scholarly journals The management of infant developmental needs by community nurses - Part 2: The development of guidelines for the support of community nurses in the management of infant developmental needs

Curationis ◽  
2007 ◽  
Vol 30 (2) ◽  
Author(s):  
R. Leech ◽  
N.C. Van Wyk ◽  
C.J.E. Uys
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Best Practice ◽  
Scientific Information ◽  
Scope Of Practice ◽  
Developmental Needs ◽  
Developmental Care ◽  
Health Care Clinics ◽  
Research Findings

In the previous article, the author described, according to the scope of practice of registered nurses, the responsibilities oi community nurses with regard to the management of infant developmental needs in primary health care clinics in South Africa. In this article, the focus is on the development of guidelines for the support of community nurses in fulfilling these responsibilities. Before the development of the guidelines is addressed, a brief overview of the background of the study, assumptions of the researcher and the methodology of the study is given. The development of the set of guidelines (DEFINE HOPE) is set against the background of the drive to improve the quality of developmental care for infants and their families. As guidelines help to translate scientific information into statements, it could be valuable to community nurses to improve their delivery of developmental care. To gather evidence for the formulation of the guidelines, the researcher utilised the themes identified during the analysis process in phase one of the research; investigated research articles; and compared findings and recommendations of the articles with the research findings obtained in phase one. In addition to the research findings and literature review, a focus group (health care professionals represented in the case study), was utilised to assist with the final development and validation of the guidelines. The researcher adapted a number of desirable attributes for guidelines, which are indicated in the literature, to compile the criteria for validation of the guidelines. In conclusion, guidelines are necessary to support community nurses in finding “best practice” within their scope of practice to ensure higher quality of developmental care to families with infants 0-2 years.

scholarly journals The management of infant developmental needs by community nurses - Part 1: Description of the responsibilities of community nurses with regard to the management of infant developmental needs

Curationis ◽  
2007 ◽  
Vol 30 (2) ◽  
Author(s):  
R. Leech ◽  
N.C. Van Wyk ◽  
C.J.E. Uys
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Scope Of Practice ◽  
Professional Collaboration ◽  
Developmental Needs ◽  
Developmental Surveillance ◽  
Developmental Care ◽  
Health Care Clinics ◽  
Service Managers

This article is one of two that describes the responsibilities of community nurses, according to their legal scope of practice, with regard to the management of developmental needs of infants in primary health care clinics in South Africa. A subsequent article describes the development of guidelines for the support of community nurses to address the developmental needs of infants 0 - 2 years. While evidence confirms that developmental surveillance should be incorporated into the ongoing health care of the infant, such services are not consistently provided in health care settings and, if provided, the delivery thereof suffers from significant inadequacies. A case study strategy was used to investigate the phenomenon and content analysis utilised to analyze the data. The Transactional Model of Development was selected to interpret the data obtained in the study. Findings of the study show that infant developmental care is not included to its fullest potential in the health care delivered to infants and their families, thereby indicating that community nurses do not meet the standards of the profession with regard to the management of infant developmental needs. Health service managers need to review their commitment and type of support to community nurses, if infant developmental care, as part of community nurses’ responsibilities, is to be effective and of high quality. Furthermore, community nurses and other health care professionals must recognize the nature and potential of inter-professional collaboration to ensure positive outcomes for infants with developmental delays and disabilities.

scholarly journals Optimal primary care management of clinical osteoarthritis and joint pain in older people: a mixed-methods programme of systematic reviews, observational and qualitative studies, and randomised controlled trials

2018 ◽  
Vol 6 (4) ◽  
pp. 1-260 ◽  
Author(s):  
Elaine Hay ◽  
Krysia Dziedzic ◽  
Nadine Foster ◽  
George Peat ◽  
Danielle van der Windt ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Professionals ◽  
Best Practice ◽  
Research Programme ◽  
Anxiety And Depression ◽  
Knee Oa ◽  
Randomised Controlled

