B. F. Al-Mifgai, J. Sharit, A. Onar-Thomas, S. Asfour
Objective: This study examined the ability for adults from a developing country to use a personal health record (PHR) to perform health-management tasks. The effects of gender differences as well as differences in attitudes about using the internet to manage health prior to and after exposure to the PHR were also investigated.Methods: A simulation of a PHR based on a well-established U.S. online patient portal was designed and tailored for this particular study population. Two hundred and three adults with a mean age of 40.9 years were recruited from various areas in Saudi Arabia and asked to perform seven common health-management tasks of varying degrees of difficulty. Their electronic health literacy and health numeracy, as well as their attitudes about using online health systems for managing their health prior to and following their interaction with the PHR, were assessed using questionnaires.Results: After controlling for education, perceived health status, and comfort using the internet, electronic health literacy and health numeracy were still found to be significant predictors of participants’ task performance, but only for the more challenging health-management tasks. No important differences based on gender were found. Exposure to the PHR significantly increased the acceptability of using the internet for managing their health.Conclusions: The change in attitudes following interaction with the PHR suggests that many adults in this society could benefit from these electronic health systems, including females who, due to cultural considerations, may desire greater control in managing their health. However, the importance of electronic health literacy and health numeracy suggests the need for designs that minimize the impact of these factors for successful performance of health-management tasks.
{"title":"Examining attitudes toward and ability to interact with an online personal health record: A case study in Saudi Arabia","authors":"B. F. Al-Mifgai, J. Sharit, A. Onar-Thomas, S. Asfour","doi":"10.5430/IJH.V6N1P1","DOIUrl":"https://doi.org/10.5430/IJH.V6N1P1","url":null,"abstract":"Objective: This study examined the ability for adults from a developing country to use a personal health record (PHR) to perform health-management tasks. The effects of gender differences as well as differences in attitudes about using the internet to manage health prior to and after exposure to the PHR were also investigated.Methods: A simulation of a PHR based on a well-established U.S. online patient portal was designed and tailored for this particular study population. Two hundred and three adults with a mean age of 40.9 years were recruited from various areas in Saudi Arabia and asked to perform seven common health-management tasks of varying degrees of difficulty. Their electronic health literacy and health numeracy, as well as their attitudes about using online health systems for managing their health prior to and following their interaction with the PHR, were assessed using questionnaires.Results: After controlling for education, perceived health status, and comfort using the internet, electronic health literacy and health numeracy were still found to be significant predictors of participants’ task performance, but only for the more challenging health-management tasks. No important differences based on gender were found. Exposure to the PHR significantly increased the acceptability of using the internet for managing their health.Conclusions: The change in attitudes following interaction with the PHR suggests that many adults in this society could benefit from these electronic health systems, including females who, due to cultural considerations, may desire greater control in managing their health. However, the importance of electronic health literacy and health numeracy suggests the need for designs that minimize the impact of these factors for successful performance of health-management tasks.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73375747","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: High blood pressure is currently affecting 103 million people in the United States and is a major risk factor for cardiovascular disease, stroke, and heart failure. The American Heart Association (AHA) launched Check. Change. Control. Program (CCC program). The program is an evidence-based hypertension management program that utilizes blood pressure self-monitoring to empower patients/participants to take ownership of their cardiovascular health.Project: Following the Partnership Model for Service Learning, Miami University and The AHA propose implementing the “Serve and Learn How to Check, Change, and Control: A Community-Based Intervention to Improve Blood Pressure Control” to improve the BP of a diverse group of residents in Middletown and Hamilton cities in Ohio.Participants: Fifteen nursing students served as volunteer health mentors. Each nursing student recruited five community members over the age of 18 and checked their blood pressure two times every month for four months. 80 community membered were recruited and joined the project for four months.Results: At the end of the program, more than half of the participants (n = 41) had blood pressure improvement (decrease in systolic or/a diastolic). On third of Tier 1/ HYPERTENSION participants (n = 10) have moved from uncontrolled (> or = to 130/80) to controlled (< or = to 129/79) based on comparing the participants’ 1st blood pressure reading to their last.Conclusions: The extremely positive effects of this project are an eye-opening on the need of applying the program on a larger scale. To apply this program on a larger scale, partnerships with community organizations such as community health and wellness centers are needed. These partnerships will provide quality access to healthcare. The students will be able to meet participants where they are in their communities in a safe, vibrant, open and welcoming centers.
