scholarly journals The difference an end-of-life diagnosis makes: qualitative interviews with providers of community health care for frail older people

2020 ◽  
Vol 70 (699) ◽  
pp. e757-e764
Author(s):  
Louisa Polak ◽  
Sarah Hopkins ◽  
Stephen Barclay ◽  
Sarah Hoare
Keyword(s):  
Health Care ◽  
Older People ◽  
Community Health ◽  
End Of Life ◽  
Community Care ◽  
Qualitative Interviews ◽  
Community Health Care ◽  
Care Provision ◽  
Care Providers ◽  
Frail Older People

BackgroundIncreasing numbers of people die of the frailty and multimorbidity associated with old age, often without receiving an end-of-life diagnosis. Compared to those with a single life-limiting condition such as cancer, frail older people are less likely to access adequate community care. To address this inequality, guidance for professional providers of community health care encourages them to make end-of-life diagnoses more often in such people. These diagnoses centre on prognosis, making them difficult to establish given the inherent unpredictability of age-related decline. This difficulty makes it important to ask how care provision is affected by not having an end-of-life diagnosis.AimTo explore the role of an end-of-life diagnosis in shaping the provision of health care outside acute hospitals.Design and settingQualitative interviews with 19 healthcare providers from community-based settings, including nursing homes and out-of-hours services.MethodSemi-structured interviews (nine individual, three small group) were conducted. Data were analysed thematically and using constant comparison.ResultsIn the participants’ accounts, it was unusual and problematic to consider frail older people as candidates for end-of-life diagnosis. Participants talked of this diagnosis as being useful to them as care providers, helping them prioritise caring for people diagnosed as ‘end-of-life’ and enabling them to offer additional services. This prioritisation and additional help was identified as excluding people who die without an end-of-life diagnosis.ConclusionEnd-of-life diagnosis is a first-class ticket to community care; people who die without such a diagnosis are potentially disadvantaged as regards care provision. Recognising this inequity should help policymakers and practitioners to mitigate it.

Mobile E-Health

2007 ◽  
pp. 155-170 ◽  
Author(s):  
Norm Archer
Keyword(s):  
Health Care ◽  
Community Health ◽  
Health Care Providers ◽  
Home Health Care ◽  
Risk Mitigation ◽  
Community Health Care ◽  
Care Providers ◽  
Health Care Environment ◽  
Medical Practitioners ◽  
Critical Issues

Health care is an industry with a diverse set of stakeholders: governments, private health care providers, medical practitioners (physicians, nurses, researchers, etc.), home health care providers and workers, and last but not least, clients/patients and their families. Overlapping and interacting environments include hospitals, clinics, long-term care facilities, primary care providers, homes, and so forth, involving acute, emergency, chronic, primary, and outpatient care. Patient transitions between these environments are often unnecessarily dif?cult due to an inability by providers to access pre-existing patient records. Mobile/wireless solutions can play an important role in supporting health care by providing applications that access health care records and reduce paperwork for clinical physicians, nurses, and other workers, community health care practitioners and their patients, or mobile chronically ill patients such as diabetics. This chapter makes the case for mobile health care and its solutions in the non-acute community health care environment, where critical issues include usability, adoption, interoperability, change management, risk mitigation, security and privacy, and return on investment. A proposed community health care application demonstrates how these issues are addressed.

scholarly journals The Use of a Family History Risk Assessment Tool within a Community Health Care System: Views of Primary Care Providers

2012 ◽  
Vol 21 (5) ◽  
pp. 652-661 ◽  
Author(s):  
Carol A. Christianson ◽  
◽  
Karen Potter Powell ◽  
Susan Estabrooks Hahn ◽  
Susan H. Blanton ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Primary Care ◽  
Health Care ◽  
Family History ◽  
Community Health ◽  
Assessment Tool ◽  
Primary Care Providers ◽  
Community Health Care ◽  
Care Providers ◽  
Community Health Care System

scholarly journals Exploring the lived experiences of pregnant women and community health care providers during the pandemic of COVID-19 in Bangladesh through a phenomenological analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sadika Akhter ◽  
Feroza Akhter Kumkum ◽  
Farzana Bashar ◽  
Aminur Rahman
Keyword(s):  
Health Care ◽  
Pregnant Women ◽  
Community Health ◽  
Lived Experience ◽  
Health Care Providers ◽  
Health Workers ◽  
Maternal And Newborn Health ◽  
Community Health Care ◽  
Care Providers ◽  
The Government

