Perceptions of Canadian Armed Forces Health Services health care professionals on cognitive assessment processes

Author(s):  
Chelsea Jones ◽  
Lorraine Smith-MacDonald ◽  
Suzette Brémault-Phillips

Lay Summary Canadian Armed Forces (CAF) Service Members (SMs) experience mild traumatic brain injuries (mTBI), which can affect cognitive functioning. Adequate cognitive functioning is needed to perform military duties safely and function in all aspects of life. A standardized process that includes cognitive screen/assessment within a mTBI rehabilitation strategy is not widely used within Canadian Forces Health Services (CFHS). A qualitative thematic analysis nested within an implementation science approach was used to explore the experiences of 17 CFHS health care professionals who perform cognitive screens/assessments. Perceived facilitators, barriers, and recommendations for improving cog-nitive assessment practices for injured CAF-SMs were identified within 5 themes. Development and implementation of cognitive screen/assessment policies and protocols will enable CFHS to best assess and treat cognitive dysfunction among CAF-SMs.

PEDIATRICS ◽  
1993 ◽  
Vol 91 (5) ◽  
pp. ii-ii

In June 1992, 35 health care professionals, child and disability advocates, researchers, clinicians, and parents met at Wingspread Center in Racine, Wisconsin, for an invitational conference on Culture and Chronic Illness in Childhood. The meeting had as its goal the identification of the state of knowledge on the interface between culture, chronic illness, child development, and family functioning so as to lay the foundations for "culturally appropriate" health policy formulation, "culturally sensitive" services, and "culturally competent" clinicians. The purpose of this special supplement is to establish a national agenda for research, policy, service delivery, and training in addressing the needs of all children with chronic illnesses and disabilities that takes the family, ethnicity, socioeconomic status, and culture into full account. To meet this task, five papers were commissioned. The first, by Newacheck et al, addresses the changes in incidence and prevalence of chronic illness and disability among children and youth by ethnic group. The second paper, by McManus et al, focuses on the trends in health services organization, delivery, and financing as they vary among ethnic groups in the United States. What emerges is a rhetoric of cultural sensitivity not paralleled in the organization or financing of health services. Groce and Zola's paper addresses how cultural attitudes and beliefs are the foundations of our perceptions about health and illness. Those perceptions at times are predisposed to conflict with a health care professional who, coming from a different culture, may hold different norms and beliefs. Brookins grounds her discussion within the context of child development and argues that for a child of color or one whose ethnic heritage is other than mainstream, the key to developmental success is bicultural competence—the ability to walk in and between two worlds.


2020 ◽  
Vol 23 (2) ◽  
pp. 160-171
Author(s):  
Rachel Fisher ◽  
Jasneet Parmar ◽  
Wendy Duggleby ◽  
Peter George J. Tian ◽  
Wonita Janzen ◽  
...  

Introduction Family caregivers (FCGs) play an integral, yet often invisible, role in the Canadian health-care system. As the population ages, their presence will become even more essential as they help balance demands on the system and enable community dwelling seniors to remain so for as long as possible. To preserve their own well-being and capacity to provide ongoing care, FCGs require support to the meet the challenges of their daily caregiving responsibilities. Supporting FCGs results in better care provision to community-dwelling seniors receiving health-care services, as well as enhancing the quality of life for FCGs. Although FCGs rely upon health-care professionals (HCPs) to provide them with support and services, there is a paucity of research pertaining to the type of health workforce training (HWFT) that HCPs should receive to address FCG needs. Programs that train HCPs to engage with, empower, and support FCGs are required. Objective To describe and discuss key findings of a caregiver symposium focused on determining components of HWFT that might better enable HCPs to support FCGs. Methods A one-day symposium was held on February 22, 2018 in Edmonton, Alberta, to gather the perspectives of FCGs, HCPs, and stakeholders. Attendees participated in a series of working groups to discuss barriers, facilitators, and recommendations related to HWFT. Proceedings and working group discussions were transcribed, and a qualitative thematic analysis was conducted to identify key themes. Results Participants identified the following topic areas as being essential to training HCPs in the provision of support for FCGs: understanding the FCG role, communicating with FCGs, partnering with FCGs, fostering FCG resilience, navigating healthcare systems and accessing resources, and enhancing the culture and context of care. Conclusions FCGs require more support than is currently being provided by HCPs. Training programs need to specifically address topics identified by participants. These findings will be used to develop HWFT for HCPs.


PEDIATRICS ◽  
1980 ◽  
Vol 65 (4) ◽  
pp. 863-863
Author(s):  
Frank J. Volpe

Recently I received the pamphlet "Age 3 - Age 7" from the American Association of Orthodontists. It strikes me as a not-so-subtle marketing effort to increase the business of orthodontists. Could it be that pediatricians are being asked to do their marketing for them? At a time when health care professionals should be doing their utmost to decrease costs and unnecessary utilization of health services, this pamphlet encourages increased utilization of services of questionable worth.


Introduction 80 The cancer journey 82 Calendars 84 Diagnosis 86 Reactions to diagnosis and treatment 88 Living with cancer 90 Fear of recurrence 92 Recurrence and facing death 94 Survivorship 96 Government health policy in the UK aims to put the patient, or service user, at the heart of local health services. For this to happen, health care professionals must gain an appreciation of what it is like to be a person with cancer, or a carer of someone with cancer. It is hard to know or understand the experience of another person, but there are various ways that we can gain insights into their experience. This section reviews ways of understanding the experience of cancer, and then goes on to look at different aspects of that experience for individuals, using the words of people with cancer....


