scholarly journals Remote Monitoring Programs for Cardiac Conditions

2021 ◽  
Vol 1 (9) ◽  
Author(s):  
Alexander Clark ◽  
Bailey Sousa ◽  
Andrea Smith ◽  
Duncan Steele ◽  
Tamara Rader ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Professionals ◽  
Remote Monitoring ◽  
Ethical Issues ◽  
Realist Review ◽  
Care Providers ◽  
Monitoring Centre ◽  
Avoidable Hospitalizations ◽  
Monitoring Programs

Remote monitoring is a type of telehealth whereby health care is delivered to patients outside traditional settings by allowing health data to be exchanged between patients and health care providers using telecommunication techniques (e.g., video conferencing) or stand-alone devices (e.g., portable heart rate monitors). The goals of remote monitoring centre around promoting home-based self-management to improve patient outcomes and/or reduce health system usage. CADTH’s Health Technology Assessment included the following analyses: A Realist Review: This sought to identify key perceived or actual mechanisms of remote monitoring programs. Substantial evidence was available regarding the use of remote monitoring programs for heart failure (n = 64) and cardiac rehabilitation (n = 23), limited evidence was available for atrial fibrillation (n = 4), and none was available for hypertension. A Perspectives and Experiences Review: This thematic synthesis of primary qualitative research sought to understand and describe peoples’ experiences with and perspectives on remote monitoring programs for cardiac conditions. CADTH also engaged patients and caregivers directly in a patient engagement section. An Ethics Review: This sought to identify and reflect upon key ethical issues that should be considered when contemplating the implementation of remote monitoring programs. Overall, the vast majority of sampled patients, caregivers, and health professionals consistently found or perceived remote monitoring programs across different cardiac conditions to be easy to use and beneficial to health. Remote monitoring programs may be an attractive adjunct as opposed to an alternative to existing health professionals and services. Although remote monitoring programs may ultimately reduce avoidable hospitalizations, they may increase net costs and workload during set-up and operational phases without careful pathway design and expectations management. More research is needed to identify the costs and cost-effectiveness of remote monitoring programs across chronic cardiac conditions.

scholarly journals Mandatory HIV testing in China: the perception of health-care providers

2007 ◽  
Vol 18 (7) ◽  
pp. 476-481 ◽  
Author(s):  
Li Li ◽  
Zunyou Wu ◽  
Sheng Wu ◽  
Sung-Jae Lee ◽  
Mary Jane Rotheram-Borus ◽  
...  
Keyword(s):  
Health Care ◽  
Hiv Testing ◽  
Health Care Providers ◽  
Perceived Risk ◽  
Ethical Issues ◽  
Service Providers ◽  
Risk Behaviour ◽  
People Living With Hiv ◽  
Care Providers ◽  
Hiv Aids

Health-care providers in China are facing an exponential increase in HIV testing and HIV-positive patients. A total of 1101 service providers were recruited to examine attitudes toward people living with HIV/AIDS (PLWHA) in China. Logistic regression models were used to assess factors associated with providers' attitudes toward mandatory HIV testing. Providers were most likely to endorse mandatory HIV testing for patients with high-risk behaviour and for all patients before surgery. Over 43% of providers endorsed mandatory testing for anyone admitted to hospital. Controlling for demographics, multivariate analyses indicated that providers with higher perceived risk of HIV infection at work, higher general prejudicial attitudes toward PLWHA, and previous contact with HIV patients were more likely to endorse mandatory HIV testing for anyone admitted to hospital. Results underscore the importance of implementing universal precautions in health-care settings and call attention to social and ethical issues associated with HIV/AIDS control and treatment in China.

scholarly journals Providing gender-affirming hormone therapy through primary care: Service users' and health professionals' experiences of a pilot clinic

2020 ◽  
Author(s):  
A Ker ◽  
Gloria Fraser ◽  
Antonia Lyons ◽  
C Stephenson ◽  
T Fleming
Keyword(s):  
Primary Care ◽  
Health Care ◽  
New Zealand ◽  
Hormone Therapy ◽  
Health Care Providers ◽  
Health Professionals ◽  
Care Service ◽  
Gender Diversity ◽  
Service Users ◽  
Care Providers

