care approach
Recently Published Documents


TOTAL DOCUMENTS

1017
(FIVE YEARS 364)

H-INDEX

36
(FIVE YEARS 6)

2022 ◽  
Vol 9 (1) ◽  
pp. 56-57
Author(s):  
Jane Shulman ◽  
David Kenneth Wright

How can health care providers (HCPs) working with 2SLGBTQ+ patients enact a whole person care approach during the SARS-CoV-2 pandemic and its aftermath, and in such desperate times, is it even reasonable to expect them to? In this presentation, a nurse/nursing educator and a health care researcher/frequent patient discuss their observations and experiences of whole person care during the SARS-CoV-2 pandemic. The conversation highlights that in the immediate chaos early on, and in the face of exhaustion, trauma, and burnout as the pandemic progressed, attending to the whole personhood of patients was/is paramount for HCPs and for the people they treat. The presenters reflect on the amplified significance of a whole person approach for 2SLGBTQ+ people who may have had negative health care experiences in the past, and may fear that they will not receive equitable care in the chaotic context of a pandemic. A whole person care approach is perhaps most necessary when it is also most difficult. In a period of such profound distress, a deeper sense of connectedness to patients may help HCPs manage feelings of helplessness they are likely to encounter, and surely helps the people they treat. The goal of this presentation is to begin a discussion about the ways that whole person approaches benefit 2SLGBTQ+ patients as well as their HCPs, with the hope that it will spark ideas for attendees to develop in their own practices.


2022 ◽  
Author(s):  
Usman Sani Dankoly ◽  
Dirk Vissers ◽  
Souad Ben El Mostafa ◽  
Abderrahim Ziyyat ◽  
Bart Van Rompaey ◽  
...  

Abstract Background: In Morocco, the treatment of type 2 diabetes (T2D) is mainly focused on medication and only 2% of patients are coached towards a healthier lifestyle. In Oujda, Eastern Morocco the prevalence of T2D is 10.2%, and the current trend is alarming, especially for women. Therefore, the aim of this study is to explore healthcare professionals' (HCP) views about the perceived barriers and benefits towards an integrated care approach in primary healthcare centers (PHCCs) to T2D management in Oujda.Methods: A descriptive study using focus groups in 8 PHCCs. This resulted in a sample of 5 doctors and 25 nurses caring for diabetes patients. The transcripts of all conversations were coded to allow for thematic analysis.Results: The participants mentioned different barriers to an integrated approach of DM management:: excessive workload; poor reimbursement policy; lack of staff and equipment; interrupted drug supply; poor working environment; limited referral; gap in the knowledge of general practitioners; health beliefs; poverty; advanced age; gender; the use of psychotropic drugs. An integrated approach could be facilitated by simplified electronic records and referral; uninterrupted free care; staff recruitment; continuous professional development; internships. Benefits: structured care; promotion of care in PHCCs; empowerment of self-management.Conclusion: HCP views reflect the urge to strengthen the management of T2D in PHCCs. There is a need for HCP with expertise in physical activity and nutrition to solve the current gap in the multidisciplinary integrated care approach. The specific local context can contribute to patients' reluctance to change their lifestyles and is a challenge to provide care in an efficient and sustainable manner. More research is needed to see how a patient-centered multidisciplinary approach to T2D management can help motivate patients in Morocco to change to a healthier lifestyle.


2022 ◽  
pp. 657-671
Author(s):  
Johannes Ntshilagane Mampane

The chapter explores and describes community participation in the National Development Plan through Primary Health Care by using case studies of LGBT organizations in South Africa. Post-Apartheid and democratic South Africa has endorsed community participation as one of the fundamental pillars of the public Primary Health Care approach in its governance structures. This chapter focuses on the current major health issue in South Africa, the HIV epidemic, which is one of the leading causes of death in the country. Particular attention is paid to members of the LGBT community because of their discrimination in public healthcare facilities on grounds of their sexual orientation. The chapter relies on secondary sources of data collection from extant literature, textbooks, journal articles, and internet sources. Challenges to address LGBT community discrimination in HIV testing, prevention, treatment, care, and support were identified and solutions to uphold their human rights were proffered. These solutions are based on the principles of social justice, inclusion, diversity, and equality.


