Hannah O'Neill, G. Ramsay, C. Downham, M. Johnston, K. Emslie, Michael S. J. Wilson, M. Kumar
Introduction: The recent adoption of publishing surgeon-specific mortality data in some settings has prompted concerns that the complex team working environment is misrepresented. This has led to consideration that outcomes data would be more accurately conveyed if team-based outcomes were published. However, there has been little investigation into what constitutes a clinical team within the surgical setting and if team size increases when providing person-centered care to more complex patients. Here, we seek to address these questions in elective colorectal surgery. Methods: This is a multi-centre retrospective case cohort study. Data were obtained from 3 Scottish sites. All elective colorectal resection procedures within a 2-month period were included. A standardised proforma was used to establish the number of professionals involved in patient care, diagnosis, management and outcome. Data were obtained from referral to discharge from cancer resection. Results: Thirty-eight cases were included. Median age was 69.5, with 63.2% being male. The number of patients with underlying co-morbidities was 15. The mean number of doctors involved in care was 19 (range 26-87). Complications were associated with a larger in-hospital medical team (p <0.001) but there were no differences in team size by co-morbidity status. Conclusion: Our study would suggest that publication of outcomes based upon one named clinician is an oversimplification of modern, person-centered management. The publication of team-based outcomes may both be more transparent with regard to clinical pathways and in turn support individual clinicians. Such reporting may enhance transparency while protecting individuals in an increasing culture of blame.
{"title":"How many doctors does it take to manage an elective general surgical patient? Individualised surgeon specific outcomes data misrepresent modern team-centred work practices","authors":"Hannah O'Neill, G. Ramsay, C. Downham, M. Johnston, K. Emslie, Michael S. J. Wilson, M. Kumar","doi":"10.5750/EJPCH.V7I2.1632","DOIUrl":"https://doi.org/10.5750/EJPCH.V7I2.1632","url":null,"abstract":"Introduction: The recent adoption of publishing surgeon-specific mortality data in some settings has prompted concerns that the complex team working environment is misrepresented. This has led to consideration that outcomes data would be more accurately conveyed if team-based outcomes were published. However, there has been little investigation into what constitutes a clinical team within the surgical setting and if team size increases when providing person-centered care to more complex patients. Here, we seek to address these questions in elective colorectal surgery. Methods: This is a multi-centre retrospective case cohort study. Data were obtained from 3 Scottish sites. All elective colorectal resection procedures within a 2-month period were included. A standardised proforma was used to establish the number of professionals involved in patient care, diagnosis, management and outcome. Data were obtained from referral to discharge from cancer resection. Results: Thirty-eight cases were included. Median age was 69.5, with 63.2% being male. The number of patients with underlying co-morbidities was 15. The mean number of doctors involved in care was 19 (range 26-87). Complications were associated with a larger in-hospital medical team (p <0.001) but there were no differences in team size by co-morbidity status. Conclusion: Our study would suggest that publication of outcomes based upon one named clinician is an oversimplification of modern, person-centered management. The publication of team-based outcomes may both be more transparent with regard to clinical pathways and in turn support individual clinicians. Such reporting may enhance transparency while protecting individuals in an increasing culture of blame.","PeriodicalId":72966,"journal":{"name":"European journal for person centered healthcare","volume":"4 1","pages":"223-227"},"PeriodicalIF":0.0,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79788488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Samantha Hughes, D. Crone, Rachel C. Sumner, Mark Redmond
Background: Arts on Prescription programmes are designed to support mental health and well-being of patients with a variety of clinical needs within the community. Despite a number of studies reporting benefits, there are some patients that do not see improvements in well-being. Yet, there is limited research investigating the reasons for this. Methods: Using a sequential mixed-methods design the present study sought to understand why some participants (N=312) experienced an increase in well-being and others did not (N=95) after attending an Arts on Prescription intervention based in the South West of England between 2009 and 2016. Results: Quantitative comparisons between the two groups identified little differences, aside from age and baseline well-being (WEMWBS scores), with those that improved being slightly younger, and having lower well-being at the outset compared with those that did not improve. A process model depicting the perceived facilitative and inhibitive factors of attending the programme was developed from the qualitative findings. This model suggests that the social aspect of the course may be implicated in the participants differential outcomes; with those that showed a decrease in well-being reporting difficulties in interacting with others during the intervention. Further, the participants who reported an increase in well-being felt vulnerable to “relapse” when finishing the course due to uncertainties regarding future support and at their ability to maintain their well-being without the provision of the programme. Conclusions: This research suggests a need to promote communication amongst groups in such interventions with the hope that this will provide a more facilitative environment for all participants to benefit. Also, such programmes should consider follow-on options to ensure the participants feel supported and confident in managing their well-being once the course comes to an end. Findings will be pertinent to those commissioning primary care art interventions, ensuring that referral policies and pathways are designed for optimal effectiveness and for potentially tailoring social prescribing programmes to suit the participants specific needs.
