scholarly journals Healthcare Providers and Caregivers’ Perspectives on the Quality of Child Health Services in Urban Indonesia: A Mixed-Methods Study

2021 ◽  
Vol 18 (15) ◽  
pp. 8047
Author(s):  
Agus Setiawan ◽  
Poppy Fitriyani ◽  
Rizkiyani Istifada ◽  
Shefaly Shorey
Keyword(s):  
Mixed Methods ◽  
Child Health ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Mixed Methods Study ◽  
Child Health Services ◽  
Structured Interviews ◽  
Mortality And Morbidity ◽  
Factors Affecting

Although Indonesia’s child mortality rate has decreased in tandem with the global trend, healthcare services can be further improved for children. This study aims to explore the perceptions of healthcare providers and caregivers of children aged below five years to improve child health in urban Indonesia. A mixed-methods study design was adopted. Quantitative data were collected via questionnaires from the caregivers. Qualitative data were collected via semi-structured interviews from the healthcare providers. Analysis of 540 caregiver questionnaires regarding the care provided to their child revealed that the majority of them were very satisfied (46.1%) and satisfied (52.2%) with the care received. Analysis of 12 interviews with healthcare providers derived three major themes: (1) importance of one’s role as a healthcare provider; (2) factors affecting the delivery of healthcare; and (3) the way forward in caring for young children. Although caregivers were very satisfied with the care received for their children, the perception of healthcare providers regarding their responsibility in delivering care to children under five years old provides insights into improving the quality of services for children in Indonesia. Our findings suggest that mortality and morbidity of children aged below five years can be best reduced by optimizing primary and secondary preventive measures.

Risk perception on the labour ward: A mixed methods study

2021 ◽  
Vol 26 (2) ◽  
pp. 56-63
Author(s):  
Claire McCarthy ◽  
Sarah Meaney ◽  
Marie Rochford ◽  
Keelin O’Donoghue
Keyword(s):  
Mixed Methods ◽  
Lived Experience ◽  
Healthcare Providers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Daily Basis ◽  
Mixed Methods Study ◽  
Structured Interviews ◽  
Staff Support ◽  
Staff Wellbeing

Healthcare providers commonly experience risky situations in the provision of maternity care, and there has been increased focus on the lived experience in recent years. We aimed to assess opinions on, understanding of and behaviours of risk on the LW by conducting a mixed methods study. Staff working in a LW setting completed a descriptive questionnaire-based study, followed by qualitative structured interviews. Statistical analysis was performed with SPSS on quantitative data and thematic analysis performed on qualitative data. Nearly two thirds of staff (64%; 73/114) completed the questionnaire, with 56.2% (n = 47) experiencing risk on a daily basis. Experiencing risk evoked feelings of apprehension (68.4%; n = 50) and worry (60.2%; n = 44) which was echoed in the qualitative work. Structured clinical assessment was utilised in risky situations, and staff described “ going on autopilot” to manage these situations. A large number of respondents reflected on their provision of care following an adverse event (87.7%; n = 64). Debriefing was mentioned as an important practice following such events by all respondents. This study describes the negative terminology prevailing in emergency obstetric care. These experiences can have a profound impact on staff. Risk reduction strategies and the provision of increased staff support and training are crucial to improve staff wellbeing in stressful scenarios.

scholarly journals Evaluation of a Case Management to Support Families With Children Diagnosed With Spinal Muscular Atrophy—Protocol of a Controlled Mixed-Methods Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Jana Willems ◽  
Erik Farin-Glattacker ◽  
Thorsten Langer
Keyword(s):  
Mixed Methods ◽  
Case Management ◽  
Muscular Atrophy ◽  
Healthcare Providers ◽  
Structured Interviews ◽  
Mixed Methods Approach ◽  
Management Intervention ◽  
Care Integration ◽  
Case Management Intervention

