scholarly journals Have We Lost Sight of the Women? An Observational Study About Normality-Centred Care in Australian Maternity Services.

Author(s):  
Harsha Ananthram ◽  
Venkat Vangaveti ◽  
Ajay Rane

Objective • Prioritising normal birth has led to harm in some instances in the UK • Australian organisations have also promoted normal birth in maternity practice • The negative impact of normal birth appears less well understood in Australia • The study explores this impact of normal birth promotion and the quality of clinical incident investigations Design • Survey-based research design Setting • Online survey Population or Sample • Australian maternity health care providers Methods • Open and close-ended questions on the survey • The survey received 1278 responses • Data analysed using SPSS software Main Outcome Measures • Perceptions on bias against or delay in interventions • Perceptions on systemic attempts to reduce caesarean rates • Perceptions on clinical incident investigations and the engagement of women in these processes Results • Promoting normal birth may by introduce bias against or delay interventions • Attempts to reduce caesarean section rates may reduce the agency of the woman to choose how she births • Incident investigations appear to be independent and improve outcomes for mothers and babies • Women with birth trauma appear to lack support and follow up postnatally Conclusions • Current regulatory standards for maternity services may need to be re-evaluated • Key performance indicators for maternity services need to change to reflect core ethical and legal obligations around informed consent

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 735
Author(s):  
Schoultz Mariyana ◽  
Leung Janni ◽  
Bonsaksen Tore ◽  
Ruffolo Mary ◽  
Thygesen Hilde ◽  
...  

Background: Due to the COVID-19 pandemic and the strict national policies regarding social distancing behavior in Europe, America and Australia, people became reliant on social media as a means for gathering information and as a tool for staying connected to family, friends and work. This is the first trans-national study exploring the qualitative experiences and challenges of using social media while in lockdown or shelter-in-place during the current pandemic. Methods: This study was part of a wider cross-sectional online survey conducted in Norway, the UK, USA and Australia during April/May 2020. The manuscript reports on the qualitative free-text component of the study asking about the challenges of social media users during the COVID-19 pandemic in the UK, USA and Australia. A total of 1991 responses were included in the analysis. Thematic analysis was conducted independently by two researchers. Results: Three overarching themes identified were: Emotional/Mental Health, Information and Being Connected. Participants experienced that using social media during the pandemic amplified anxiety, depression, fear, panic, anger, frustration and loneliness. They felt that there was information overload and social media was full of misleading or polarized opinions which were difficult to switch off. Nonetheless, participants also thought that there was an urge for connection and learning, which was positive and stressful at the same time. Conclusion: Using social media while in a shelter-in-place or lockdown could have a negative impact on the emotional and mental health of some of the population. To support policy and practice in strengthening mental health care in the community, social media could be used to deliver practical advice on coping and stress management. Communication with the public should be strengthened by unambiguous and clear messages and clear communication pathways. We should be looking at alternative ways of staying connected.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1279.1-1279
Author(s):  
Z. Rutter-Locher ◽  
J. Galloway ◽  
H. Lempp

