scholarly journals Barriers and facilitators to adherence to anti-diabetic medications: Ethiopian patients’ perspectives

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Bruck M. Habte ◽  
Tedla Kebede ◽  
Teferi G. Fenta ◽  
Heather Boon
Keyword(s):  
Diabetes Education ◽  
Healthcare Providers ◽  
Common Factors ◽  
Public Hospitals ◽  
Barriers And Facilitators ◽  
Structured Interviews ◽  
Religious Healing ◽  
Number Of Factors ◽  
Open Coding

Background: Little is known about the experiences of Ethiopian patients with type 2 diabetes related to adherence to their anti-diabetic medications. This may limit attempts to develop and implement patient-centred approaches that consider Ethiopian contexts.Objectives: To conduct an exploratory study with a focus on identifying barriers and facilitators to anti-diabetic medications adherence in Ethiopian patients with type 2 diabetes.Methods: Qualitative methods were used to conduct semi-structured interviews with 39 purposively selected participants attending clinic in three public hospitals in central Ethiopia. Open coding was used to analyse the data to identify key themes.Results: A number of factors were identified as barriers and facilitators to participants’ adherence to their anti-diabetic medications. The most common factors were perceptions related to their illness including symptoms, consequences and curability; perceptions of medications including safety concerns, convenience and their necessity; religious healing practices and beliefs; perceptions about and experiences with their healthcare providers and the healthcare system including the availability of medications and diabetes education; and finally perceived self-efficacy and social support.Conclusions: The findings of this study provide guidance to strengthen diabetes education programmes so that they reflect local patient contexts focusing among other things on the illness itself and the anti-diabetic medications.

scholarly journals Implementing a Canadian Shared-care ADHD Program in Beijing: Barriers and Facilitators to Consider Prior to Start-up

2021 ◽  
Author(s):  
Sayna Bahraini ◽  
Alexander Maisonneuve ◽  
Yirong Liu ◽  
André Samson ◽  
Qian Ying ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Shared Care ◽  
Stepped Care ◽  
Barriers And Facilitators ◽  
Service Development ◽  
Care Pathways ◽  
Theory Approach ◽  
Structural Level ◽  
Structured Interviews ◽  
Intervention Level

Abstract Background: The ADHD Shared Care Pathways is a program that has been developed in Canada with two main strategies: (a) to implement shared care between general practitioners (GPs) and specialists, and (b) to implement stepped care in which the patient is treated at the most appropriate level of care, depending on complexity or outcome of their illness. The current study aims to identify challenges and facilitators in implementing this program in a Chinese context. Methods: Two focus groups were conducted using semi-structured interviews with a total of 7 healthcare providers in Beijing. A grounded theory approach using open, axial and selective coding provided three main themes pertaining to the barriers and facilitators faced at: (1) a social-level from of the perspectives of patients and healthcare providers; (2) at a structural-level related to both internal and external organizational environments; (3) and at the intervention-level. Results: Results reveal multilayered challenges in implementing an ADHD Shared Care Pathways program for children in China. Conclusion: Our study highlights the importance of consultation in a new implementation context in order to get a “lay of the land”. By extension, our results demonstrate areas for service development and further research.

scholarly journals Factors that influence enrollment in syringe services programs in rural areas: a qualitative study among program clients in Appalachian Kentucky

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Umedjon Ibragimov ◽  
Katherine E. Cooper ◽  
Evan Batty ◽  
April M. Ballard ◽  
Monica Fadanelli ◽  
...  
Keyword(s):  
Grounded Theory ◽  
Rural Areas ◽  
Healthcare Providers ◽  
Individual Characteristics ◽  
Barriers And Facilitators ◽  
Risk Environment ◽  
Structured Interviews ◽  
Meso Level ◽  
Appalachian Kentucky ◽  
Low Threshold

