WorldWideScience

Sample records for bk060035 patient health

  1. Health Encounters with Minority Patients

    Directory of Open Access Journals (Sweden)

    Ragnhild Ihle

    2014-12-01

    Full Text Available During recent decades there has been an increasing claim for patient participation and shared decision-making in health services across the Western world. Focus on participation recasts the relationship between healthcare providers and their patients. Professionals are compelled to acquaint themselves with new worldviews, new ways of understanding illness and disease, and to communicate with patients with language, religion and cultural backgrounds increasingly different from their own. Contested concepts such as communication, tolerance, participation and shared decision-making emerge, as do claims about non-participation, oppressive practice and muting of patients. In this article we look into how the paternalistic tenets of intercultural communication, tolerance and the culture of medicine intersect in such ways that empowerment and shared decision-making in health can be constrained. Modern day health concerns such as lifelong disabilities or chronic illness have multiple faces, and there is no one agreed-upon approach to assessment, treatment or non-treatment. Patients and providers have to engage in communication to detect enablers and constraints, bodily and socially. If communication is envisioned as a one-way delivery of knowledge or prescriptions, or a difference in culture is magnified to a degree that other characteristics fade away, the patient risks oppression, muting, and poor healthcare. We argue in favour of appropriating a critical perspective on interaction in healthcare and intercultural communication, and in favour for interpreting face-to-face interaction as situated social practice. A situated social practice compels those present to communicate to create an agreed-upon situational definition, and to enter into a recuperative dialogue where patients too may exercise agency and present themselves as empowered.

  2. Bone health in cancer patients

    DEFF Research Database (Denmark)

    Coleman, R; Body, J J; Aapro, M;

    2014-01-01

    cancer for many patients resulting in a major reduction in skeletal complications, reduced bone pain and improved quality of life. Secondly, many of the treatments we use to treat cancer patients have effects on reproductive hormones, which are critical for the maintenance of normal bone remodelling...... in the metastatic processes required for cancer dissemination, and there are emerging data showing that, at least in some clinical situations, the use of bone-targeted treatments can reduce metastasis to bone and has potential impact on patient survival.......There are three distinct areas of cancer management that make bone health in cancer patients of increasing clinical importance. First, bone metastases are common in many solid tumours, notably those arising from the breast, prostate and lung, as well as multiple myeloma, and may cause major...

  3. Patient moderator interaction in online health communities.

    Science.gov (United States)

    Huh, Jina; McDonald, David W; Hartzler, Andrea; Pratt, Wanda

    2013-01-01

    An increasing number of people visit online health communities to share experiences and seek health information. Although studies have enumerated reasons for patients' visits to online communities for health information from peers, we know little about how patients gain health information from the moderators in these communities. We qualitatively analyze 480 patient and moderator posts from six communities to understand how moderators fulfill patients' information needs. Our findings show that patients use the community as an integral part of their health management practices. Based on our results, we suggest enhancements to moderated online health communities for their unique role to support patient care.

  4. Involving patients with E-health

    DEFF Research Database (Denmark)

    Nielsen, Karen Dam

    2015-01-01

    With e-health technologies, patients are invited as co-producers of data and information. The invitation sparks new expectations, yet often results in disappointments. With persistent ambitions to involve patients by means of e-health, it seems crucial to gain a better understanding of the nature...

  5. Oral health in patients with liver cirrhosis

    DEFF Research Database (Denmark)

    Ladegaard Grønkjær, Lea; Vilstrup, Hendrik

    2015-01-01

    Objective: The aim of this study was to describe the oral care habits and self-perceived oral health in patients with liver cirrhosis, as well as to evaluate the impact of oral health on well-being and the relation to nutritional status. Participants and methods: From October 2012 to May 2013, we...... carried out a prospective study on patients with liver cirrhosis. Questions on oral care habits and self-perceived oral health were answered, and the Oral Health Impact Profile questionnaire (OHIP-14) provided information on oral conditions. The findings were compared with The Danish Institute for Health...... Services Research report on the Danish population’s dental status. Results: One hundred and seven patients participated. Their oral care habits and self-perceived oral health were poorer than the Danish population; the patients had fewer teeth (on average 19 vs. 26, P=0.0001), attended the dentist less...

  6. Moving towards health oriented patient education (HOPE).

    Science.gov (United States)

    Glanville, I K

    2000-01-01

    The economics of prevention supports reimbursement of nurse practitioners for patient education. The role has undergone historical change, shifting from imparting disease-oriented health education (DOPE) toward empowering patients to use their own resources to the fullest to attain health. Nurse practitioners are well suited to provide care that facilitates behavior change and health-oriented patient education (HOPE). Essentials for effective patient education include use of an open communication style, written instructions, and the address of barriers. Adult literacy and reader-friendliness must be considered when assembling written materials. PMID:12119971

  7. Oral health in patients with liver cirrhosis

    DEFF Research Database (Denmark)

    Ladegaard Grønkjær, Lea; Vilstrup, Hendrik

    2015-01-01

    Objective: The aim of this study was to describe the oral care habits and self-perceived oral health in patients with liver cirrhosis, as well as to evaluate the impact of oral health on well-being and the relation to nutritional status. Participants and methods: From October 2012 to May 2013, we...... carried out a prospective study on patients with liver cirrhosis. Questions on oral care habits and self-perceived oral health were answered, and the Oral Health Impact Profile questionnaire (OHIP-14) provided information on oral conditions. The findings were compared with The Danish Institute for Health......’ nutritional risk score (P=0.01). Conclusion: Our results showed that cirrhosis patients cared less for oral health than the background population. Their resulting problems may be contributing factors to their nutritional risk and decreased well-being. Oral health problems may thus have adverse prognostic...

  8. Designing online health services for patients

    OpenAIRE

    Crotty, Bradley H; Slack, Warner V

    2016-01-01

    Patients are increasingly interacting with their healthcare system through online health services, such as patient portals and telehealth programs. Recently, Shabrabani and Mizrachi provided data outlining factors that are most important for users or potential users of these online services. The authors conclude convincingly that while online health services have great potential to be helpful to their users, they could be better designed. As patients and their families play an increasingly ac...

  9. Patient satisfaction with transgender health services.

    Science.gov (United States)

    Bockting, W; Robinson, B; Benner, A; Scheltema, K

    2004-01-01

    Measuring patient satisfaction (i.e., patients' subjective evaluation of health care services received) is increasingly important in assessing health care outcomes because of the current emphasis on greater partnership between providers (therapist, doctor, staff) and consumers (patients) in health care. In care of transgender persons, achieving good patient satisfaction is particularly challenging given the primary role mental health professionals play as arbiters of who has access to sex reassignment and when such candidates are ready. Dependence on a mental health professional in this "gate-keeping" role is perceived by some members of the transgender community as unnecessarily pathologizing. This study compared satisfaction ratings of 180 transgender and 837 other sexual health patients with psychotherapeutic, psychiatric, and sexual medicine services provided at a university-based sexual health clinic. Five consecutive surveys conducted during 1993-2002 showed high patient satisfaction. We found few significant differences between transgender and other sexual health patients, except that in 1995, transgender patients had higher satisfaction on their perceived ability to handle the problems that originally had led them to therapy. Survey results helped target areas in need of improvement (e.g., friendliness and courtesy of staff, handling of phone calls), and efforts by the providers to improve services resulted in significant increases in patient satisfaction. These findings put individual complaints in perspective and showed that despite the challenges inherent in providing transgender care good satisfaction can be achieved. We encourage providers to implement quality assurance and improvement procedures to give patients the opportunity to provide feedback and have a voice in shaping their own health care. PMID:15205065

  10. Involving patients with E-health

    DEFF Research Database (Denmark)

    Nielsen, Karen Dam

    2015-01-01

    With e-health technologies, patients are invited as co-producers of data and information. The invitation sparks new expectations, yet often results in disappointments. With persistent ambitions to involve patients by means of e-health, it seems crucial to gain a better understanding of the nature......, sources and workings of the expectations that come with being invited. I analyse the use of an e-health system for ICD-patients, focusing on how patients sought to serve as information providers. Continuing STS-research on invisible work in technology use, I show how using the system involved complex work...... that understanding the dialogic dynamics and ‘overflows’ of information filtration work can help unpack the challenges of facilitating (patient) participation with e-health and other filtration devices....