Background:Rheumatological diseases are common in Sub-Saharan Africa [1] but specialist healthcare is limited and there are less than 150 rheumatologists currently serving 1 billion people in Sub-Saharan Africa [2]. Rheumatologists practising in the UK NHS are likely to be exposed to migrant patients. There is therefore, an unmet need for health care providers to understand the differences in rheumatology healthcare provision between Sub-Saharan Africa and the UK and the barriers which migrants face in their transition of rheumatology care.Objectives:To gain an understanding of the experiences of patients with rheumatological conditions, about their past healthcare in Sub-Saharan Africa and their transition of care to the UK.Methods:A qualitative study using semi-structured interviews was conducted. Participants were recruited from two rheumatology outpatient clinics in London. Thematic analysis was applied to identify key themes.Results:Seven participants were recruited. Five had rheumatoid arthritis, one had ankylosing spondylitis and one had undifferentiated inflammatory arthritis. Participants described the significant impact their rheumatological conditions had on their physical and emotional wellbeing, including their social and financial implications. Compared to the UK, rheumatology healthcare in Sub-Saharan Africa was characterised by higher costs, limited access to specialists, lack of investigations and treatments, the use of traditional medicines and poor communication by clinicians. Barriers to transition of rheumatology care to the UK were: poor understanding of rheumatological conditions by the public and primary care providers, lack of understanding of NHS entitlements by migrants, fear of data sharing with immigration services and delayed referral to specialist care. Patient, doctor and public education were identified by participants as important ways to improve access to healthcare.Conclusion:This study has described, for the first time, patients’ perspectives of rheumatology health care in Sub-Saharan Africa and the transition of their care to the UK. These initial findings allow healthcare providers in the UK to tailor management for this migrant population and suggests that migrants need more information about their NHS entitlements and specific explanations on what non-clinical data will be shared with immigration services. To increase access to appropriate care, a concerted effort by clinicians and public health authorities is necessary to raise awareness and provide better education to patients and migrant populations about rheumatological conditions.References:[1]G. Mody, “Rheumatology in Africa-challenges and opportunities,” Arthritis Res. Ther., vol. 19, no. 1, p. 49, 2017.[2]M. A. M. Elagib et al., “Sudan and Sweden Active Rheumatoid Arthritis in Central Africa: A Comparative Study Between,” J. Rheumatol. J. Rheumatol. January, vol. 43, no. 10, pp. 1777–1786, 2016.Acknowledgments:We are grateful to the patients involved in this study for their time and involvement.Disclosure of Interests:None declared


2021 ◽  
pp. 238008442110119
Author(s):  
M. McNally ◽  
L. Rock ◽  
M. Gillis ◽  
S. Bryan ◽  
C. Boyd ◽  
...  

Background: The COVID-19 novel coronavirus closed oral health care in Nova Scotia (NS) Canada in March 2020. Preparing for a phased reopening, a knowledge exchange coalition (representing government, academia, hospitals, oral health professions, and regulators) developed return-to-work (RTW) guidelines detailing the augmentation of standard practices to ensure safety for patients, oral health care providers (OHPs), and the community. Using online surveys, this study explored the influence of the RTW guidelines and related education on registered NS OHPs during a phased return to work. Methods: Dissemination of R2W guidelines included website or email communiques and interdisciplinary education webinars that coincided with 2 RTW phases approved by the government. Aligned with each phase, all registered dentists, dental hygienists, and dental assistants were invited to complete an online survey to gauge the influence of the coalition-sponsored education and RTW guidelines, confidence, preparedness, and personal protective equipment use before and after the pandemic. Results: Three coalition-sponsored multidisciplinary webinars hosted 3541 attendees prior to RTW. The response to survey 1 was 41% (881/2156) and to survey 2 was 26% (571/2177) of registrants. Survey 1 (82%) and survey 2 (89%) respondents “agreed/strongly agreed” that R2W guidelines were a primary source for guiding return to practice, and most were confident with education received and had the skills needed to effectively treat patients during the COVID-19 pandemic. Confidence and preparedness improved in survey 2. Gowns/lab coat use for aerosol-generating procedures increased from 26% to 93%, and the use of full face shields rose from 6% to 93% during the pandemic. Conclusions: A multistakeholder coalition was effective in establishing and communicating comprehensive guidelines and web-based education to ensure unified reintegration of oral health services in NS during a pandemic. This multiorganizational cooperation lay the foundation for responses to subsequent waves of COVID-19 and may serve as an example for collaboratively responding to future public health threats in other settings. Knowledge Transfer Statement: The return-to-work strategy that was developed, disseminated, and assessed through this COVID-19 knowledge exchange coalition will benefit oral health practitioners, professional regulators, government policy makers, and researchers in future pandemic planning.