{"title":"Understanding well-being outcomes in primary care arts on referral interventions: a mixed method study","authors":"Samantha Hughes, D. Crone, Rachel C. Sumner, Mark Redmond","doi":"10.5750/EJPCH.V7I3.1768","DOIUrl":"https://doi.org/10.5750/EJPCH.V7I3.1768","url":null,"abstract":"Background: Arts on Prescription programmes are designed to support mental health and well-being of patients with a variety of clinical needs within the community. Despite a number of studies reporting benefits, there are some patients that do not see improvements in well-being. Yet, there is limited research investigating the reasons for this. Methods: Using a sequential mixed-methods design the present study sought to understand why some participants (N=312) experienced an increase in well-being and others did not (N=95) after attending an Arts on Prescription intervention based in the South West of England between 2009 and 2016. Results: Quantitative comparisons between the two groups identified little differences, aside from age and baseline well-being (WEMWBS scores), with those that improved being slightly younger, and having lower well-being at the outset compared with those that did not improve. A process model depicting the perceived facilitative and inhibitive factors of attending the programme was developed from the qualitative findings. This model suggests that the social aspect of the course may be implicated in the participants differential outcomes; with those that showed a decrease in well-being reporting difficulties in interacting with others during the intervention. Further, the participants who reported an increase in well-being felt vulnerable to “relapse” when finishing the course due to uncertainties regarding future support and at their ability to maintain their well-being without the provision of the programme. Conclusions: This research suggests a need to promote communication amongst groups in such interventions with the hope that this will provide a more facilitative environment for all participants to benefit. Also, such programmes should consider follow-on options to ensure the participants feel supported and confident in managing their well-being once the course comes to an end. Findings will be pertinent to those commissioning primary care art interventions, ensuring that referral policies and pathways are designed for optimal effectiveness and for potentially tailoring social prescribing programmes to suit the participants specific needs.","PeriodicalId":72966,"journal":{"name":"European journal for person centered healthcare","volume":"2 1","pages":"530-539"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75988097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tristan Price, R. Baines, M. Marshall, Niall Cameron, M. Bryce, J. Archer
Rationale, aims and objectives: Learning from significant medical events is a core component of quality and safety practice in healthcare worldwide and is a key component of efforts to increase the person-centeredness of clinical service. However, the evidence that analysis of, or reflection on, significant events has a positive impact on subsequent doctor performance is relatively sparse. This review aims to explore the impact of undertaking significant event analysis on medical performance. Method: A systematic review using the following databases: PubMed, EMBASE, Medline, PsycINFO and the Cochrane Collaboration Library. Citation searches were carried out on included studies. Impact was defined according to a modified adaptation of the Kirkpatrick evaluation model. The selection and quality appraisal of studies was conducted by 2 reviewers, independently and blinded. Data were extracted from included studies related to: study type and location, population, methodology and intervention type. Results: Six papers met the inclusion criteria for this review. Of these: one reported learners’ reaction (Kirkpatrick 1); 2 reported modified attitudes (modified Kirkpatrick 2a); 5 reported the acquisition of knowledge (modified Kirkpatrick level 2b) and all 6 identified reported changes in behaviour (modified Kirkpatrick level 3a). Significant event analysis is reported to identify gaps in knowledge, improve teamwork and communication and encourage reflection leading to improvements in practice. Time, resources and team dynamics were identified as factors that impacted on the effectiveness of significant event analysis. Significant event analysis may benefit from suspending existing hierarchies during the process itself and external facilitation. Conclusion: There is a lack of high quality evidence within the existing literature to ascertain the effectiveness of significant event analysis in the medical context. Existing studies are largely based on self-reported measures, which may reinforce the importance of the discursive process for practitioners. Future research could be directed at identifying the pedagogical processes that effect changes in performance as a result of engaging in significant event analysis, leading to substantial increase in the person-centeredness of clinical care.