  11. Oral Health in Psychiatric Patients

    Directory of Open Access Journals (Sweden)

    Ozlem Gurbuz

    2011-12-01

    Full Text Available Although oral health is a major determinant of general health and quality of life, it has a low priority in the context of mental illness. Chronic mental illness and its treatment carry inherent risks for significant oral diseases. Both the disease itself and its various pharmacologic management modalities lead to a range of oral complications and side effects, with caries, periodontal disease and xerostomia being encountered most frequently. Older age, female gender, length of hospitalization, duration of mental illness, psychiatric diagnosis are the most discussed predictors for adverse dental outcomes in the reviewed studies. Poor oral hygiene, higher intake of carbonates, smoking, poor perception of oral health self-needs, length of psychiatric disorder, length of psychotropic treatment, and less access to dental care pose at high risk for poor oral health among this population. This article emphasizes the importance of preventive dentistry programs to improve dental healthcare psychiatric chronic inpatients and the signifance of bridging dental health education to psychiatric rehabilitation programs. In this review, general information concerning the oral manifestations of mental illness, effect of medication of mental illness on oral health, the factors affecting oral health among this special population have been provided.

  12. Addressing health literacy in patient decision aids

    OpenAIRE

    McCaffery, K; Holmes-Rovner, M.; S. Smith; Rovner, D.; Nutbeam, Don; Clayman, M.L.; Kelly-Blake, K.; Wolf, M.(University of Notre Dame, Notre Dame, USA); Stacey, S

    2013-01-01

    Background Effective use of a patient decision aid (PtDA) can be affected by the user’s health literacy and the PtDA’s characteristics. Systematic reviews of the relevant literature can guide PtDA developers to attend to the health literacy needs of patients. The reviews reported here aimed to assess: 1. a) the effects of health literacy / numeracy on selected decision-making outcomes, and b) the effects of interventions designed to mitigate the influence of lower health literacy on decision-...

  13. Patient involvement in Danish health care

    DEFF Research Database (Denmark)

    Vrangbaek, Karsten

    2015-01-01

    for analysis of patient involvement in health care. This framework is used to analyze key governance features of patient involvement in Denmark based on previous research papers and reports describing patient involvement in Danish health care. FINDINGS: Patient involvement is important in Denmark...... be identified when pursuing the strategies at the same time. RESEARCH LIMITATIONS/IMPLICATIONS: Because of the chosen research approach, the research results may lack generalizability. Therefore, researchers are encouraged to test the proposed framework further. PRACTICAL IMPLICATIONS: The paper includes...... implications for the development of patient involvement in health care. ORIGINALITY/VALUE: This paper fulfills a need to study different types of patient involvement and to develop a theoretical framework for characterizing and analyzing such involvement strategies....

  14. Oral Health in Psychiatric Patients

    OpenAIRE

    Ozlem Gurbuz; Kursat Altinbas; Erhan Kurt

    2011-01-01

    Although oral health is a major determinant of general health and quality of life, it has a low priority in the context of mental illness. Chronic mental illness and its treatment carry inherent risks for significant oral diseases. Both the disease itself and its various pharmacologic management modalities lead to a range of oral complications and side effects, with caries, periodontal disease and xerostomia being encountered most frequently. Older age, female gender, length of hospitalizatio...

  15. Designing online health services for patients.

    Science.gov (United States)

    Crotty, Bradley H; Slack, Warner V

    2016-01-01

    Patients are increasingly interacting with their healthcare system through online health services, such as patient portals and telehealth programs. Recently, Shabrabani and Mizrachi provided data outlining factors that are most important for users or potential users of these online services. The authors conclude convincingly that while online health services have great potential to be helpful to their users, they could be better designed. As patients and their families play an increasingly active role in their health care, online health services should be made easier for them to use and better suited to their health-related needs. Further, the online services should be more welcoming to people of all literacy levels and from all socioeconomic backgrounds. PMID:27307985

  16. Improving Health Outcomes for Low Health Literacy Heart Failure Patients.

    Science.gov (United States)

    Friel, Catherine J

    2016-09-01

    According to the National Assessment of Adult Literacy (2003), only 12% of U.S. adults have a proficient level of health literacy, with adults 65 years and older more likely to have a below basic or a basic health literacy level. An estimated 5.8 million individuals in the United States have heart failure (HF) and it is one of the most common reasons for those aged 65 and over to be hospitalized. Many patients with HF are at risk for poor health outcomes due to low health literacy. This article reviews the literature with regard to the effectiveness of methods used to address low health literacy among HF patients and describes a pilot study implemented by a home care agency in the northeast to address high HF readmission rates. PMID:27580282

  17. Health Technology Assessment and patient safety

    OpenAIRE

    Andrew Mulcahy; Tom Walley

    2005-01-01

    Health Technology Assessment (HTA) is a process used to evaluate the clinical effectiveness and costeffectiveness of health technologies by a systematic review of clinical, economic, and utilization research.

    Despite widespread investment in patient safety technologies in the U.K., U.S., and elsewhere, little HTA has been done to establish the clinical or cost-effectiveness of these technologies. The HTA and patient safety literature suggests there are four categori...

  18. Health utilities of hypertensive patients in Vietnam

    NARCIS (Netherlands)

    Nguyen, T.P.; Postma, M.J.; Veninga, Catharina

    2015-01-01

    Objectives: With a lack of an essential evidence on utilities to support cost-effectiveness analysis of hypertension management in Vietnam, we aimed to gather data on health utilities for hypertensive patients and identify predictors of utility. Methods: Hypertensive patients, from 40 to 80 years ol

  19. Mental Health Issues and Special Care Patients.

    Science.gov (United States)

    Clark, David B

    2016-07-01

    Mental illness is a major health issue in the world today, yet often remains misunderstood, unrecognized, and undertreated. Patients suffering from severe psychiatric disorders generally display poor oral health, often as a consequence of both lifestyle and avoidant-type behaviors that become exacerbated by their illness. Individuals with severe mental illness display a greater incidence of oral disease compared with a similar demographic not dealing with these particular disorders. Efforts to enhance the oral health of these vulnerable patients will play a significant role in the overall rebuilding of their self-esteem and contribute positively to their journey toward stability and recovery. PMID:27264850

  20. Smartphone Applications for Patients' Health and Fitness.

    Science.gov (United States)

    Higgins, John P

    2016-01-01

    Healthcare providers are often looking for ways to objectively monitor and improve their patients' health and fitness, especially in between patient visits. Some insurance companies are using applications data as incentives to improve health and lower premiums. As more and more people start to use smartphones, they may provide a tool to help improve a patient's health and fitness. Specifically, fitness applications or "apps" on smartphones are programs that use data collected from a smartphone's inbuilt tools, such as the Global Positioning System, accelerometer, microphone, speaker, and camera, to measure health and fitness parameters. The apps then analyze these data and summarize them, as well as devise individualized plans based on users' goals, provide frequent feedback, personalized coaching, and additional motivation by allowing milestones to be shared on social media. This article introduces evidence that apps can better help patients reach their health and fitness goals. It then discusses what features to look for in an app, followed by an overview of popular health and fitness apps. Last, patient scenarios with app recommendations, limitations of apps, and future research are discussed.

  1. Evaluating a Sexual Health Patient Education Resource.

    Science.gov (United States)

    Matzo, Marianne; Troup, Sandi; Hijjazi, Kamal; Ferrell, Betty

    2015-01-01

    This article shares the findings of an evaluation of a patient teaching resource for sexual health entitled Everything Nobody Tells You About Cancer Treatment and Your Sex Life: From A to Z, which was accomplished through systematic conceptualization, construction, and evaluation with women diagnosed with breast or gynecologic cancer. This resource, which has evolved from patient-focused research and has been tested in the clinical setting, can be used in patient education and support. Oncology professionals are committed to addressing quality-of-life concerns for patients across the trajectory of illness. Sexuality is a key concern for patients and impacts relationships and overall quality of life. Through careful assessment, patient education, and support, clinicians can ensure that sexuality is respected as an essential part of patient-centered care.

  2. MedlinePlus Connect: Linking Patient Portals and Electronic Health Records to Health Information

    Science.gov (United States)

    ... Patient portals, patient health record (PHR) systems, and electronic health record (EHR) systems can use MedlinePlus Connect to provide health information for patients, families, and healthcare providers using standard ...

  3. Mental health of patients with lung cancer

    OpenAIRE

    Τogas Κ.; Alexias G.