{"title":"Nursing students serve and learn how to check, change, and control blood pressure in the local community","authors":"Eyad Musallam, Amanda N Changet","doi":"10.5430/IJH.V5N2P62","DOIUrl":"https://doi.org/10.5430/IJH.V5N2P62","url":null,"abstract":"Background: High blood pressure is currently affecting 103 million people in the United States and is a major risk factor for cardiovascular disease, stroke, and heart failure. The American Heart Association (AHA) launched Check. Change. Control. Program (CCC program). The program is an evidence-based hypertension management program that utilizes blood pressure self-monitoring to empower patients/participants to take ownership of their cardiovascular health.Project: Following the Partnership Model for Service Learning, Miami University and The AHA propose implementing the “Serve and Learn How to Check, Change, and Control: A Community-Based Intervention to Improve Blood Pressure Control” to improve the BP of a diverse group of residents in Middletown and Hamilton cities in Ohio.Participants: Fifteen nursing students served as volunteer health mentors. Each nursing student recruited five community members over the age of 18 and checked their blood pressure two times every month for four months. 80 community membered were recruited and joined the project for four months.Results: At the end of the program, more than half of the participants (n = 41) had blood pressure improvement (decrease in systolic or/a diastolic). On third of Tier 1/ HYPERTENSION participants (n = 10) have moved from uncontrolled (> or = to 130/80) to controlled (< or = to 129/79) based on comparing the participants’ 1st blood pressure reading to their last.Conclusions: The extremely positive effects of this project are an eye-opening on the need of applying the program on a larger scale. To apply this program on a larger scale, partnerships with community organizations such as community health and wellness centers are needed. These partnerships will provide quality access to healthcare. The students will be able to meet participants where they are in their communities in a safe, vibrant, open and welcoming centers.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77131374","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}
The structural constellation, applicable to education, was used to test the hypothesis that postgraduate students do not have difficulties to be evaluated. To test this hypothesis, the WHOQOL-BREF questionnaire (World Health Organization Quality of Life Instrument abbreviated) was applied to 36 students of the Postgraduate Program in Agronomy of the Universidade Federal de Uberlândia, on the first and last days of the school semester of 2017. Half of these students spontaneously accepted to participate in the constellation and responded to two systemic questionnaires, one at the beginning and the other at the end of the semester. During the first month of classes, the 18 students were submitted to the nine squares of the structural constellation technique. At the beginning of the semester, the two groups presented the same quality of life profile. After the constellation, the desire of the 18 students to increase their comfort during the assessments was achieved. In addition, the constellation improved the quality of life of the treated group, regarding the psychological and the environment domains. Another important aspect was the positive correlation between the desire of greater comfort during the assessments and the social domain, before the constellation, and with the psychological domain after the constellation. Knowing that the two groups were initially equal and that the quality of life was improved for the group that participated in the constellation, we hope that this type of therapy can help students to look at the evaluation process with more self-confidence and tranquility, which may improve their academic performance.