{"title":"Learning from significant medical events: a systematic review","authors":"Tristan Price, R. Baines, M. Marshall, Niall Cameron, M. Bryce, J. Archer","doi":"10.5750/EJPCH.V7I2.1637","DOIUrl":"https://doi.org/10.5750/EJPCH.V7I2.1637","url":null,"abstract":"Rationale, aims and objectives: Learning from significant medical events is a core component of quality and safety practice in healthcare worldwide and is a key component of efforts to increase the person-centeredness of clinical service. However, the evidence that analysis of, or reflection on, significant events has a positive impact on subsequent doctor performance is relatively sparse. This review aims to explore the impact of undertaking significant event analysis on medical performance. Method: A systematic review using the following databases: PubMed, EMBASE, Medline, PsycINFO and the Cochrane Collaboration Library. Citation searches were carried out on included studies. Impact was defined according to a modified adaptation of the Kirkpatrick evaluation model. The selection and quality appraisal of studies was conducted by 2 reviewers, independently and blinded. Data were extracted from included studies related to: study type and location, population, methodology and intervention type. Results: Six papers met the inclusion criteria for this review. Of these: one reported learners’ reaction (Kirkpatrick 1); 2 reported modified attitudes (modified Kirkpatrick 2a); 5 reported the acquisition of knowledge (modified Kirkpatrick level 2b) and all 6 identified reported changes in behaviour (modified Kirkpatrick level 3a). Significant event analysis is reported to identify gaps in knowledge, improve teamwork and communication and encourage reflection leading to improvements in practice. Time, resources and team dynamics were identified as factors that impacted on the effectiveness of significant event analysis. Significant event analysis may benefit from suspending existing hierarchies during the process itself and external facilitation. Conclusion: There is a lack of high quality evidence within the existing literature to ascertain the effectiveness of significant event analysis in the medical context. Existing studies are largely based on self-reported measures, which may reinforce the importance of the discursive process for practitioners. Future research could be directed at identifying the pedagogical processes that effect changes in performance as a result of engaging in significant event analysis, leading to substantial increase in the person-centeredness of clinical care.","PeriodicalId":72966,"journal":{"name":"European journal for person centered healthcare","volume":"416 1","pages":"228-237"},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87111432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: This study explores the perspectives of both patients with an ethnic minority background and health professionals on missed appointments in a Danish migrant health clinic. Study design: A clinical case study involving patients and health professionals. Since the patients represent a vulnerable group, who are difficult to reach, health professionals were included in the study. This aids the study by making sure to cover different perspectives. Methods: Individual semi-structured interviews were conducted. In total, 6 patients and 6 health professionals, comprising one social worker, 2 nurses and 3 doctors, agreed to participate. Transcripts were analysed using Interpretative Phenomenological Analysis. Results: Patients, who missed appointments, appeared to have poor mental health, limited financial resources, transport expenses and language barriers. Patients’ physical and mental health affects their everyday lives and hinders them from keeping their scheduled appointments. Conclusion: These results may help health professionals provide a more person-centered care and to improve approaches and interventions aimed at reducing the number of patients missing appointments. This study identified barriers to keeping appointments and emphasizes that the reasons behind missed appointments at the clinic are complex and require a creative and holistic approach from health professionals.
