scholarly journals What Influences Health Professionals’ Recommendations for Non-Scheduled Childhood Vaccinations? A Qualitative Study of Health Professionals’ Perspectives in Three Provinces of China

Vaccines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1433
Author(s):  
Jiejie Cheng ◽  
Shiyu Lin ◽  
Chaoqi Wu ◽  
Natasha Howard ◽  
Jiatong Zou ◽  
...  
Keyword(s):  
Health Professionals ◽  
Varicella Vaccine ◽  
Monitoring And Evaluation ◽  
Economic Incentives ◽  
Professional Organizations ◽  
Structured Interviews ◽  
School Absence ◽  
Parental Autonomy ◽  
Study Sites ◽  
Rural Parents

Recommendations by health professionals are important for vaccines that are not included in national schedules. This study explored health professionals’ perspectives on recommending non-scheduled (user-fee) childhood vaccinations in China, identifying key influences on professionals’ interactions with caregivers. We conducted individual semi-structured interviews with 20 health professionals from three provinces in China and analyzed data thematically using deductive and inductive coding. Health professionals from all three provinces were uncomfortable about being perceived to encourage parents to accept vaccines that incurred a fee. They provided information about non-scheduled vaccines but emphasized parental autonomy in decision-making. Rural parents were less aware of unscheduled vaccines and health professionals were more likely to encourage parents living in more affluent areas to consider these vaccines; varicella vaccine was preferred by parents as a way of preventing school absence. Economic incentives for unscheduled vaccines were given to staff at most study sites, although the amount given varied widely. These variations meant that staff receiving lower incentives were not motivated to promote non-scheduled vaccines if their workload was high; on the contrary, those receiving higher incentives were more likely to promote these vaccines. Health professionals need more guidance on how to recommend unscheduled vaccines in an informative, positive and appropriate manner. It is evident that parents’ awareness of these vaccines, and their economic circumstances, influence vaccinators recommendation practice. Economic incentives prompted health professionals to recommend non-scheduled vaccines; however, the application of such staff incentives varied widely in China. To adopt appropriate economic incentives, professional organizations should develop protocols for the use of incentives that account for their influence on recommendation practices. Suitable recommendation policy needs to balance basic salaries with performance-based incentives, consider overall workload, and include monitoring and evaluation of economic incentives.

scholarly journals Post-stroke fatigue: an exploratory study with patients and health professionals to develop a patient-reported outcome measure

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Ingrid Johansen Skogestad ◽  
Marit Kirkevold ◽  
Petra Larsson ◽  
Christine Råheim Borge ◽  
Bent Indredavik ◽  
...  
Keyword(s):  
Future Development ◽  
Health Professionals ◽  
Outcome Measure ◽  
Patient Reported Outcome ◽  
Stroke Survivors ◽  
Structured Interviews ◽  
Post Stroke ◽  
Patient Reported Outcome Measure ◽  
Patient Reported ◽  
Initial Hospital

Abstract Background Post-stroke fatigue (PSF) is commonly reported and described as disabling by patients recovering from stroke. However, a major challenge is how to accurately diagnose and assess PSF. Therefore, the aim of this study was to explore PSF as it is experienced by stroke survivors and described by health professionals to guide future development of a PSF-specific PROM. Methods Individual semi-structured interviews were conducted with stroke survivors experiencing PSF (n = 9) and three focus groups were conducted with health professionals (n = 16). Data were analyzed through inductive content analysis. Results The analysis revealed four themes illustrating the experience and descriptions of PSF: 1) PSF characteristics, 2) interfering and aggravating factors, 3) management, and 4) PSF awareness, which refers to stroke survivors first becoming aware of PSF after their initial hospital admission. Conclusion This study highlights the complexity and multidimensionality of PSF. The results from this study will guide future development of a PSF-PROM and support its content validity.

scholarly journals POS0160-HPR THE CARE PROCESS OF HIP AND KNEE OSTEOARTHRITIS: GIVING AN ACCOUNT OF PATIENTS’ EXPERIENCE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 292.2-293
Author(s):  
S. Battista ◽  
M. Manoni ◽  
A. Dell’isola ◽  
M. Englund ◽  
A. Palese ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Health Professionals ◽  
Emotional Experience ◽  
Functional Limitations ◽  
Care Quality ◽  
Care Process ◽  
Exact Science ◽  
Structured Interviews ◽  
Patients Experience