{"title":"How does it feel to be evaluated? A systemic look at postgraduate students","authors":"D. Carvalho, M. Ranal, C. Mendes-Rodrigues","doi":"10.5430/IJH.V5N2P49","DOIUrl":"https://doi.org/10.5430/IJH.V5N2P49","url":null,"abstract":"The structural constellation, applicable to education, was used to test the hypothesis that postgraduate students do not have difficulties to be evaluated. To test this hypothesis, the WHOQOL-BREF questionnaire (World Health Organization Quality of Life Instrument abbreviated) was applied to 36 students of the Postgraduate Program in Agronomy of the Universidade Federal de Uberlândia, on the first and last days of the school semester of 2017. Half of these students spontaneously accepted to participate in the constellation and responded to two systemic questionnaires, one at the beginning and the other at the end of the semester. During the first month of classes, the 18 students were submitted to the nine squares of the structural constellation technique. At the beginning of the semester, the two groups presented the same quality of life profile. After the constellation, the desire of the 18 students to increase their comfort during the assessments was achieved. In addition, the constellation improved the quality of life of the treated group, regarding the psychological and the environment domains. Another important aspect was the positive correlation between the desire of greater comfort during the assessments and the social domain, before the constellation, and with the psychological domain after the constellation. Knowing that the two groups were initially equal and that the quality of life was improved for the group that participated in the constellation, we hope that this type of therapy can help students to look at the evaluation process with more self-confidence and tranquility, which may improve their academic performance.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87255025","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}
Often times interprofessional health care team members presume individuals with aphasia due to stroke lack the capacity to participate in and contribute to decision-making. This belief may hinder the client’s participation in the decision-making process. Two main impairments resulting from stroke, that impede communication and limit capacity for autonomous participation in decision-making, are aphasia and cognitive deficits. Reduced capacity for communication in the client with stroke, combined with complexity in health team dialogue and process, may further diminish the individual’s ability to engage in autonomous decision-making. Health team members need to use reliable methods and devise new methods which can more accurately measure capacity for autonomous decision-making. This review elucidates the necessity for (1) autonomous decision-making in persons with aphasia, (2) assessing the need for capacity, (3) concrete ways to assess cognitive function, and (4) interprofessional team decision-making.
{"title":"An interprofessional approach to promoting autonomous decision-making for clients who are aphasic","authors":"Jessie Johnson, S. Westgate, L. Oliver","doi":"10.5430/IJH.V5N2P44","DOIUrl":"https://doi.org/10.5430/IJH.V5N2P44","url":null,"abstract":"Often times interprofessional health care team members presume individuals with aphasia due to stroke lack the capacity to participate in and contribute to decision-making. This belief may hinder the client’s participation in the decision-making process. Two main impairments resulting from stroke, that impede communication and limit capacity for autonomous participation in decision-making, are aphasia and cognitive deficits. Reduced capacity for communication in the client with stroke, combined with complexity in health team dialogue and process, may further diminish the individual’s ability to engage in autonomous decision-making. Health team members need to use reliable methods and devise new methods which can more accurately measure capacity for autonomous decision-making. This review elucidates the necessity for (1) autonomous decision-making in persons with aphasia, (2) assessing the need for capacity, (3) concrete ways to assess cognitive function, and (4) interprofessional team decision-making.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79174140","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. Molla, T. Bacon-Baguley, Susan DeVuyst-Miller, W. Wonderlin, E. Benedetti
Background/Objective: Implementation of the Affordable Care Act (ACA) in the US has given opportunity to obtain health insurance for thousands who were previously uninsured. Many believe that the ACA is an improvement over previous insurance, while others view it as making health care more costly. The purpose of this study was to survey individuals regarding knowledge and perceptions of the ACA.Methods: Researchers in public health, physician assistant studies, pharmacy and medical education developed a survey to assess the impact of the ACA. The survey included demographic questions and statements which assessed ACA support, and perspectives of the ACA’s impact on pharmaceutical and medical coverage and personal out of pocket costs. A convenience sampling was used to recruit participants at a public venue in an urban setting.Results: Demographics of the 179 surveyed include: median age 31 years; 84% Caucasian; 37% married; 58% completed a minimum of four years of college; and 45% with income exceeding $50,000. 13 (7%) were uninsured before the ACA, and 8 (4%) after. 130 (73%) had prescription coverage before the ACA with 107 (60%) reported no change in coverage, 22 (12%) better coverage, and 21 (12%) less coverage after the ACA. An association for ACA support was found based on political affiliation with more Democrats than Republicans supporting the ACA (p < .001). 71 (71%) who support the ACA, reported insurance did not improved after the ACA.Conclusions: These findings identify that in a sample of upper middle class individuals, a majority support the ACA despite a lack of improvement in their own insurance indicating that personal sacrifice for the general population is occurring.