© 2020 CSIRO Publishing Journal Compilation © Royal New Zealand College of General Practitioners 2020 This is an open access article licensed under a. INTRODUCTION: Primary health care providers are playing an increasingly important role in providing gender-affirming health care for gender diverse people. This article explores the experiences of a primary care-based pilot clinic providing gender-affirming hormone therapy in Wellington, New Zealand. AIM: To evaluate service users' and health professionals' experiences of a pilot clinic at Mauri Ora (Victoria University of Wellington's Student Health and Counselling Service) that provided gender-affirming hormones through primary care. METHODS: In-depth interviews were conducted with four (out of six) service users and four health professionals about their perspectives on the clinic. Interviews were transcribed verbatim and analysed using thematic analysis. RESULTS: Three themes were identified in service users' interviews, who discussed receiving affirming care due to the clinic's accessibility, relationship-centred care and timeliness. Three themes were identified in the health professionals' interviews, who described how the clinic involves partnership, affirms users' gender and agency, and is adaptable to other primary care settings. Both service users and health professionals discussed concerns about the lack of adequate funding for primary care services and the tensions between addressing mental health needs and accessing timely care. DISCUSSION: The experiences of service users and health professionals confirm the value of providing gender-affirming hormone therapy in primary care. Models based in primary care are likely to increase accessibility, depathologise gender diversity and reduce wait times.

Level of physical activity and its correlates among health care workers in Ethiopia, 2019

2019 ◽  
Author(s):  
Tigist Demssew Adane ◽  
Birhan Gebresillassie Gebregiorgis ◽  
Elda Mekonnen Nigussie ◽  
Abate Dargie Wubetu
Keyword(s):  
Physical Activity ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Workers ◽  
Health Professionals ◽  
Associated Factors ◽  
P Value ◽  
Care Providers ◽  
Care Workers ◽  
Study Participants

Abstract Background These days, engaging at sufficient regular physical activity strongly recommended for good health and physical functioning. Physical activity can increase the self-confidence of the health professionals and they would become fit for daily activities with patients. Knowing the level of physical activity can help health care professionals to plan for physical activity programs. This study aimed to measure the level of physical activity and associated factors among adult health professionals at Tirunesh Beijing general hospital.Objective The aim of this study was to assess the level of physical activity and associated factors among health care workers in Ethiopia, 2019.Methods Institution based cross-sectional study conducted level of physical activity and associated factors among health care workers in Ethiopia, 2019. Two hundred nighty seven adult health professionals were participated, which was a 97.4% response rate. The global physical activity questionnaire used to measure the level of physical activity. Descriptive statistics and binary logistic regression analyses was done to affirm the variables characteristics. A predictor variable with a p-value of less than 0.2 exported to multivariate analysis. During multivariate analysis, statistical significance declared at a p-value of < 0.05.Results In general, the majority of the study participants, 89.2% (95% CI: 85.9-92.6) were achieved recommended levels of physical activity. Regarding the intensity of the physical activity, the overall mean time score was 518.4 mints per week or 2352.6 MET/week. For moderate-intensity physical activity, 83.5% of the study participants were physically active, (≥150 minutes/week). In the case of vigorous activity, about 32.7% of the study participants were physically active and engaged in vigorous physical activity (≥75 minutes /week). The study participants, who had self-motivation for physical activity, had a BMI of less than 25 kg/m2 and aged < 40 years were physically active.Conclusions Health care providers’ habit of physical activity improved as compared with the previous studies. However, the current level of physical activity of health professionals is not adequate. Health care providers’ age, body mass index and self-motivation attribute to physical activity. The level of physical activity can increase by enhancing staff motivation towards physical activity.

Medical “Gatekeeping” for Psychosocial Research on Serious Illness

2017 ◽  
Vol 28 (3) ◽  
pp. 218-233
Author(s):  
Pam McGrath ◽  
Amandeep Kaur ◽  
Rennette Feracho ◽  
Mary Anne Patton
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Ethical Issues ◽  
Psychosocial Health ◽  
Research Process ◽  
Care Providers ◽  
Research Recruitment ◽  
Serious Illness ◽  
Sample Representation ◽  
The Impact

The discussion explores ethical issues associated with medical “gatekeeping” in relation to psychosocial health research associated with serious illness and loss. “Gatekeeping” is defined as the process whereby health-care providers prevent access to eligible patients for research recruitment. The impact of this practice on the research process is explored, including issues of sample representation, selection bias, and wastage of time and resources. The reflection of ethical issues is set in the context of research on clinical empathic responsiveness and accuracy, paternalism, and the ethical principles of autonomy, beneficence, and justice.

