scholarly journals The conceptualisation of patient-centred care: A case study of diabetes management in public facilities in southern Malawi

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Martha Makwero ◽  
Adamson Muula ◽  
Felix C. Anyawu ◽  
Jude Igumbor
Keyword(s):  
Diabetes Management ◽  
Healthcare Providers ◽  
Major Elements ◽  
Relationship Building ◽  
Exploratory Research ◽  
Framework Analysis ◽  
Policy Makers ◽  
Patient Centred Care ◽  
Group Interviews ◽  
Relational Framework

Background: Patient-centred care (PCC) is one of the pillars of Malawi’s quality of care policy initiatives. The role of PCC in facilitating quality service delivery is well documented, and its importance may heighten in chronic disease management. Yet, PCC conceptualisation is known to be context specific.Aim: The study aimed to understand the conceptualisation of PCC amongst patients, healthcare providers (HCP) and policy makers in Diabetes Mellitus (DM) management.Setting: This study was conducted in DM clinics in Southern Malawi.Methods: Our qualitative exploratory research study design used in-depth and focus group interviews. We interviewed patients with DM, HCPs and policy makers. The study used framework analysis guided by Mead and Bower’s work.Results: Patient-centred care conceptualisations from groups of participants showed convergence. However, they differed in emphasis in some elements. The prominent themes emerging from the participants’ conceptualisation of PCC included the following: meeting individual needs, goals and expectations, accessing medication, supporting relationship building, patient involvement, information sharing, holistic care, timeliness and being realistic.Conclusion: Patient-centred care conceptualisation in Malawi goes beyond the patient–HCP relational framework to include the technical aspects of care. Contrary to the global view, accessing medication and timeliness are major elements in PCC conceptualisation in Malawi. Whilst PCC conceptualisation is contextual, meeting expectations and needs of patients is fundamental.

scholarly journals Ten-year trends in epidemiology and outcomes of pediatric kidney replacement therapy in Europe: data from the ESPN/ERA-EDTA Registry

2021 ◽  
Author(s):  
Marjolein Bonthuis ◽  
Enrico Vidal ◽  
Anna Bjerre ◽  
Özlem Aydoğ ◽  
Sergey Baiko ◽  
...  
Keyword(s):  
Replacement Therapy ◽  
Cox Regression ◽  
Patient Survival ◽  
Healthcare Providers ◽  
Resource Planning ◽  
Policy Makers ◽  
Age Related ◽  
Kidney Replacement Therapy ◽  
Over Time ◽  
Related Population

Abstract Background For 10 consecutive years, the ESPN/ERA-EDTA Registry has included data on children with stage 5 chronic kidney disease (CKD 5) receiving kidney replacement therapy (KRT) in Europe. We examined trends in incidence and prevalence of KRT and patient survival. Methods We included all children aged <15 years starting KRT 2007–2016 in 22 European countries participating in the ESPN/ERA-EDTA Registry since 2007. General population statistics were derived from Eurostat. Incidence and prevalence were expressed per million age-related population (pmarp) and time trends studied with JoinPoint regression. We analyzed survival trends using Cox regression. Results Incidence of children commencing KRT <15 years remained stable over the study period, varying between 5.5 and 6.6 pmarp. Incidence by treatment modality was unchanged over time: 2.0 for hemodialysis (HD) and peritoneal dialysis (PD) and 1.0 for transplantation. Prevalence increased in all age categories and overall rose 2% annually from 26.4 pmarp in 2007 to 32.1 pmarp in 2016. Kidney transplantation prevalence increased 5.1% annually 2007–2009, followed by 1.5% increase/year until 2016. Prevalence of PD steadily increased 1.4% per year over the entire period, and HD prevalence started increasing 6.1% per year from 2011 onwards. Five-year unadjusted patient survival on KRT was around 94% and similar for those initiating KRT 2007–2009 or 2010–2012 (adjusted HR: 0.98, 95% CI:0.71–1.35). Conclusions We found a stable incidence and increasing prevalence of European children on KRT 2007–2016. Five-year patient survival was good and was unchanged over time. These data can inform patients and healthcare providers and aid health policy makers on future resource planning of pediatric KRT in Europe.