    2016-01-01

    Background: Lung cancer is a very common type of cancer. The psychological reactions of these patients haven't been studied yet. Aim: The examination of the mental health of lung cancer patients. Methods: A bibliographical review of relevant articles was conducted at the electronic data bases of Pubmed, Pcych Info and Scholar Google by key-words. The quest included researches and reviews which have been published in Greek and English language between 1990- 2013. Results: Lung canc...

  4. Health Technology Assessment and patient safety

    Directory of Open Access Journals (Sweden)

    Andrew Mulcahy

    2005-12-01

    Full Text Available

    Health Technology Assessment (HTA is a process used to evaluate the clinical effectiveness and costeffectiveness of health technologies by a systematic review of clinical, economic, and utilization research.

    Despite widespread investment in patient safety technologies in the U.K., U.S., and elsewhere, little HTA has been done to establish the clinical or cost-effectiveness of these technologies. The HTA and patient safety literature suggests there are four categories of patient safety HTA, including HTA for existing safety technologies, underutilized safety technologies, emerging safety technologies, as well as safety aspects of technologies with a non-safety primary purpose.

    Recent HTA and other research, including a 2002 evidencebased evaluation of patient safety technologies from the U.S. Agency for Health Research and Quality, provide an important foundation for a more comprehensive approach to patient safety HTA. However, HTA programs must address prioritization, methodology, and dissemination challenges introduced by patient safety technologies before significant progress can Te made.

  5. Patient preference for genders of health professionals.

    NARCIS (Netherlands)

    Kerssens, J.J.; Bensing, J.M.; Andela, M.G.

    1997-01-01

    Preferences for physicians' gender is an obvious and well documented example of considerations of patients' attitudes. But research carried out in this field is rather limited to the domain of family medicine. This article describes preferences for 13 different health professions: surgeons, neurolog

  6. Patient preference for genders of health professionals.

    OpenAIRE

    Kerssens, J. J.; BENSING, J; Andela, M.G.

    1997-01-01

    Preferences for physicians' gender is an obvious and well documented example of considerations of patients' attitudes. But research carried out in this field is rather limited to the domain of family medicine. This article describes preferences for 13 different health professions: surgeons, neurologists, anaesthetists, internists, general practitioners, psychiatrists, psychologists, social workers, hospital and district nurses, home helps, gynaecologists and midwives. Our investigation also c...

  7. Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome

    DEFF Research Database (Denmark)

    Storgaard, Filip Holst; Pedersen, Christina Gravgaard; Jensen, Majbritt Lykke;

    Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome.......Physiotherapy improves patient reported shoulder function and health status in patients with subacromial impingement syndrome....

  8. Health innovation for patient safety improvement

    Directory of Open Access Journals (Sweden)

    Renukha Sellappans

    2013-01-01

    Full Text Available Medication error has been identified as a major factor affecting patient safety. Many innovative efforts such as Computerised Physician Order Entry (CPOE, a Pharmacy Information System, automated dispensing machines and Point of Administration Systems have been carried out with the aim of improving medication safety. However, areas remain that require urgent attention. One main area will be the lack of continuity of care due to the breakdown of communication between multiple healthcare providers. Solutions may include consideration of “health smart cards” that carry vital patient medical information in the form of a “credit card” or use of the Malaysian identification card. However, costs and technical aspects associated with the implementation of this health smart card will be a significant barrier. Security and confidentiality, on the other hand, are expected to be of primary concern to patients. Challenges associated with the implementation of a health smart card might include physician buy-in for use in his or her everyday practice. Training and technical support should also be available to ensure the smooth implementation of this system. Despite these challenges, implementation of a health smart card moves us closer to seamless care in our country, thereby increasing the productivity and quality of healthcare.

  9. Health Service Utilization and Poor Health Reporting in Asthma Patients

    Science.gov (United States)

    Behr, Joshua G.; Diaz, Rafael; Akpinar-Elci, Muge

    2016-01-01

    The management and treatment of adult asthma has been associated with utilization of health services. Objectives: First, to investigate the likelihood of health service utilization, including primary care, emergency department, and hospital stays, among persons diagnosed with an asthma condition relative to those that do not have an asthma condition. Second, to examine the likelihood of poor physical health among asthma respondents relative to those that do not have an asthma condition. Third, to demonstrate that these relationships vary with frequency of utilization. Fourth, to discuss the magnitude of differences in frequent utilization between asthma and non-asthma respondents. Data Source: Data is derived from a random, stratified sampling of Hampton Roads adults, 18 years and older (n = 1678). Study Design: Study participants are interviewed to identify asthma diagnosis, access to primary care, frequency of emergency department utilization, hospital admissions, and days of poor physical health. Odds-ratios establish relationships with the covariates on the outcome variable. Findings: Those with asthma are found more likely (OR 1.50, 95% CI 1.05–2.15) to report poor physical health relative to non-asthma study participants. Further, asthma respondents are found more likely (OR 4.23, 95% CI 1.56–11.69) to frequently utilize primary care that may be associated with the management of the condition and are also more likely to utilize treatment services, such as the emergency department (OR 1.87, 95% CI 1.32–2.65) and hospitalization (OR 2.21, 95% CI 1.39–3.50), associated with acute and episodic care. Further, it is a novel finding that these likelihoods increase with frequency of utilization for emergency department visits and hospital stays. Conclusion: Continuity in care and better management of the diseases may result in less demand for emergency department services and hospitalization. Health care systems need to recognize that asthma patients are

  10. The patient health questionnaire-9: validation among patients with glaucoma.

    Directory of Open Access Journals (Sweden)

    Vijaya K Gothwal

    Full Text Available BACKGROUND: Depression and anxiety are two common normal responses to a chronic disease such as glaucoma. This study analysed the measurement properties of the depression screening instrument - Patient Health Questionnaire-9 (PHQ-9 using Rasch analysis to determine if it can be used as a measure. METHODS: In this hospital-based cross-sectional study, the PHQ-9 was administered to primary glaucoma adults attending a glaucoma clinic of a tertiary eye care centre, South India. All patients underwent a comprehensive clinical evaluation. Patient demographics and sub-type of glaucoma were abstracted from the medical record. Rasch analysis was used to investigate the following properties of the PHQ-9: behaviour of the response categories, measurement precision (assessed using person separation reliability, PSR; minimum recommended value 0.80, unidimensionality (assessed using item fit [0.7-1.3] and principal components analysis of residuals, and targeting. RESULTS: 198 patients (mean age ± standard deviation  = 59.83±12.34 years; 67% male were included. The native PHQ-9 did not fit the Rasch model. The response categories showed disordered thresholds which became ordered after category reorganization. Measurement precision was below acceptable limits (0.62 and targeting was sub-optimal (-1.27 logits. Four items misfit that were deleted iteratively following which a set of five items fit the Rasch model. However measurement precision failed to improve and targeting worsened further (-1.62 logits. CONCLUSIONS: The PHQ-9, in its present form, provides suboptimal assessment of depression in patients with glaucoma in India. Therefore, there is a need to develop a new depression instrument for our glaucoma population. A superior strategy would be to use the item bank for depression but this will also need to be validated in glaucoma patients before deciding its utility.

  11. 77 FR 11120 - Patient Safety Organizations: Voluntary Relinquishment From UAB Health System Patient Safety...

    Science.gov (United States)

    2012-02-24

    ... mission and primary activity is to conduct activities to improve patient safety and the quality of health... Relinquishment From UAB Health System Patient Safety Organization AGENCY: Agency for Healthcare Research and... relinquishment from the UAB Health System Patient Safety Organization of its status as a Patient......

  12. Health care practitioners and dying patients

    Directory of Open Access Journals (Sweden)

    Panagiotis Pentaris

    2013-06-01

    Full Text Available A full understanding of and a competent approach to dying patients may lead to a more qualitative service delivery, an enhanced quality of life paradigms, and the patients’ wellbeing, all of which remain the ultimate goal of health care practice. The modern world has developed in parallel with secularism and religious diversity. This paper aims to illustrate the secularization process in Britain (with indications of generalized meanings and juxtaposes it with a description of the needs of dying patients regarding the meanings of religion and nonreligion. Although this paper draws on and provides a review of selected theoretical literature, it also addresses a significant challenge: the lack of scientifi c research on the subject. Hence, this paper aims to give an overview of the issues, but not synthesise them. The arguments that are elaborated in the paper are also supported by the author’s current research project in the city of London. The approach here is client oriented, and concerns social and health care. Practitioners ought to become competent, and maintain their competence throughout their professional career. Religious competence seems to have not been at the centre of discussions, regardless of the historical pathway that religious discourse has drawn since the beginnings of humanity. The paper concludes with certain suggestions for future research and inclusive approaches regarding religious matters.