Abstract Background Like many countries, the government of Bangladesh also imposed stay-at-home orders to restrict the spread of severe acute respiratory syndrome coronavirus-2 (COVID-19) in March, 2020. Epidemiological studies were undertaken to estimate the early possible unforeseen effects on maternal mortality due to the disruption of services during the lockdown. Little is known about the constraints faced by the pregnant women and community health workers in accessing and providing basic obstetric services during the pandemic in the country. This study was conducted to explore the lived experience of pregnant women and community health care providers from two southern districts of Bangladesh during the pandemic of COVID-19. Methods The study participants were recruited through purposive sampling and non-structured in-depth interviews were conducted. Data was collected over the telephone from April to June, 2020. The data collected was analyzed through a phenomenological approach. Results Our analysis shows that community health care providers are working under tremendous strains of work load, fear of getting infected and physical and mental fatigue in a widely disrupted health system. Despite the fear of getting infected, the health workers are reluctant to wear personal protective suits because of gender norms. Similarly, the lived experience of pregnant women shows that they are feeling helpless; the joyful event of pregnancy has suddenly turned into a constant fear and stress. They are living in a limbo of hope and despair with a belief that only God could save their lives. Conclusion The results of the study present the vulnerability of pregnant women and health workers during the pandemic. It recognizes the challenges and constraints, emphasizing the crucial need for government and non-government organizations to improve maternal and newborn health services to protect the pregnant women and health workers as they face predicted waves of the pandemic in the future.

Mobile E-Health

2010 ◽  
pp. 446-457 ◽  
Author(s):  
Norm Archer
Keyword(s):  
Health Care ◽  
Community Health ◽  
Health Care Providers ◽  
Home Health Care ◽  
Risk Mitigation ◽  
Community Health Care ◽  
Care Providers ◽  
Health Care Environment ◽  
Medical Practitioners ◽  
Critical Issues

Health care is an industry with a diverse set of stakeholders: governments, private health care providers, medical practitioners (physicians, nurses, researchers, etc.), home health care providers and workers, and last but not least, clients/patients and their families. Overlapping and interacting environments include hospitals, clinics, long-term care facilities, primary care providers, homes, and so forth, involving acute, emergency, chronic, primary, and outpatient care. Patient transitions between these environments are often unnecessarily difficult due to an inability by providers to access pre-existing patient records. Mobile/wireless solutions can play an important role in supporting health care by providing applications that access health care records and reduce paperwork for clinical physicians, nurses, and other workers, community health care practitioners and their patients, or mobile chronically ill patients such as diabetics. This chapter makes the case for mobile health care and its solutions in the non-acute community health care environment, where critical issues include usability, adoption, interoperability, change management, risk mitigation, security and privacy, and return on investment. A proposed community health care application demonstrates how these issues are addressed.

scholarly journals Cancer related knowledge, attitude, and practice among community health care providers and health assistants in rural Bangladesh

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nazirum Mubin ◽  
Redwan Bin Abdul Baten ◽  
Sayeeda Jahan ◽  
Fatema Tuz Zohora ◽  
Naim Mahmud Chowdhury ◽  
...  
Keyword(s):  
Health Care ◽  
Community Health ◽  
Health Care Providers ◽  
Rural Areas ◽  
Cancer Control ◽  
Community Health Care ◽  
Care Providers ◽  
Rural Bangladesh ◽  
Attitude And Practice ◽  
Knowledge Attitude And Practice

Abstract Background Cancer remains one of the primary causes of death in Bangladesh. The success of cancer control in rural areas depends on the ability of the health care system and workforce to identify and manage cases properly at early stages. Community Health Workers (CHW) can play a vital role in this process. The present study aims to assess cancer related Knowledge, Attitude, and Practice (KAP) among 2 categories of CHWs - Community Health Care Providers (CHCP) and Health Assistants (HA) in rural Bangladesh. Methods A descriptive cross-sectional study was conducted using a self-administered questionnaire from July 2019 to June 2020. Multi-stage sampling technique was used to determine the sample. One Upazilla Health Complex (UHC) from each of the eight administrative divisions of Bangladesh were randomly chosen as study sites, from which 325 CHCPs and HAs were in the final sample. Multivariate logistic regression models were developed to determine the association between KAP scores and demographic variables. Results Our study shows that a modest number of respondents scored above average in the knowledge (54.15%), attitude (58.15%), and practice (65.54%) sections. Majority CHCPs (90.91%) and HAs (96.06%) did not receive govt. training on cancer. Only 20.71% HAs and 25.2% CHCPs knew about the availability of cancer treatment options in Bangladesh. Uncertainty about the availability of relevant treatments or vaccinations at public facilities was also high. Having cancer in the family, income, duration of employment and workplace locations were important predictors of cancer related KAP scores. Conclusion Healthcare workforce’s knowledge gap and unfavorable attitude towards cancer may result in poor delivery of care at the rural level. For many people in rural areas, CHCPs and HAs are the first point of contact with the healthcare system and thus effective cancer control strategies must consider them as key stakeholders. Targeted training programs must be adopted to address the cancer related KAP gaps among CHCPs and HAs.

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