scholarly journals Predictors of poor health and functional recovery following road trauma: protocol of a British Columbian inception cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e049623
Author(s):  
Leona K Shum ◽  
Herbert Chan ◽  
Shannon Erdelyi ◽  
Lulu X Pei ◽  
Jeffrey R Brubacher
Keyword(s):  
Resource Use ◽  
Healthcare Resource ◽  
Healthcare Providers ◽  
Healthcare Resource Use ◽  
Physical And Mental Health ◽  
Inception Cohort ◽  
Policy Makers ◽  
Productivity Costs ◽  
Poor Outcome ◽  
Lost Productivity

IntroductionRoad trauma (RT) is a major public health problem affecting physical and mental health, and may result in prolonged absenteeism from work or study. It is important for healthcare providers to know which RT survivors are at risk of a poor outcome, and policy-makers should know the associated costs. Unfortunately, outcome after RT is poorly understood, especially for RT survivors who are treated and released from an emergency department (ED) without the need for hospital admission. Currently, there is almost no research on risk factors for a poor outcome among RT survivors. This study will use current Canadian data to address these knowledge gaps.Methods and analysisWe will follow an inception cohort of 1500 RT survivors (16 years and older) who visited a participating ED within 24 hours of the accident. Baseline interviews determine pre-existing health and functional status, and other potential risk factors for a poor outcome. Follow-up interviews at 2, 4, 6, and 12 months (key stages of recovery) use standardised health-related quality of life tools to determine physical and mental health outcome, functional recovery, and healthcare resource use and lost productivity costs.Ethics and disseminationThe Road Trauma Outcome Study is approved by our institutional Research Ethics Board. This study aims to provide healthcare providers with knowledge on how quickly RT survivors recover from their injuries and who may be more likely to have a poor outcome. We anticipate that this information will be used to improve management of all road users following RT. Healthcare resource use and lost productivity costs will be collected to provide a better cost estimate of the effects of RT. This information can be used by policy-makers to make informed decisions on RT prevention programmes.

scholarly journals An Investigation into the Implementation Processes of Ghana’s Primary Health Care Strategy: The Community-Based Health Planning and Services Programme.

2021 ◽  
Author(s):  
Matthew Kwame Edusei ◽  
Kofi Bobi Barimah ◽  
Samuel Kwadwo Asibuo
Keyword(s):  
Health Planning ◽  
Exploratory Research ◽  
Community Based ◽  
Policy Makers ◽  
Implementation Challenges ◽  
The Public ◽  
Implementation Processes ◽  
Health Goals ◽  
Health Strategy ◽  
District Assemblies

Abstract Background: Ghana has adopted the community-based health planning and services (CHPS) programme as the public health strategy for meeting its universal health goals. The programme is facing implementation challenges that are affecting its expansion within the communities. This research was undertaken to examine the implementation processes of CHPS and suggest solutions to improve its scaling-up within the communities.Method : An exploratory research design was used with a mixed method approach that involved the testing of a hypothesis. Results : The study found that in places with on-going CHPS programmes, there is statistically significant (p<0.001) evidence that the implementation processes are not flawed. However, the district assemblies were selective in the allocation of CHPS zones within the communities. Conclusion : Chieftaincy conflicts within the communities are impeding the community entry aspect of the CHPS policy implementation processes and needs to be addressed by policy makers in the relevant government agencies.

scholarly journals Health Communication and Inter-professional Care in Context of Multimorbidity Management: Assessment of Health Professional Curricular Focus in India

2021 ◽  
Vol 6 ◽  
Author(s):  
Sanghamitra Pati ◽  
Rajeshwari Sinha ◽  
Pranab Mahapatra
Keyword(s):  
Health Communication ◽  
Health Professional ◽  
Healthcare Providers ◽  
Multidisciplinary Care ◽  
Term Care ◽  
Policy Makers ◽  
Competency Based ◽  
Professional Care ◽  
Care Demands

To meet the long term care demands of chronic diseases as well as multimorbidity, healthcare providers from different disciplines need to work collaboratively in practice. This requires healthcare providers to be appropriately trained on delivery of inter-professional care (IPC) and health communication aspects during formative professional years. In this study, we have looked at the prevailing undergraduate and postgraduate healthcare professional curricula to understand the focus on health communication and on IPC for the delivery of multidisciplinary care for multimorbidity management. We observe that while there are exclusive courses on health communication being delivered at different levels, the focus on IPC is still in stages of infancy. The IPC component is just beginning to be woven into the health professional curricula through elements like competency-based curriculum, rotational posting, inter-departmental engagements. At the same time, the need to put curricular attention on multimorbidity is also highlighted here. There remains wider scope for strengthening learning on health communication and IPC among different disciplines within the curricula in the context of multimorbidity. We expect our findings to provide key inputs to academic planners and policy makers towards the introduction of adequate curricular components for addressing multimorbidity along with necessary prescriptions for health communication and IPC in India.

