scholarly journals eHealth, Participatory Medicine, and Ethical Care: A Focus Group Study of Patients’ and Health Care Providers’ Use of Health-Related Internet Information

2015 ◽  
Vol 17 (6) ◽  
pp. e155 ◽  
Author(s):  
Anne Townsend ◽  
Jenny Leese ◽  
Paul Adam ◽  
Michael McDonald ◽  
Linda C Li ◽  
...  
2000 ◽  
Vol 9 (5) ◽  
pp. 439-444 ◽  
Author(s):  
Suzanne S. Duke ◽  
Sarah A. Mcgraw ◽  
Nancy E. Avis ◽  
Amanda Sherman

2020 ◽  
Vol 16 (3) ◽  
pp. 279-292
Author(s):  
Sarah Marshall

Purpose Ideas of health-related deservingness in theory and practise have largely been attached to humanitarian notions of compassion and care for vulnerable persons, in contrast to rights-based approaches involving a moral-legal obligation to care based on universal citizenship principles. This paper aims to provide an alternative to these frames, seeking to explore ideas of a human rights-based deservingness framework to understand health care access and entitlement amongst precarious status persons in Canada. Design/methodology/approach Drawing from theoretical conceptualizations of deservingness, this paper aims to bring deservingness frameworks into the language of human rights discourses as these ideas relate to inequalities based on noncitizenship. Findings Deservingness frameworks have been used in public discourses to both perpetuate and diminish health-related inequalities around access and entitlement. Although, movements based on human rights have the potential to be co-opted and used to re-frame precarious status migrants as “undeserving”, movements driven by frames of human rights-based deservingness can subvert these dominant, negative discourses. Originality/value To date, deservingness theory has primarily been used to speak to issues relating to deservingness to welfare services. In relation to deservingness and precarious status migrants, much of the literature focuses on humanitarian notions of the “deserving” migrant. Health-related deservingness based on human rights has been under-theorized in the literature and the authors can learn from activist movements, precarious status migrants and health care providers that have taken on this approach to mobilize for rights based on being “human”.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Harst ◽  
S Oswald ◽  
P Timpel

Abstract Background Telemedicine solutions providing patient-centered care over distance need to be integrated into the regional setting. The acceptance by both providers and patients hat to be continuously evaluated using methods of participatory implementation research. In controlled trials, often taking place in laboratory settings, these methods cannot be applied. In the following, research in progress is presented. Methods Based on socio-demographic data, epidemiology prevalence of age-related chronic diseases and data on the value of health care provision in Saxony, Germany a model region was chosen. Then, a focus group (n = 6) was conducted to differentiate the results and analyze the health networks of patients. For this, network maps putting the individual in the middle and his/her sources of information and support in case of illness in concentric circles around it, were used. The focus group was audiotaped, transcribed and analyzed by two researchers using MaxQDA. Results With a mean age of 47.8 years (n = 17,431), high prevalence of diabetes (>15.85 %) and hypertension (>39.1%) and an expected shortage of primary physicians in 2030, the town of Kamenz is a mirror image of the current health care challenges in rural areas of Saxony. Participants of the focus groups also stated problems in finding a primary physician or a dentist. Compensatory behavior, such as traveling large distances, relying on self-researched online diagnoses and immediately going to the emergency room for medical support was described. According to the network maps, primary sources of support in case of illness are partners and relatives, yet there is little connection between those and health care providers, as well as between different medical specialists. Conclusions The results will lead to potential use cases of telemedicine to be included into a standardized questionnaire for the assessment of telemedicine readiness in the model region. Key messages Telemedicine implementation in a rural area can be studied using a participatory approach. Focus groups and network maps are useful qualitative methods for participatory research and can inform the design of quantitative measurements.


10.2196/23860 ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. e23860
Author(s):  
Michael Louis Millenson

For those of us who believe deeply in a collaborative relationship between patients and doctors, the chaos created by the COVID-19 pandemic has brought an uncomfortable question to the fore: Is participatory medicine still relevant during a pandemic? Drawing liberally upon the Jewish tradition of Talmudic reasoning, I would like to offer 3 considered replies: “Yes,” “no,” and “it depends.” Sometimes, patients may have no choice but to cede control to medical professionals, even though patients are still the experts on their own lives. Other times, the shared control of participatory medicine is both an ethical and clinical imperative. However, as the worldwide toll exacted by COVID-19 has made us grimly aware, no one is really in control. That is why, in these uncertain times, the path forward requires maintaining mutual trust between health care providers and patients, whatever the circumstances. After all, it is our bodies and our selves at stake.