BackgroundOsteoarthritis (OA) is the most common long-term condition managed in UK general practice. However, care is suboptimal despite evidence that primary care and community-based interventions can reduce OA pain and disability.ObjectivesThe overall aim was to improve primary care management of OA and the health of patients with OA. Four parallel linked workstreams aimed to (1) develop a health economic decision model for estimating the potential for cost-effective delivery of primary care OA interventions to improve population health, (2) develop and evaluate new health-care models for delivery of core treatments and support for self-management among primary care consulters with OA, and to investigate prioritisation and implementation of OA care among the public, patients, doctors, health-care professionals and NHS trusts, (3) determine the effectiveness of strategies to optimise specific components of core OA treatment using the example of exercise and (4) investigate the effect of interventions to tackle barriers to core OA treatment, using the example of comorbid anxiety and depression in persons with OA.Data sourcesThe North Staffordshire Osteoarthritis Project database, held by Keele University, was the source of data for secondary analyses in workstream 1.MethodsWorkstream 1 used meta-analysis and synthesis of published evidence about effectiveness of primary care treatments, combined with secondary analysis of existing longitudinal population-based cohort data, to identify predictors of poor long-term outcome (prognostic factors) and design a health economic decision model to estimate cost-effectiveness of different hypothetical strategies for implementing optimal primary care for patients with OA. Workstream 2 used mixed methods to (1) develop and test a ‘model OA consultation’ for primary care health-care professionals (qualitative interviews, consensus, training and evaluation) and (2) evaluate the combined effect of a computerised ‘pop-up’ guideline for general practitioners (GPs) in the consultation and implementing the model OA consultation on practice and patient outcomes (parallel group intervention study). Workstream 3 developed and investigated in a randomised controlled trial (RCT) how to optimise the effect of exercise in persons with knee OA by tailoring it to the individual and improving adherence. Workstream 4 developed and investigated in a cluster RCT the extent to which screening patients for comorbid anxiety and depression can improve OA outcomes. Public and patient involvement included proposal development, project steering and analysis. An OA forum involved public, patient, health professional, social care and researcher representatives to debate the results and formulate proposals for wider implementation and dissemination.ResultsThis programme provides evidence (1) that economic modelling can be used in OA to extrapolate findings of cost-effectiveness beyond the short-term outcomes of clinical trials, (2) about ways of implementing support for self-management and models of optimal primary care informed by National Institute for Health and Care Excellence recommendations, including the beneficial effects of training in a model OA consultation on GP behaviour and of pop-up screens in GP consultations on the quality of prescribing, (3) against adding enhanced interventions to current effective physiotherapy-led exercise for knee OA and (4) against screening for anxiety and depression in patients with musculoskeletal pain as an addition to current best practice for OA.ConclusionsImplementation of evidence-based care for patients with OA is feasible in general practice and has an immediate impact on improving the quality of care delivered to patients. However, improved levels of quality of care, changes to current best practice physiotherapy and successful introduction of psychological screening, as achieved by this programme, did not substantially reduce patients’ pain and disability. This poses important challenges for clinical practice and OA research.LimitationsThe key limitation in this work is the lack of improvement in patient-reported pain and disability despite clear evidence of enhanced delivery of evidence-based care.Future work recommendations(1) New thinking and research is needed into the achievable and desirable long-term goals of care for people with OA, (2) continuing investigation into the resources needed to properly implement clinical guidelines for management of OA as a long-term condition, such as regular monitoring to maintain exercise and physical activity and (3) new research to identify subgroups of patients with OA as a basis for stratified primary care including (i) those with good prognosis who can self-manage with minimal investigation or specialist treatment, (ii) those who will respond to, and benefit from, specific interventions in primary care, such as physiotherapy-led exercise, and (iii) develop research into effective identification and treatment of clinically important anxiety and depression in patients with OA and into the effects of pain management on psychological outcomes in patients with OA.Trial registrationCurrent Controlled Trials ISRCTN06984617, ISRCTN93634563 and ISRCTN40721988.FundingThis project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research Programme and will be published in full inProgramme Grants for Applied Research Programme; Vol. 6, No. 4. See the NIHR Journals Library website for further project information.

