scholarly journals Sexual assault survivors’ perspectives on clinical follow-up in the Eden District, South Africa: A qualitative study

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Gail Holton ◽  
Kate Joyner ◽  
Robert Mash
Keyword(s):  
Health Care ◽  
Sexual Assault ◽  
Health Care Providers ◽  
Care Providers ◽  
Sexual Assault Survivors ◽  
Care Services ◽  
Follow Up Care ◽  
Negative Perceptions ◽  
Assault Survivors

Background: Although effective follow-up of sexual assault survivors is linked to optimal recovery, attendance at follow-up consultations is poor. It is therefore essential that health care providers maximise the benefit of follow-up care for every sexual assault survivor.Aim: This study explored the personal experiences of sexual assault survivors to better understand the enablers of, and barriers to, attendance at follow-up consultations.Methods: This phenomenological qualitative study was conducted at the three hospitals which manage most sexual assault survivors within the Eden District. Using purposive sampling, 10 participants were selected. Consenting participants shared their experiencesduring semi-structured interviews with the researcher.Results: Authoritative, client-held documentation was a powerful enabler to accessing follow-up care. Individualised, patient-centred care further enhanced participants’ access to, and utilisation of, health care services. The failure of health care providers to integrate follow-up care for sexual assault survivors into established chronic care services was a missedopportunity in the continuum of care. Negative perceptions, based on others’ or personal prior experience of police, judicial and health care systems, were further barriers to follow-up care.Conclusion: This study highlights the need of survivors of sexual assault for integrated,patient-centred care, encompassing principles of good communication. Committed actions of all stakeholders are necessary to tackle negative perceptions that create barriers to follow-upcare. A simple practical strategy, the provision of a scheduled appointment on official stationery, is easy to effect at facility level. As a powerful enabler to follow-up care, this should be implemented as a priority intervention.

scholarly journals Sustainability of an HIV PEP Program for Sexual Assault Survivors: “Lessons Learned” from Health Care Providers

2011 ◽  
Vol 5 (1) ◽  
pp. 102-112 ◽  
Author(s):  
Janice Du Mont ◽  
Sheila Macdonald ◽  
Terri Myhr ◽  
Mona R Loutfy
Keyword(s):  
Health Care ◽  
Sexual Assault ◽  
Focus Groups ◽  
Health Care Providers ◽  
Lessons Learned ◽  
Post Exposure Prophylaxis ◽  
Care Providers ◽  
Sexual Assault Survivors ◽  
Survey Responses ◽  
Assault Survivors

This study explored challenges to continuing an HIV post-exposure prophylaxis (PEP) program of care provided to sexual assault survivors in the province of Ontario, Canada. Data were collected as part of an implementation and evaluation of a universal offering of HIV PEP (known as the HIV PEP Program) at 24 of 34 provincial hospital-based sexual assault treatment centres. Experienced health care providers were surveyed (n = 132) and interviewed in four focus groups (n = 26) about their perceptions of what, if any, factors threatened their ability to maintain the HIV PEP Program. All focus groups were audio-recorded and the recordings transcribed. The transcriptions and open-ended survey responses were analyzed using content analysis. Administrator, nurse, physician, social worker, and pharmacist respondents perceived important barriers to sustainability of the HIV PEP Program. Eight constructs were identified within four broad themes: resources (inadequate funds, overworked and unacknowledged staff), expertise (insufficient external supports, insufficiently trained and knowledgeable staff), commitment (lack of institutional support, physician resistance to offering HIV PEP), and accommodation (lack of flexibility in addressing specific client and community needs, inaccessibility and lack of clarity of tools). We discuss the implications of these findings and the actions that were taken to address the challenges.

Changing focus: Living with advanced cancer—Development of a palliative care transition project.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 152-152
Author(s):  
Paul Joseph Daeninck ◽  
Simone Stenekes ◽  
Tara Carpenter-Kellett ◽  
Jill Talylor-Brown ◽  
Mark Kristjanson ◽  
...  
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Advanced Cancer ◽  
Health Care Providers ◽  
Care Providers ◽  
Cancer Centre ◽  
Palliative Approach ◽  
Follow Up Care ◽  
Treatment Summary