Background:The care process is often a complex and intimate process experienced by patients. Osteoarthritis (OA) care is usually characterised by multimodal interventions that consider the broader array of symptoms and functional limitations and often require a high level of patients’ compliance. Despite efforts to improve the quality of care of patients suffering from OA, and the publication of state-of-the-art clinical practice guidelines [1], the quality of the care process, as experienced by patients, seems to be suboptimal [2]. Hence, it is essential to investigate how patients experience this process to highlight potential elements that can enhance or spoil it to optimise the care quality.Objectives:To explore the patients’ experience of the received OA care process.Methods:Qualitative study, 10 semi-structured interviews were performed. The interview guide was created by a pool of healthcare professionals (physiotherapists, psychologists, nurses) and expert patients. It investigated the emotional experience, beliefs, expectations, perceived barriers and facilitators towards conservative treatments perceived by patients suffering from OA. The interviews lasted approximately one hour, were transcribed verbatim and analysed independently by two authors, who labelled their core parts to find categories and subcategories. A theme-based analysis was performed following an ecological paradigm, naturalistic epistemology, philosophy of phenomenological research.Results:Our analysis revealed 7 main categories with several subcategories (Fig. 1). 1) Uncertainty as some patients perceived treatment choice not to be based on medical evidence “there is an almost religious way of thinking on how to deal with the pathology. It is not an exact science when you choose the physicians you choose the treatment”. 2) Relationship with the self and the others as some patients did not feel understood or even shameful and hopeless about their condition. 3) Patients’ and Health Professionals’ beliefs about the pathology management where common thoughts were the perceived (ab)use of passive therapies, the movement as something dangerous and that OA is “something that you try to resist to, but (surgery) is your destiny”. 4) facilitators and 5) barriers of the adherence to therapeutic exercise that revolve around the cost of the therapy, the time needed and the willingness to change life habits. 6) Patients’ attitudes towards pathology in which the oldest patients perceive OA as “something I have to accept since I am getting old” and the youngest as “Something I have to fight”. 7) Relationship with food in which diet is seen as something that “you force yourself to follow” which is useful only to lose weight and not to preserve a high health status and where overeating is used “to eat your feelings”.Figure 1.Categories and Subcategories stemmed from the analysis of the patients’ interviewsConclusion:Patients suffering from hip and knee OA seem to experience an uncertain care process. The lack of clear explanations and the attitude towards conservative treatment, which is considered as “a pastime while waiting for surgery,” fosters the importance of providing patients with adequate information about the treatment, to shift their beliefs and improve their awareness. This will enhance a patient-centred and shared decision-making treatments.References:[1]Fernandes L, Hagen KB, Bijlsma JWJ, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann. Rheum. Dis. 2013;72:1125–35.[2]Basedow M, Esterman A. Assessing appropriateness of osteoarthritis care using quality indicators: a systematic review. J Eval Clin Pract 2015;21:782–9.Acknowledgements:This work is part of the project funded by EULAR Health Professionals Research Grant 2020.Disclosure of Interests:None declared

Asking the Hard Questions: Psychologists’ Discomfort With Inquiring About Sexual Abuse Histories

2021 ◽  
pp. 107780122110145
Author(s):  
Belinda Nixon ◽  
Elly Quinlan
Keyword(s):  
Mental Health ◽  
Sexual Abuse ◽  
Mental Health Professionals ◽  
Thematic Analysis ◽  
Health Professionals ◽  
Early Career ◽  
Evidence Based ◽  
Structured Interviews ◽  
Early Career Psychologists ◽  
University Training

The literature on sexual abuse indicates low rates of inquiry by mental health professionals. This study explores early career psychologists’ experiences of inquiry into their clients’ sexual abuse histories. Twelve Australian psychologists participated in semi-structured interviews with transcripts analyzed using thematic analysis. The vast majority of participants reported that they did not routinely inquire about sexual abuse with barriers including not knowing what to do, discomfort, stigma, and fear of negative outcomes. Participants asserted that their university training in sexual abuse inquiry was inadequate. Findings emphasize the need for the development of an evidence-based framework for sexual abuse training.