{"title":"Public perception of the United States’ Affordable Care Act","authors":"A. Molla, T. Bacon-Baguley, Susan DeVuyst-Miller, W. Wonderlin, E. Benedetti","doi":"10.5430/IJH.V5N2P28","DOIUrl":"https://doi.org/10.5430/IJH.V5N2P28","url":null,"abstract":"Background/Objective: Implementation of the Affordable Care Act (ACA) in the US has given opportunity to obtain health insurance for thousands who were previously uninsured. Many believe that the ACA is an improvement over previous insurance, while others view it as making health care more costly. The purpose of this study was to survey individuals regarding knowledge and perceptions of the ACA.Methods: Researchers in public health, physician assistant studies, pharmacy and medical education developed a survey to assess the impact of the ACA. The survey included demographic questions and statements which assessed ACA support, and perspectives of the ACA’s impact on pharmaceutical and medical coverage and personal out of pocket costs. A convenience sampling was used to recruit participants at a public venue in an urban setting.Results: Demographics of the 179 surveyed include: median age 31 years; 84% Caucasian; 37% married; 58% completed a minimum of four years of college; and 45% with income exceeding $50,000. 13 (7%) were uninsured before the ACA, and 8 (4%) after. 130 (73%) had prescription coverage before the ACA with 107 (60%) reported no change in coverage, 22 (12%) better coverage, and 21 (12%) less coverage after the ACA. An association for ACA support was found based on political affiliation with more Democrats than Republicans supporting the ACA (p < .001). 71 (71%) who support the ACA, reported insurance did not improved after the ACA.Conclusions: These findings identify that in a sample of upper middle class individuals, a majority support the ACA despite a lack of improvement in their own insurance indicating that personal sacrifice for the general population is occurring.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79723708","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}
Gabrielle Pratte, T. Schuster, J. Berbari, C. Camden
Background: Best practices in Developmental Coordination Disorder (DCD) recommend building parental capacities to enhance children’s functioning but few outcome measures are available to document the impact of such interventions. The Parent Knowledge and Skills Questionnaire (PKSQ) is a valid instrument currently only available in English evaluating parental perception of their ability to manage their child, understand DCD’s impact and use knowledge about DCD. The aim of the study was to translate the PKSQ in French and assess the factor structure consistency between the French and English versions.Methods: PKSQ was translated in French using a back-translation method. Parents of children with DCD were recruited in collaboration with the DCD association and rehabilitation centers. Parents completed the questionnaire online (n = 99). Confirmatory factor analysis was conducted based on the questionnaire response data and estimated item-domain correlations were compared with the English version.Results: All items of the original PKSQ were culturally appropriate in the Quebec French context and were thus included in the final version (n = 22). The French questionnaire version showed overall good consistency with the English version. The frequency of statistically inferior item-domain correlations was consistent with the expected rate of 5% under the no difference assumption (3/22, 95% confidence interval: 3% to 35%). Items showed moderate to large correlations with their underlying construct (estimated item-domain correlations between 0.45-0.91).Conclusions: Results suggest the French version of the PKSQ is consistent with the 3-factor structure of the English version, and may now be used to evaluate interventions based on DCD best practices.