152 Background: The improvement in cancer screening, detection and treatment is changing the illness trajectory and experience for patients. Many cancer patients are living longer with advanced disease as treatment options have expanded. Thus, accurate prognostication is becoming challenging and referral to palliative care programs is often delayed until close to death. This has made the transition to a predominantly palliative approach to care complex to navigate for the health care team, patient and family. Methods: CancerCare Manitoba has undertaken an innovative project “Changing Focus: Living with Advanced Cancer” to enhance communication with primary health care providers (HCPs) and assist patients and caregivers in the transition to a palliative approach to care. The project includes development of an individualized patient treatment summary that provides details of the patient’s cancer treatment and symptoms, identifies the role of the HCPs involved with the patient and family, as well as the expectations for follow up care at the cancer centre and in the community. The transition appointment includes discussion around the treatment summary, standardized follow up care plan, and written information about palliative care, decision making, symptom management, unique issues for caregivers and details about local supports and resources is provided. Results: This presentation will focus on the development and implementation of this project within the cancer centre and throughout the province. Evaluation of this approach is ongoing. Family members and patients will provide feedback using a standardized questionnaire, and ongoing improvement will be built into the evolution of this program. HCPs will also be engaged in evaluation from their perspective. Conclusions: We expect this intervention will allow patients and families better quality of life and possibly improve the interval between the termination of chemotherapy and death.

Cancer Survivors’ Reported Discussions with Health Care Providers About Follow-Up Care and Receipt of Written Care Plans

2017 ◽  
Vol 33 (6) ◽  
pp. 1181-1188 ◽  
Author(s):  
Sarah C. Reed ◽  
Rod Walker ◽  
Rebecca Ziebell ◽  
Borsika Rabin ◽  
Stephanie Nutt ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Survivors ◽  
Health Care Providers ◽  
Care Providers ◽  
Care Plans ◽  
Follow Up Care

From common sense to evidence-based: An evaluation of survivorship planning.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 76-76
Author(s):  
Sam Gaster
Keyword(s):  
Health Care ◽  
Cancer Survivors ◽  
Health Care Providers ◽  
Common Sense ◽  
Care Providers ◽  
Care Plans ◽  
Follow Up Care ◽  
The Future ◽  
The Impact

76 Background: The Institute of Medicine’s (IOM; 2005) seminal report, From Cancer Patient to Cancer Survivor: Lost in Transition, recommended survivorship care plans (SCPs) as a common sense approach to improve the care of cancer survivors. The American Society of Clinical Oncology (ASCO; Mayer et al., 2014) reiterated the importance of these plans and provided strategic guidance for their implementation. The American College of Surgeons’ Commission on Cancer requires SCP delivery from accredited cancer programs as of 2015. Despite the push from these organizations, SCPs remain understudied (Mayer, Birken, Check, & Chen, 2014). The impact of SCPs on patient outcomes is poorly understood. Additionally, there is limited data on patients’ preferences for SCPs. This evaluation describes the use and assessment of SCPs at six regional cancer centers in the Midwest. Methods: Feedback was collected from 30 cancer survivors after receipt of a SCP. Responses were collected with 22-item questionnaire. Outcomes included survivors’ satisfaction with the clarity and detail of SCPs, likelihood to use SCPs in the future, intention to share SCPs with other health care providers, and perceived knowledge about treatment and follow-up care. Results: Over 75% (n = 23) of survivors agreed that SCPs were easy to understand. Ninety-three percent (n = 28) of survivors indicated that SCPs contained the right amount of information. Fifty-three percent (n = 16) of survivors are very likely to use their SCP in the future, whereas 47% (n = 14) are somewhat likely to use their SCP in the future. The majority (77%; n = 23) of survivors intend to share their SCP with another health care provider. Ninety-seven percent (n = 29) of survivors felt more knowledge about their treatment and follow-up car as a result of receiving a SCP. Conclusions: This evaluation highlights the many benefits of SCPs for cancer survivors. Results suggest that SCPs educate survivors about their treatment and follow-up care. Additionally, results indicate that many survivors intend to share SCPs, perhaps allowing for better coordination between oncology and primary care. Further research is warranted on the adoption of healthy lifestyle behaviors and receipt of routine health care after delivery of SCPs.