Abstract Background Enrolling sufficient number of people who inject drugs (PWID) into syringe services programs (SSP) is important to curtail outbreaks of drug-related harms. Still, little is known about barriers and facilitators to SSP enrollment in rural areas with no history of such programs. This study’s purpose was to develop a grounded theory of the role of the risk environment and individual characteristics of PWID in shaping SSP enrollment in rural Kentucky. Methods We conducted one-on-one semi-structured interviews with 41 clients of 5 SSPs that were established in rural counties in Appalachian Kentucky in 2017–2018. Interviews covered PWID needs, the process of becoming aware of SSPs, and barriers and facilitators to SSP enrollment. Applying constructivist grounded theory methods and guided by the Intersectional Risk Environment Framework (IREF), we applied open, axial and selective coding to develop the grounded theory. Results Stigma, a feature of IREF’s meso-level social domain, is the main factor hampering SSP enrollment. PWID hesitated to visit SSPs because of internalized stigma and because of anticipated stigma from police, friends, family and healthcare providers. Fear of stigma was often mitigated or amplified by a constellation of meso-level environmental factors related to healthcare (e.g., SSPs) and social (PWID networks) domains and by PWID’s individual characteristics. SSPs mitigated stigma as a barrier to enrollment by providing low threshold services in a friendly atmosphere, and by offering their clients program IDs to protect them from paraphernalia charges. SSP clients spread positive information about the program within PWID networks and helped their hesitant peers to enroll by accompanying them to SSPs. Individual characteristics, including child custody, employment or high social status, made certain PWID more susceptible to drug-related stigma and hence more likely to delay SSP enrollment. Conclusions Features of the social and healthcare environments operating at the meso-level, as well as PWID’s individual characteristics, appear to enhance or mitigate the effect of stigma as a barrier to SSP enrollment. SSPs opening in locations with high stigma against PWID need to ensure low threshold and friendly services, protect their clients from police and mobilize PWID networks to promote enrollment.

scholarly journals Situations of using white lie during patient care: a qualitative study into nurses’ perspectives

2020 ◽  
Author(s):  
Alireza Nikbakht nasrabadi ◽  
soodabeh joolaee ◽  
Elham Navab ◽  
Maryam esmaeilie ◽  
mahboobe shali
Keyword(s):  
Patient Care ◽  
Professional Competence ◽  
Healthcare Providers ◽  
Cultural Knowledge ◽  
Public Hospitals ◽  
Hospital Nurses ◽  
Structured Interviews ◽  
Related Factors ◽  
Wide Range ◽  
Data Saturation

Abstract Background: Keep the patients well and fully informed about diagnosis, prognosis, and treatments is one of the patient’s rights in any healthcare system. Although all healthcare providers have the same viewpoint about rendering the truth in treatment process, sometimes the truth is not told to the patients and instead, healthcare staff use “white lie”. This study aimed to explore the nurses’ experience of white lies during patient care.Methods: This qualitative and descriptive study was conducted during June to December 2018. Eighteen hospital nurses were purposively recruited with maximum variation from ten teaching and public hospitals affiliated to Tehran University of Medical Sciences. Purposeful sampling was used and data were collected by semi-structured interviews that were continued until data saturation. Data was classified and analyzed by content analysis approach.Results: The data analysis in this study resulted in four main categories and eleven subcategories. The main categories included hope crisis, bad news, cultural diversity, and nurses’ limited professional competence. Conclusion: Results of the present study showed that, the use of white lie by nurses during patient care may be due to a wide range of patient, nurse and organizational-related factors. Communication was the main factor that influenced information rendering. Nurses’ communication with patients should be based on mutual respect, trust and adequate cultural knowledge, and also nurses should provide precise information to patients, so they can make accurate decisions regarding their health care.

scholarly journals Implementing a Canadian Shared-Care ADHD Program in Beijing: Barriers and Facilitators To Consider Prior To Start-Up.