2022 ◽  
Author(s):  
Lauren R. Cirrincione ◽  
Bridgit O. Crews ◽  
Jane A. Dickerson ◽  
Matthew D. Krasowski ◽  
Jessica Rongitsch ◽  
...  

Objectives: Recently, an estradiol immunoassay manufacturer (Beckman Coulter, USA) issued an “Important Product Notice” alerting clinical laboratories their assay (Access Sensitive Estradiol) was not indicated for patients undergoing exogenous estradiol treatment. The objective of this analysis was to evaluate immunoassay bias relative to liquid chromatography tandem mass spectrometry (LC-MS/MS) in transgender women and to examine the influence of unconjugated estrone on measurements. Design: Cross sectional secondary analysis. Methods: Estradiol concentrations from 89 transgender women were determined by three immunoassays (Access Sensitive Estradiol [‘New BC’] and Access Estradiol assays [‘Old BC’], Beckman Coulter; Estradiol III assay [‘Roche’], Roche Diagnostics) and LC-MS/MS. Bias was evaluated with and without adjustment for estrone concentrations. The number of participants who shifted between three estradiol concentration ranges for each immunoassay versus LC-MS/MS (>300 pg/mL, 70-300 pg/mL, and <70 pg/mL) was calculated. Results: The New BC assay had the largest magnitude overall bias (median: -34%) and was -40%, -22%, and -10%, among participants receiving tablet, patch, or injection preparations, respectively. Overall bias was -12% and +17% for the Roche and Old BC assays, respectively. When measured with the New BC assay, 18 participants shifted to a lower estradiol concentration range (versus 9 and 10 participants based on Roche or Old BC assays, respectively). Adjustment for estrone did not minimize bias. Conclusions: Immunoassay measurement of estradiol in transgender women may lead to falsely decreased concentrations that have the potential to affect management. A multi-disciplinary health care approach is needed to ensure appropriate analytical methods are available.


2022 ◽  
Vol 75 (1) ◽  
Author(s):  
Dalila de Alcântara Martins ◽  
Prisca Dara Lunieres Pêgas Coêlho ◽  
Sandra Greice Becker ◽  
Alaidistania Aparecida Ferreira ◽  
Maria Luiza Carvalho de Oliveira ◽  
...  

ABSTRACT Objective: to understand how religiosity can influence the health of individuals diagnosed with mental disorders, based on comprehensive care. Methods: this is an integrative literature review, with the inclusion of articles in Portuguese, English and Spanish, between 2010 and 2018. Results: the critical analysis and qualitative synthesis of the 24 selected studies were categorized into two subtopics: The influence of religiosity in promoting comprehensive mental health care; Mental health versus religiosity: influencing conditions for effective access to comprehensive care. Final considerations: a positive influence of religiosity was identified in the lives of individuals diagnosed with mental disorders; however, evidence shows that health teams do not feel comfortable and prepared to work with religiosity as an expression of spirituality. This being one of the dimensional aspects of health, it can be inferred, on the results, the existence of this gap in the comprehensive care approach.


2021 ◽  
Vol 6 (2) ◽  
pp. 182
Author(s):  
Nurleli Nurleli ◽  
Ainayya Afninda Utami ◽  
Erita Gustina ◽  
Suvi Novida

Bronchial asthma is a disease of respiratory tract obstruction caused by muscle contraction, inflammation, and accumulation of secretions around the bronchi. Meeting the need for oxygenation is part of the management of asthmatic bronchial patients. This case study aims to describe the fulfillment of oxygenation needs. The case study method uses a descriptive design with a nursing care approach in the same two cases, namely respondents with bronchial asthma. The case study was conducted at the Putri Hijau Kindergarten II Hospital from October to December 2018. The data collection method was through interviews, physical examinations, supporting examinations, using the assessment format as an instrument in data collection. After intervention with effective cough relaxation techniques as well as collaboration in the administration of drug and oxygen therapy, during four days of treatment, both respondents were able to meet their oxygenation needs optimally. It was concluded that the intervention had an effect on the effectiveness of airway clearance so as to eliminate shortness of breath, based on this study, it is hoped that it can be applied by health workforce.