Monitoring the Physical Health of Cancer Survivors: A Survivorship-Focused Medical History

2006 ◽  
Vol 24 (32) ◽  
pp. 5105-5111 ◽  
Author(s):  
Patricia A. Ganz
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Cancer Survivors ◽  
Medical History ◽  
Health Care Providers ◽  
Primary Care Physicians ◽  
Care Providers ◽  
Follow Up Care ◽  
Physical Effects

Cancer survivors frequently visit their primary-care physicians, as well as oncology specialists, for follow-up care. There is a need to monitor these survivors for the late physical effects of cancer, yet few health care providers have received training in how to do this. This article provides guidance on how to take a cancer survivor-directed medical history to facilitate the elicitation of relevant exposures, family history, and symptoms that may be related to the late effects of cancer therapy.

scholarly journals Experiencia en tiempos de pandemia

2020 ◽  
Vol 1 (2) ◽  
pp. 21-31
Author(s):  
Santos Ibáñez Barceló ◽  
Luis Alcaraz Clemente ◽  
Francisca Del Valle Cebrián
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Workers ◽  
Psychological Needs ◽  
Contact Tracing ◽  
Care Providers ◽  
Care Services ◽  
Phone Calls ◽  
Primary Care Services

En los últimos meses, el virus SARS-CoV-2 ha generado una crisis global que atañe a todos los ámbitos de la vida. La enorme velocidad de propagación y el elevado número de contagios entre los profesionales de la salud han requerido aumentar la disponibilidad de personal sanitario. En respuesta, numerosos países han propuesto la posibilidad de que estudiantes de medicina y recién graduados sean contratados para realizar diversos trabajos que alivien estas carencias. En España, la declaración del Estado de Alarma inició la regulación legal para que esta posibilidad fuese llevada a cabo, lo que ha permitido contratar a estudiantes y médicos pre-MIR en diversos territorios. Dentro de este marco, se describe la experiencia llevada a cabo en la Gerencia de Atención Integrada de Almansa (Albacete), con la creación de un equipo integrado por dos graduados en medicina a la espera de escoger plaza MIR y una especialista de oftalmología. En el período comprendido entre el 27 de marzo y el 21 de abril de 2020, se ha realizado seguimiento clínico vía telefónica de 274 pacientes dados de alta con diagnóstico o sospecha de COVID-19, 790 llamadas y 26 derivaciones al servicio de Urgencias. El seguimiento telefónico supone una tarea que, aunque cuenta con limitaciones, puede ser desempeñada por médicos con menor experiencia laboral. Su papel ha sido clave en estos momentos, pues disminuye la congestión de los servicios hospitalarios y permite el adecuado control epidemiológico de los casos y sus contactos. Esta experiencia ha puesto de manifiesto otros puntos que atañen a la incertidumbre en tiempos cambiantes, las necesidades psicológicas de acompañamiento o el refuerzo de valores. Elementos como la telemedicina, el valor de la atención primaria, o la consideración de los estudiantes en la asistencia sanitaria deberán tenerse en cuenta por los planes de estudio de ahora en adelante. In recent months SARS-CoV-2 has generated a global crisis, which has had an impact on all aspects of life. The quick spread of the virus amongst medical professionals has meant that more and more health workers are needed. To address this demand, many countries have approached Medicine graduates to assist health care providers. The state of emergency in Spain started the legal process so this initiative could materialise and, ultimately, Medicine students and pre-resident medical interns could be hired across different territories. This account describes the experience of two pre-specialty graduates and a consultant ophthalmologist within this context. This team conducted clinical follow-up phone calls on 274 patients discharged from hospital with confirmed or suspected COVID-19, 790 calls and 26 referrals to A&E. Although with limitations, clinical follow- up conversations can be carried out by less experienced doctors. Their role has been key as they ease up congestion in hospital services as well as contributing towards the provision of epidemiological control and contact tracing. This experience has brought to light other issues related to the uncertainty in these fast-moving times, the psychological needs of social interaction and the strengthening of human values. Therefore, aspects such as telemedicine, the importance of primary care services and the role of students in health care will have to be taken into account in university programmes of study in the future.

Responding to Delayed Disclosure of Sexual Assault in Health Settings: A Systematic Review

2016 ◽  
Vol 19 (3) ◽  
pp. 251-265 ◽  
Author(s):  
Stephanie Lanthier ◽  
Janice Du Mont ◽  
Robin Mason
Keyword(s):  
Health Care ◽  
Sexual Assault ◽  
Health Care Providers ◽  
Support Services ◽  
Primary Objective ◽  
Adult Women ◽  
Care Providers ◽  
Sexual Assault Survivors ◽  
Secondary Objective ◽  
Delayed Disclosure

Few adolescent and adult women seek out formal support services in the acute period (7 days or less) following a sexual assault. Instead, many women choose to disclose weeks, months, or even years later. This delayed disclosure may be challenging to support workers, including those in health-care settings, who lack the knowledge and skills to respond effectively. We conducted a systematic literature review of health-care providers’ responses to delayed disclosure by adolescent and adult female sexual assault survivors. Our primary objective was to determine how health-care providers can respond appropriately when presented with a delayed sexual assault disclosure in their practice. Arising out of this analysis, a secondary objective was to document recommendations from the articles for health-care providers on how to create an environment conducive to disclosing and support disclosure in their practice. These recommendations for providing an appropriate response and supporting disclosure are summarized.

