental health issues are a major public health concern worldwide. Sexual minorities, lesbian, gay and bisexual, suffer from prejudice and it determines health inequities, especially for their mental health.ObjectiveTo show the relation between discrimination and mental health issues in lesbian, gay and bisexual (LGB) people and to increase understanding of this serious neglected public health problem.MethodsThe search was conducted using Science Direct and Scopus, using the following keywords: “discrimination” and “mental health” and “lesbian” and “gay” and “bisexual”. Using the review of literature, documents in English (articles, official documents, editorial, reviews, clinical trials).DiscussionNumerous studies have identified highest risk behavior, as illicit drug use, sexual risk-taking behaviors and mental health issues among LGB people. Some previous studies propose that health and risk disparities between heterosexual and LGB identifying or behaving people are due to minority stress–that is, that the stigma, discrimination, and violence experienced, leading to stress, thus predisposing illness, disease (worse mental and physical health outcomes) and potentially substance use, which may be used to relieve or escape stress.ConclusionHealth professionals and healthcare organizations must cover these unmet mental health needs if they move to more integrated, coordinated models of care. Health educators should attend to the unique needs of each sexual orientation group when presenting sexual health information and health care providers should undergo diversity and sensitivity training to work more effectively with those groups.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

scholarly journals Oral medicine modification for older adults: a qualitative study of nurses

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018151 ◽  
Author(s):  
Aoife Mc Gillicuddy ◽  
Abina M Crean ◽  
Maria Kelly ◽  
Laura Sahm
Keyword(s):  
Older Adults ◽  
Qualitative Study ◽  
Acute Care ◽  
Long Term Care ◽  
Oral Medicine ◽  
Term Care ◽  
Ethical Implications ◽  
Age Related ◽  
Medicine Administration

ObjectiveOral medicines are frequently modified (eg, tablets crushed) for older adults. However, these modifications can have clinical, legal and/or ethical implications. Nurses bear responsibility for medicine administration and hence, perform these modifications. The aim of this study was to investigate the knowledge, attitudes and beliefs of nurses about oral medicine modification for older adults.DesignA qualitative study was conducted using semi-structured, face-to-face interviews with nurses providing care to older adults in acute and long-term care settings. Interviews were audio-recorded, transcribed verbatim and analysed thematically.SettingsSixteen purposively selected care settings; 4 acute-care and 12 long-term care settings were included. Nurses were recruited by convenience sampling at these sites.ParticipantsEighteen nurses participated (83% female, 67% long-term care, 33% acute-care, median age (IQR) 38 years (32.5–52.0)).ResultsThree major themes: modifying—a necessary evil, nurses’ role as patient advocate and modifying—we are working very much as a teamand two minor themes: fractional dosing, and covert administration emerged from the data. Nurses viewed oral medicine modifications as being a routine and necessary occurrence in geriatric patient care due to limitations of available formulations and the presence of age-related challenges in drug administration. Nurses’ knowledge of residents’ requirements ensured that they advocate for those with individualised formulation needs, however, nurses rely on pharmacists for information about modifications. Nurses expressed a desire for supports including increased education and ward-specific, pharmacist-developed recommendations on common modifications.ConclusionsThis study has provided useful insights into the views of nurses regarding oral medicine modification for older adults. The unique and varied formulation requirements of older adults must be acknowledged. Increased engagement by healthcare professionals, the pharmaceutical industry, regulatory agencies and policy-makers is required to facilitate the development of age-appropriate formulations. In the interim, practical interventions, informed by the findings of this study, are required.

scholarly journals DETERMINANTS OF MOTHER’S CHOICE OF PLACE DELIVERY IN COMMUNITY OF BAJO, MUNA DISTRICT: A QUALITATIVE STUDY

2016 ◽  
Vol 2 (3) ◽  
pp. 155-159 ◽  
Author(s):  
La Ode Ali Imran ◽  
Pitrah Asfian ◽  
Rahma Tia
Keyword(s):  
Qualitative Study ◽  
Health Care Providers ◽  
Health Concern ◽  
Care Providers ◽  
Analysis Model ◽  
Care Services ◽  
Lack Of Information ◽  
The Government ◽  
Colaizzi's Method ◽  
Financial Concern

Background: Muna is the area where Bajo community prefer to choose shaman for giving birth Objectives: This study aims to determine the reasons why mothers choose shamans or midwives to give birth in Renda Village, Towea Subdistrict, Muna District.Methods: This was a descriptive qualitative study to investigate determinants of mother’s choice of place delivery in Renda Towea village of Muna, Indonesia. In-depth interview was performed to three mothers who gave birth with Shaman, and two mothers with Midwives. This study was conducted on July, 2016 in the village of Renda Towea, Muna district. Data were analyzed by content analysis model using Colaizzi’s method of data analysis.Results: Results were grouped into: Reasons to choose midwives to give birth (Health concern, Family support, and Complete facilities), and Reasons to select shaman to give birth (Tradition, Financial concern, Short distance, Lack of information)Conclusions: Various reasons of mothers in choosing maternal care services. The findings of this study suggest that the government and health care providers should create the collaboration between midwives and shaman, increase financial support, and increase and evaluate health visitations to this community.

scholarly journals Perspective of Healthcare Providers using Reproductive Smart Mobile Application in Jakarta: A Qualitative Study

2020 ◽  
Author(s):  
Budi Wiweko ◽  
Aida Riyanti ◽  
Shanty Olivia ◽  
Muhammad Priangga ◽  
Vita Silvana ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Group Discussion ◽  
Healthcare Providers ◽  
Maternal Health Service ◽  
Care Providers ◽  
Cross Sectional ◽  
District Hospitals ◽  
Smart Mobile

Abstract Objective : Our study aimed to evaluate the perspectives of health care providers of JAKPROS ( Jakarta Reproduksi Sehat ) application that is used to improve the maternal health service. This descriptive qualitative study engaged 16 healthcare providers from two sub-district hospitals. The participants were selected using purposive sampling and cross-sectional design. Participant were asked to fill the written informed consent.Data were collected by in-depth discussion of a list of selected questions in a focus group discussion. Results: Most health care providers used paper-based systems in their hospitals.They said that it was very helpful in helping them communicate with their patients and provide information. The application has many benefits that help doctors provide the best service for patients during pregnancy.The use and adoption of app is needed to make a further improvements in the healthcare system. This study will help improve the application for more widespread use in a greater number of hospitals. JAKPROS made healthcare provider easier to communicate and track patient’s health. This app also assist patients related to the doctor’s schedule, health information, and nearest hospital.

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