{"title":"Why does the patient not show up? Clinical case studies in a Danish migrant health clinic","authors":"L. Abdulkadir, I. Mottelson, D. Nielsen","doi":"10.5750/EJPCH.V7I2.1672","DOIUrl":"https://doi.org/10.5750/EJPCH.V7I2.1672","url":null,"abstract":"Purpose: This study explores the perspectives of both patients with an ethnic minority background and health professionals on missed appointments in a Danish migrant health clinic. Study design: A clinical case study involving patients and health professionals. Since the patients represent a vulnerable group, who are difficult to reach, health professionals were included in the study. This aids the study by making sure to cover different perspectives. Methods: Individual semi-structured interviews were conducted. In total, 6 patients and 6 health professionals, comprising one social worker, 2 nurses and 3 doctors, agreed to participate. Transcripts were analysed using Interpretative Phenomenological Analysis. Results: Patients, who missed appointments, appeared to have poor mental health, limited financial resources, transport expenses and language barriers. Patients’ physical and mental health affects their everyday lives and hinders them from keeping their scheduled appointments. Conclusion: These results may help health professionals provide a more person-centered care and to improve approaches and interventions aimed at reducing the number of patients missing appointments. This study identified barriers to keeping appointments and emphasizes that the reasons behind missed appointments at the clinic are complex and require a creative and holistic approach from health professionals.","PeriodicalId":72966,"journal":{"name":"European journal for person centered healthcare","volume":"41 1","pages":"316-324"},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75284058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Horoko Takaki, I. Ieiri, Hidetoshi Shibuta, D. Onozuka, A. Hagihara
Rationale, aims and objectives: A relationship between physicians and patients with serious headache has an influence on healthcare utilization. However, there is insufficient evidence related to healthcare utilization among headache patients with comorbid depression. The present study aimed to compare and identify barriers to healthcare utilization among US adults with serious headache and comorbid depression. Methods: We used data from the 2012 National Health Interview Survey, comprising a sample of 34,525 adults. Multivariate logistic regression models were used and adjusted by sociodemographics and several chronic conditions. Results: Adults with serious headache and comorbid depression had significantly more healthcare visits, hospital emergency visits and trouble finding a healthcare provider than adults with neither condition. Regarding adults with a usual place of care, adults with both conditions had significantly higher odds of changing their usual place of care than adults with neither condition. Further, barriers to healthcare utilization in adults with both conditions, without a usual place of care, were significantly associated with the following aspects: “Doesn’t like /trust /believe in doctors” and “Too expensive /no insurance /cost.” Conclusions: The results of this study indicate that headache patients with comorbid depression had more difficulties with physicians compared to adults with neither condition. The barriers to healthcare utilization were not convenience, but distrust of doctors or the cost of healthcare. Developments of the relationship between physicians and headache patients with comorbid depression could enable the patients to have regular healthcare visits, improve their health outcomes and reduce the burden of suffering, important indices as part of the person-centered healthcare approach.