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  

Abstract Background Many countries across Europe are facing considerable challenges in providing accessible and high quality care regardless of where people live. A major element is the difficulty that countries face to attract and retain health care professionals to work in remote and rural areas. This applies to primary care services as well as to hospital care, and to the care provided by physicians and other health professionals, including nurses. A widely shared question is therefore how to safeguard access to health care in rural areas and to solve recruitment and retention problems in such regions, both of medical and nursing staff. The workshop will build on last year’s joint workshop of the Sections on HSR and HWR that ended with questions related to how to organize accessible and equitable health services including the workforces required to do so. Objectives This workshop will provide a snapshot of studies from across the European region, with a particular focus on differences between rural and urban health care practices and the types of solutions being used to reduce regional disparities in provision of care. This often refers to retention and recruitment strategies, but the session will also address other types of solutions in the organization of care that can help ensure accessible care, including in vulnerable regions and settings. Tackling this challenge will therefore require a joint approach, tapping into experience from health workforce research as well as wider health services research, bringing together research into the organization and management of healthcare and into the health human resources providing this care, operated from different angles and being informed by different research traditions and data sources. Based on statements, we will discuss the topic of how to organize accessible and equitable health services including the workforces required to do so after the presentations. Key messages Workforce policies should focus on retaining primary care workforce in rural areas and integrated policies should attract new primary care practices. Both in primary care and hospital care new solutions are being sought which should help resolve regional differences in access to care and attractiveness for the health workforce.


2017 ◽  
Vol 42 (1) ◽  
pp. 48-66 ◽  
Author(s):  
Casey Scheibling ◽  
James Gillett ◽  
Gordon Brett

In the “Health 2.0” era, digital media has altered how health care is conducted and how patients consume medical information. This article explores the reasons why health-care professionals create their own blogs and how they use blogging as a component of their work. We examine interviews with medical bloggers ( n = 83) featured on “Grand Rounds,” a weekly medical blog forum or “carnival,” to interpret the ways in which blogging is incorporated into their everyday lives. In performing a qualitative thematic analysis, we develop five themes that help capture what blogs mean to these health-care practitioners. The uses of blogs speak to articulating and reestablishing a professional reputation, connecting with patients informally, writing for therapeutic reasons, negotiating institutional constraints, and promoting community and health-care reform.


2015 ◽  
Vol 6 (3) ◽  
Author(s):  
Sarah E. Kelling

Objective: To use selected literature to describe strengths and opportunities for improvement related to accessibility of health services in the community pharmacy setting. Summary: Pharmacists have been described as one of the most accessible health care professionals, particularly as nearly 90% of Americans live within 5 miles of a community pharmacy. However, geography alone does not provide access to health services. Individuals must be able to gain entry into the health care system, access a health care location where needed services are provided, and find a health care provider with whom the patient can communicate and trust. Current and potential opportunities for community pharmacists to increase access via each step are described. Conclusion: Community pharmacists are highly accessible health care professionals who are trusted by patients. Opportunities exist to further increase access to dispensing and non-dispensing services in order to better meet the needs of the public.   Type: Commentary


Author(s):  
Raymond F. Patterson

Correctional settings hold a range of opportunities for Psychiatrists to assume leadership roles. The increase in the number of detainees and inmates who require mental health services has created numerous administrative and clinical opportunities for psychiatrists. The ‘front end’ of arrest and pretrial determinations has been a longstanding component of forensic practice, related to competence, criminal responsibility, and probation. Following incarceration, assessment of mental health needs, access to care, and provision of treatment as well as quality improvement partially constitute the jail and prison components of mental health services. The ‘aftercare’ aspect of mental health services in correctional psychiatry involves individuals released on parole with need and/or requirement for mental health treatment. The leadership role for psychiatrists working in correctional environments is distinctly different from typical psychiatric venues where the psychiatrist and other mental health professionals are ‘in control;’ in correctional environments, the dynamics are different and require collaboration and advocacy. Within correctional systems it is essential that ‘correctional culture’ be understood by the psychiatric/mental health leadership. With effective psychiatric leadership, mental health care delivery and its coordination with correctional management of prisoners both stand to be improved. The need for dedicated and qualified leadership for mental health services and appropriate education and training in correctional mental health practices provide remarkable opportunities for psychiatrists. Psychiatrists and other health care professionals must be educated and trained to provide the necessary leadership for these extraordinarily complex systems of care and confinement.


2020 ◽  
Vol 185 (7-8) ◽  
pp. e1183-e1186
Author(s):  
Amir Minerbi ◽  
Markus Besemann ◽  
Tom Kari ◽  
Christina Gentile ◽  
Gaurav Gupta

ABSTRACT Introduction Speech recognition (SR) uses computerized word recognition software that automatically transcribes spoken words to written text. Some studies indicate that SR may improve efficiency of electronic charting as well as associated cost and turnaround time1,2, but it remains unclear in the literature whether SR is superior to traditional transcription (TT). This study compared the impact of report generation efficiency of SR to TT at the Canadian Armed Forces Health Services Centre. Materials and Methods Dragon Medical Dictation™ SR software and traditional telephone dictation TT were used for two prespecified clinical days per week. In order to adjust for note length, total transcription efficacy was calculated as follows: word count/[dictation time + correction time]. The means and standard deviations were then separately calculated for TT visits and for SR visits. Differences in transcription efficacy and in visit measures, including patient demographics, visit duration, number of issues raised during the visit, and interventions performed, were compared using ANOVA, with the significance level set to 0.05. Results A total of 340 consecutive visits were analyzed; 198 were dictated over the phone using TT and 142 were transcribed using SR software. Dictation efficacy was significantly higher (p < 0.0001) for TT as compared to SR, while turnaround times were shorter for SR (0.12 versus 4.75 days). Conclusions In light of these results, the Canadian Forces Health Services Centre in Ottawa has returned to use of TT because the relative inefficiency of report generation was deemed to have a greater impact on clinical care when compared to slower dictation turnaround time.


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