  13. Mental health related Internet use among psychiatric patients

    OpenAIRE

    Kalckreuth, Sophie; Trefflich, Friederike; Rummel-Kluge, Christine

    2015-01-01

    Background: The Internet is of great importance in today’s health sector, as most Internet users utilize online functions for health related purposes. Concerning the mental health care sector, little data exist about the Internet use of psychiatric patients. It is the scope of this current study to analyze the quantity and pattern of Internet usage among mental health patients. Methods: Patients from all services of the Department of Psychiatry at a university hospital were surveyed by comple...

  14. Do patients choose hospitals that improve their health?

    OpenAIRE

    Nils Gutacker; Luigi Siciliani; Giuseppe Moscelli; Hugh Gravelle

    2015-01-01

    Many health care systems collect and disseminate information on provider quality in order to facilitate patient choice and induce competitive behaviour amongst providers. The Department of Health in England has recently mandated the collection of patient-reported health outcome measures (PROMs) for the purpose of performance assessment and consumer information. This is the first attempt to routinely measure the gain in health that patients experience as the result of care and thus offer a mor...

  15. Infertility Patients' Mental Health Problems Often Unaddressed

    Science.gov (United States)

    ... therapy on top of that. To Pasch, the solution is for clinics to have a mental health ... Services, or federal policy. More Health News on: Depression Infertility Recent Health News Related MedlinePlus Health Topics ...

  16. Patients' and health professionals' use of social media in health care: Motives, barriers and expectations

    NARCIS (Netherlands)

    Antheunis, M.L.; Tates, K.; Nieboer, T.E.

    2013-01-01

    OBJECTIVE: To investigate patients' and health professionals' (a) motives and use of social media for health-related reasons, and (b) barriers and expectations for health-related social media use. METHODS: We conducted a descriptive online survey among 139 patients and 153 health care professionals

  17. Rheumatology 2.0 : empowering patients by eHealth

    NARCIS (Netherlands)

    Vaart, van der R.

    2013-01-01

    The role of the Internet in health care is increasing. Especially in the care for patients with chronic diseases eHealth offers many opportunities to empower patients in their own treatment, by providing them online self-management tools. The research in this thesis focusses on the use of eHealth in

  18. Do illness perceptions predict health outcomes in primary care patients?

    DEFF Research Database (Denmark)

    Frostholm, Lisbeth; Oernboel, Eva; Christensen, Kaj S;

    2007-01-01

    patients, (2) patients without chronic disorders presenting physical disease, and (3) patients presenting medically unexplained symptoms (MUS). RESULTS: Negative illness perceptions were associated with poor physical and mental health at baseline. They most strongly predicted changes in health status...... at follow-up for the whole group of patients. Patients presenting with MUS had more negative illness perceptions and lower mental and physical components subscale of the SF-36 scores at all time points. CONCLUSIONS: Patients' perception of a new or recurrent health problem predicts self-reported physical......OBJECTIVE: Little is known about whether illness perceptions affect health outcomes in primary care patients. The aim of this study was to examine if patients' illness perceptions were associated with their self-rated health in a 2-year follow-up period. METHODS: One thousand seven hundred eighty...

  19. Personalized Strategies to Activate and Empower Patients in Health Care and Reduce Health Disparities

    Science.gov (United States)

    Chen, Jie; Mullins, C. Daniel; Novak, Priscilla; Thomas, Stephen B.

    2016-01-01

    Designing culturally sensitive personalized interventions is essential to sustain patients' involvement in their treatment and encourage patients to take an active role in their own health and health care. We consider patient activation and empowerment as a cyclical process defined through patient accumulation of knowledge, confidence, and…

  20. Improving physical health monitoring for patients with chronic mental health problems who receive antipsychotic medications.

    Science.gov (United States)

    Abdallah, Nihad; Conn, Rory; Latif Marini, Abdel

    2016-01-01

    Physical health monitoring is an integral part of caring for patients with mental health problems. It is proven that serious physical health problems are more common among patients with severe mental health illness (SMI), this monitoring can be challenging and there is a need for improvement. The project aimed at improving the physical health monitoring among patients with SMI who are receiving antipsychotic medications. The improvement process focused on ensuring there is a good communication with general practitioners (GPs) as well as patient's education and education of care home staff. GP letters requesting physical health monitoring were updated; care home staff and patients were given more information about the value of regular physical health monitoring. There was an improvement in patients' engagement with the monitoring and the monitoring done by GPs was more adherent to local and national guidelines and was communicated with the mental health service.

  1. Improving physical health monitoring for patients with chronic mental health problems who receive antipsychotic medications

    Science.gov (United States)

    Abdallah, Nihad; Conn, Rory; Latif Marini, Abdel

    2016-01-01

    Physical health monitoring is an integral part of caring for patients with mental health problems. It is proven that serious physical health problems are more common among patients with severe mental health illness (SMI), this monitoring can be challenging and there is a need for improvement. The project aimed at improving the physical health monitoring among patients with SMI who are receiving antipsychotic medications. The improvement process focused on ensuring there is a good communication with general practitioners (GPs) as well as patient's education and education of care home staff. GP letters requesting physical health monitoring were updated; care home staff and patients were given more information about the value of regular physical health monitoring. There was an improvement in patients' engagement with the monitoring and the monitoring done by GPs was more adherent to local and national guidelines and was communicated with the mental health service. PMID:27559474

  2. Sexual health in patients with rheumatoid arthritis: experiences, needs and communication with health care professionals.

    Science.gov (United States)

    Josefsson, Kristina Areskoug; Gard, Gunvor

    2012-06-01

    Pain, fatigue and decreased joint mobility caused by rheumatoid arthritis (RA) often decrease sexual health in RA patients. Regular physiotherapy interventions in patients with RA are often aimed at improving those factors. The aim of the present study was to explore the experiences and views of patients concerning the impact of RA on their sexual health, the possible impact of physiotherapy interventions, and communication in clinical situations. A self-administered questionnaire was sent to patients with RA at two rehabilitation clinics in Sweden. The questionnaire included questions concerning the impact of RA on intimate relationships and sexual function, as well as experiences of physiotherapy and sexual health communication with health professionals. The questionnaire was answered by 63 patients. The majority of the patients thought that pain, stiffness, fatigue and physical capacity were related to sexual health. Communication between health professionals and patients about sexual health was less common, even if the desire for communication about sexual health was higher in this study than in other studies. The authors concluded that physiotherapists need to be aware that pain, fatigue, decreased joint mobility and physical capacity can affect sexual health and that physiotherapy can make a difference in sexual health in patients with RA. The impact of RA on sexual health is rarely discussed by health professionals and RA patients, and needs greater attention.

  3. Health Insurance Status May Affect Cancer Patients' Survival

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_160304.html Health Insurance Status May Affect Cancer Patients' Survival 2 studies highlight disparities in outcomes for uninsured and Medicaid patients To use the sharing features on this ...

  4. Health, function and disability in stroke patients in the community

    Directory of Open Access Journals (Sweden)

    Bárbara P. B. Carvalho-Pinto

    2016-01-01

    Full Text Available ABSTRACT Background Stroke patients commonly have impairments associated with reduction in functionality. Among these impairments, the motor impairments are the most prevalent. The functional profile of these patients living in the community who are users of the primary health-care services in Brazil has not yet been established Objective To describe the functional profile of stroke patients who are users of the primary health-care services in Brazil, looking at one health-care unit in the city of Belo Horizonte, Brazil. Method From medical records and home visits, data were collected regarding health status, assistance received following the stroke, personal and environmental contextual factors, function and disability, organized according to the conceptual framework of the International Classification of Functioning, Disability and Health (ICF. Test and instruments commonly applied in the assessment of stroke patients were used. Results Demographic data from all stroke patients who were users of the health-care unit (n=44, age: 69.23±13.12 years and 67±66.52 months since the stroke participated of this study. Most subjects presented with disabilities, as changes in emotional function, muscle strength, and mobility, risks of falling during functional activities, negative self-perception of quality of life, and perception of the environment factors were perceived as obstacles. The majority of the patients used the health-care unit to renew drug prescriptions, and did not receive any information on stroke from health professionals, even though patients believed it was important for patients to receive information and to provide clarifications. Conclusion Stroke patients who used primary health-care services in Brazil have chronic disabilities and health needs that require continuous health attention from rehabilitation professionals. All of these health needs should be considered by health professionals to provide better management as part of

  5. 76 FR 71345 - Patient Safety Organizations: Voluntary Relinquishment From Child Health Patient Safety...