{"title":"Healthcare utilization among adults with serious headache and comorbid depression in the US population","authors":"Horoko Takaki, I. Ieiri, Hidetoshi Shibuta, D. Onozuka, A. Hagihara","doi":"10.5750/EJPCH.V7I2.1639","DOIUrl":"https://doi.org/10.5750/EJPCH.V7I2.1639","url":null,"abstract":"Rationale, aims and objectives: A relationship between physicians and patients with serious headache has an influence on healthcare utilization. However, there is insufficient evidence related to healthcare utilization among headache patients with comorbid depression. The present study aimed to compare and identify barriers to healthcare utilization among US adults with serious headache and comorbid depression. Methods: We used data from the 2012 National Health Interview Survey, comprising a sample of 34,525 adults. Multivariate logistic regression models were used and adjusted by sociodemographics and several chronic conditions. Results: Adults with serious headache and comorbid depression had significantly more healthcare visits, hospital emergency visits and trouble finding a healthcare provider than adults with neither condition. Regarding adults with a usual place of care, adults with both conditions had significantly higher odds of changing their usual place of care than adults with neither condition. Further, barriers to healthcare utilization in adults with both conditions, without a usual place of care, were significantly associated with the following aspects: “Doesn’t like /trust /believe in doctors” and “Too expensive /no insurance /cost.” Conclusions: The results of this study indicate that headache patients with comorbid depression had more difficulties with physicians compared to adults with neither condition. The barriers to healthcare utilization were not convenience, but distrust of doctors or the cost of healthcare. Developments of the relationship between physicians and headache patients with comorbid depression could enable the patients to have regular healthcare visits, improve their health outcomes and reduce the burden of suffering, important indices as part of the person-centered healthcare approach.","PeriodicalId":72966,"journal":{"name":"European journal for person centered healthcare","volume":"45 1","pages":"243-253"},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88179957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
a Senior Research Advisor, Stanford Medicine X Program, Stanford University School of Medicine, Stanford, CA, USA b Research Assistant, Stanford Medicine X Program, Stanford University School of Medicine, Stanford, CA, USA c Research Assistant, Stanford Medicine X Program, Stanford University School of Medicine, Stanford, CA, USA d Professor, Department of Anesthesiology, Perioperative and Pain Medicine; Executive Director, Stanford Medicine X Program & Director, Stanford Anesthesia Informatics and Media Lab, Stanford, CA, USA
a .美国加利福尼亚州斯坦福大学医学院斯坦福医学X项目高级研究顾问b .美国加利福尼亚州斯坦福大学医学院斯坦福医学X项目研究助理c .美国加利福尼亚州斯坦福大学医学院斯坦福医学X项目研究助理d .麻醉学、围手术期和疼痛医学系教授;斯坦福医学X项目执行主任兼斯坦福麻醉信息学和媒体实验室主任，美国加州斯坦福
{"title":"Co-Production, Co-Education and Person-Centered Healthcare Practice","authors":"A. Price, Urvi Gupta, Ujwal Srivastava, Larry Chu","doi":"10.5750/EJPCH.V7I2.1748","DOIUrl":"https://doi.org/10.5750/EJPCH.V7I2.1748","url":null,"abstract":"a Senior Research Advisor, Stanford Medicine X Program, Stanford University School of Medicine, Stanford, CA, USA b Research Assistant, Stanford Medicine X Program, Stanford University School of Medicine, Stanford, CA, USA c Research Assistant, Stanford Medicine X Program, Stanford University School of Medicine, Stanford, CA, USA d Professor, Department of Anesthesiology, Perioperative and Pain Medicine; Executive Director, Stanford Medicine X Program & Director, Stanford Anesthesia Informatics and Media Lab, Stanford, CA, USA","PeriodicalId":72966,"journal":{"name":"European journal for person centered healthcare","volume":"29 1","pages":"219-222"},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90810577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Elmqvist, Jeanette Lindahl, Paula Bergman, Birgitta Ekeberg, I. Svensson
Background: It is well recognized that long waiting times at Emergency Departments (ED) influence patient satisfaction rates. Evidence suggests that changes in the design of healthcare environments can improve patient care when these changes include the provision of nature and music elements in different ways. Aim: To explore how patients, relatives and staff perceive a slideshow with nature pictures and music in the emergency department waiting room. Method: A descriptive survey design including a slideshow with nature pictures and music shown in the waiting room. Questionnaires were distributed to patients and relatives (n=94) as well as to the staff (n=76), analysed with descriptive statistics and content analysis. Results: A majority (67%) of the participants thought that the slideshow contributed to a positive environment in the waiting room. Content analysis of 254 comments demonstrated it to be experienced as relaxing and calming. There is, however, room for improvement regarding quality, length and variation of the slideshow. Conclusion: An organized wait time with different alternative activities including nature elements and music in the waiting environment may have positive impacts. The challenge lies in creating a supportive design, which supports the three separate groups and their needs for control in terms of freedom of choice and variation.