DECISION ANALYTIC MODELING IN HEALTH CARE DECISION MAKING

1999 ◽  
Vol 15 (2) ◽  
pp. 332-339 ◽  
Author(s):  
Laura A. Bloom ◽  
Bernard S. Bloom
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Complex Systems ◽  
Health Care Professionals ◽  
Scientific Information ◽  
The Past ◽  
New Information ◽  
Modeling Techniques ◽  
Care Decision

The need to choose among alternatives instead of allowing the market to make choices has led health care professionals to rely on scientific information as an aid in decision making. Mathematical modeling is one of the increasingly common tools used over the past three decades to produce new information. But we have used almost exclusively noncomplex models to help analyze complex systems problems. The need to integrate the complexity of the interactions of clinical, quality of life, and economic attributes into such models can no longer be ignored. The opportunity is available to use existing complex systems modeling techniques for health care questions to improve the quality of study outputs, which can, in turn, help produce more rational decisions.

Continuity of care for children in the ‘too hard’ basket: a literature review of care needs in the health system

1996 ◽  
Vol 21 (2) ◽  
pp. 17-22
Author(s):  
Cas O'Neill ◽  
Julie Contole ◽  
Robyne Schwarz ◽  
Doug Bryan ◽  
Christine Minogue
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Collaborative Research ◽  
Health Care Needs ◽  
Review Of Literature ◽  
Care Needs ◽  
Research Findings ◽  
Set Up

The following review of literature arose from Project Partnership, an initiative of the Royal Children's Hospital, Melbourne, which was set up to identify systemic and organisational changes which could improve continuity and quality of care for children with long-term and complex health care needs. This article examines research findings and other literature relevant to the experience of families whose children have complex health care needs; the experience of hospital based, health care professionals who care for this group of children; and the complexities of undertaking collaborative research in a large health bureaucracy.

Problems in the Health Care of Dying Old Men: Complaints by their Widows

1995 ◽  
Vol 31 (2) ◽  
pp. 121-141 ◽  
Author(s):  
Maria M. Talbott
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Medical Care ◽  
Health Care Professionals ◽  
Lack Of Control ◽  
Old Men

Complaints of older widows regarding their husbands' health care are investigated in this study. Sixty-four older widows were interviewed several years after their husbands' deaths. The deaths occurred in the early 1980s. Forty-six percent reported problems in the health care their husbands had received. Widows whose husbands had not known in advance that they were going to die were more likely to complain about their husbands' medical care than widows whose husbands had known in advance. Complaints were also related to the frequency of several symptoms of grief. The widows' complaints about their husbands' care focus on quality of care, perceived insensitivity on the part of health care professionals, lack of control over the death, and the organization of services.

scholarly journals PARE0008 MOBILE APPLICATION “MOJRA” FOR MONITORING PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1290.1-1290 ◽  
Author(s):  
N. Teodorovic ◽  
S. Djordjevic ◽  
L. Vranic
Keyword(s):  
Rheumatoid Arthritis ◽  
Health Care ◽  
Best Practice ◽  
Mobile Apps ◽  
Digital Health ◽  
Work Capacity ◽  
Learning Center ◽  
Approval Procedure ◽  
The Republic

Background:In Serbia, regular examinations with a rheumatologist are scheduled on average every 3 to 4 months. With this in mind, there is a real possibility that many patient data during this period may not be presented to the doctor during the examination, either because the patient forgets them or because they may focus on other issues and may not highlight key factsObjectives:To overcome this problem, the Association of Patients with Rheumatic Diseases of Serbia-ORS in cooperation with an IT firm developed the application “MojRA”, which was presented at the annual rheumatology congress of Serbia held in September 2019. The application “MojRA” is intended for patients suffering from rheumatoid arthritis - RA. The application enables efficient storage and systematization of data, allows doctors to monitor the condition of their patients between two examinations and have a medical history. “MojRA” is available for now from smartphones running the android operating system on the google play store. The privacy of patient information is guaranteed.Methods:Patients with RA will be able to record and store information about important moments during treatment in a simple and transparent way. At each subsequent visit they will be able to describe what happened to their illness in the meantime. The application can create different types of reports and views.At the same time, the doctor can use the app to inform the patient about her/his condition in real time, which will contribute to better and more meaningful communication. All this would improve the quality of health care, preserving work capacity and improving the quality of life.Results:In order to simplify biotherapy committee approval procedure for patients of RA, the “Charger” has been developed in association with ORS and URes. The “Charger” will connect data collected by MojRa to the registry of RA patients, making the whole approval procedure more efficient and transparent.Testing of the second version of this application is underway, meetings are held between the patients using the application and the IT company that created it.Plans are to expand the app to other types of arthritis in the near future, too, and will soon be completed for devices running Apple operating systems.Conclusion:In addition to being of great benefit to patients and doctors, it can in the future be of immeasurable importance for the savings in the overall health care system of the Republic of Serbia.References:[1]Mobile Apps for Rheumatoid Arthritis: Opportunities and Challenges, Mollard E, Michaud K, Rheum Dis Clin, May 2019, Volume 45, Issue 2, Pages 197–209[2]Apps for People With Rheumatoid Arthritis to Monitor Their Disease Activity: A Review of Apps for Best Practice and Quality, Rebecca Grainger, Hutt Hospital, JMIR Publications, Advancing Digital Health Research, Feb 27, 2017.[3]ACR Mobile Apps,https://www.rheumatology.org/Learning-Center/Apps,American College of Reumatology.Disclosure of Interests:None declared