scholarly journals Spirituality as an Essential Element of Person-Centered Care

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 885-886
Author(s):  
Rachel Nathan ◽  
Deborah Zuercher ◽  
Steven Eveland ◽  
Anjana Chacko ◽  
Raya Kheirbek
Keyword(s):  
Health Care ◽  
Chronic Illness ◽  
Health Care Providers ◽  
Spiritual Care ◽  
Ethical Issues ◽  
Critical Role ◽  
Essential Element ◽  
Care Providers ◽  
Sensitivity Assessment ◽  
Centered Care

Abstract Data demonstrate that the majority of patients with serious or chronic illness would like their clinicians to address their spirituality but that the majority of clinicians do not provide such care. Reasons cited include lack of training. Palliative Medicine, built on the biopsychosocial-spiritual model of care, has long recognized the critical role of spirituality in the care of patients with complex, serious, and chronic illness. There is mounting evidence that spiritual care is a fundamental component of all high-quality compassionate health care, and it is most effective when it is recognized and reflected in the attitudes and actions of both patients and health care providers. We conducted focus groups as a first step in the process to arrive at a consensus definition of “spiritual care.” A second step involved collecting and comparing frameworks and models that recognize that providers cannot be made compassionate simply through the imposition of rules; methods were needed to achieve behavior change. The study group developed and piloted curriculum to train health care providers. The created curricula covered the definitions of a spiritual care, self-awareness, cultural sensitivity, assessment, and skills. As part of ongoing curriculum development processes, training included evaluation tools to accompany skill development . Our work demonstrated the need for compassionate presence during encounters, for applying the spirituality in professional life; and for identifying ethical issues in inter-professional spiritual care. We concluded that it is feasible to train clinicians to address spirituality and provide holistic and patient-centered care in an effort to minimize suffering.

Personalized Health Care

2015 ◽  
Author(s):  
Jared Sparks
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Ethical Issues ◽  
Models Of Care ◽  
Care Providers ◽  
Patient Centered ◽  
Broad Term ◽  
Personalized Health ◽  
Personalized Health Care ◽  
Effective Health Care

Personalized health care (PHC) is a broad term that describes how we leverage our growing understanding of the human body and developing technology to provide more effective health care. PHC requires that health care providers consider prevention and treatment in the context of available advanced technologies, best practices, and known variables that define us as individuals. These variables or characteristics may run the gamut from genetic, to biologic, to environmental, to even personality, personal values, and choice. By considering how these characteristics interact with specific illnesses and available interventions, outcomes can be improved. The purpose of this article is to: describe PHC’s current conceptualization including relationship with personalized medicine and patient-centered models of care, discuss its development and application by specific stakeholders, and review pertinent economic, legislative, and ethical issues.

scholarly journals Willingness to Pay for Social Health Insurance and Associated Factors among Health Care Providers in Addis Ababa, Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Abel Mekonne ◽  
Benyam Seifu ◽  
Chernet Hailu ◽  
Alemayehu Atomsa
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Willingness To Pay ◽  
Health Care Providers ◽  
Health Professionals ◽  
Addis Ababa ◽  
Social Health Insurance ◽  
Social Health ◽  
Care Providers ◽  
The Government

Background. Cost sharing between beneficiaries and government is critical to attain universal health coverage. The government of Ethiopia introduced social health insurance to improve access to quality health services. Hence, HCP are the ultimate frontline service provider; their WTP for health insurance could influence the implementation of the scheme directly or indirectly. However, there is limited evidence on willingness to pay (WTP) for social health insurance (SHI) among health professionals. Methods. A cross-sectional study was conducted in Addis Ababa, Ethiopia, from May 1st to August 15th, 2019. A total sample of 480 health care providers was selected using a multistage sampling method. The collected data were entered into Epi Info version 7.1 and analyzed with SPSS version 23. Binary and multiple logistic regression analysis was carried out to identify the associated factor outcome variable. The association was presented in odds ratio with 95% confidence interval and significance determined at a P value less than 0.05. Result. A total of 460 health care providers responded to the questionnaire, making a 95.8% response rate. Of the respondents, only 132 (28.7%) were WTP for SHI. Higher educational status [AOR=2.9, 95% CI (1.2-7.3)], higher monthly income [AOR=2.2, 95% CI (1.2-4.3)], recent family illness [AOR=2.4, 95% CI (1.4-4.4)], and a good awareness about SHI [AOR=4.4, 95% CI (2.4-7.8)] showed significant association with WTP for SHI. The main reasons for not WTP were thinking the government should cover the cost, preferring out-pocket payment and the provided SHI scheme does not cover all the health care costs health care providers lost interest in pay for SHI. Conclusion and Recommendation. The majority of health care providers were not willing to pay for the introduced SHI scheme. The provided SHI scheme should be clear and provide special consideration for health care providers as the majority of them receives free health care service from their employer health care institution. Also, the government, health professional associations, and other concerned stakeholders should provide awareness creation programs by targeting low and middle-level health professionals in order to increase WTP for SHI among health care providers.