2019 ◽  
Vol 34 (s1) ◽  
pp. s129-s130
Author(s):  
Peter Horrocks ◽  
Vivienne Tippett ◽  
Peter Aitken

Introduction:Evidence-based training and curriculum are seen as vital in order to be successful in preparing paramedics for an effective disaster response. The creation of broadly recognized standard core competencies to support the development of disaster response education and training courses for general health care providers and specific health care professionals will help to ensure that medical personnel are truly prepared to care for victims of mass casualty events.Aim:To identify current Australian operational paramedic’s specific disaster management education and knowledge as it relates to disaster management core competencies identified throughout the literature and the frequency of measures/techniques which these paramedics use to maintain competency and currency.Methods:Paramedics from all states of Australia were invited to complete an anonymous online survey. Two professional bodies distributed the survey via social media and a major ambulance service was surveyed via email.Results:The study population includes 130 respondents who self-identified as a currently practicing Australian paramedic. Paramedics from all states except South Australia responded, with the majority coming from Queensland Ambulance Service (N= 81%). In terms of experience, 81.54% of respondents report being qualified for greater than 5 years. Initial analysis shows that despite the extensive experience of the practitioners surveyed when asked to rate from high to low their level of knowledge of specific disaster management core competencies a number of gaps exist.Discussion:Core competencies are a defined level of expertise that is essential or fundamental to a particular job, and serve to form the foundation of education, training, and practice for operational service delivery. While more research is needed, these results may help inform industry, government, and education providers to better understand and to more efficiently provide education and ongoing training to paramedics who are responsible for the management of disaster within the Australian community.


2006 ◽  
Vol 72 (2) ◽  
pp. 174-179
Author(s):  
Om P. Sharma ◽  
Diane M. Scala-Barnett ◽  
Michael F. Oswanski ◽  
Amy Aton ◽  
Shekhar S. Raj

Delayed diagnosis of injury (DDI) during hospitalization and missed injuries (MI) on autopsy in trauma deaths result in untoward outcomes. Autopsy is an effective educational tool for health care providers to evaluate trauma care. A retrospective study of trauma registry patients and coroner's records was categorized into groups 1 (alive patients) and 2 (trauma deaths) and analyzed. DDI incidence was similar in group 1 (1.8%) and group 2 (1.9%). Autopsy analysis (163 patients) yielded 139 MI in 94 patients (57.6%), <3 per cent of MI had negative impact on survival. Bony injuries comprised 68 per cent of DDI and 19 per cent of MI. Group 1 DDI patients were sicker with higher injury severity score (ISS: 16.07) than their cohorts (ISS 7.13, P value <0.05). These patients had higher Glasgow Coma Scale (14.41) and lower ISS (16.07) as compared with group 2 MI patients (ISS: 33.49, GCS: 6.45, P value <0.05). Autopsy rate was 99.5 per cent in trauma deaths, 57 per cent for nontrauma deaths, and 79 per cent for all deaths. Less than 3 per cent of MI had negative impact on survival. Routine ongoing patient assessment with pertinent diagnostic workup is essential in reducing DDI. Trauma autopsies reveal MI, which aid performance improvement (PI).


2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S53-S53
Author(s):  
David Rubin ◽  
Laurent Peyrin-Biroulet ◽  
Walter Reinisch ◽  
Swati Tole ◽  
Laura Sullivan ◽  
...  

