Active and Healthy Aging

This study aims to investigate the difficulties experienced by elderly persons in accessing healthcare services and their satisfaction with issues as regards the healthcare system. In this study, qualitative research was carried out to assess the difficulties regarding the healthcare delivery system and satisfaction with the healthcare services. This qualitative research was performed through in-depth interviews with 6 men and 4 women aged 65+ years, in Ankara, the capital city of Turkey. It was discovered that elderly persons required the support of others to access a doctor, a health institution or hospital and the care and support of others for the regular intake of their drugs with increasing age. They were satisfied with the current family physician program. The most significant challenges experienced by elderly persons regarding the healthcare delivery system included crowded hospitals, difficulty walking, the unavailability of wheel chairs, and inadequate assistance from support staff.

Meeting Patients Where They Are

In this chapter the author describes the challenges of engaging and communicating with patients and how technology can improve communication, elicit honest patient disclosure, and create more productive conversation and help patients engage and partner in their care. The author will also discuss how research with multimedia programs reveals it can help reduce anxiety, improve knowledge, help low health literacy audiences, and contribute to improved outcomes. This chapter will also examine how multimedia decision aid programs can help patients understand their options and complex risk information, while helping them consider their values and preferences so they can truly engage in shared decision making.

Best Practices to Promote Patient and Donor Engagement to Care in Living Donor Transplant

Increasing evidence has demonstrated that patients' involvement promotes better health care outcomes and cost-effectiveness of services. However, limited literature is available about the experience of living donor kidney transplantation and best practices to promote patients and donors' engagement. Aim of the present chapter is to review the literature about patient engagement in the context of chronic kidney disease, and to introduce an innovative protocol developed to promote potential donors and recipients' participation and adherence to care at the Niguarda Ca' Granda Hospital in Milan (Italy). Results are critical to reflect on the identification of best practices for patients' engagement in the context of chronic kidney disease. Through a better understanding of the emotional and affective dynamics and the relational implications that may influence the elaboration of the information given by health care providers, it will be possible to develop evidence-informed interventions.

Informatics and Health Services

Personal electronic health records are seen as a key component to improved health care for patients, empowering motivated patients by giving them access to their own records resulting in increased self-care, shared decision making, and better clinical outcomes. Benefits through electronic record keeping would also accrue to health care providers through the availability and retrievability of data, reduced duplication of medical tests, more effective physician diagnosis and treatment, reduced incidence of prescription errors, and flagging inappropriate drug combinations. Utilizing information technology could also moderate the cost of health care services. Electronic health records would also improve clinical research through access to a large database of patient electronic records for research and determining best practices. Although potential benefits are considerable, many challenges to implementation must be addressed and resolved before this potential of improved health care provision and cost efficiency can be realized.

Electronic Patient Records (EPR), Library Services (LS) and Multidisciplinary Team (MDT) Meetings

Patients with Long-Term Conditions (LTCs) account for around 50% of General Practitioner (GP) appointments, 64% of outpatient appointments and 70% of hospital bed days. There needs to be a wider access to knowledge and understanding such as directories with information leaflets, documents, books on lifestyle, helpful contacts and sources to information that can support patients and the general public on the most important elements their health. This cannot be achieved just through patients accessing their health records in sole. The objective of this paper is to 1) highlight the importance of integrating General Practice (GP), Electronic Patient Records (EPR) with Library Services (LS) and 2) also explore why it would be advantageous to implement patient-centred Multidisciplinary Team (MDT) meetings in primary care for patients with Long-Term Conditions (LTCs). This article provides a UK glance and how primary care services can be improved, integrating for the better. Having access to Electronic Patient Records (EPR) alone will not help or encourage a patient to gain confidence and/ or understanding especially if patients are overwhelmed by their healthcare choices and Health Literacy (HL) complexities. Patients' whose first language is not English for example, approaching more methods to support HL is/ will be challenging. Library and Health Services partnerships should be initiated to allowing access to wider resources. In addition, patient-centred Multidisciplinary Team (MDT) meetings should be arranged at dedicated time points between a doctor and patient/ carer and these can take place in a private section within library setting involving wider participation in care plans. Given that more patients and the public will have opportunity to access their health records, a “Libraries and Health” partnership can help integrate primary healthcare better thus allowing all to access health-related literature, using books, leaflets and digital media in a comfortable environment in a setting that also has staff that can support with HL and technology. An EPR and MDT initiative should be supported with library and health partnerships; this needs to be encouraged.