{"title":"Parental management of developmental coordination disorder: Validation of a French translation of the Parental Knowledge and Skills Questionnaire","authors":"Gabrielle Pratte, T. Schuster, J. Berbari, C. Camden","doi":"10.5430/IJH.V5N2P36","DOIUrl":"https://doi.org/10.5430/IJH.V5N2P36","url":null,"abstract":"Background: Best practices in Developmental Coordination Disorder (DCD) recommend building parental capacities to enhance children’s functioning but few outcome measures are available to document the impact of such interventions. The Parent Knowledge and Skills Questionnaire (PKSQ) is a valid instrument currently only available in English evaluating parental perception of their ability to manage their child, understand DCD’s impact and use knowledge about DCD. The aim of the study was to translate the PKSQ in French and assess the factor structure consistency between the French and English versions.Methods: PKSQ was translated in French using a back-translation method. Parents of children with DCD were recruited in collaboration with the DCD association and rehabilitation centers. Parents completed the questionnaire online (n = 99). Confirmatory factor analysis was conducted based on the questionnaire response data and estimated item-domain correlations were compared with the English version.Results: All items of the original PKSQ were culturally appropriate in the Quebec French context and were thus included in the final version (n = 22). The French questionnaire version showed overall good consistency with the English version. The frequency of statistically inferior item-domain correlations was consistent with the expected rate of 5% under the no difference assumption (3/22, 95% confidence interval: 3% to 35%). Items showed moderate to large correlations with their underlying construct (estimated item-domain correlations between 0.45-0.91).Conclusions: Results suggest the French version of the PKSQ is consistent with the 3-factor structure of the English version, and may now be used to evaluate interventions based on DCD best practices.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87355734","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}
Rachel B. Nowlin, Sarah K. Brown, Jessica R. Ingram, Amanda R. Drake, Johan R. Smith
Background: Previous research indicates traumatic exposure and posttraumatic stress disorder (PTSD) occur at a higher rate in people with severe mental illness (SMI) than in the general population, and co-occurring PTSD symptoms can worsen outcomes for patients with SMI.Objective: This study assessed the presence and influence of PTSD symptoms in individuals with SMI in an inpatient psychiatric setting, and rates of PTSD diagnoses in this population.Methods: Retrospective analysis of demographic information and behavioral health outcomes, using a representative sample of adult and geriatric inpatient psychiatric patients (N = 4,126).Results: This study found elevated PTSD symptoms in over 65% of patients, and significant positive correlations between PTSD symptomatology and behavioral and emotional dysfunction. This study also explored differences in patients with PTSD symptoms who did and did not receive a PTSD diagnosis, finding associations for admission severity, race, and gender.Conclusions: Traumatization and PTSD symptoms were prevalent in psychiatric inpatient settings, and had an impact on behavioral health outcomes. Recommendations include the use of PTSD screening in behavioral healthcare admission processes, and the furtherance of trauma-informed care for inpatient psychiatric patients with SMI, due to the volume of traumatization and PTSD symptoms in the population.
{"title":"Presence and influence of trauma in inpatient psychiatric care","authors":"Rachel B. Nowlin, Sarah K. Brown, Jessica R. Ingram, Amanda R. Drake, Johan R. Smith","doi":"10.5430/IJH.V5N2P21","DOIUrl":"https://doi.org/10.5430/IJH.V5N2P21","url":null,"abstract":"Background: Previous research indicates traumatic exposure and posttraumatic stress disorder (PTSD) occur at a higher rate in people with severe mental illness (SMI) than in the general population, and co-occurring PTSD symptoms can worsen outcomes for patients with SMI.Objective: This study assessed the presence and influence of PTSD symptoms in individuals with SMI in an inpatient psychiatric setting, and rates of PTSD diagnoses in this population.Methods: Retrospective analysis of demographic information and behavioral health outcomes, using a representative sample of adult and geriatric inpatient psychiatric patients (N = 4,126).Results: This study found elevated PTSD symptoms in over 65% of patients, and significant positive correlations between PTSD symptomatology and behavioral and emotional dysfunction. This study also explored differences in patients with PTSD symptoms who did and did not receive a PTSD diagnosis, finding associations for admission severity, race, and gender.Conclusions: Traumatization and PTSD symptoms were prevalent in psychiatric inpatient settings, and had an impact on behavioral health outcomes. Recommendations include the use of PTSD screening in behavioral healthcare admission processes, and the furtherance of trauma-informed care for inpatient psychiatric patients with SMI, due to the volume of traumatization and PTSD symptoms in the population.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81354800","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}
