scholarly journals A Qualitative Study on the Unmet Needs of Cancer Carers in Vietnam

2020 ◽  
Author(s):  
Chris Jenkins ◽  
Hien Thi Ho ◽  
Hoa Le Phuong Nghiem ◽  
Gillian Prue ◽  
Lynne Lohfeld ◽  
...  

Abstract Background: Due to limited resources in hospitals and social and cultural norms regarding caregiving in Vietnam, carers provide a range of supportive functions for family members diagnosed with cancer. This paper provides empirical evidence on the self-identified unmet needs of carers of inpatients in national oncology hospitals in Vietnam.Methods: An international, multidisciplinary research team conducted focus group and in-depth interviews with informal carers (n=20) and health care providers (n=22) and collaboratively analysed the results using thematic content analysis.Results: Thematic content analysis highlighted four main areas of needs: (i) material requirements such as accessible and comfortable facilities, accommodation and finance; (ii) information needs about cancer, caring, and nutrition; (iii) emotional support; and (iv) training about how to provide care to their family members during (a) treatment and (b) recovery phases.Conclusions: Carers provide invaluable support in supporting people with a cancer diagnosis, particularly given wider systemic challenges in delivering cancer services in Vietnam. Increasing visibility and formal support is likely to have both a positive impact upon the health and wellbeing of carers, as well as for cancer patients under their care.

2019 ◽  
Author(s):  
Robert Sumaguingsing ◽  
Rudolf Cymorr Kirby Palogan Martinez

Among cultures which place emphasis on the centrality of family in ones lives, the care for the dying patient is more often than not delegated on family members. Given this context, it is interesting to note that few research have been done on the experiences of these individuals who provide care to their dying relatives. This research aims to understand the lives of these informal carers as they provide care to their dying relatives. After securing clearance from an IRB, seven (5) informants, deemed as coresearchers, were recruited and agreed to participate in this study. The co-researchers where selected based on a pre-set criteria and the number were reached based on theoretical saturation. Multiple individual in-depth face-to-face interviews were done to create the individual narratives which was later reflectively analysed. Interpretive phenomenology as espoused by van Manen served as the philosophical underpinning of the study. Consequently, the proposed analytic technique of van Manen was utilized as the process of reflective analysis. After the process of reflective analysis, three (3) themes were gathered, namely: Ambivalence in anticipation, Courage in uncertainty, Meaning in suffering. These themes represent for the co-researchers their lives as they care for their dying relatives. Further, these themes reflects for the co-researchers a phenomenon of living moment-to-moment, unsure of what tomorrow will bring, patiently waiting for their relative to cross over. For them, there seems to be a constant struggle of finding a reason for being and a sense of what has happened, what is happening and what could happen to their dying relative and their family after their death. This essence can be symbolically represented by a swinging pendulum, constantly in motion trying to situate ambivalence in their anticipation, looking for courage amidst uncertainty and finding formeaning in their experience of suffering. The insights suggest that there is a need for constant dialogue among family members and health care providers as they assumed the role of primary caregivers. Further continued emotional, moral and spiritual support is implied during this transition as well as follow-ups when the families are at the home setting.


2021 ◽  
Vol 8 ◽  
pp. 237437352110180
Author(s):  
Robin E. McAtee ◽  
Laura Spradley ◽  
Leah Tobey ◽  
Whitney Thomasson ◽  
Gohar Azhar ◽  
...  

Millions of Americans live with dementia. Caregivers of this population provide countless hours of multifaceted, complex care that frequently cause unrelenting stress which can result in immense burden. However, it is not fully understood what efforts can be made to reduce the stress among caregivers of persons with dementia (PWD). Therefore, the aim of this pretest–posttest designed study was to evaluate changes in caregiver burden after providing an educational intervention to those caring for PWD in Arkansas. Forty-one participants completed the Zarit Caregiver Burden Scale before and after attending a 4-hour dementia-focused caregiving workshop. The analysis of the means, standard deviations, and paired t tests showed that there was an increase in the confidence and competence in caring for PWD 30 to 45 days after attending the workshop. Health care providers need to understand both the vital role caregivers provide in managing a PWD and the importance of the caregiver receiving education about their role as a caregiver. Utilizing caregiver educational programs is a first step.


2019 ◽  
Vol 2 (1) ◽  
pp. 53-56
Author(s):  
Gustavo Ferrer ◽  
Chi Chan Lee ◽  
Monica Egozcue ◽  
Hector Vazquez ◽  
Melissa Elizee ◽  
...  