scholarly journals The Patient Experience of Inpatient Care During the COVID-19 Pandemic: Exploring Patient Perceptions, Communication, and Quality of Care at a University Teaching Hospital in the United Kingdom

2021 ◽  
Vol 8 ◽  
pp. 237437352199774
Author(s):  
Thomas Key ◽  
Avadhut Kulkarni ◽  
Vikram Kandhari ◽  
Zayd Jawad ◽  
Angela Hughes ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Patient Experience ◽  
Health Care Professionals ◽  
Disease Transmission ◽  
Inpatient Care ◽  
University Teaching ◽  
Health Board ◽  
Experience Of Care

The coronavirus disease 2019 (COVID-19) pandemic has necessitated many rapid changes in the provision and delivery of health care in hospital. This study aimed to explore the patient experience of inpatient care during COVID-19 pandemic. An electronic questionnaire was designed and distributed to inpatients treated at a large University Health Board over a 6-week period. It focused on hospital inpatients’ experience of being cared for by health care professionals wearing personal protective equipment (PPE), explored communication, and patients’ perceptions of the quality of care. A total of 704 patients completed the survey. Results demonstrated that patients believe PPE is important to protect the health of both patients and staff and does not negatively impact on their care. In spite of routine use of PPE, patients were still able to identify and communicate with staff. Although visiting restrictions were enforced to limit disease transmission, patients maintained contact with their relatives by using various electronic forms of communication. Overall, patients rated the quality of care they received at 9/10. This single-center study demonstrates a positive patient experience of care at an unprecedented time.

Caring for Gravely Ill Children

PEDIATRICS ◽  
1994 ◽  
Vol 94 (4) ◽  
pp. 433-439 ◽  
Author(s):  
Alan R. Fleischman ◽  
Kathleen Nolan ◽  
Nancy N. Dubler ◽  
Michael F. Epstein ◽  
Mary Ann Gerben ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Professionals ◽  
Treatment Plan ◽  
Ethics Committees ◽  
Well Being ◽  
Pediatric Health Care ◽  
Spiritual Well Being ◽  
Primary Focus

Background. Much has been written about the care of the hopelessly ill adult, but there is little guidance for pediatric health care professionals in the management of children who are critically or terminally ill. Methods. Through a 3-day meeting in Tarrytown, NY, attended by a group of pediatricians and others directly involved in these issues, a principled approach was developed for the treatment of, and health care decision-making for, children who are gravely ill. Results. The group agreed that the needs and interests of the child must be the central focus of any treatment plan and that the child should be involved to as great extent possible, consistent with developmental maturity, in the decision-making process. Quality of future life should be viewed as being relevant in all decisions. Parents are believed to be the natural guardians of children and ought to have great latitude in making decisions for them. However, parental discretion is not absolute and professionals must maintain an independent obligation to protect the child's interests. Conclusions. Decision-making should be collaborative among patient, parents, and professionals. When conflict arises, consultation and ethics committees may assist in resolution. When cure or restoration of function is no longer possible, or reasonable, promotion of comfort becomes the primary goal of management. Optimal use of pain medication and compassionate concern for the physical, psychological, and spiritual well-being of the child and family should be the primary focus of the professionals caring for the dying child.