Objective: The study provides a comprehensive assessment of readmission risks of patients by nonelderly adult and elderly age groups admitted with different chronic condition types and multiple chronic condition (MCC) burdens.Methods: The study examines the all-cause readmission risks of hospitalized adult patients in 18-64 and 65 and above age groups admitted for any cause having three mutually exclusive chronic condition types: Ambulatory Care Sensitive Condition (ACSC); non-ACSC, and non-chronic. Using 2009 hospital discharge data from HCUP-SID of AHRQ, linked to the contextual and provider data from HRSA, a multilevel logistic regression model is applied on data pooled over 5 states adjusting for patient, hospital, and community characteristics.Results: The hospitalized elderly with chronic ACSC has higher risks of readmissions than those without, or relative to the nonelderly with chronic ACSC. However, nonelderly adults faced steeper increases in risks of readmissions than the elderly in response to increased MCC burden, irrespective of types of chronic conditions.Conclusions: A lower number of ACSCs is associated with higher reduction in the risks of readmission in the elderly than in the nonelderly adults. Management of chronic conditions in general is associated with reduced readmission risks across all age groups, more so for nonelderly adults.
{"title":"Chronic illness and hospital readmission rate by adult age groups","authors":"Jayasree Basu","doi":"10.5430/IJH.V5N2P12","DOIUrl":"https://doi.org/10.5430/IJH.V5N2P12","url":null,"abstract":"Objective: The study provides a comprehensive assessment of readmission risks of patients by nonelderly adult and elderly age groups admitted with different chronic condition types and multiple chronic condition (MCC) burdens.Methods: The study examines the all-cause readmission risks of hospitalized adult patients in 18-64 and 65 and above age groups admitted for any cause having three mutually exclusive chronic condition types: Ambulatory Care Sensitive Condition (ACSC); non-ACSC, and non-chronic. Using 2009 hospital discharge data from HCUP-SID of AHRQ, linked to the contextual and provider data from HRSA, a multilevel logistic regression model is applied on data pooled over 5 states adjusting for patient, hospital, and community characteristics.Results: The hospitalized elderly with chronic ACSC has higher risks of readmissions than those without, or relative to the nonelderly with chronic ACSC. However, nonelderly adults faced steeper increases in risks of readmissions than the elderly in response to increased MCC burden, irrespective of types of chronic conditions.Conclusions: A lower number of ACSCs is associated with higher reduction in the risks of readmission in the elderly than in the nonelderly adults. Management of chronic conditions in general is associated with reduced readmission risks across all age groups, more so for nonelderly adults.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83232733","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}
Objective: Before the beginning of medicalisation in Australia during the 1950s, childbirth was the sole domain of women. Contemporary birthing practices have posed a more medicalised technological environment on women resulting in both good and bad outcomes. In recent surveys, 45.5% of Australian women reported experiencing birth as traumatic; with nearly 20% experiencing postnatal depression. While there have been some studies on women’s trauma experiencing a caesarean section, minimal research has been completed into perceived traumatic experiences related to normal vaginal births.Methods: This study utilized a qualitative methodology to explore psychological and emotional impact of women’s experiences with perceived traumatic normal births. The research used an in-depth semi-structured interview and analysed the data within the phenomenological paradigm. The data analysis revealed nine themes: I was determined to birth naturally; Not telling me what they were doing; I just had to force her to be born; it was really horrific; I know that is just what the system is like. . . they’re hospital midwives. . . they’re medical; I didn’t feel connected to them; She stood up for me; After the birth, just horrible; I deserve a better birth.Results: Although the rates are unclear, these findings highlight that some women suffer trauma from their experience of a normal vaginal birth. The perceived causes include: midwives not always being with women and supporting physiological childbirth; women not being fully informed; power asymmetries and hegemony inside the birthing room; and a fetocentric model of care that left women feeling disrespected, disempowered and objectified.Conclusions: The findings indicate a need for midwives to truly be with women and provide continuity of care, as well as supporting the physiological process of childbirth, medical and midwifery professional education on trauma awareness following birth, a rethinking of antenatal education programs to include coping strategies and greater midwifery support in the hospital post-natal stay.