Background: During the process of transition of care from the intensive care setting, clarity, and understanding are vital to a patient's outcome. A successful transition of care requires collaboration between health-care providers and the patient's family. The objective of this project was to assess the quality of continuity of care with regard to family perceptions, education provided, and psychological stress during the process. Methods: A prospective study conducted in a long-term acute care (LTAC) facility. On admission, family members of individuals admitted to the LTAC were asked to fill out a 15-item questionnaire with regard to their experiences from preceding intensive care unit (ICU) hospitalization. The setting was an LTAC facility. Patients were admitted to an LTAC after ICU admission. Results: Seventy-six participants completed the questionnaire: 38% expected a complete recovery, 61% expected improvement with disabilities, and 1.3% expected no recovery. With regard to the length of stay in the LTAC, 11% expected < 1 week, 26% expected 1 to 2 weeks, 21% expected 3 to 4 weeks, and 42% were not sure. Before ICU discharge, 33% of the participants expected the transfer to the LTAC. Also, 72% did not report a satisfactory level of knowledge regarding their family's clinical condition or medical services required; 21% did not receive help from family members; and 50% reported anxiety, 20% reported depression, and 29% reported insomnia. Conclusion: Families' perception of patients' prognosis and disposition can be different from what was communicated by the physician. Families' anxiety and emotional stress may precipitate this discrepancy. The establishment of optimal projects to eliminate communication barriers and educate family members will undoubtedly improve the quality of transition of care from the ICU.


Author(s):  
Marianne Hatfield ◽  
Rebecca Ciaburri ◽  
Henna Shaikh ◽  
Kirsten M. Wilkins ◽  
Kurt Bjorkman ◽  
...  

OBJECTIVE: Mistreatment of health care providers (HCPs) is associated with burnout and lower-quality patient care, but mistreatment by patients and family members is underreported. We hypothesized that an organizational strategy that includes training, safety incident reporting, and a response protocol would increase HCP knowledge, self-efficacy, and reporting of mistreatment. METHODS: In this single-center, serial, cross-sectional study, we sent an anonymous survey to HCPs before and after the intervention at a 213-bed tertiary care university children’s hospital between 2018 and 2019. We used multivariable logistic regression to examine the effect of training on the outcomes of interest and whether this association was moderated by staff role. RESULTS: We received 309 baseline surveys from 72 faculty, 191 nurses, and 46 residents, representing 39.1%, 27.1%, and 59.7%, respectively, of eligible HCPs. Verbal threats from patients or family members were reported by 214 (69.5%) HCPs. Offensive behavior was most commonly based on provider age (85, 28.5%), gender (85, 28.5%), ethnicity or race (55, 18.5%), and appearance (43, 14.6%) but varied by role. HCPs who received training had a higher odds of reporting knowledge, self-efficacy, and experiencing offensive behavior. Incident reporting of mistreatment increased threefold after the intervention. CONCLUSIONS: We report an effective organizational approach to address mistreatment of HCPs by patients and family members. Our approach capitalizes on existing patient safety culture and systems that can be adopted by other institutions to address all forms of mistreatment, including those committed by other HCPs.


Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Rayetta Johnson

Background and Issues: The burden of stroke in North Carolina is one of the highest in the nation (approximately 28,000 stroke hospitalizations from 2003-2007). The number and high costs of stroke have made it incumbent to improve the numbers of patients receiving effective treatment. There are two major barriers for treatment of acute stroke: time and access. The utilization of telestroke in community hospitals aids in decreasing these barriers by providing immediate access to a stroke neurologist. In order for telestroke to be successful, awareness and education regarding acute stroke care must be provided for health care providers as well as the communities. Thus, the development of a telestroke system requires nursing and medical expertise. The Primary Stroke Center Team at Wake Forest Baptist Medical Center in Winston-Salem, N.C. implemented a telestroke network system (Intouch's Health's RP-7 Robotic system) in January of 2010 to provide 24/7 access to the medical center's acute stroke experts and the latest advancements in stroke interventions. There are eight hospitals in the network at the present time. Methods: Our team identified that many of the network hospital's staff are not experienced in taking care of a stroke patient and that a “roadmap” is useful to guide them in these steps.The stroke nurse specialist developed a quality improvement plan for the network hospitals which included: an evidence-based algorithm for patient care; stroke education, in particular, neurological assessment and tPA administration classes for the ED staff; quarterly meetings to provide outcome and feedback data with each network hospital; stroke awareness events for the community. Mock telestroke consults were also performed prior to “going live” with telestroke for each of the network hospitals. Of utmost importance is the early involvement and education of the EMS system in the respective county of the network hospital. The buy-in of EMS was found to be a key component in the success of the network. Finally, attention to customized quality improvement efforts for each of the facilities are required to accomplish integration into the telestroke network. Results: The data has been analyzed, and thus far, a 24% rate of tPA administration has been seen with our network hospitals (an increase from the 3.6% national average). Comparisons between each of the eight network hospitals' rates of administration of tPA prior to and after joining the network show a trend of increase (10%-40%). The effectiveness of the algorithm has also been explored by analysis of feedback and initial results have shown a positive impact. Conclusion: A combination of improving access to stroke neurologists in conjunction with a focus on improving the level of care via evidenced based stroke care teaching and implementation of algorithms at a network hospital is required for implementing and building a successful telestroke network.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Hossein Motahari-Nezhad ◽  
Maryam Shekofteh ◽  
Maryam Andalib-Kondori