Background: Spinal muscular atrophy (SMA) is a rare neuromuscular disease characterized by degeneration of the anterior horn cells in the spinal cord, resulting in muscle atrophy, and proximal muscle weakness. SMA presents with a wide range of symptoms requiring multiple clinical specialists and therapists. Integrating care between disciplines can be challenging due to the dynamic course of the disease, and great distances between specialist centers and local providers. Insufficient care integration can lead to suboptimal quality of care and more difficulties for patients and families. This study aims to improve care integration through a Case Management intervention, and taking a mixed-methods approach, to evaluate its impact.Methods: An exploratory, controlled, two-armed study with baseline, post- and follow-up measurement and process evaluation is conducted to evaluate our intervention compared to usual care. Through a multi-perspective state analysis, we investigate the experiences of caregivers and healthcare providers concerning the actual healthcare quality of patients with SMA I and II. Semi-structured interviews and care diaries are used. We apply that data to conceive a tailored Case Management intervention supplemented by a digital platform. The intervention's effect is examined in comparison to a control group taking a mixed-methods approach. As primary endpoints, we investigate the caregivers' health-related quality of life and the quality of care integration. Secondary endpoints are the use of healthcare services (patients and caregivers) and costs. We assess the process quality from the perspectives of caregivers and healthcare providers through semi-structured interviews.Discussion: This is an exploratory, controlled study to assess the impact of a tailored Case Management intervention to improve the care of patients with SMA I and II. After the evaluation, results on feasibility, expected effect sizes, and process quality will be available. On this basis, future randomized controlled trials can be planned. If demonstrated beneficial, the experience gained within this study may also be valuable for care strategies in other regions and other (non-pediatric) patient groups with rare diseases and/or chronic, complex conditions.Clinical Trial registration:https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00018778, identifier: DRKS00018778.

scholarly journals Investigate Knowledge Management Technology Implementation for Supporting Decision Making in Ethiopian Health Sectors

2021 ◽  
Author(s):  
Mniyichel Zeru ◽  
Amare Desta ◽  
Steve Smithson ◽  
Million Meshesha
Keyword(s):  
Decision Making ◽  
Knowledge Management ◽  
Technology Implementation ◽  
Care Delivery ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Structured Interviews ◽  
Factors Affecting ◽  
Management Technology

Abstract Introduction: Knowledge management technology is a key tool for facilitating and improving the quality of health care delivery in hospitals. However, the use and implementation of this technology is not an easy task. The aim of this study is to investigate a knowledge management technology implementation in Ethiopian hospitals, with a particular reference to Jimma University Specialized Hospital. Methodology: Information about challenges of knowledge management technology implementation was gathered using qualitative research methods, through conducting semi-structured interviews. Purposive sampling method was applied to select fifty-four participants from a well-defined population. Findings were first validated, according to published literature and research works, and then sorted into three main areas with recommended solutions, such as current usage of KM technology to enhance and improve decision-making, factors affecting implementation of KM technology Results: This study revealed that overall level of KM technology implementation in Ethiopia hospitals is still low. Conclusion: Implementation and use of KM technology with a view to improving the quality of hospital health services is needed. Thus, it suggested that hospital managers should make much more effort to develop a strategy and policy on the implementation and use of KM technology so that the hospital could improve the quality of healthcare services.

scholarly journals A strengths-based approach to exploring diabetes management in an Indigenous minority population: A mixed methods study

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261030
Author(s):  
Kathleen Abu-Saad ◽  
Nihaya Daoud ◽  
Giora Kaplan ◽  
Arnona Ziv ◽  
Arnon D. Cohen ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Glycemic Control ◽  
Diabetes Management ◽  
Social Economic ◽  
Well Being ◽  
Healthcare Services ◽  
Mixed Methods Study ◽  
Minority Population ◽  
Factors Affecting ◽  
Indigenous Minority

Indigenous and other marginalized racial/ethnic minorities have poorer health status than majority populations, including higher rates of type 2 diabetes. These disparities have typically been addressed using a ‘deficit-based’ discourse that isolates disease management from the broader social, economic, political context and does not incorporate patient perspectives. We aimed to explore factors affecting glycemic control among Indigenous Arabs with diabetes in Israel using a strengths-based approach that centered participants’ knowledge of their context, needs, resources and strengths. We conducted an exploratory sequential mixed methods study, which included 10 focus groups (5 men’s, 5 women’s) and 296 quantitative in-person surveys. Participants with diagnosed diabetes were randomly drawn from the patient list of the largest healthcare service organization (survey response rate: 93%). Prominent and interconnected themes emerged from focus group discussions, including: diet, physical activity, and social, economic, mental/psychological and political stress. The discussions raised the need for adapting diabetes management approaches to incorporate participants’ communal, physical and psychological well-being, and socioeconomic/political realities. The connections between these factors and diabetes management were also reflected in multivariable analyses of the survey data. Women (OR: 2.03; 95% CI: 1.09–4.63), people with disabilities (OR: 2.43; 95% CI: 1.28–4.64), and unemployed people (OR: 2.64; 95% CI: 1.28–5.44) had higher odds of economic barriers to diabetes management. Furthermore, female sex (OR: 2.26; 95% CI: 1.25–4.09), unemployment (OR: 4.07; 95% CI: 1.64–10.10), and suboptimal glycemic control (OR: 1.20, 95% CI: 1.03–1.41 per 1-unit increase in HbA1c) were associated with moderate-to-severe depressive symptoms. A pro-active, team-based healthcare approach incorporating Indigenous/minority participants’ knowledge, experience, and strengths has the potential to improve individuals’ diabetes management. Healthcare services should be structured in ways that enable providers to listen to their patients, address their key concerns, and foster their strengths.