    Science.gov (United States)

    2011-11-17

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary Relinquishment From Child Health Patient Safety Organization, Inc. AGENCY: Agency for Healthcare Research and... relinquishment from Child Health Patient Safety Organization, Inc. of its status as a Patient Safety...

  6. Creating the Exceptional Patient Experience in One Academic Health System.

    Science.gov (United States)

    Lee, Vivian S; Miller, Thomas; Daniels, Chrissy; Paine, Marilynn; Gresh, Brian; Betz, A Lorris

    2016-03-01

    Whether patient satisfaction scores can act as a catalyst for improving health care is highly debated. Some argue that pursuing patient satisfaction is overemphasized and potentially at odds with providing good care because it leads providers to overtest and overtreat patients and to bend to unreasonable patient demands, all to improve their ratings. Others cite studies showing that high patient satisfaction scores correlate with improved health outcomes. Ideally, assessing patient satisfaction metrics will encourage empathy, communication, trust, and shared decision making in the health care delivery process. From the patient's perspective, sharing such metrics motivates physicians to provide patient-centered care and meets their need for easily accessible information about their providers. In this article, the authors describe a seven-year initiative, which began in 2008, to change the culture of the University of Utah Health Care system to deliver a consistently exceptional patient experience. Five factors affected the health system's ability to provide such care: (1) a lack of good decision-making processes, (2) a lack of accountability, (3) the wrong attitude, (4) a lack of patient focus, and (5) mission conflict. Working groups designed initiatives at all levels of the health system to address these issues. What began as a patient satisfaction initiative evolved into a model for physician engagement, values-based employment practices, enhanced professionalism and communication, reduced variability in performance, and improved alignment of the mission and vision across hospital and faculty group practice teams. PMID:26606723

  7. Group Health Education in Inpatient Rehabilitation: Patients' Role Perceptions

    Science.gov (United States)

    Schöpf, Andrea C.; Ullrich, Antje; Nagl, Michaela; Farin, Erik

    2016-01-01

    Objective: Group health education is an important aspect of medical rehabilitation. While interaction and active involvement are important characteristics of group health education, little is known about patients' understanding of their role in this form of education. This study explored patients' understanding of their role in group health…

  8. The prisoner as patient - a health services satisfaction survey

    Directory of Open Access Journals (Sweden)

    Rustad Åse-Bente

    2009-09-01

    Full Text Available Abstract Background There is evidence for higher morbidity among prison inmates than in the general population. Despite this, patient satisfaction with the prison health services is scarcely investigated. The aim of the present study was to investigate patient satisfaction with prison health services in Norway and to analyze possible patient and service effects. Methods The survey took part in 29 prisons in the southern and central part of Norway, representing 62% of the total prison capacity in Norway. A total of 1,150 prison inmates with prison health services experiences completed a satisfaction questionnaire (90% response rate. The patients' satisfaction was measured on a 12-item index. Multilevel analyses were used to analyze both patient and service characteristics as predictors of satisfaction. Results The study revealed high levels of dissatisfaction with prison health services. There were substantial differences between services, with between-service-variance accounting for 9% of the total variance. Satisfaction was significantly associated with a senior staff member's evaluation of the health services possessing adequate resources and the quality of drug abuse treatment. At the patient level, satisfaction was significantly associated with older age, frequent consultations and better self-perceived health. Conclusion Prison inmates' satisfaction with the health services provided are low compared with patient satisfaction measured in other health areas. The substantial differences observed between services - even when adjusting for several known factors associated with patient satisfaction - indicate a potential for quality improvement.

  9. Patient provider communication about the health effects of obesity

    NARCIS (Netherlands)

    Durant, Nefertiti H.; Bartman, Barbara; Person, Sharina D.; Collins, Felicia; Austin, S. Bryn

    2009-01-01

    Objective: We assessed the influence of race/ethnicity and provider Communication oil overweight and obese patients' perceptions of the damage weight causes to their health. Methods: The-study included 1071 overweight and obese patients who completed the 2002 Community Health Center (CHC) User surve

  10. Improving psychosocial health in hemodialysis patients after a disaster.

    Science.gov (United States)

    Weiner, Sheila; Kutner, Nancy G; Bowles, Tess; Johnstone, Stephanie

    2010-01-01

    Twenty-two social workers implemented a cognitive-behavioral intervention with 69 patients in 22 dialysis units in Louisiana to improve psychosocial health following Hurricanes Katrina and Rita. Pre- and post-intervention questionnaires measured psychosocial status domains (general health status, social functioning, burden of kidney disease, depressed mood, anxiety, and mastery). Participants rated their general health status (p disease [p = .05]).

  11. Contributions of public health to patient compliance.

    Science.gov (United States)

    Rimer, B K; Glanz, K; Lerman, C

    1991-08-01

    This paper discusses the contributions of public health to compliance in five areas: clinical trials, smoking cessation, dietary compliance, breast cancer screening and hypertension control. Public health programs have been based on a number of theoretical foundations, most notably, social learning theory and the health belief model. Social marketing, community organization, and, more recently, consumer information processing models also are important. The strongest public health programs embody an ecological approach, with interventions directed not only at individuals, but also at groups, communities and changing institutional norms. Among the most important contributions of public health interventions are: multiple levels of intervention and evaluation, tailoring to target audiences, use of social support and community organization for behavior change. Together, community health and clinical compliance-enhancing strategies can exert a synergistic impact on health behavior change. PMID:1918439

  12. Health literacy and its influencing factors in Iranian diabetic patients

    OpenAIRE

    Mohammadi, Zahra; Tehrani Banihashemi, Arash; Asgharifard, Homa; Bahramian, Mehran; Baradaran, Hamid Reza; Khamseh, Mohammad E.

    2015-01-01

    Background: Health literacy is the ability to obtain, read, understand and use healthcare information to make appropriate health decisions and follow instructions for treatment. The aim of this study was to identify the effect of various factors on health literacy in patients with diabetes. Methods: 407 patients with diabetes older than 15 years of age were identified from the Diabetes Clinic affiliated to the Institute of Endocrinology and Metabolism (IEM) of Iran University of Medical Scien...

  13. Patients' satisfaction evaluation with the health center of elis province.

    Science.gov (United States)

    Karavida, Angeliki; Stamouli, Maria-Aggeliki; Balis, Charalampos

    2014-01-01

    Patient satisfaction related to the provided health services is a key indicator of the quality of the health sector. The SERVQUAL model was employed as a way of measuring the level of patient satisfaction with the services of the Health Center of Elis Province. Although certain aspects such as "Assurance" and "Empathy" meet the users' needs, improvements like a detailed medical record and an overhaul of the equipment need to be introduced. PMID:25000072

  14. Patients' satisfaction evaluation with the health center of elis province.

    Science.gov (United States)

    Karavida, Angeliki; Stamouli, Maria-Aggeliki; Balis, Charalampos

    2014-01-01

    Patient satisfaction related to the provided health services is a key indicator of the quality of the health sector. The SERVQUAL model was employed as a way of measuring the level of patient satisfaction with the services of the Health Center of Elis Province. Although certain aspects such as "Assurance" and "Empathy" meet the users' needs, improvements like a detailed medical record and an overhaul of the equipment need to be introduced.