Author(s):  
Samuel O Bolarinde ◽  

Background of the study: Smartphones medically related applications are quickly becoming one of the main tools for accessing clinical information among health care professionals. Aim of Study: This study assessed the perception of patients on usage of smartphones by health care professionals during clinic hours. Methodology: The study recruited 185 patients. Data on demographic characteristics and perception of patients on the use of smartphones for medical information were obtained using a self-administered questionnaire. Data were summarized using a descriptive statistics and inferential statistics of Chi square. Alpha level was set at 0.005 Results: 76 Males, 109 Females participated in this study. 67.6% (125) own a smartphones. 34.6% (64) have seen health care professionals using smartphones during clinic hours, 28.1% (18) had their health care providers explain to them reasons for using smartphone. 34.1% (63) agreed it was unprofessional for health care provider to use smartphone during clinic, 33.5% (62) disagreed, 32.4% (60) were undecided. No association observed between respondents’ age (χ2= 12.00, p= 0.606), educational qualification (χ2= 8.501, p= 0.075) and responses to the statement that use of smartphones by health care professional was unprofessional. Conclusion: Although one third of the respondents agreed that usage of smartphones by healthcare professionals in the clinic while attending to patients was unprofessional however, usage of smartphone for health related information by health care professionals during clinic hours should be with caution to avoid losing the confidence repose in them by their patients.


Author(s):  
Dennis Myers ◽  
Terry A. Wolfer ◽  
Maria L. Hogan

A complex web of attitudinal, cultural, economic, and structural variables condition the decision to respond to communications promoting healthy behavior and participation in risk reduction initiatives. A wide array of governmental, corporate, and voluntary sector health-related organizations focus on effective messaging and health care options, increasing the likelihood of choices that generate and sustain wellness. Researchers also recognize the significant and multifaceted ways that religious congregations contribute to awareness and adoption of health-promoting behaviors. These religiously based organizations are credible disseminators of health education information and accessible providers of venues that facilitate wellness among congregants and community members. The religious beliefs, spirituality, and faith practices at the core of congregational cultural life explain the trustworthiness of their messaging, the health of their adherents, and the intention of their care provision. Considerable inquiry into the impact of religion and spirituality on health reveals substantive correlations with positive psychological factors known to sustain physical and psychological health—optimism, meaning and purpose, hope, well-being, self-esteem, gratefulness, social support, and marital stability. However, the beliefs and practices that create receptivity to health-related communications, care practices, and service provision can also be a deterrent to message impact and participation in healthy behaviors. When a productive relationship between spirituality and health exists, congregational membership offers rituals (e.g., worship, education, mission) and relationships that promote spiritual well-being. Research demonstrates increased life satisfaction and meaning in life, with health risk reduction associated with a sense of belonging, enriched social interactions, and shared experiences. Congregations communicate their commitment to wellness of congregants and community members alike through offering a variety of congregationally based and collaborative wellness and risk reduction programs. These expressions of investment in individual and community health range across all age, gender, and ethnic demographics and address most of the prominent diagnostic categories. These programs are ordered along three dimensions: primary prevention (health care messaging and education), secondary prevention (risk education), and tertiary prevention (treatment). Applying the dimensions of sponsorship, goal/mission, focus, services, staffing, and intended outcome highlights the similarities and differences among them. Several unique facets of congregational life energize the effectiveness of these programs. Inherent trust and credibility empower adherence, and participation decisions and financial investment provide service availability. These assets serve as attractive contributions in collaborations among congregations and between private and public health care providers. Current research has not yet documented the best practices associated with program viability. However, practice wisdom in the planning, implementation, and evaluation of congregationally based and collaborative health-related programs suggests guidelines for future investigation. Congregational leaders and health care professionals emphasize well-designed needs assessment. Effective congregational health promotion and risk reduction may be linked to the availability and expertise of professionals and volunteers enacting the roles of planner/program developer, facilitator, convener/mediator, care manager/advocate, health educator, and direct health care service provider.