scholarly journals Impact of COVID-19 on utilization of maternal, newborn and child health services in Nigeria: protocol for a country-level mixed-methods study

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1106
Author(s):  
Godwin Akaba ◽  
Osasuyi Dirisu ◽  
Kehinde Okunade ◽  
Eseoghene Adams ◽  
Jane Ohioghame ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Child Health ◽  
Study Design ◽  
Qualitative Data ◽  
Health Care Facilities ◽  
Mixed Methods Study ◽  
Child Health Services ◽  
Newborn And Child Health ◽  
The Impact ◽  
And Child Health

Background: Battling with COVID-19 and providing essential services along the continuum of care could be challenging. This study will evaluate the impact of COVID-19 on utilization of maternal, newborn and child health (MNCH) services in Nigeria and explore the barriers being experienced by women and their families in getting access to MNCH services, as well as other contextual factors that may have shaped the utilization of MNCH services during the COVID-19 pandemic. Methods and analysis: The study will adopt an observational mixed-methods study design involving 18 health care facilities delivering MNCH services in six selected states across six geopolitical zones of Nigeria. We will retrieve longitudinal data on MNCH services from all selected hospitals three months before and after the first recorded case of COVID-19 in Nigeria. Qualitative data will be collected using in-depth interviews conducted via mobile phones or ZOOM meeting platforms among stakeholder participants (users of MNCH services, health workers and policymakers) to ascertain their perceptions on how COVID-19 has shaped the utilization of MNCH services. We will triangulate quantitative and qualitative data to better understand the impact of COVID-19 on the utilization of MNCH services in Nigeria. Ethics and dissemination: Ethics approvals have been obtained from the Health Research Ethics Committee of the tertiary hospitals involved in the study. Our findings will provide the first evidence from an African setting on the impact of COVID-19 on the utilization of MNCH services using a mixed-methods study design for policy formulation towards sustained MNCH service delivery.

scholarly journals Factors affecting psychological problems in primary caregivers of People with Multiple Sclerosis: a qualitative study

2020 ◽  
Vol 6 (6) ◽  
Author(s):  
Bita Sadeghi ◽  
Fateme Estebsari ◽  
Maryam Rassouli ◽  
Abbas Ebadi
Keyword(s):  
Multiple Sclerosis ◽  
Content Analysis ◽  
Healthcare Providers ◽  
Primary Caregivers ◽  
Psychological Problems ◽  
Structured Interviews ◽  
Policy Makers ◽  
Factors Affecting ◽  
The Family

Objectives: The present research aimed to explore factors affecting psychological problems among primary caregivers of individuals with Multiple Sclerosis (PCIMS). Methods: The present qualitative research employed a content analysis approach and was conducted in Isfahan, Iran in 2018-19. The participants were selected through purposive sampling method. Semi-structured interviews were conducted to explore psychological problems involved in providing care to MS patients and the factors affecting them with 8 patients, 10 caregivers and 3 healthcare providers. Conventional content analysis was used to analyze the data. Results: The acquired data were put in 4 main categories of “isolation and loneliness”, “caregiver’s concerns”, “frustration and hopelessness” and “Disruption in the family foundation”, each with certain sub-categories. Conclusion: The present results can be helpful to manage psychological disorders and the underlying factors of PCIMS. Thus, healthcare providers and policy-makers should consider these areas and make special attempts to improve the performance and conditions of these caregivers to maximize the quality of care provided.

scholarly journals Experiences of family caregivers of patients with terminal disease and the quality of end-of-life care received: a mixed methods study

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e10516
Author(s):  
Celia Martí-García ◽  
Manuel Fernández-Alcántara ◽  
Patricia Suárez López ◽  
Carolina Romero Ruiz ◽  
Rocío Muñoz Martín ◽  
...  
Keyword(s):  
Mixed Methods ◽  
End Of Life Care ◽  
Qualitative Interview ◽  
Mixed Methods Study ◽  
Life Care ◽  
Structured Interviews ◽  
Terminal Disease ◽  
Oncological Patients ◽  
At Home

The aim of this study was to analyze the perceptions and experiences of relatives of patients dying from a terminal disease with regard to the care they received during the dying process, considering the oncological or non-oncological nature of the terminal disease, and the place where care was provided (at home, emergency department, hospital room, or palliative care unit). For this purpose, we conducted a mixed-methods observational study in which two studies were triangulated, one qualitative using semi-structured interviews (n = 30) and the other quantitative, using questionnaires (n = 129). The results showed that the perception of relatives on the quality of care was highly positive in the quantitative evaluation but more critical and negative in the qualitative interview. Experience of the support received and palliative measures was more positive for patients attended in hospital in the case of oncological patients but more positive for those attended at home in the case of non-oncological patients.