2021 ◽  
Author(s):  
Sayna Bahraini ◽  
Alexander Maisonneuve ◽  
Yirong Liu ◽  
André Samson ◽  
Qian Ying ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Shared Care ◽  
Stepped Care ◽  
Barriers And Facilitators ◽  
Service Development ◽  
Care Pathways ◽  
Theory Approach ◽  
Structural Level ◽  
Structured Interviews ◽  
Intervention Level

Abstract Background The ADHD Shared Care Pathways is a program that has been developed in Canada with two main strategies: (a) to implement shared care between general practitioners (GPs) and specialists, and (b) to implement stepped care in which the patient is treated at the most appropriate level of care, depending on complexity or outcome of their illness. The current study aims to identify challenges and facilitators in implementing this program in a Chinese context. Methods Two focus groups were conducted using semi-structured interviews with a total of 7 healthcare providers in Beijing. A grounded theory approach using open, axial and selective coding provided three main themes pertaining to the barriers and facilitators faced at: (1) a Social-level from of the perspectives of patients and healthcare providers; (2) at a structural-level related to both internal and external organizational environments; (3) and at the intervention-level. Results Results reveal multilayered challenges in implementing an ADHD Shared Care Pathways program for children in China. Conclusion Our study highlights the importance of consultation in a new implementation context in order to get a “lay of the land”. By extension, our results demonstrate areas for service development and further research.

scholarly journals Cyberincivility Experience of Korean Clinical Nurses in the Workplace: A Qualitative Content Analysis

2020 ◽  
Vol 17 (23) ◽  
pp. 9052
Author(s):  
Sang Suk Kim ◽  
Ho Jeong Song ◽  
Jung Jae Lee
Keyword(s):  
Content Analysis ◽  
Qualitative Content Analysis ◽  
Healthcare Providers ◽  
Online Communication ◽  
Public Hospitals ◽  
Structured Interviews ◽  
Clinical Nurses ◽  
Health Related ◽  
Private And Public ◽  
Hierarchical Communication

Although clinical nurses use online platforms to acquire health-related information and communicate with other healthcare providers, there are increasing reports on their incivility exposure in cyberspace. However, an in-depth understanding of their cyberincivility experience is lacking. This study aimed to identify Korean clinical nurses’ perception and experience of cyberincivility. A qualitative study was conducted. Twenty clinical nurses from seven private and public hospitals in the Seoul metropolitan area were recruited using purposive sampling. Individual semi-structured interviews were conducted with the nurses from June to September 2019. Conventional content analysis was applied for the interview data analysis. Clinical nurses perceived cyberincivility as disrespectful and condemning behavior as users hide under the shield of anonymity to persecute others without fear of retribution. Four themes regarding participants’ cyberincivility experience emerged: unprofessional behavior, hierarchical communication, lack of respect and morality, and forming an inefficient work environment. The results of this study provide an understanding regarding clinical nurses’ experience of cyberincivility that goes beyond that of previous studies, which mainly focused on students. These results could increase awareness of cyberincivility among clinical nurses, and provide key information for the design of cybercivility educational programs and guidelines to curb cyberincivility, nurture professional online communication, and consequently improve quality of care.

scholarly journals Investigation of Barriers and Facilitators to Medication Adherence in Patients With Type 2 Diabetes Across Different Health Literacy Levels: An Explanatory Sequential Mixed Methods Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Yen-Ming Huang ◽  
Olayinka O. Shiyanbola
Keyword(s):  
Type 2 Diabetes ◽  
Mixed Methods ◽  
Medication Adherence ◽  
Health Literacy ◽  
Blood Sugar ◽  
Mixed Methods Study ◽  
Perceived Barriers ◽  
Barriers And Facilitators ◽  
Structured Interviews

Type 2 diabetes (T2D) incurs tremendous healthcare costs associated with various complications due to poor blood sugar control. Medication adherence, which is correlated with patients’ health literacy, should be consistently practiced to achieve optimal control of blood sugar. A comprehensive understanding of specific communication and psychosocial factors related to medication-taking behaviors across different levels of health literacy among people with T2D will guide the development of effective interventions and strategies to enhance medication adherence. To understand barriers and facilitators to medication adherence in people with T2D across different health literacy levels, the Health Literacy Pathway Model was used to identify the psychosocial and communication factors that may influence medication adherence. This mixed methods study used an explanatory sequential design, including a quantitative survey followed by qualitative semi-structured interviews. Two hundred and five participants completed the survey questionnaire, and 23 participants completed semi-structured interviews. Confirmed by quantitative and qualitative data, having stronger self-efficacy and fewer concerns about medications, as well as experiencing fewer perceived barriers to medication-taking, are necessary for better medication adherence among those with low adherence. Our findings will be useful to tailor interventions for diabetes care through addressing concerns among low-adherent patients with low health literacy and emphasizing self-efficacy and perceived barriers to medication adherence among all low-adherent patients with T2D.