A Computational Perspective of Knowledge Empowerment for Healthcare Decision Making

People in a variety of settings can be heard uttering the phrase that “knowledge is power” or the relatively equivalent concept that “information is power.” However, the research literature in particular lacks a simple and standardized way to examine the relationship between knowledge and power. There is a lack operational quantitative definitions of this relationship to adequately support the building of complex computational models used in addressing some longstanding public health and healthcare delivery issues like differential access to care, inequitable care and treatment, institutional bias, disparities in health outcomes, and eliminating barriers to patient-centered care. The objective of this discussion is to present a relational algorithm that can be used in both conceptual discussions on knowledge empowerment modeling, as well as in the building of computational models that want to explore the variable of knowledge empowerment within computer simulation experiments.

Using the Communication AssessmenT Checklist in Health to Assess the Communication Quality of Web Based Resources for Prostate Cancer

Introduction: The communication quality of web resources for patients is unknown. The purpose of this study was to assess prostate cancer websites using the Communication AssessmenT Checklist in Health (CATCH). Methods: CATCH is a theory-based tool consisting of 50 elements nested in 12 concepts. Two raters independently applied it to 35 HON certified websites containing information on prostate cancer treatment. Results: Websites contained a mean 24.1 (SD= 3.6) CATCH items. The concepts Language, Readability, Layout, Typography and Appearance were present in over 80% of sites. Content, Risk Communication, Usefulness, and Scientific Value were present in 50% or less. Discussion: The prostate cancer websites evaluated in this study did not present treatment information in a useful, informative or credible way for patients. The communication quality of these resources could be improved with a clear strategic intent focused on decision-making, using CATCH as a guiding framework.

A Need for Greater Collaboration

Patient safety concerns have risen to such levels that multiple organizations and initiatives have been created to reduce hospital readmissions and medication errors in the United States healthcare system. Interprofessional education and collaborative practice (IPECP) has become a center of focus in healthcare education and the competency-based programs help health providers function more effectively as a team, train new university and college healthcare students to become ready for collaborative practice, and assist in making new policies and practices to improve today's healthcare system. This chapter provides a comprehensive overview of healthcare initiatives created to help lower hospital readmission rates and polypharmacy errors. These projects, programs, and initiatives optimize patient care while minimizing costs. With pharmacists, physicians, nurses, social workers, and other professionals and caregivers build better teams with improved communication and understanding each other's roles and responsibilities, the global healthcare system will overcome the numerous challenges.

The Power of Collaborative Inquiry and Metaphor in Meeting the Health Literacy Needs of Rural Immigrant Women

Rural communities often face the need to reach out to immigrant groups to help sustain their populations. However, rural communities often lack the necessary support and resources required to meet the needs of immigrant communities. This chapter reports on the role of a participatory education project in meeting the needs of immigrant Old Colony Mennonite women. Building on an existing ESL program in a rural community in Southwestern Ontario, a participatory health literacy pilot project was developed employing an action research format. With the participants, the authors explored the participant identified topic of dealing with the stress of parenting, using metaphors (presentational knowing) and collaborative inquiry. Post-project, in-depth, semi-structured interviews were completed with participants and program staff. Interview data was analyzed using a constant comparison method and five themes are identified and discussed: (1) reconsidering the nature of their children; (2) the power of language to transform; (3) modeling with language; (4) changing parental behaviours; and (5) normalizing what happens at home. The authors then discuss the efficacy of utilizing presentational knowing and collaborative inquiry as a pedagogical strategy for meeting the learning needs of rural immigrants.

LiveWell – Promoting Healthy Living and Wellbeing for Parkinson Patients through Social Network and ICT Training

About 1.2 million people in Europe have Parkinson's disease (PD). PD patients often suffer from social exclusion and depression due to progressive lack of control over the disease. Eventually, most require constant care, leading to huge socioeconomic burdens. To partially tackle this issue, 7 partners in 7 countries participated in LiveWell (EU-funded project, 2012-14) to develop an innovative Web-based education, training and social community platform targeting PD patients, carers and clinicians. This paper describes LiveWell from conception to completion, presents lessons learnt over the course of the project, and highlights some identified main areas of best practice. The Project Consortium might not have had the chance to implement everything learnt in the current outputs, but these lessons and guidelines can be later used to improve LiveWell, and can also be generalised to benefit similar e-health services. The combination of appropriate online education and social communities could help patients and carers cope positively with PD, promoting social inclusion and better outcomes.