Purpose This study aims to investigate the characteristics, as well as the purpose and posts of the COVID-19 Facebook groups. Design/methodology/approach A systematic search for COVID-19 Facebook groups was conducted on June 1, 2020. Characteristics of the groups were examined using descriptive statistics. Mann-Whitney test was used to study the differences between groups. The study of the most popular groups’ posts was also carried out using the content analysis method. Findings The groups had a combined membership of 2,729,061 users. A total of 147,885 posts were received. There were about approximately 60% public groups. A high percentage of the groups (86.5%) had descriptions. The results showed a significant relationship between the groups’ description status and the number of members (p-value = 0.016). The majority of COVID-19 Facebook groups (56%) were created to meet their members’ information needs. The highest number of studied posts were related to vaccination (35.2%), followed by curfew rules (19.6%) and symptoms (10.6%). Originality/value Translating these insights into policies and practices will put policymakers and health-care providers in a stronger position to make better use of Facebook groups to support and enhance public knowledge about COVID-19.


2020 ◽  
Author(s):  
Inga Hunter ◽  
Phoebe Elers ◽  
Caroline Lockhart ◽  
Hans Guesgen ◽  
Amardeep Singh ◽  
...  

BACKGROUND Smart home and telemonitoring technologies have often been suggested to assist health care workers in supporting older people to age in place. However, there is limited research examining diverse information needs of different groups of health care workers and their access to appropriate information technologies. OBJECTIVE The aim of this study was to investigate the issues associated with using technologies that connect older people to their health care providers to support aging in place and enhance older people’s health and well-being. METHODS Seven focus group discussions were conducted comprising 44 health care professionals who provided clinic-based or in-home services to community-dwelling older people. Participants were asked about their information needs and how technology could help them support older people to age in place. The recordings of the sessions were transcribed and thematically analyzed. RESULTS The perspectives varied between the respondents who worked in primary care clinics and those who worked in community-based services. Three overarching themes were identified. The first theme was “access to technology and systems,” which examined the different levels of technology in use and the problems that various groups of health care professionals had in accessing information about their patients. Primary care professionals had access to good internal information systems but they experienced poor integration with other health care providers. The community-based teams had poor access to technology. The second theme was “collecting and sharing of information,” which focused on how technology might be used to provide them with more information about their patients. Primary care teams were interested in telemonitoring for specific clinical indicators but they wanted the information to be preprocessed. Community-based teams were more concerned about gaining information on the patients’ social environment. The third theme was that all respondents identified similar “barriers to uptake”: cost and funding issues, usability of systems by older people, and information security and privacy concerns. CONCLUSIONS The participants perceived the potential benefits of technologies, but they were concerned that the information they received should be preprocessed and integrated with current information systems and tailored to the older people’s unique and changing situations. Several management and governance issues were identified, which needed to be resolved to enable the widespread integration of these technologies into the health care system. The disconnected nature of the current information architecture means that there is no clear way for sensor data from telemonitoring and smart home devices to be integrated with other patient information. Furthermore, cost, privacy, security, and usability barriers also need to be resolved. This study highlights the importance and the complexity of management and governance of systems to collect and disseminate such information. Further research into the requirements of all stakeholder groups and how the information can be processed and disseminated is required.


10.2196/24157 ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. e24157
Author(s):  
Inga Hunter ◽  
Phoebe Elers ◽  
Caroline Lockhart ◽  
Hans Guesgen ◽  
Amardeep Singh ◽  
...  