2021 ◽  
Vol 16 (2) ◽  
pp. 241-251
Author(s):  
Beh Yew Hin ◽  
Zaihan Ariffin

Globally, non-syndromic tooth agenesis is commonly seen in clinical practice. However, its management is often complex and requires a multidisciplinary team approach for the maximal outcome. While various treatment options are possible, considerations for the treatment are not only based on the dentofacial conditions but also cultural and social background and personal preference of the patient. Thus, patientcentred care approach should always be practised for an optimal outcome. In the present case, a patient with established craniofacial growth presenting with bilateral agenesis of maxillary lateral incisors and over-retained deciduous maxillary left canine sought for aesthetic improvements. The patient did not prefer any orthodontic treatment citing a prolonged treatment duration and sub-optimal motivation as a hindrance. Thus, a prosthodontic only approach was taken by providing a conventional cantilever bridge and ceramic veneers to achieve the aims of treatment. This article discusses the possible limitation of such prosthodontic only solution in managing tooth agenesis.


2021 ◽  
pp. 1-16
Author(s):  
Andreas Schmitt ◽  
Bernhard Kulzer ◽  
André Reimer ◽  
Christian Herder ◽  
Michael Roden ◽  
...  

<b><i>Introduction:</i></b> Depression is a common and serious complication of diabetes. Treatment approaches addressing the specific demands of affected patients are scarce. <b><i>Objective:</i></b> The aim of this work was to test whether a stepped care approach for patients with diabetes and depression and/or diabetes distress yields greater depression reduction than treatment-as-usual. <b><i>Methods:</i></b> Two-hundred and sixty patients with diabetes and elevated depressive symptoms (CES-D ≥16) and/or elevated diabetes distress (PAID ≥40) were randomized to stepped care for depression or diabetes treatment-as-usual. The primary outcome was the rate of meaningful depression reduction at the 12-month follow-up according to the HAMD (score &#x3c;9 or reduction by ≥50%). Secondary outcomes were changes in depression scores (HAMD/CES-D), diabetes distress (PAID), diabetes acceptance (AADQ), well-being (WHO-5), quality of life (EQ-5D/SF-36), self-care behavior (SDSCA/DSMQ), HbA<sub>1c</sub>, and biomarkers of inflammation. <b><i>Results:</i></b> One-hundred and thirty-one individuals were assigned to stepped care and 129 to treatment-as-usual. Overall, 15.4% were lost to follow-up. Meaningful depression reduction was observed in 80.2 versus 51.2% in stepped care versus treatment-as-usual (<i>p</i> &#x3c; 0.001, intention-to-treat analysis). Of the secondary measures, the HAMD (∆ –3.2, <i>p</i> &#x3c; 0.001), WHO-5 (∆ 1.5, <i>p</i> = 0.007), and AADQ (∆ –1.0, <i>p</i> = 0.008) displayed significant treatment effects, while effects on CES-D (∆ –2.3, <i>p</i> = 0.065), PAID (∆ –3.5, <i>p</i> = 0.109), and SDSCA (∆ 0.20, <i>p</i> = 0.081) were not significantly different. Both groups showed comparable changes in EQ-5D/SF-36, DSMQ, HbA<sub>1c</sub>, and biomarkers of inflammation (all <i>p</i> ≥ 0.19). <b><i>Conclusions:</i></b> The stepped care approach improved depression, well-being, and acceptance. The results support that increasing treatment intensity on demand is effective and can help provide more optimal treatment. The inclusion of diabetes-specific interventions may be beneficial for patients with diabetes and elevated depression.


Sign in / Sign up

Export Citation Format

Share Document