The ethics of interprofessional collaboration

2013 ◽  
Vol 20 (4) ◽  
pp. 426-435 ◽  
Author(s):  
Joyce Engel ◽  
Dawn Prentice
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Moral Distress ◽  
Ethical Issues ◽  
Interprofessional Collaboration ◽  
Care Providers ◽  
Quality Health Care ◽  
Health Care Outcomes ◽  
Quality Health ◽  
Interprofessional Competencies

Interprofessional collaboration has become accepted as an important component in today’s health care and has been guided by concerns with patient safety, quality health-care outcomes, and economics. It is widely accepted that interprofessional collaboration improves patient outcomes through enhanced communication among health-care providers and increased accessibility to services. Although there is a paucity of research that provides confirmatory evidence, interprofessional competencies continue to be incorporated into the curricula of health-care students. This article examines the ethics of interprofessional collaboration and ethical issues that arise from the mainstream adoption of interprofessional competencies and the potential for moral distress in nursing.

Dual loyalty, medical ethics, and health care in offshore asylum-seeker detention

2019 ◽  
pp. 260-272 ◽  
Author(s):  
Deborah Zion
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Asylum Seekers ◽  
Ethical Issues ◽  
Care Providers ◽  
Ethical Considerations ◽  
Dual Loyalty ◽  
Christmas Island ◽  
Care Workers ◽  
Refugees And Asylum Seekers

This chapter examines the ethical issues related to the practice of health care in an environment where human rights are absent, specifically relating to the conditions for refugees and asylum seekers who arrive by sea in Australian territory. The ethical considerations of working within the offshore detention environment are discussed. Health-care workers in these harsh environments often have divided loyalties, when duties to their patients conflict with duties to their employer or to the state. The author draws on published accounts and interviews with health-care providers who have worked on Manus Island and Nauru and Christmas Island, the sites used by Australia for offshore detention of asylum seekers.

Legal and Ethical Imperatives for Using Certified Sign Language Interpreters in Health Care Settings: How to “Do No Harm” When “It’s (All) Greek” (Sign Language) to You

2016 ◽  
Vol 17 (3) ◽  
pp. 114-128 ◽  
Author(s):  
Angela M. Nonaka
Keyword(s):  
Health Care ◽  
Sign Language ◽  
Health Care Providers ◽  
Limited English Proficiency ◽  
Ethical Issues ◽  
The United States ◽  
Care Providers ◽  
Sign Language Interpreters ◽  
Health Care Settings ◽  
Sign Language Interpreting

Communication obstacles in health care settings adversely impact patient–practitioner interactions by impeding service efficiency, reducing mutual trust and satisfaction, or even endangering health outcomes. When interlocutors are separated by language, interpreters are required. The efficacy of interpreting, however, is constrained not just by interpreters’ competence but also by health care providers’ facility working with interpreters. Deaf individuals whose preferred form of communication is a signed language often encounter communicative barriers in health care settings. In those environments, signing Deaf people are entitled to equal communicative access via sign language interpreting services according to the Americans with Disabilities Act and Executive Order 13166, the Limited English Proficiency Initiative. Yet, litigation in states across the United States suggests that individual and institutional providers remain uncertain about their legal obligations to provide equal communicative access. This article discusses the legal and ethical imperatives for using professionally certified (vs. ad hoc) sign language interpreters in health care settings. First outlining the legal terrain governing provision of sign language interpreting services, the article then describes different types of “sign language” (e.g., American Sign Language vs. manually coded English) and different forms of “sign language interpreting” (e.g., interpretation vs. transliteration vs. translation; simultaneous vs. consecutive interpreting; individual vs. team interpreting). This is followed by reviews of the formal credentialing process and of specialized forms of sign language interpreting—that is, certified deaf interpreting, trilingual interpreting, and court interpreting. After discussing practical steps for contracting professional sign language interpreters and addressing ethical issues of confidentiality, this article concludes by offering suggestions for working more effectively with Deaf clients via professional sign language interpreters.

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