Background Smart home and telemonitoring technologies have often been suggested to assist health care workers in supporting older people to age in place. However, there is limited research examining diverse information needs of different groups of health care workers and their access to appropriate information technologies. Objective The aim of this study was to investigate the issues associated with using technologies that connect older people to their health care providers to support aging in place and enhance older people’s health and well-being. Methods Seven focus group discussions were conducted comprising 44 health care professionals who provided clinic-based or in-home services to community-dwelling older people. Participants were asked about their information needs and how technology could help them support older people to age in place. The recordings of the sessions were transcribed and thematically analyzed. Results The perspectives varied between the respondents who worked in primary care clinics and those who worked in community-based services. Three overarching themes were identified. The first theme was “access to technology and systems,” which examined the different levels of technology in use and the problems that various groups of health care professionals had in accessing information about their patients. Primary care professionals had access to good internal information systems but they experienced poor integration with other health care providers. The community-based teams had poor access to technology. The second theme was “collecting and sharing of information,” which focused on how technology might be used to provide them with more information about their patients. Primary care teams were interested in telemonitoring for specific clinical indicators but they wanted the information to be preprocessed. Community-based teams were more concerned about gaining information on the patients’ social environment. The third theme was that all respondents identified similar “barriers to uptake”: cost and funding issues, usability of systems by older people, and information security and privacy concerns. Conclusions The participants perceived the potential benefits of technologies, but they were concerned that the information they received should be preprocessed and integrated with current information systems and tailored to the older people’s unique and changing situations. Several management and governance issues were identified, which needed to be resolved to enable the widespread integration of these technologies into the health care system. The disconnected nature of the current information architecture means that there is no clear way for sensor data from telemonitoring and smart home devices to be integrated with other patient information. Furthermore, cost, privacy, security, and usability barriers also need to be resolved. This study highlights the importance and the complexity of management and governance of systems to collect and disseminate such information. Further research into the requirements of all stakeholder groups and how the information can be processed and disseminated is required.


2018 ◽  
Vol 38 (3) ◽  
pp. 18-26 ◽  
Author(s):  
Shawn E. Cody ◽  
Susan Sullivan-Bolyai ◽  
Patricia Reid-Ponte

Background The hospitalization of a family member in an intensive care unit can be stressful for the family. Family bedside rounds is a way for the care team to inform family members, answer questions, and involve them in care decisions. The experiences of family members with intensive care unit bedside rounds have been examined in few studies. Objectives To describe (1) the experiences of family members of patients in the intensive care unit who participated in family bedside rounds (ie, view of the illness, role in future management, and long-term consequences on individual and family functioning) and (2) the experiences of families who chose not to participate in family bedside rounds and their perspectives regarding its value, their illness view, and future involvement in care. Methods A qualitative descriptive study was done, undergirded by the Family Management Style Framework, examining families that participated and those that did not. Results Most families that participated (80%) found the process helpful. One overarching theme, Making a Connection: Comfort and Confidence, emerged from participating families. Two major factors influenced how that connection was made: consistency and preparing families for the future. Three types of consistency were identified: consistency in information being shared, in when rounds were being held, and in informing families of rounding delays. In terms of preparing families for the future, families appeared to feel comfortable with the situation when a connection was present. When any of the factors were missing, families described feelings of anger, frustration, and fear. Family members who did not participate described similar feelings and fear of the unknown because of not having participated. Conclusion What health care providers say to patients’ families matters. Families may need to be included in decision-making with honest, consistent, easy-to-understand information.


Author(s):  
Martine Audibert ◽  
Jacky Mathonnat ◽  
Aurore Pélissier ◽  
Xiao Xian Huang

The New Rural Cooperative Medical Scheme was gradually introduced from 2003 in China. This paper is based on a representative survey of 24 randomly selected township hospitals in Weifang prefecture over the period 2000-2008. Using a generalized form of differences-in-differences model, it aims to assess the effect of the reform on the utilization and income structure of the township hospitals. The estimations provide three main results linked to the effects of the New Rural Cooperative Medical Scheme on the behavior of the key stakeholders (households, health care providers and Health Bureau). Firstly, the reform had positive impacts on the utilization of township hospitals, particularly on the inpatient activity, but no significant impact on their income structure. Secondly, a decrease in the burden of hospitalization costs for households is suggested by the higher positive impact of the reform on the volume of inpatients in poor areas than in the other ones. Lastly, the marginal impact of the reform decreases over time.


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