Using implementation science to initiate survivorship care plan practice change.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 175-175
Author(s):  
Betty Goracke Olguin ◽  
Lindsay L. Benes
Keyword(s):  
Health Care ◽  
Side Effects ◽  
Implementation Science ◽  
Health Care Providers ◽  
Care Coordination ◽  
Survivorship Care ◽  
Care Providers ◽  
Follow Up Care ◽  
Strongly Agree

175 Background: Failure to address coordination of cancer survivorship care can result in physical disability, emotional distress, and increased health care costs. The Institute of Medicine (IOM) recommended Survivorship Care Plans (SCPs) to improve care coordination among cancer survivors. Despite evidence supporting SCPs there remains limited implementation of SCPs. The use of implementation science, frameworks, and strategies that address contextual and process factors, could improve use of SCPs in oncology clinics (Selove et al., 2016). Methods: This innovation used the Quality Implementation Framework (QIF) (Meyers, Durlak, & Wandersman, 2012) to guide implementation. The QIF outlines steps and strategies for four phases of implementation; initial considerations regarding the host setting, creating a structure for implementation, ongoing structure once implementation begins, and improving future application. Results: During the project period (January 29, 2018 through April 23, 2018), 17 SCP visits were conducted; all 17 patients completed study surveys. In response to, “My health care providers work together as a team to ensure that my needs are met,” 65% reported strongly agree, 29% reported agree, 5% reported disagree, and 0% reported strongly disagree. When asked “My health care providers have informed me of what my follow-up care should be” 65% reported strongly agree and 35% reported agree. Of the 17 PCP surveys mailed, four were returned. In response to “For this patient the SCP helps me coordinate follow-up care,” three PCPs responded “agree.” When asked “For this patient, the SCP helps me provide better care,” three responded “strongly agree.” One PCP reported neutral feelings toward both statements. All PCPs reported SCP helped them better understand cancer treatment given and side effects. Conclusions: Successful SCP implementation, replicating outcomes of trials supporting SCPs, is attributable to the use of implementation science. Results from this project demonstrated SCPs achieved care coordination and patient satisfaction. SCPs enhanced PCPs’ understanding of cancer treatment and side effects which could increase likelihood PCPs discuss survivorship issues, as demonstrated in literature.

Needs assessment for gender sensitive reproductive health services for adolescents

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Fatemeh Rahmanian ◽  
Soheila Nazarpour ◽  
Masoumeh Simbar ◽  
Ali Ramezankhani ◽  
Farid Zayeri
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Health Services ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Providers ◽  
Reproductive Health Services ◽  
Care Needs ◽  
Reproductive Health Care ◽  
Care Services

AbstractBackgroundA dimension of reproductive health services that should be gender sensitive is reproductive health services for adolescents.ObjectiveThis study aims to assess needs for gender sensitive reproductive health care services for adolescents.MethodsThis was a descriptive cross-sectional study on 341 of health care providers for adolescents in health centers and hospitals affiliated to Shiraz University of Medical Sciences in Iran in 2016. The subjects of the study were recruited using a convenience sampling method. The tools for data collection were: (1) a demographic information questionnaire and; (2) a valid and reliable questionnaire to Assess the Needs of Gender-Sensitive Adolescents Reproductive Health Care Services (ANQ-GSARHS) including three sections; process, structure and policy making for the services. Data were analyzed using SPSS 21.ResultsThree hundred and forty-one health providers with an average working experience of 8.77 ± 5.39 [mean ± standard deviation (SD)] years participated in the study. The results demonstrated the highest scores for educational needs (92.96% ± 11.49%), supportive policies (92.71% ± 11.70%) and then care needs (92.37% ± 14.34%) of the services.ConclusionsProviding gender sensitive reproductive health care services for adolescents needs to be reformed as regards processes, structure and policies of the services. However, the gender appropriate educational and care needs as well as supportive policies are the priorities for reform of the services.

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