scholarly journals Changing relationships: how does patient involvement transform professional identity? An ethnographic study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e045520
Author(s):  
Marie-Pierre Codsi ◽  
Philippe Karazivan ◽  
Ghislaine Rouly ◽  
Marie Leclaire ◽  
Antoine Boivin
Keyword(s):  
Quality Improvement ◽  
Data Collection ◽  
Health Professionals ◽  
Clinical Care ◽  
Ethnographic Study ◽  
Structured Interviews ◽  
Administrative Team ◽  
Nurse Clinician ◽  
New Perspective ◽  
Relational Framework

ObjectivesTo understand identity tensions experienced by health professionals when patient partners join a quality improvement committee.DesignQualitative ethnographic study based on participatory observation.SettingAn interdisciplinary quality improvement committee of a Canadian urban academic family medicine clinic with little previous experience in patient partnership.ParticipantsTwo patient partners, seven health professionals (two family physicians, two residents, one pharmacist, one nurse clinician and one nurse practitioner) and three members of the administrative team.Data collectionData collection included compiled participatory observations, logbook notes and semi-structured interviews, collected between the summer of 2017 to the summer of 2019.Data analysisGhadiri’s identity threats theoretical framework was used to analyse qualitative material and to develop conceptualising categories, using QDA Miner software (V.5.0).ResultsAll professionals with a clinical care role and patient partners (n=9) accepted to participate in the ethnographic study and semi-structured interviews (RR=100%). Transforming the ‘caregiver–patient’ relationship into a ‘colleague–colleague’ relationship generated identity upheavals among professionals. Identity tensions included competing ideals of the ‘good professional’, challenges to the impermeability of the patient and professional categories, the interweaving of symbols associated with one or the other of these identities, and the inner balance between the roles of caregiver and colleague.ConclusionThis research provides a new perspective on understanding how working in partnership with patients transform health professionals’ identity. When they are called to work with patients outside of a simple therapeutic relationship, health professionals may feel tensions between their identity as caregivers and their identity as colleague. This allows us to better understand some underlying tensions elicited by the arrival of different patient engagement initiatives (eg, professionals’ resistance to working with patients, patients’ status and remuneration, professionals’ concerns toward patient ‘representativeness’). Partnership with patients imply the construction of a new relational framework, flexible and dynamic, that takes into account this coexistence of identities.

scholarly journals Record of the circumstances of falls in the community: perspective in the Iberian Peninsula

2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Maria de Fátima Araújo ◽  
Nilza Nogueira Caldevilla ◽  
Candida Maciel ◽  
Felicidade Malheiro ◽  
María Aurora Rodríguez-Borrego ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Health Professionals ◽  
Assessment Instruments ◽  
Structured Interviews ◽  
Basic Health ◽  
Risk Of Falls ◽  
Quantitative Descriptive ◽  
One Year ◽  
Two Stages ◽  
Basic Health Units

ABSTRACT Objective: to determine the diagnosis of the situation regarding documentation of falls and risk of falls in people older than 75 years in basic health units in Spain and Portugal. Method: mixed exploratory study in two stages: (i) quantitative descriptive of randomly selected fall records produced in one year (597 records; 197 Spanish and 400 Portuguese); and (ii) qualitative, with the purpose of knowing the perception of health professionals employing semi-structured interviews (72 professionals, 16 Spanish and 56 Portuguese). The study areas were two basic health units in southern Spain and northern Portugal. Results: in the fall records, the number of women was higher. The presence of fall was associated with the variables age, presence of dementia, osteoarticular disease, previous falls and consumption of antivertiginous medication. Health professionals perceived an absence of risk assessment instruments, as well as lack of prevention programs and lack of awareness of this event. Conclusion: falls are perceived as an area of priority attention for health professionals. Nonetheless, there is a lack of adherence to the registration of falls and risk assessment, due to organizational, logistical and motivational problems.