{"title":"Benefits of a slideshow with nature pictures and music in the emergency department waiting room - a pilot study","authors":"C. Elmqvist, Jeanette Lindahl, Paula Bergman, Birgitta Ekeberg, I. Svensson","doi":"10.5750/EJPCH.V7I2.1682","DOIUrl":"https://doi.org/10.5750/EJPCH.V7I2.1682","url":null,"abstract":"Background: It is well recognized that long waiting times at Emergency Departments (ED) influence patient satisfaction rates. Evidence suggests that changes in the design of healthcare environments can improve patient care when these changes include the provision of nature and music elements in different ways. Aim: To explore how patients, relatives and staff perceive a slideshow with nature pictures and music in the emergency department waiting room. Method: A descriptive survey design including a slideshow with nature pictures and music shown in the waiting room. Questionnaires were distributed to patients and relatives (n=94) as well as to the staff (n=76), analysed with descriptive statistics and content analysis. Results: A majority (67%) of the participants thought that the slideshow contributed to a positive environment in the waiting room. Content analysis of 254 comments demonstrated it to be experienced as relaxing and calming. There is, however, room for improvement regarding quality, length and variation of the slideshow. Conclusion: An organized wait time with different alternative activities including nature elements and music in the waiting environment may have positive impacts. The challenge lies in creating a supportive design, which supports the three separate groups and their needs for control in terms of freedom of choice and variation.","PeriodicalId":72966,"journal":{"name":"European journal for person centered healthcare","volume":"26 1","pages":"344-350"},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82165840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background, aims and objectives: The present study aimed to investigate the perceived barriers in access to healthcare among the population with hearing loss in Greece (deaf and hard of hearing). Methods: The sample consisted of 86 deaf and 54 hard of hearing adults that live in Attica. Core demographic data and information regarding participants’ access to health services was gathered using a self-completed structured questionnaire. Results: The 93% of deaf and the 77.8% of hard of hearing struggled to navigate the healthcare system and reported barriers in access to health services and unmet needs (p=0.009). There were difficulties in booking an appointment (p<0.001), lack of appropriate administrative means (e.g., booking via email) so as to book a visit without the mediation of another person (p<0.001), long waiting time (p=0.01) and intention to manage very consciously the limited benefits (regarding the free interpretation hours) that are entitlements (p<0.001). Regarding engagement with healthcare providers, poor adherence to medical instructions was revealed, as the 41.2% of deaf and the 60% of the hard of hearing did not adhere to the recommended medication, making a self-assessment that they did not need to do so (p=0.02). This minority population faces disproportionate difficulties in access to healthcare and therefore significant interventions to tackle these barriers need to be considered in order to create the person-centeredness of their care.