  15. High-quality Health Information Provision for Stroke Patients

    Science.gov (United States)

    Du, Hong-Sheng; Ma, Jing-Jian; Li, Mu

    2016-01-01

    Objective: High-quality information provision can allow stroke patients to effectively participate in healthcare decision-making, better manage the stroke, and make a good recovery. In this study, we reviewed information needs of stroke patients, methods for providing information to patients, and considerations needed by the information providers. Data Sources: The literature concerning or including information provision for patients with stroke in English was collected from PubMed published from 1990 to 2015. Study Selection: We included all the relevant articles on information provision for stroke patients in English, with no limitation of study design. Results: Stroke is a major public health concern worldwide. High-quality and effective health information provision plays an essential role in helping patients to actively take part in decision-making and healthcare, and empowering them to effectively self-manage their long-standing chronic conditions. Different methods for providing information to patients have their relative merits and suitability, and as a result, the effective strategies taken by health professionals may include providing high-quality information, meeting patients’ individual needs, using suitable methods in providing information, and maintaining active involvement of patients. Conclusions: It is suggested that to enable stroke patients to access high-quality health information, greater efforts need to be made to ensure patients to receive accurate and current evidence-based information which meets their individual needs. Health professionals should use suitable information delivery methods, and actively involve stroke patients in information provision. PMID:27569241

  16. Seeking health information: what sources do your patients use?

    Science.gov (United States)

    Cutilli, Carolyn Crane

    2010-01-01

    Healthcare professionals believe that it is important for patients to be educated about health for optimal outcomes. For education to occur, healthcare professionals need to know where patients seek information. The concept of health information-seeking behavior (HISB) focuses on how patients obtain information (strategies/actions). Theories/ models are presented to describe how patients obtain information and what they do with information that is available. The most recent HISB research has examined the use of the Internet for health information. Although the Internet is utilized by many individuals, studies show that the most common and trusted source of information is healthcare professionals. Individuals use other sources of health information (e.g., TV, radio, newspaper, magazines, Internet, and family/friends/coworkers) to supplement information provided by healthcare professionals. When and how individuals use supplemental information varies and is associated with many factors such as race, education, income, health literacy, and health status. Utilizing health information also depends on an individual's health orientation. As nurses, we need to utilize knowledge about HISB to assist patients in obtaining health information to optimize health outcomes.

  17. The prisoner as patient - a health services satisfaction survey

    OpenAIRE

    Rustad Åse-Bente; Bjørngaard Johan; Kjelsberg Ellen

    2009-01-01

    Abstract Background There is evidence for higher morbidity among prison inmates than in the general population. Despite this, patient satisfaction with the prison health services is scarcely investigated. The aim of the present study was to investigate patient satisfaction with prison health services in Norway and to analyze possible patient and service effects. Methods The survey took part in 29 prisons in the southern and central part of Norway, representing 62% of the total prison capacity...

  18. Patient and health care professional views and experiences of computer agent-supported health care

    Directory of Open Access Journals (Sweden)

    Ron Neville

    2006-03-01

    Conclusions Patients and HCPs welcomed the introduction of agent technology to the delivery of health care. Widespread use will depend more on the trust patients place in their own GP than on technological issues.

  19. HIV-infected mental health patients: characteristics and comparison with HIV-infected patients from the general population and non-infected mental health patients

    OpenAIRE

    Schadé Annemiek; van Grootheest Gerard; Smit Johannes H

    2013-01-01

    Abstract Objectives HIV-infected patients are at increased risk of developing mental health symptoms, which negatively influence the treatment of the HIV-infection. Mental health problems in HIV-infected patients may affect public health. Psychopathology, including depression and substance abuse, can increase hazardous sexual behaviour and, with it, the chance of spreading HIV. Therefore, it is important to develop an optimal treatment plan for HIV-infected patients with mental health problem...

  20. Skill set or mind set? Associations between health literacy, patient activation and health.

    Directory of Open Access Journals (Sweden)

    Samuel G Smith

    Full Text Available OBJECTIVE: There is ongoing debate on whether health literacy represents a skill-based construct for health self-management, or if it also more broadly captures personal 'activation' or motivation to manage health. This research examines 1 the association between patient activation and health literacy as they are most commonly measured and 2 the independent and combined associations of patient activation and health literacy skills with physical and mental health. METHODS: A secondary analysis of baseline cross-sectional data from the LitCog cohort of older adults was used. Participants (n = 697 were recruited from multiple US-based health centers. During structured face-to-face interviews, participants completed the Test of Functional Health Literacy in Adults (TOFHLA, the Patient Activation Measure (PAM, the SF-36 physical health summary subscale, and Patient Reported Outcomes Measurement Information Service (PROMIS short form subscales for depression and anxiety. RESULTS: The relationship between health literacy and patient activation was weak, but significant (r = 0.11, p<0.01. In models adjusted for participant characteristics, lower health literacy was associated with worse physical health (β = 0.13, p<0.001 and depression (β = -0.16, p<0.001. Lower patient activation was associated with worse physical health (β = 0.19, p<0.001, depression (β = -0.27, p<0.001 and anxiety (β-0.24, p<0.001. CONCLUSIONS: The most common measures of health literacy and patient activation are weakly correlated with each other, but also independently correlated with health outcomes. This suggests health literacy represents a distinct skill-based construct, supporting the Institute of Medicine's definition. Deficits in either construct could be useful targets for behavioral intervention.

  1. Patient privacy, consent, and identity management in health information exchange

    CERN Document Server

    Hosek, Susan D

    2013-01-01

    As a step toward improving its health information technology (IT) interoperability, the Military Health System is seeking to develop a research roadmap to better coordinate health IT research efforts, address IT capability gaps, and reduce programmatic risk for its enterprise projects. This report identifies gaps in research, policy, and practice involving patient privacy, consent, and identity management that need to be addressed to improve the quality and efficiency of care through health information exchange.

  2. Do patient preferences for health information vary by health literacy or numeracy? A qualitative assessment.

    Science.gov (United States)

    Gaglio, Bridget; Glasgow, Russell E; Bull, Sheana S

    2012-01-01

    Seeking health information can be a complicated process for a patient. Patients must know the topic of interest, where to look or ask, how to assess and comprehend, and how to evaluate the credibility and trustworthiness of the sources. In this study, the authors describe preferences of patients with multiple risk factors for cardiovascular disease with varying health literacy and numeracy abilities for receiving health information. Participants were recruited from 2 health care systems. Health literacy and numeracy were assessed and participants completed an orally administered survey consisting of open-ended questions about obtaining health information and preferences for health information. In-depth interviews were conducted with a subset of participants. A diverse sample of 150 individuals (11.3% Latino, 37.3% African American, 44.7% with income less than $15,000/year) participated. Most participants had adequate functional health literacy, while 65% had low numeracy skills. Regardless of health literacy or numeracy ability, participants overwhelmingly preferred to receive health information during a face-to-face conversation with their health care provider. While individuals with adequate functional health literacy identified a variety of health information sources, actions are needed to ensure multiple modalities are available and are in plain, clear language that reinforces patients' understanding and application of information to health behavior.

  3. Patient mobility in European Union: health spas in Ischia, Italy

    NARCIS (Netherlands)

    A.P. den Exter (André)

    2005-01-01

    textabstractIn a new case on patients seeking medical services abroad, the Leichtle case, the European Court of Justice (ECJ) confirmed its previous rulings on patient mobility. According to the Court, patients in the European Union have a (conditional) right to receive health care

  4. Development of the Patient Activation Measure for mental health.

    Science.gov (United States)

    Green, Carla A; Perrin, Nancy A; Polen, Michael R; Leo, Michael C; Hibbard, Judith H; Tusler, Martin

    2010-07-01

    Our objective was to adapt the physical health Patient Activation Measure (PAM) for use among people with mental health conditions (PAM-MH). Data came from three studies among people with chronic mental health conditions and were combined in Rasch analyses. The PAM-MH's psychometric properties equal those of the original 13-item PAM. Test-retest reliability and concurrent validity were good, and the PAM-MH showed sensitivity to change. The PAM-MH appears to be a reliable and valid measure of patient activation among individuals with mental health problems. It appears to have potential for use in assessing change in activation. PMID:19728074

  5. Oral health of patients with severe rheumatic heart disease.

    Science.gov (United States)

    Maharaj, Breminand; Vayej, Ahmed C

    2012-07-01

    In order to determine whether adequate attention is paid to the maintenance of good oral health in patients at risk of developing infective endocarditis, we studied 44 black patients with severe rheumatic heart disease before they had cardiac surgery. Plaque and gingival index scores were calculated and panoramic radiographs were done in all patients. There were 17 males and 27 females (mean age: 30.6 years). The plaque and gingival index scores were classified as poor in 31.8 and 54.6% of patients, respectively. Panoramic radiographic findings included caries in 56.8% of patients, peri-apical pathology in 18.1% and retained roots in 22.7% of patients. This study demonstrates that inadequate attention is paid to the maintenance of good oral health in patients with severe rheumatic heart disease. The oral and dental care of patients at risk of developing infective endocarditis needs to be improved. PMID:22836156

  6. Health Games - Modern Tools for Enhancing Patient Adherence

    Directory of Open Access Journals (Sweden)

    Sameer Bhaskar GOKHALE

    2015-06-01

    Full Text Available Low patient adherence remains a major public health challenge globally and imposes a considerable economic burden on healthcare systems. It is critical to develop an effective intervention to improve patient adherence. Factors such as physician-patient relation, patient's health literacy, attitude, cultural variations, and patient’s involvement in decision making are responsible for improving adherence. Information technology has revolutionized almost all industries including healthcare but its use has not shown its full promise to boost adherence. Recent developments in smart phone market penetration, gamification, and easy to navigate user experience have made it possible for healthcare providers to effectively connect with patients using innovative ways enabled by technology. Leveraging on this fact, healthcare industry should be focusing on development and use of interactive health games. Indication-wise games can be developed in collaboration with physicians, academics, thought leaders and experienced media companies. In summary, gamification mayeffectively be used to improve patient adherence.