The transition between mental health services in Scotland

2018 ◽  
Vol 23 (1) ◽  
pp. 12-24 ◽  
Author(s):  
Juliette van der Kamp
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Transition Period ◽  
Organisational Development ◽  
Structured Interviews ◽  
Content Type ◽  
Experience Difficulty

Purpose The purpose of this paper is to describe the barriers and facilitators to an effective transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). It also presents a new entry into considering how the transition can be improved. Design/methodology/approach Insights into the transition from CAMHS to AMHS were gathered through eight semi-structured interviews with mental health professionals. Two methods of data analysis were employed to explore the emerging themes in the data and the observed deficit approach to organisational development. Findings The findings identified a vast volume of barriers in comparison to facilitators to the transition. Adolescents who transition from CAMHS to AMHS initially experience difficulty adapting to the differences in the services due to the short duration of the transition period. However, despite the established barriers to the transition, adolescents tend to adapt to the differences between the services. Findings also showed a negative framing towards the transition amongst the mental health professionals which resembles a deficit approach to organisational development. Originality/value This paper explores mental health professionals’ perspectives regarding the transition in Dumfries and Galloway, Scotland. The transition is increasingly recognised as an area in health care that requires improvement. This research provides a new way to consider the transition by exploring the perceived deficit approach to organisational development in the services.

scholarly journals Causes of multidrug-resistant tuberculosis from the perspectives of health providers: challenges and strategies for adherence to treatment during the COVID-19 pandemic in Brazil

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ludmilla Leidianne Limirio Souza ◽  
Felipe Lima dos Santos ◽  
Juliane de Almeida Crispim ◽  
Regina Célia Fiorati ◽  
Sónia Dias ◽  
...  
Keyword(s):  
Health Professionals ◽  
Social Protection ◽  
Multidrug Resistant ◽  
Social Risk ◽  
Health Providers ◽  
Adherence To Treatment ◽  
Structured Interviews ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis ◽  
Mdr Tb

Abstract Background Multidrug-resistant tuberculosis (MDR-TB) is a serious phenomenon on a global scale that can worsen with the COVID-19 pandemic. The study aimed to understand the perceptions of health professionals about MDR-TB, their strategies to ensure adherence to treatment and their challenges in the context of the COVID-19 pandemic in a priority municipality for disease control. Methods We conducted a qualitative study and recruited 14 health providers (four doctors, three nurses, three nursing technicians, three nursing assistants and a social worker) working in a city in the state of São Paulo, Brazil. Remote semi-structured interviews were conducted with the participants. For data analysis, the thematic content analysis technique was applied according to the study’s theoretical framework. Results The study revealed the causes of MDR-TB are associated with poverty, vulnerability, and social risk. A pre-judgement from the providers was observed, namely, all patients do not adhere due their resistance and association with drug abuse or alcoholism. The study also observed difficulty among health providers in helping patients reconstruct and reframe their life projects under a care perspective, which would strengthen adherence. Other issues that weakened adherence were the cuts in social protection and the benefits really necessary to the patients and a challenge for the providers manage that. The participants revealed that their actions were impacted by the pandemic and insecurity and fear manifested by patients after acquiring COVID-19. For alleviating this, medical appointments by telephone, delivery of medicine in the homes of patients and visits by health professionals once per week were provided. Conclusion The study advances knowledge by highlighting the challenges faced by the health system with the adherence of patients with MDR-TB in a context aggravated by the pandemic. An improvement in DOT is really necessary to help the patients reframe their lives without prejudices, face their fears and insecurity, recover their self-esteem and motivate in concluding their treatment.

scholarly journals Terapia Nutricional Enteral Domiciliar em tempos de isolamento social devido à pandemia de COVID-19

2020 ◽  
Vol 35 (3) ◽  
pp. 199-203
Author(s):  
Emilaine Ferreira dos Santos ◽  
Estela Iraci Rabito ◽  
Caryna Eurich Mazur ◽  
Rubia Daniela Thieme ◽  
Maria Eliana Madalozzo Schieferdecker
Keyword(s):  
Health Services ◽  
Enteral Nutrition ◽  
Social Distance ◽  
Health Professionals ◽  
Care Service ◽  
Specific Treatment ◽  
Monitoring And Evaluation ◽  
The Social ◽  
Work Routine ◽  
Coronavirus Infection

Home enteral nutrition (HEN) provides care for the special need for food at home. Although the majority of patients in HEN is clinically stable, support from health professionals, and monitoring and evaluation for maintenance or evolution of therapy are necessary. However, the current pandemic situation of COVID-19 and the lack of specific treatment for coronavirus infection have led to changes in the health services work routine. The social distance recommendation to contain the progress of COVID-19 interferes with the home care service. Thus, in order to provide assistance effectively and safely to the patient, family members and health professionals, adaptations can be made. Therefore, the objective of this manuscript is to discuss elements and recommendations that contribute to HEN care during the COVID-19 pandemic.