scholarly journals Barriers and Facilitators to Kangaroo Mother Care Implementation in Côte D’Ivoire: A Qualitative Study

2021 ◽  
Author(s):  
Kadidiatou Raissa Kourouma ◽  
Marie Laurette Agbré Yacé ◽  
Daouda Doukouré ◽  
Lassina Cissé ◽  
Chantière Somé-Meazieu ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Healthcare Providers ◽  
Kangaroo Mother Care ◽  
Decision Makers ◽  
Barriers And Facilitators ◽  
Structured Interviews ◽  
Cote D’Ivoire ◽  
Côte D'ivoire

Abstract BackgroundKangaroo Mother Care (KMC) is a key high impact intervention, low technology and cost-effective for the care of preterm and low birth weight newborn. Côte d’Ivoire has adopted the intervention and opened the first KMC unit in 2019. After one year of functioning, we aimed to assess barriers and facilitators of KMC implementation as well as proposed solutions to improve KMC implementation in Côte d’Ivoire.MethodThis was a qualitative study, using semi-structured interviews, carried out in September 2020 in the first KMC unit opened at the Teaching Hospital of Treichville. The study involved healthcare providers providing KMC and mothers of newborn who were receiving or received KMC at the unit. A thematic analysis was performed using Nvivo 12.ResultsA total of 44 semi-structured interviews were conducted, 12 with healthcare providers and 32 with mothers. The barriers identified were lack of supplies, insufficiency of human resources, lack of space for admission, lack of home visits, lack of food for mothers, lack of collaboration between health services involved in newborn care, increased workload, the beliefs of carrying the baby on the chest, partner resistance, low rate of exclusive breastfeeding, lack of community awareness. Facilitators identified were training of healthcare providers, leadership, the cost of the intervention, the value of the intervention for healthcare providers, mothers −healthcare providers relationship, mothers’ adherence to KMC.The proposed solution to improve KMC implementation were volunteer staff motivation, intensifying mothers and families education and counselling, the recruitment of a psychologist and the involvement of all stakeholders.ConclusionsOur study highlighted the challenges to implement KMC in Côte d’Ivoire with unique and specific barriers to implementation. We recommend to researchers and decision makers to respectively design strategies and adopt intervention that specifically address these barriers and facilitators to a better uptake of KMC. Decision makers should also take into account the proposed solution for a better implementation and scaling up of KMC intervention.

scholarly journals Awareness and Perception of Plant-Based Diets for the Treatment and Management of Type 2 Diabetes in a Community Education Clinic: A Pilot Study

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Vincent Lee ◽  
Taylor McKay ◽  
Chris I. Ardern
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Management ◽  
Community Education ◽  
Current Knowledge ◽  
Diabetes Education ◽  
Healthcare Providers ◽  
Educational Interventions ◽  
Diet Change ◽  
Education Centre

Objective. To assess awareness, barriers, and promoters of plant-based diet use for management of type 2 diabetes (T2D) for the development of an appropriate educational program.Design. Cross-sectional study of patients and healthcare providers.Setting. Regional Diabetes Education Centre in ON, Canada.Participants.n=98patients attending the Diabetes Education Centre andn=25healthcare providers.Variables Measures. Patient questionnaires addressed demographics, health history, and eating patterns, as well as current knowledge, confidence levels, barriers to, promoters of, and interests in plant-based diets. Staff questionnaires addressed attitudes and current practice with respect to plant-based diets.Analysis. Mean values, frequency counts, and logistic regression (alpha = 0.05).Results. Few respondents (9%) currently followed a plant-based diet, but 66% indicated willingness to follow one for 3 weeks. Family eating preferences and meal planning skills were common barriers to diet change. 72% of healthcare providers reported knowledge of plant-based diets for diabetes management but low levels of practice.Conclusions and Implications. Patient awareness of the benefits of a plant-based diet for the management of diabetes remains suboptimal and may be influenced by perception of diabetes educators and clinicians. Given the reported willingness to try (but low current use of) plant-based diets, educational interventions targeting patient and provider level knowledge are warranted.