Patients’ preferences and factors influencing initial advance care planning discussions’ timing: A cross-cultural mixed-methods study

2020 ◽  
Vol 34 (7) ◽  
pp. 906-916 ◽  
Author(s):  
Jun Miyashita ◽  
Ayako Kohno ◽  
Shao-Yi Cheng ◽  
Su-Hsuan Hsu ◽  
Yosuke Yamamoto ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Advance Care Planning ◽  
Healthcare Providers ◽  
Mixed Methods Study ◽  
Care Planning ◽  
Factors Affecting ◽  
Factors Associated ◽  
Younger Age ◽  
Outpatient Departments ◽  
Advance Care

Background: Although advance care planning discussions are increasingly accepted worldwide, their ideal timing is uncertain and cultural factors may pertain. Aim: To evaluate timing and factors affecting initiation of advance care planning discussions for adult patients in Japan and Taiwan. Design: Mixed-methods questionnaire survey to quantitatively determine percentages of patients willing to initiate advance care planning discussions at four stages of illness trajectory ranging from healthy to undeniably ill, and to identify qualitative perceptions underlying preferred timing. Setting/participants: Patients aged 40–75 years visiting outpatient departments at four Japanese and two Taiwanese hospitals were randomly recruited. Results: Overall (of 700 respondents), 72% (of 365) in Japan and 84% (of 335) in Taiwan ( p < 0.001) accepted discussion before illness. In Japan, factors associated with willingness before illness were younger age and rejection of life-sustaining treatments; in Taiwan, older age, stronger social support, and rejection of life-sustaining treatments. Four main categories of attitudes were extracted: the most common welcomed discussion as a wise precaution, responses in this first category outnumbered preference for postponement of discussion until imminent end of life, acceptance of the universal inevitability of death, and preference for discussion at healthcare providers’ initiative. Conclusion: The majority of patients are willing to begin discussion before their health is severely compromised; about one out of five patients are unwilling to begin until clearly facing death. To promote advance care planning, healthcare providers must be mindful of patients’ preferences and factors associated with acceptance and reluctance to initiate advance care planning.

scholarly journals Strengthening human and physical infrastructure of primary healthcare settings to deliver hypertension care in Vietnam: a mixed-methods comparison of two provinces

2020 ◽  
Vol 35 (8) ◽  
pp. 918-930
Author(s):  
Lana Meiqari ◽  
Thi-Phuong-Lan Nguyen ◽  
Dirk Essink ◽  
Pamela Wright ◽  
Fedde Scheele
Keyword(s):  
Mixed Methods ◽  
Primary Healthcare ◽  
Rural Areas ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Structured Interviews ◽  
Readiness Assessment ◽  
Term Care ◽  
Middle Income ◽  
Levels Of Care

Abstract In Vietnam, the overall prevalence of hypertension (HTN) was 21%, with lower estimates for the prevalence of HTN awareness and treatment. The health systems, like other low- and middle-income countries, were designed to provide acute care for episodic conditions, rather than a chronic condition where patients need long-term care across time and disciplines. This article describes the delivery and organization of HTN care at primary healthcare (PHC) settings in both urban and rural areas at Hue Province of Central Vietnam in comparison with Thai Nguyen province in Northern Vietnam based on the infrastructure capacity and patients’ and providers’ perspectives and experiences We used mixed-methods design that included in-depth semi-structured interviews with patients and healthcare providers at purposively selected PHC facilities in two districts of each province and a modified version of the service availability and readiness assessment inventory at all PHC facilities. We found that HTN patients in both provinces can access healthcare services to diagnose, treat and control their HTN condition at the PHC level with a focus on district facilities. Health services in Hue have allowed commune health stations (CHSs) to provide routine monitoring and prescription refills for HTN patients while maintaining periodical visits to a higher level of care to monitor the stability of the disease. Such provision of care at CHSs remained restricted in Thai Nguyen. Further improvements are necessary for referral procedures, information system to allow for longitudinal follow-up across levels of care and defining a basic health insurance or benefits package, which meets patients’ preferences with a monthly timespan for prescription refills.

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