{"title":"Women’s experiences of perceived traumatic vaginal birth in Australian maternity settings","authors":"A. Yates, L. Jones, Merv Jackson","doi":"10.5430/IJH.V5N2P1","DOIUrl":"https://doi.org/10.5430/IJH.V5N2P1","url":null,"abstract":"Objective: Before the beginning of medicalisation in Australia during the 1950s, childbirth was the sole domain of women. Contemporary birthing practices have posed a more medicalised technological environment on women resulting in both good and bad outcomes. In recent surveys, 45.5% of Australian women reported experiencing birth as traumatic; with nearly 20% experiencing postnatal depression. While there have been some studies on women’s trauma experiencing a caesarean section, minimal research has been completed into perceived traumatic experiences related to normal vaginal births.Methods: This study utilized a qualitative methodology to explore psychological and emotional impact of women’s experiences with perceived traumatic normal births. The research used an in-depth semi-structured interview and analysed the data within the phenomenological paradigm. The data analysis revealed nine themes: I was determined to birth naturally; Not telling me what they were doing; I just had to force her to be born; it was really horrific; I know that is just what the system is like. . . they’re hospital midwives. . . they’re medical; I didn’t feel connected to them; She stood up for me; After the birth, just horrible; I deserve a better birth.Results: Although the rates are unclear, these findings highlight that some women suffer trauma from their experience of a normal vaginal birth. The perceived causes include: midwives not always being with women and supporting physiological childbirth; women not being fully informed; power asymmetries and hegemony inside the birthing room; and a fetocentric model of care that left women feeling disrespected, disempowered and objectified.Conclusions: The findings indicate a need for midwives to truly be with women and provide continuity of care, as well as supporting the physiological process of childbirth, medical and midwifery professional education on trauma awareness following birth, a rethinking of antenatal education programs to include coping strategies and greater midwifery support in the hospital post-natal stay.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":"129 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90712924","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}
With rising healthcare costs, payers are transforming the way they pay healthcare providers. Currently, there is much interest in value-based financing and accountable care models. However, finance transformation in healthcare goes beyond changing funding models. The way funds flow to providers and how patients share healthcare costs also need to be transformed to ensure an overall sustainable value-based financing system. A structured model of finance transformation in healthcare is proposed in this article supported by evidential review, which discusses several fundamental and critical factors affecting finance transformation and explores some strategies that could help sustain the new financing models. Hopefully, this model can serve as a useful guide to healthcare systems embarking on finance transformation for long term cost sustainability.
{"title":"Finance transformation for healthcare: A structured model for planning and action","authors":"Harold Tan, L. Juan","doi":"10.5430/IJH.V5N1P42","DOIUrl":"https://doi.org/10.5430/IJH.V5N1P42","url":null,"abstract":"With rising healthcare costs, payers are transforming the way they pay healthcare providers. Currently, there is much interest in value-based financing and accountable care models. However, finance transformation in healthcare goes beyond changing funding models. The way funds flow to providers and how patients share healthcare costs also need to be transformed to ensure an overall sustainable value-based financing system. A structured model of finance transformation in healthcare is proposed in this article supported by evidential review, which discusses several fundamental and critical factors affecting finance transformation and explores some strategies that could help sustain the new financing models. Hopefully, this model can serve as a useful guide to healthcare systems embarking on finance transformation for long term cost sustainability.","PeriodicalId":73454,"journal":{"name":"International journal of healthcare","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81362766","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}
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