2007 ◽  
Vol 30 (4) ◽  
pp. 38
Author(s):  
S. Bernatsky ◽  
D. Feldman ◽  
M. Roper ◽  
E. Rosenberg

The objective of our work was to identify facilitators of optimal care, as well as potential barriers, for patients with rheumatoid arthritis (RA). The design was a focus group study. Individuals with established RA were identified through invitation letters sent using a random sample of the Quebec Arthritis Society mailing list. Patients were eligible for participation if they had a diagnosis of RA confirmed by a rheumatologist and if they had sought care within the McGill Réseau Universitaire Intégré de Santé network. We planned a series of focus group meetings (90 minutes each) to obtain sufficient data in terms of spectrum of ideas. In each moderator-led group, participants were asked to discuss five questions related to quality care. A co-moderator was available to document non-verbal communication, with audio-taping of all sessions and professional transcription for data analysis. Qualitative content analysis, based on grounded theory, was the chosen means of identifying recurring themes and categories. Two focus group sessions have been completed with two more scheduled. Preliminary findings indicate the importance of good communication between family physicians, specialists, and allied health care workers. Final coding of transcripts and computer-assisted content analysis is being completed. However it appears that focus group may be useful in studying optimal care for chronic diseases such as RA. Our preliminary findings emphasize the necessity of good communication among health care providers. Ultimately we hope to generate knowledge that can be transformed into better health for Canadians with arthritis and other chronic diseases.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Rienna Russo ◽  
Simona Kwon ◽  
Jennifer Tsui ◽  
Stella S Yi

Introduction: Nationally, New York City (NYC) has one of the largest immigrant populations and highest gentrification rates. Satellite ethnic enclaves are increasingly prevalent as residents relocate to more affordable neighborhoods. Ethnic immigrant communities already face unique challenges to accessing health care, including linguistic and cultural discordance regarding health-related beliefs and norms. Residence outside of ethnic enclaves may further hinder health care utilization, as culturally appropriate services may become less accessible. Characterization of immigrants visiting doctors’ offices within and outside of ethnic enclaves may inform efforts to retain these populations in care. Hypothesis: We compared immigrants accessing health care within major ethnic enclaves to immigrants accessing care elsewhere to ascertain differences in 1) demographic characteristics; 2) reasons for choosing health care facilities; and 3) distances traveled for health care. Methods: Data were from the 2018 Examining Norms and Behaviors Linked to Eating (ENABLE) Pilot Study. Chinese American participants were recruited using venue-based and snowball sampling methods, with assistance from NYC community-based organizations. Surveys included detailed questions on demographics and health-related factors. Participants were included in the analysis if doctor’s office and home zip code data were available (n=143). Data were analyzed using RStudio v.1.2.5 and STATA v.15.0. Results: The majority of participants saw a Chinatown-based doctor (64%; 92 of 143); and were not Chinatown residents (81%; 116 of 143). A greater number of individuals who saw Chinatown-based doctor had less than a college education; were living with food insecurity; were on public insurance; and were less acculturated. Individuals accessing care in Chinatown prioritized doctor’s offices where doctors and medical staff spoke their language more so than individuals accessing care elsewhere. Overall, people who saw a Chinatown-based doctor traveled significantly further (β=1.51 miles [approximately 15 minutes via subway]; 95% CI 0.25, 2.77). Of people who saw a Chinatown-based doctor, 75% (69 of 92) were not Chinatown residents. On average, these individuals traveled 5.14 miles (SD=3.38) to the doctor. Conclusion: In conclusion, there is a need to expand in-language services for immigrant communities. Immigrants visiting doctors in ethnic enclaves are demographically different and travel further distances for health care. Accessing in language services is a priority for these individuals. Immigrants may prioritize language access over geographic access when choosing their health care providers. Strategies to strengthen community-clinical linkages, including connecting community members with bilingual community health workers, may increase healthcare access of under-served, ethnic populations.


2013 ◽  
Vol 19 (2) ◽  
pp. 130 ◽  
Author(s):  
Victoria Team ◽  
Lenore H. Manderson ◽  
Milica Markovic

In this article, we report on a small qualitative scale study with immigrant Russian-speaking Australian women, carers of dependent family members. Drawing on in-depth interviews, we explore women’s health-related behaviours, in particular their participation in breast and cervical cancer screening. Differences in preventive health care policies in country of origin and Australia explain their poor participation in cancer screening. Our participants had grown up in the former Soviet Union, where health checks were compulsory but where advice about frequency and timing was the responsibility of doctors. Following migration, women continued to believe that the responsibility for checks was their doctor’s, and they maintained that, compared with their experience of preventive medicine in the former Soviet Union, Australian practice was poor. Women argued that if reproductive health screening were important in cancer prevention, then health care providers would take a lead role to ensure that all women participated. Data suggest how women’s participation in screening may be improved.


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