scholarly journals To live and age as who we really are

2020 ◽  
Vol 3 ◽  
pp. 6
Author(s):  
Lorna Roe ◽  
Miriam Galvin ◽  
Laura Booi ◽  
Lenisa Brandao ◽  
Jorge Leon Salas ◽  
...  
Keyword(s):  
Lived Experience ◽  
Trinity College ◽  
Healthcare Providers ◽  
Open Letter ◽  
Brain Health ◽  
Policy Makers ◽  
Trinity College Dublin ◽  
Multidisciplinary Group ◽  
Lgbt People ◽  
Global Brain

This Open Letter discusses the theme of ‘diversity in brain health’ in research, practice and policy for older LGBT+ people. It is written by a multidisciplinary group of Atlantic Fellows for Equity in Brain Health at the Global Brain Health Institute in Trinity College Dublin (TCD), from a variety of disciplines (health economics, human geography, anthropology, psychology, gerontology) and professions (researcher, clinicians, writers, practicing artists). The group developed a workshop to explore the theme of ‘Diversity and Brain Health’ through the lens of non-normative gender identities and sexualities. Guided by two advisors (Prof Agnes Higgins, TCD; Mr Ciaran McKinney, Age and Opportunity), we invited older LGBT+ people and those interested in the topic of LGBT+ and ageing, healthcare providers, policy makers and interested members of the research community. We partnered with colleagues in the School of Law to include socio-legal perspectives. Following the workshop, Roe and Walrath wrote an opinion editorial, published in the Irish Times during the 2019 PRIDE festival, and were subsequently invited by HRB Open Access to provide a more detailed expansion of that work. In this Open Letter we describe the theme of ‘diversity and brain health’ and some of the lessons we learned from listening to the lived experience of older LGBT+ people in Ireland today. We illustrate why it’s important to understand the lived experience of older LGBT+ people and highlight the failure of the State to evaluate the experience of LGBT+ people in policy implementation. We call on researchers, clinicians, service planners and policy makers, to recognize and address diversity as an important way to address health inequities in Ireland.

scholarly journals Impacting Networked Technologies on Teaching Practices

2018 ◽  
Author(s):  
Maria Cutajar ◽  
Matthew Montebello
Keyword(s):  
Higher Education ◽  
Teaching Practices ◽  
Exploratory Research ◽  
Higher Education Administrators ◽  
Online Environment ◽  
Teaching Experiences ◽  
Policy Makers ◽  
Education Administrators ◽  
Shed Light ◽  
Work And Life

Networked technologies are found permeating all work and life activities even in the education realm. Today’s networked technologies are changing the way we interact within the online environment and amongst themselves. Networked technologies have unleashed a plethora of possibilities for educators to take advantage of by employing them as part of their teaching practices. In this paper are presented findings related to how academics are experiencing networked technologies for teaching and their relation to learning. A phenomenographic approach and subsequently a quantitative stance was employed to shed light on the nature and the current dynamic of such practices. This paper recounts the phenomenographic outcome, but it particularly attends to subsequent quantitative findings obtained from consideration of learning experiences against the phenomenographic map of variation in teaching experiences whereby an unexpected clustering trend was exposed. The outcomes of this exploratory research provide crucial and essential insights for higher education administrators and policy makers on how to regulate themselves with regards to the adoption of networked technologies within their institution.

Peer Mentoring to Foster Resilient Age-Friendly Rural Communities in Maine

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 420-420
Author(s):  
Jennifer Crittenden ◽  
Laura Lee ◽  
Patricia Oh
Keyword(s):  
Rural Communities ◽  
Social Engagement ◽  
Peer Mentoring ◽  
Relationship Building ◽  
Built Environments ◽  
Community Initiatives ◽  
The Social ◽  
Resilient Communities ◽  
Group Interviews ◽  
New Strategies

Abstract Maine has a growing number of age-friendly community initiatives (AFCIs); 116 communities are actively working to adapt the social, service, and built environments for aging and 71 have formally joined the AARP Network of Age-Friendly States and Communities. During COVID, rural municipalities were faced with dynamic changes that limited older resident’s access to services and social engagement. To overcome these limitations, it is critical for emergent AFCIs to have tools and strategies to maintain and further enhance healthy environments and resilient communities. This study uses group interviews with 6 leaders of established AFCIs and 6 leaders of emergent AFCIs to explore how the Lifelong Fellows Program, a peer mentoring model that matches experienced leaders with newly formed initiatives, was able to spur development of new strategies to build community resilience. Prominent themes were (1) engaging new local and regional partners; (2) intergenerational volunteerism; (3) fun and flexibility; and (4) relationship-building.