Abstract Background Despite recent progress in treatment for inflammatory bowel diseases (IBD), there is a need for therapies with long-term efficacy and improved safety. Clinical trials in IBD face challenges with patient recruitment because of study designs, competitive or overlapping trials, and a limited number of eligible patients. We sought to better understand patients’ motivations, awareness of, and experience with IBD clinical trials. Methods We conducted an international survey of adult patients with IBD consisting of 2 components. The quantitative component, a 15-minute online survey, was completed by all patients. A qualitative component, a 30-minute telephone interview, was completed by a subset of patients from the United States (US). All percentages indicate results from the online survey. Results 226 patients (mean age, 41.9 y) completed the online survey. Survey respondents included patients with ulcerative colitis (52%) and Crohn’s disease (48%) from the US (n=100, 21 of whom underwent a phone interview), Brazil (n=26), Canada (n=25), France (n=25), Germany (n=25), and Spain (n=25). Ninety-six percent of respondents reported at least a basic understanding of clinical trials, and 34 (15%) were current or past clinical trial participants. Patients reported learning about trials through 1 or more sources (could select as many as applied): health care providers (42%), pharmaceutical manufacturer websites (31%), social media (30%), online support groups (28%), and foundations (18%-23%). In the survey, patients rated conversations with health care providers most helpful, but patients who were interviewed revealed that most physicians often do not initiate conversations about clinical trials, and patients typically do not ask. Primary motivators for trial participation (rated from “does not encourage me at all” to “encourages me very much”) included altruistic goals of advancing medicine (67%), potentially mitigating risks of uncontrolled IBD such as colon cancer (59%), and access to treatment options that could improve quality of life (59%) or would otherwise be unaffordable (52%). Major barriers to participation (rated from “does not discourage me at all” to “discourages me very much”) included invasive screening and monitoring (35%), concern over receiving placebo (35%), or suboptimal treatment (33%), and concerns about posttrial access to study medication (27%). The majority (68%) reported that being in a clinical trial means being a “guinea pig” for an experimental treatment. Conclusion Opportunities to improve patients’ clinical trial experience in IBD include better communication with health care providers and improved patient education about clinical trial design and ethics. Ultimately, a better understanding of the patient perspective will be important for more informed patients and potentially higher recruitment and enrollment.


1996 ◽  
Vol 1 (3) ◽  
pp. 179-182 ◽  
Author(s):  
Peggy Foster

Health promotion activities are actively encouraged in most countries, including the UK. Meanwhile many health care providers and health experts are becoming increasingly concerned about the growing evidence of significant health inequalities between social groups in the UK, and in particular the strong association between relative deprivation and poor health. In 1995, a report for the British government entitled ‘Variations in health: What can the Department of Health and the NHS do?’, identified the need for the Department of Health and the NHS to play a key role in coordinating and implementing public health programmes intended to reduce inequalities in health. Examination of existing evidence on the effectiveness of health promotion and prevention programmes designed to improve the health status of the most vulnerable groups in society reveals very little evidence to support current enthusiasm for adopting public health strategies in order to reduce variations in health status between the affluent and the poor. Alternative and potentially more effective health care responses to inequalities in health status need to be considered.


Author(s):  
Royce W. Waltrip ◽  
Nancy Mahler ◽  
Alina Ahsan ◽  
Leslie B. Herbert

Abstract Background: Treatments for multiple sclerosis (MS) relapse include intravenous corticosteroids and repository corticotropin injection. Despite available treatment, in the Multiple Sclerosis in America 2017 survey, only 47% of patients reported always/often contacting their MS health care provider (HCP) during relapse. In this study, the Multiple Sclerosis in America 2017 survey participants who received intravenous corticosteroids or repository corticotropin injection for treatment of past relapses completed a follow-up survey to understand how patients characterize relapse severity and to explore predictors of patients contacting their HCP during a relapse. Methods: Patients were18 years and older, diagnosed as having MS by an HCP, and currently using disease-modifying therapy. Patients completed an online survey assessing relapse characteristics and interactions with the HCP treating the patient’s MS. Regression analysis identified predictors of patients contacting their HCP during relapse. Results: Mean age of the 126 respondents was 49.2 years, 81.0% were female, and most (80.2%) had one or more relapses in the past 2 years. Patients estimated that 38.3% of their relapses were mild; 45.1%, moderate; and 16.6%, severe. Number and frequency of symptoms increased with relapse severity. Less than half (46.0%) reported they were extremely likely to contact their HCP during a relapse. The best predictors of being likely to contact the HCP during relapse were the HCP having previously discussed the importance of immediately communicating a relapse and patients’ willingness to accept the HCP’s recommendation for relapse treatment. Conclusions: Findings highlight the importance of HCPs’ advance discussions with patients with MS regarding relapse management to increase the likelihood patients will contact their HCP during relapse.


PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247848
Author(s):  
Agazi Fitsum Gebreselassie ◽  
Abebe Bekele ◽  
Heaven Yeshaneh Tatere ◽  
Rex Wong

Background Healthcare facilities in Ethiopia are responsible for collecting samples for testing and treating COVID-19 patients, providing COVID-19 information to staff, establishment of response teams, and provision of adequate personal protective equipment (PPE). Working at the frontlines against the pandemic, health care providers’ level of knowledge about COVID-19, attitude towards their work, and confidence in the preparedness of their facilities are essential factors in mounting a successful response. Objectives This study investigated the knowledge level of HCP in Ethiopia on this novel coronavirus, and their perspectives on whether their workplaces have sufficient preparedness to handle this disease. Methods A self-administered online survey was conducted. Results The knowledge related to COVID-19 among HCPs was high, with an overall average of 91.5%. The majority of our respondents were supportive to the government’s measures to minimize disease transmission, but most of them were also frustrated by how COVID affected their day to day lives. The majority of them were worried about contracting COVID at work and transmitting the infection to their families. Most respondents did not feel safe going to work (P<0.001). Apart from providing adequate information on COVID-19, most workplaces did not have sufficient PPE (P<000.1) and medical supplies (P<0.001). Close to 50% of respondents agreed and disagreed that their workplaces had clear protocols for handling COVID-19 (P = 0.144). Those who handled known COVID patients were more likely to agree their workplaces had clear protocols (OR = 2.69, P<0.001). Conclusion Improving supplies of PPEs and establishing a clear communicating protocol in handling COVID patients are highly recommended.


2021 ◽  
Author(s):  
Jannik Schaaf ◽  
Michaela Neff ◽  
Manuela Till ◽  
Niels Tegtbauer ◽  
Holger Storf

Abstract BackgroundIn rare diseases, only a low number of regionally distributed experts are available in medical care. The health service platform for rare diseases (www.se-atlas.de) provides a search for health care providers and patient organisations in Germany for specific rare diseases and presents the results to patients or physicians. The objective of this study was to examine the background and purpose, user satisfaction and usability when using se-atlas and to receive suggestions on improvements for implementation in the next release of se-atlas. MethodsWe conducted an online survey over a total period of five weeks between December 2020 and January 2021. Participants were members of patient organisations of rare diseases and experts of rare diseases centres in Germany. The questionnaire addressed the objectives of this study in 10 questions. We used Likert scales (4 to 6 points), as well as the System Usability Scale to measure usability (range: 0 to 100). The data obtained from the survey was analysed descriptively. ResultsIn total, 55 participants completed the survey (16 experts and 39 members of patient organisations). The results demonstrate that users know se-atlas mainly through patient organisations and the German National Action League for People with Rare Diseases. Furthermore, the experts use se-atlas more frequently than members of patient organisations do. Regarding to user satisfaction, participants were satisfied when using se-atlas (scale 1-6, mean = 4.31, SD = 1.18). They rated se-atlas functions with an average between 3.82 and 4.4 (scale 1-6). Additionally, se-atlas functions were considered as important with an average between 3.11 and 3.75 (scale 1-4). With regard to usability, the website was rated with an overall SUS score of 67.1, whereas the results differ between the participants group (experts = 76.1, patient organisations = 63.1). Moreover, participants made suggestions, e.g. that more disease entries should be available and usability can be improved. ConclusionsThis study involved experts and members of patient organisations to assess the background and purpose, user satisfaction and usability when using se-atlas. Despite the promising results and first new implementations, further optimisations of the platform in terms of usability and various functionalities are necessary.


Sign in / Sign up

Export Citation Format

Share Document