{"title":"Inequalities in access to health services faced by the population with hearing loss in Greece: a cross-sectional study","authors":"Dialechti Tsimpida, P. Galanis, D. Kaitelidou","doi":"10.5750/EJPCH.V7I2.1721","DOIUrl":"https://doi.org/10.5750/EJPCH.V7I2.1721","url":null,"abstract":"Background, aims and objectives: The present study aimed to investigate the perceived barriers in access to healthcare among the population with hearing loss in Greece (deaf and hard of hearing). Methods: The sample consisted of 86 deaf and 54 hard of hearing adults that live in Attica. Core demographic data and information regarding participants’ access to health services was gathered using a self-completed structured questionnaire. Results: The 93% of deaf and the 77.8% of hard of hearing struggled to navigate the healthcare system and reported barriers in access to health services and unmet needs (p=0.009). There were difficulties in booking an appointment (p<0.001), lack of appropriate administrative means (e.g., booking via email) so as to book a visit without the mediation of another person (p<0.001), long waiting time (p=0.01) and intention to manage very consciously the limited benefits (regarding the free interpretation hours) that are entitlements (p<0.001). Regarding engagement with healthcare providers, poor adherence to medical instructions was revealed, as the 41.2% of deaf and the 60% of the hard of hearing did not adhere to the recommended medication, making a self-assessment that they did not need to do so (p=0.02). This minority population faces disproportionate difficulties in access to healthcare and therefore significant interventions to tackle these barriers need to be considered in order to create the person-centeredness of their care.","PeriodicalId":72966,"journal":{"name":"European journal for person centered healthcare","volume":"30 1","pages":"386-394"},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79327227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Vang, A. H. Andersen, O. Hendricks, G. Handberg, Z. Illés, K. Roessler
Objective: The objective of the current study was to investigate the contemporary concept of patient-centeredness compared to the original notion of patient-centeredness in practice and politics. Methods: This is accomplished through a concept-analysis of patient-centeredness on the basis of the original publications by Michael and Enid Balint as well as policy documents regarding patient-centeredness in the Danish healthcare system in the period 2014-2016. A case study was conducted on patient-centeredness in the Danish healthcare system using interviews with doctor and patient before and after the consultation and video observation of the consultation. The interviews and observations were transcribed and analysed using a framework derived from Pragmatics of Human Communication. Results: Substantial differences between the original patient-centeredness and contemporary patient-centeredness were identified. Both types of patient-centeredness were practised. However, contemporary patient-centeredness was only realised in the patient performing the doctor’s role-obligations of prescribing and monitoring treatment, resulting in a breakdown of the doctor-patient relationship that was only restored by the doctor’s practice of original patient-centeredness. Conclusion: Contemporary patient-centeredness over-emphasises content aspects of the doctor-patient encounter in favour of relationship aspects. Original patient-centeredness emphasises the relationship aspects of the encounter and support addressing existential concerns that might have important implications for treatment.
{"title":"Patient-centeredness in the 21st century: Instrumentalisation or improved communication?","authors":"M. Vang, A. H. Andersen, O. Hendricks, G. Handberg, Z. Illés, K. Roessler","doi":"10.5750/EJPCH.V7I2.1673","DOIUrl":"https://doi.org/10.5750/EJPCH.V7I2.1673","url":null,"abstract":"Objective: The objective of the current study was to investigate the contemporary concept of patient-centeredness compared to the original notion of patient-centeredness in practice and politics. Methods: This is accomplished through a concept-analysis of patient-centeredness on the basis of the original publications by Michael and Enid Balint as well as policy documents regarding patient-centeredness in the Danish healthcare system in the period 2014-2016. A case study was conducted on patient-centeredness in the Danish healthcare system using interviews with doctor and patient before and after the consultation and video observation of the consultation. The interviews and observations were transcribed and analysed using a framework derived from Pragmatics of Human Communication. Results: Substantial differences between the original patient-centeredness and contemporary patient-centeredness were identified. Both types of patient-centeredness were practised. However, contemporary patient-centeredness was only realised in the patient performing the doctor’s role-obligations of prescribing and monitoring treatment, resulting in a breakdown of the doctor-patient relationship that was only restored by the doctor’s practice of original patient-centeredness. Conclusion: Contemporary patient-centeredness over-emphasises content aspects of the doctor-patient encounter in favour of relationship aspects. Original patient-centeredness emphasises the relationship aspects of the encounter and support addressing existential concerns that might have important implications for treatment.","PeriodicalId":72966,"journal":{"name":"European journal for person centered healthcare","volume":"1 1","pages":"325-333"},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87799476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Burn out accross persons and systems: comparative studies on vulnerability and resilience","authors":"K. Stoyanova, D. Stoyanov","doi":"10.5750/EJPCH.V7I2.1744","DOIUrl":"https://doi.org/10.5750/EJPCH.V7I2.1744","url":null,"abstract":"","PeriodicalId":72966,"journal":{"name":"European journal for person centered healthcare","volume":"56 1","pages":"410-411"},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90770941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：