  7. Patient education and health outcomes: implications for library service.

    OpenAIRE

    Marshall, J G; Haynes, R B

    1983-01-01

    Many librarians take an active role in patient education, for practical and ethical reasons; however, it is important to examine the effect of such activities on health outcomes. Although the rationale for patient education is that increased knowledge leads to a change in attitude that in turn affects behavior, studies have shown that this is not always true. Furthermore, other studies have shown that patient education programs by themselves have no lasting influence on patient compliance wit...

  8. Health Literacy, Computer Skills and Quality of Patient-Physician Communication in Chinese Patients with Cataract

    OpenAIRE

    Xianchai Lin; Mei Wang; Yajing Zuo; Mingge Li; Xiaofeng Lin; Siping Zhu; Yongxin Zheng; Minbin Yu; Lamoureux, Ecosse L.

    2014-01-01

    PURPOSE: The aim of the study was to assess levels of health literacy and computer skills in Chinese patients with cataract, and their impact on the doctor-patient relationship. METHODS: We undertook a cross-sectional study of cataract patients scheduled for cataract extraction procedures in Guangdong Province, China. Generic health literacy was assessed using 3 established screening questions. Adequate computer skills was determined if patients had used a computer and routinely used search e...

  9. The Danish patient safety experience: the Act on Patient Safety in the Danish Health care system

    DEFF Research Database (Denmark)

    Lundgaard, Mette; Rabøl, Louise; Jensen, Elisabeth Agnete Brøgger;

    2005-01-01

    This paper describes the process that lead to the passing of the Act for Patient Safety in the Danisk health care sytem, the contents of the act and how the act is used in the Danish health care system. The act obligates frontline health care personnel to report adverse events, hospital owners...... to act on the reports and the National Board of Health to commuicate the learning nationally. The act protects health care providers from sanctions as a result of reporting. In January 2004, the Act on Patient Safety in the Danish health care system was put into force. In the first twelve months 5740...... adverse events were reported. the reports were analyzed locally (hospital and region), anonymized ad then sent to the National Board af Health. The Act on Patient Safety has driven the work with patient safety forward but there is room for improvement. Continuous and improved feedback from all parts...

  10. Electronic Health Record Patient Portal Adoption by Health Care Consumers: An Acceptance Model and Survey

    OpenAIRE

    Tavares, Jorge; De Oliveira, Tiago

    2016-01-01

    Background The future of health care delivery is becoming more citizen centered, as today’s user is more active, better informed, and more demanding. Worldwide governments are promoting online health services, such as electronic health record (EHR) patient portals and, as a result, the deployment and use of these services. Overall, this makes the adoption of patient-accessible EHR portals an important field to study and understand. Objective The aim of this study is to understand the factors ...

  11. Measuring and improving patient safety through health information technology: The Health IT Safety Framework.

    Science.gov (United States)

    Singh, Hardeep; Sittig, Dean F

    2016-04-01

    Health information technology (health IT) has potential to improve patient safety but its implementation and use has led to unintended consequences and new safety concerns. A key challenge to improving safety in health IT-enabled healthcare systems is to develop valid, feasible strategies to measure safety concerns at the intersection of health IT and patient safety. In response to the fundamental conceptual and methodological gaps related to both defining and measuring health IT-related patient safety, we propose a new framework, the Health IT Safety (HITS) measurement framework, to provide a conceptual foundation for health IT-related patient safety measurement, monitoring, and improvement. The HITS framework follows both Continuous Quality Improvement (CQI) and sociotechnical approaches and calls for new measures and measurement activities to address safety concerns in three related domains: 1) concerns that are unique and specific to technology (e.g., to address unsafe health IT related to unavailable or malfunctioning hardware or software); 2) concerns created by the failure to use health IT appropriately or by misuse of health IT (e.g. to reduce nuisance alerts in the electronic health record (EHR)), and 3) the use of health IT to monitor risks, health care processes and outcomes and identify potential safety concerns before they can harm patients (e.g. use EHR-based algorithms to identify patients at risk for medication errors or care delays). The framework proposes to integrate both retrospective and prospective measurement of HIT safety with an organization's existing clinical risk management and safety programs. It aims to facilitate organizational learning, comprehensive 360 degree assessment of HIT safety that includes vendor involvement, refinement of measurement tools and strategies, and shared responsibility to identify problems and implement solutions. A long term framework goal is to enable rigorous measurement that helps achieve the safety

  12. Measuring and improving patient safety through health information technology: The Health IT Safety Framework.

    Science.gov (United States)

    Singh, Hardeep; Sittig, Dean F

    2016-04-01

    Health information technology (health IT) has potential to improve patient safety but its implementation and use has led to unintended consequences and new safety concerns. A key challenge to improving safety in health IT-enabled healthcare systems is to develop valid, feasible strategies to measure safety concerns at the intersection of health IT and patient safety. In response to the fundamental conceptual and methodological gaps related to both defining and measuring health IT-related patient safety, we propose a new framework, the Health IT Safety (HITS) measurement framework, to provide a conceptual foundation for health IT-related patient safety measurement, monitoring, and improvement. The HITS framework follows both Continuous Quality Improvement (CQI) and sociotechnical approaches and calls for new measures and measurement activities to address safety concerns in three related domains: 1) concerns that are unique and specific to technology (e.g., to address unsafe health IT related to unavailable or malfunctioning hardware or software); 2) concerns created by the failure to use health IT appropriately or by misuse of health IT (e.g. to reduce nuisance alerts in the electronic health record (EHR)), and 3) the use of health IT to monitor risks, health care processes and outcomes and identify potential safety concerns before they can harm patients (e.g. use EHR-based algorithms to identify patients at risk for medication errors or care delays). The framework proposes to integrate both retrospective and prospective measurement of HIT safety with an organization's existing clinical risk management and safety programs. It aims to facilitate organizational learning, comprehensive 360 degree assessment of HIT safety that includes vendor involvement, refinement of measurement tools and strategies, and shared responsibility to identify problems and implement solutions. A long term framework goal is to enable rigorous measurement that helps achieve the safety

  13. The health mediators-qualified interpreters contributing to health care quality among Romanian Roma patients.

    Science.gov (United States)

    Roman, Gabriel; Gramma, Rodica; Enache, Angela; Pârvu, Andrada; Moisa, Ştefana Maria; Dumitraş, Silvia; Ioan, Beatrice

    2013-11-01

    In order to assure optimal care of patients with chronic illnesses, it is necessary to take into account the cultural factors that may influence health-related behaviors, health practices, and health-seeking behavior. Despite the increasing number of Romanian Roma, research regarding their beliefs and practices related to healthcare is rather poor. The aim of this paper is to present empirical evidence of specificities in the practice of healthcare among Romanian Roma patients and their caregivers. Using a qualitative exploratory descriptive design, this study is based on data gathered through three focus groups with 30 health mediators in the counties of Iasi and Cluj (Romania). We identified various barriers to access to healthcare for Roma patients: lack of financial resources and health insurance coverage, lack of cognitive resources or lack of personal hygiene, but also important cultural issues, such as the shame of being ill, family function, disclosure of disease-related information, patient's autonomy, attitudes towards illness and health practices, that should be considered in order to create a culturally sensitive environment in Romanian medical facilities:… The role of the health mediators within the context of cultural diversity is also discussed, as cultural brokers contributing to health care quality among Romanian Roma patients Bridging cultural differences may improve patient-healthcare provider relationships, but may have limited impact in reducing ethnic disparities, unless coupled with efforts of Roma communities to get involved in creating and implementing health policies.