Are Wearables Good or Bad for Society?

2018 ◽  
pp. 1313-1337 ◽  
Author(s):  
Daniel W. E. Hein ◽  
Jennah L. Jodoin ◽  
Philipp A. Rauschnabel ◽  
Björn S. Ivens
Keyword(s):  
Augmented Reality ◽  
Market Research ◽  
Wearable Devices ◽  
Exploratory Research ◽  
Policy Makers ◽  
Smart Glasses ◽  
Societal Benefits ◽  
Copyright Laws ◽  
The Media ◽  
New Form

Recent market research forecasts predict that a new form of wearable devices will soon influence the media landscape: Augmented Reality Smart Glasses. While prior research highlights numerous potentials in personal and professional settings of smart glasses, this technology has also triggered several controversies in public discussions, for example, the risk of violating privacy and copyright laws. Yet, little research addresses the questions of whether smart glasses are good or bad for societies, and if yes, why. This study conducts exploratory research to contribute to narrowing this gap. Based on a survey among consumers, the authors identify several societal benefits and risks that determine consumers' evaluation of the anticipated and desired success of smart glasses. These findings lead to numerous important implications for consumers, scholars, managers, and policy makers.

We Can Trust without Data, But We Are Accountable Only through Measurement

2017 ◽  
pp. 255-270
Author(s):  
Vahé A. Kazandjian
Keyword(s):  
Healthcare Providers ◽  
Quality And Safety ◽  
Policy Makers ◽  
The Core ◽  
Measurement Tools ◽  
Key Dimensions ◽  
Local Traditions ◽  
Analytical Tools ◽  
Probabilistic Nature ◽  
Nature Of Medicine

Traditional expectations about healthcare continue to be challenged by the umbrella concerns about accountability and trust. The core of this challenge is two-fold: healthcare providers have seen the absolute trust placed into their intentions and practices erode through the quantification of quality and safety of care, and, the recipients of care have been empowered with timely and specific data to demand accountability rather than unquestionably trust providers. The purpose of this chapter is to review the key dimensions of the operationalization of performance measurement and the translation of its findings to statements about quality and safety of care. The past four decades have seen the continuous discovery and refining of analytical tools to quantify what once was taken for granted: that patients always receive the best care possible. These tools have uncovered the probabilistic nature of medicine and the resulting nature of the relationships outcomes have to processes. Hence the expectations of patients, payers of care and policy makers require being continuously modified to reflect the limitations of medicine and healthcare. The education of various audiences as to what the measures mean not only is a necessary requisite for sound project design but also will determine how the accountability model is shaped in each environment based on the generic measurement tools results, local traditions of care and caring, and expectations about outcomes.

Predicting Diabetes amongst Native American Elders

2011 ◽  
Vol 3 (4) ◽  
pp. 27-43
Author(s):  
S. Upadhyaya ◽  
K. Farahmand ◽  
T. Baker-Demaray
Keyword(s):  
Native American ◽  
Native Americans ◽  
Rural Areas ◽  
Operating Characteristic ◽  
Healthcare Professionals ◽  
Characteristic Curve ◽  
Healthcare Providers ◽  
Prevention Strategies ◽  
Community Members ◽  
Policy Makers

One in three Americans will be diabetic by 2050, and the rate of diabetes is disproportionately high among Native Americans, especially among Native elders age 55 and older. Early identification and prevention strategies have been regarded as the cornerstone of preventative medicine. The objective of the authors’ research was to identify factors related to diabetes and their interactions specifically among Native elders and develop a simple prediction model which can be used by healthcare professionals while interacting with Native elders in remote or rural areas. Data from a survey of 18,078 Native American elders was used in their study. After eliminating outliers using Pearson’s residuals and Cook’s distance, the area under the receiver operating characteristic curve was 0.7812 for men and 0.7230 for women. The results from the authors’ analysis provide additional perspective on how diabetes affects Native elders thus helping healthcare providers and policy makers when dealing with these community members.

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