scholarly journals The identity of a new profession

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Brenda Le ◽  
Darren Tellier
Keyword(s):  
Chinese Medicine ◽  
Health Professions ◽  
Mixed Methods Study ◽  
Professional Organizations ◽  
Structured Interviews ◽  
Web Based ◽  
Education Practice ◽  
Healthcare Needs ◽  
Definition Of ◽  
Medical Traditions

In Canada, there is a growing interest in regulating the practices of acupuncture and Chinese herbology under the banner of ‘Traditional Chinese Medicine’ (TCM). However, the origins and definition of TCM are unclear and therefore disputed. While TCM is often used as an umbrella term to represent Chinese medical traditions that span millennia, numerous academics consider TCM to be a modern construct that has departed from the foundational roots of Chinese medicine. To better understand TCM and its implications for the profession, our study investigates: 1) historical precedents leading up to the formal creation of TCM; 2) characteristics and defining features of TCM; and 3) how this relates to education, practice and regulation of the profession in Canada. A mixed-methods study design was employed. Semi-structured interviews were conducted to explore perceptions of individuals who contributed to mediums that discussed the formation of TCM or traditions that exist outside of TCM. In addition, an anonymous web-based survey was sent to TCM-related professional organizations, who were asked to distribute the survey to their members to capture the views of persons practicing within TCM-related health professions in Canada. Due to a lack of participation from the organizations, no survey data was collected. Interviews revealed that TCM is a product of the standardization and simplification of Chinese medicine during the 1950’s and 60’s in China to meet healthcare needs at the time. Currently in Canada, there appears to be a lack of awareness that the establishment of TCM is not a comprehensive representation of Chinese medical traditions, and that many aspects of it may not be suited to the healthcare landscape of modern-day Canada. There is a need for more discussion surrounding the identity of this new profession.

scholarly journals Harmonization of medical products regulation: A key factor for improving regulatory capacity in the East African Community

2020 ◽  
Author(s):  
Margareth Ndomondo-Sigonda ◽  
Jacqueline Miot ◽  
Shan Naidoo ◽  
Nelson Enos Masota ◽  
Brian Ng'andu ◽  
...  
Keyword(s):  
Public Health ◽  
Monitoring And Evaluation ◽  
Good Manufacturing Practice ◽  
Structured Interviews ◽  
East African ◽  
East African Community ◽  
Medical Products ◽  
Inspection Systems ◽  
African Community ◽  
Regulatory Harmonization

Abstract Background: Limited capacity to regulate medical products is associated with circulation of products which do not meet standards of quality, safety and efficacy with negative public health and economic outcomes. This study focused on assessing the effect of the East African Community (EAC) medicines regulatory harmonization initiative on the capacity of national medicines regulatory agencies, with a focus on registration and inspection systems. Methods: An exploratory mixed-method design using both qualitative and quantitative data, was employed. Data was collected from six national medicines regulatory authorities (NMRAs) and the EAC Secretariat through a combination of semi-structured interviews, questionnaires, and checklists for the period 2010/11-2015/16 whereas 2010/11 data served as baseline. Interviews were conducted with heads of NMRAs, regulatory and monitoring and evaluation experts, and the EAC Secretariat Project Officer. A set of 14 indicators grouped into 6 categories were used to measure NMRAs performance. Results: Policy and legal frameworks provide a foundation for effective regulation. Collaboration, harmonization, joint dossier reviews and inspections of manufacturing sites, reliance and cooperation are key factors for building trust and capacity among NMRAs. Five out of six of the EAC Partner States have comprehensive medicines laws with autonomous NMRAs. All the NMRAs have functional registration and good manufacturing practice inspection systems supported by regional harmonised guidelines for registration, inspection, quality management and information management systems with four NMRAs attaining ISO 9001:2015 certification.Conclusions: The EAC regulatory harmonization initiative has contributed to improved capacity to regulate medical products. The indicators generated from this research can be replicated for evaluation of similar initiatives across and beyond the African continent and contribute to public health policy.

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