Depression, Fatigue, and QoL in Colorectal Cancer Patients During and After Treatment

2016 ◽  
Vol 38 (7) ◽  
pp. 893-908 ◽  
Author(s):  
Hong-Yi Tung ◽  
Tung-Bo Chao ◽  
Yu-Hua Lin ◽  
Shu-Fen Wu ◽  
Hui-Yen Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Health Care ◽  
Cancer Patients ◽  
Health Care Professionals ◽  
Nursing Intervention ◽  
Prevalence Of Depression ◽  
Study Population ◽  
Colorectal Cancer Patients

In this study, we sought to explore the prevalence of depression and fatigue in colorectal cancer patients during and after treatment to examine how these variables affect quality of life (QoL). In total, 170 patients with colorectal cancer participated in this study. The study population was divided into two groups: one receiving treatment and another that had finished treatment. The results showed that depression and fatigue measurements were higher in patients receiving treatment. Depression was a strong and significant predictor of QoL in both groups, whereas fatigue was not, with the exception of the symptom score. These findings underscore the importance of early detection and management of depression and fatigue during the treatment and survival stages of patients with colorectal cancer. Our findings indicate that health care professionals should provide appropriate nursing intervention to decrease depression and fatigue and enhance patient QoL.

scholarly journals Assessing Apps for Patients with Genitourinary Tumors Using the Mobile Application Rating Scale (MARS): Systematic Search in App Stores and Content Analysis (Preprint)

2019 ◽  
Author(s):  
Miguel Ángel Amor-García ◽  
Roberto Collado-Borrell ◽  
Vicente Escudero-Vilaplana ◽  
Alejandra Melgarejo-Ortuño ◽  
Ana Herranz-Alonso ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Health Care ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Mobile Application ◽  
Rating Scale ◽  
Cross Sectional ◽  
Cancer Symptoms ◽  
Genitourinary Cancers

BACKGROUND The large number of available cancer apps and their impact on the population necessitates a transparent, objective, and comprehensive evaluation by app experts, health care professionals, and users. To date, there have been no analyses or classifications of apps for patients with genitourinary cancers, which are among the most prevalent types of cancer. OBJECTIVE The objective of our study was to analyze the quality of apps for patients diagnosed with genitourinary cancers using the Mobile Application Rating Scale (MARS) and identify high-quality apps. METHODS We performed an observational cross-sectional descriptive study of all smartphone apps for patients diagnosed with genitourinary cancers available on iOS and Android platforms. In July 2019, we searched for all available apps for patients with genitourinary cancers (bladder, prostate, cervical, uterine, endometrial, kidney, testicular, and vulvar) or their caregivers. Apps were downloaded and evaluated, and the general characteristics were entered into a database. The evaluation was performed by 2 independent researchers using the MARS questionnaire, which rates 23 evaluation criteria clustered in 5 domains (Engagement, Functionality, Esthetics, Information, and Subjective Quality) on a scale from 1 to 5. RESULTS In total, 46 apps were analyzed. Of these, 31 (67%) were available on Android, 6 (13%) on iOS, and 9 (20%) on both platforms. The apps were free in 89% of cases (41/46), and 61% (28/46) had been updated in the previous year. The apps were intended for prostate cancer in 30% of cases (14/46) and cervical cancer in 17% (8/46). The apps were mainly informative (63%, 29/46), preventive (24%, 11/46), and diagnostic (13%, 6/46). Only 7/46 apps (15%) were developed by health care organizations. The mean MARS score for the overall quality of the 46 apps was 2.98 (SD 0.77), with a maximum of 4.63 and a minimum of 1.95. Functionality scores were quite similar for most of the apps, with the greatest differences in Engagement and Esthetics, which showed acceptable scores in one-third of the apps. The 5 apps with the highest MARS score were the following: “Bladder cancer manager,” “Kidney cancer manager,” “My prostate cancer manager,” “Target Ovarian Cancer Symptoms Diary,” and “My Cancer Coach.” We observed statistically significant differences in the MARS score between the operating systems and the developer types (<i>P</i>&lt;.001 and <i>P</i>=.01, respectively), but not for cost (<i>P</i>=.62). CONCLUSIONS MARS is a helpful methodology to decide which apps can be prescribed to patients and to identify which features should be addressed to improve these tools. Most of the apps designed for patients with genitourinary cancers only try to provide data about the disease, without coherent interactivity. The participation of health professionals in the development of these apps is low; nevertheless, we observed that both the participation of health professionals and regular updates were correlated with quality.

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