scholarly journals Using projective exercises to identify patient perspectives of living with comorbid type 2 diabetes and asthma

2019 ◽  
pp. 174239531987278 ◽  
Author(s):  
Michelle L Litchman ◽  
Nancy A Allen ◽  
Carrie McAdam-Marx ◽  
Michael Feehan
Keyword(s):  
Type 2 Diabetes ◽  
Dual Diagnosis ◽  
Chronic Condition ◽  
Healthcare Providers ◽  
Health Condition ◽  
Patient Perspectives ◽  
Emotional Impact ◽  
Comorbid Conditions ◽  
Structured Interviews

Objective Patient self-management of a single chronic condition can be challenging, but few studies have examined the emotional impact of living with comorbid conditions and how that differs from a single chronic condition. This study examined patient perspectives of the emotional impact of living with asthma or asthma with comorbid type 2 diabetes (asthma+diabetes). Methods Data were collected from 41 adults (asthma only n = 22, asthma+diabetes n = 19) using semi-structured interviews on two separate online bulletin boards. Respondents engaged in discussions that leveraged two projective exercises: describing their health condition(s) as an animal, and selecting one of eight images that best illustrated how they were living with and managing their health condition(s). Results Respondents described physical and emotional challenges related to managing asthma or asthma+diabetes. Animal- and image- projective exercises were categorized by response and health condition. Thematic analysis across both projective exercises identified four themes: (1) frustrations with dual diagnosis, (2) juggling the dual diagnosis, (3) anticipating the future, and (4) unpredictability. Discussion Projective exercises are one way to elicit feelings about living with chronic conditions. Healthcare providers can improve support for patients with more than one health condition by providing education on how to manage comorbid conditions.

scholarly journals Identified barriers and facilitators to stroke risk screening in children with sickle cell anemia: results from the DISPLACE consortium

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Shannon M. Phillips ◽  
Alyssa M. Schlenz ◽  
Martina Mueller ◽  
Cathy L. Melvin ◽  
Robert J. Adams ◽  
...  
Keyword(s):  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Transcranial Doppler ◽  
Stroke Risk ◽  
Ecological Model ◽  
Healthcare Providers ◽  
Transcranial Doppler Ultrasound ◽  
The United States ◽  
Barriers And Facilitators ◽  
Structured Interviews

Abstract Background Children with sickle cell anemia are at risk for stroke. Ischemic stroke risk can be identified among children ages 2–16 years with sickle cell anemia using transcranial Doppler ultrasound. Despite strong recommendations for transcranial Doppler screening in guidelines released by the National Heart, Lung, and Blood Institute, implementation of transcranial Doppler screening in sickle cell anemia remains suboptimal. The purpose of this study was to identify barriers and facilitators to transcranial Doppler screening in a large national consortium to inform subsequent implementation interventions. Methods A qualitative descriptive approach was used to conduct 52 semi-structured interviews with a sample of patients with sickle cell anemia, their parents or primary caregivers, and healthcare providers dispersed across the United States. Interviews took place from September 2018 through March 2019. Directed content analysis was conducted with an adapted version of the Multilevel Ecological Model of Health as an initial coding framework, completed July 2019. Frequency analysis was conducted to determine predominant barrier and facilitator themes. Results Fourteen barrier themes and 12 facilitator themes emerged representing all levels of the ecological framework. Two barrier themes (Logistical Difficulties and Competing Life Demands and Gaps in Scheduling and Coordination), and 5 facilitator themes (Coordination, Scheduling and Reminders; Education and Information; Provider and Staff Investment and Assistance; Positive Patient Experience; and Convenient Location) were predominant. Conclusions Barriers and facilitators to transcranial Doppler screening in children with sickle cell anemia are complex and occur across multiple ecological levels. One barrier theme and 3 facilitator themes were found to be optimal to address in subsequent implementation interventions.

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