  14. Quality of life, mental health and health beliefs: comparison between haemodialysis and peritoneal dialysis patients

    OpenAIRE

    Theofilou P

    2010-01-01

    Aim: The comparative study between in-centre haemodialysis (HD) and continuous ambulatory peritoneal dialysis (PD) patients regarding self-reported quality of life (QoL) as well as some psychological dimensions that may affect and may be affected by the patient’s state of health, like health locus of control beliefs, depression and anxiety. Material and Method: The sample consists of 144 patients in-centre haemodialysis or continuous ambulatory peritoneal dialysis (CAPD). Patient-reported ass...

  15. Health food store recommendations: implications for breast cancer patients

    OpenAIRE

    Mills, Edward; Ernst, Edzard; Singh, Rana; Ross, Cory; Wilson, Kumanan

    2003-01-01

    Background Many breast cancer patients use complementary and alternative medicine (CAM). We aimed to determine what advice health food store employees present to individuals seeking treatment options for breast cancer. Methods Eight data gatherers asked employees of all retail health food stores in a major Canadian city, what they recommended for a patient with breast cancer. The data gatherers inquired about product safety, potential drug interactions, costs and efficacy. They also enquired ...

  16. The mental patients' rights movement and mental health institutional change.

    Science.gov (United States)

    Brown, P

    1981-01-01

    The mental patients' rights movement has added to the widespread critique of institutional psychiatry and provided leadership in opposing treatment methods such as electroshock, psychosurgery, and overdrugging, which are dangerous and regressive not only to patients, but to the expanded population of non-institutionalized persons as well. The movement has had some success in court cases for democratic rights, such as the right to treatment, the right to refuse treatment, patient labor, and commitment law. At the same time patients' rights demands have been partly coopted by mental health administrators. In a number to cases, mental health officials supported patients' rights litigation because it enabled them to speed up their deinstitutionalization programs. Overall, the conjuncture of the movement with economic impetus toward deinstitutionalization has allowed mental health planners to use the patients' rights issues to justify their essentially fiscal policy. Providers and administrators have set up advocacy offices, posted patients' bills of rights, and incorporated ex-patient representatives on advisory boards. Yet mental health administrators are generally opposed to a broad application of patients' rights. PMID:7333723

  17. High-quality Health Information Provision for Stroke Patients

    Institute of Scientific and Technical Information of China (English)

    Hong-Sheng Du; Jing-Jian Ma; Mu Li

    2016-01-01

    Objective:High-quality information provision can allow stroke patients to effectively participate in healthcare decision-making,better manage the stroke,and make a good recovery.In this study,we reviewed information needs of stroke patients,methods for providing information to patients,and considerations needed by the information providers.Data Sources:The literature concerning or including information provision for patients with stroke in English was collected from PubMed published from 1990 to 2015.Study Selection:We included all the relevant articles on information provision for stroke patients in English,with no limitation of study design.Results:Stroke is a major public health concern worldwide.High-quality and effective health information provision plays an essential role in helping patients to actively take part in decision-making and healthcare,and empowering them to effectively self-manage their long-standing chronic conditions.Different methods for providing information to patients have their relative merits and suitability,and as a result,the effective strategies taken by health professionals may include providing high-quality information,meeting patients' individual needs,using suitable methods in providing information,and maintaining active involvement of patients.Conclusions:It is suggested that to enable stroke patients to access high-quality health information,greater efforts need to be made to ensure patients to receive accurate and current evidence-based information which meets their individual needs.Health professionals should use suitable information delivery methods,and actively involve stroke patients in information provision.

  18. Patient aggression in clinical psychiatry: perceptions of mental health nurses.

    NARCIS (Netherlands)

    Jonker, E.J.; Goossens, P.J.J.; Steenhuis, I.H.; Oud, N.E.

    2008-01-01

    Mental health nurses are faced with an increasing number of aggressive incidents during their daily practice. The coercive intervention of seclusion is often used to manage patient aggression in the Netherlands. However, GGZ Nederland, the Dutch association of service providers for mental health and

  19. Management of mental health disorders in HIV-positive patients

    OpenAIRE

    Southern African HIV Clinicians Society

    2013-01-01

    These guidelines are intended as a reference document to assist HIV nurse and doctor clinicians in managing mental health disorders. It is intended to improve awareness, knowledge and capacity to support patients living with HIV and mental health disorders.

  20. Management of mental health disorders in HIV-positive patients

    Directory of Open Access Journals (Sweden)

    Southern African HIV Clinicians Society

    2013-12-01

    Full Text Available These guidelines are intended as a reference document to assist HIV nurse and doctor clinicians in managing mental health disorders. It is intended to improve awareness, knowledge and capacity to support patients living with HIV and mental health disorders.

  1. Involving citizens and patients in health research.

    Science.gov (United States)

    Venuta, Rosa; Graham, Ian D

    2010-01-01

    The Canadian Institutes of Health Research's (CIHR), Canada's premier health research funding agency, is moving forward in realizing a more systematic, ongoing integration of citizens' input in priority setting, governance and funding programs and tools. In 2008, the Canadian Institutes of Health Research (CIHR) developed a Framework for Citizen Engagement. This Framework establishes guidelines for implementing a more systematic approach to consulting and engaging citizens, such as in assessing the merit and relevance of research applications, developing strategic plans, setting research priorities and for strengthening their role on CIHR's governance committees. This paper describes the current context for public consultation in Canada's federal health care system, the new CIHR citizen engagement framework and discusses citizen engagement activities and efforts undertaken by CIHR institutes and branches. It reviews the methods used by CIHR to engage citizens in four key focus areas: 1. Representation on CIHR's Boards and Committees; 2. Corporate and Institute strategic plans, priorities, policies, and guidelines; 3. Research priority setting and integrated knowledge translation; 4. Knowledge dissemination and public outreach. In discussing CIHR's experiences, the paper identifies some of the challenges and benefits of engaging citizens in CIHR's research processes, including participating in decision making and informing strategic priorities. PMID:20539148

  2. Bone Health in Patients with Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Vit Zikan

    2011-01-01

    Full Text Available Multiple sclerosis (MS is a gait disorder characterized by acute episodes of neurological defects leading to progressive disability. Patients with MS have multiple risk factors for osteoporotic fractures, such as progressive immobilization, long-term glucocorticoids (GCs treatment or vitamin D deficiency. The duration of motor disability appears to be a major contributor to the reduction of bone strength. The long term immobilization causes a marked imbalance between bone formation and resorption with depressed bone formation and a marked disruption of mechanosensory network of tightly connected osteocytes due to increase of osteocyte apoptosis. Patients with higher level of disability have also higher risk of falls that combined with a bone loss increases the frequency of bone fractures. There are currently no recommendations how to best prevent and treat osteoporosis in patients with MS. However, devastating effect of immobilization on the skeleton in patients with MS underscores the importance of adequate mechanical stimuli for maintaining the bone structure and its mechanical competence. The physical as well as pharmacological interventions which can counteract the bone remodeling imbalance, particularly osteocyte apoptosis, will be promising for prevention and treatment of osteoporosis in patients with MS.

  3. Patient satisfaction with emergency oral health care in rural Tanzania.

    Science.gov (United States)

    Ntabaye, M K; Scheutz, F; Poulsen, S

    1998-10-01

    Emergency oral health care, as conceived in Tanzania, is an on-demand service provided at a rural health center or dispensary by a Rural Medical Aide. The service includes: simple tooth extraction under local anesthesia, draining of abscesses, control of acute oral infection with appropriate drug therapy, first aid for maxillo-facial trauma, and recognition of oral conditions requiring patient referral for further care at the district or regional hospital dental clinic. The objective of the present study was to describe patient satisfaction with emergency oral health care services in rural Tanzania and determine the relative importance of factors influencing patient satisfaction. The study was carried out as a cross-sectional interview survey between April 1993 and May 1994 using a patient satisfaction questionnaire in rural villages in the Rungwe district of Tanzania. It included 206 patients aged 18 years or more who had received emergency oral health care between April 1993 and March 1994. Overall, 92.7% of the respondents reported that they were satisfied with the service. Patients who were married, had no formal education and lived more than 3 km from the dispensary were more likely to be satisfied with treatment. In a logistic regression model, a good working atmosphere at the dispensary, a good relationship between care provider and patients (art of care) and absence of post-treatment complications significantly influenced patient satisfaction with odds ratios of 10.3, 17.4 and 6.2, respectively. PMID:9792119

  4. Health status measurement in patients with severe asthma

    NARCIS (Netherlands)

    Peters, J.B.; Rijssenbeek-Nouwens, L.H.; Bron, A.O.; Fieten, K.B.; Weersink, E.J.; Bel, E.H.; Vercoulen, J.H.M.M.

    2014-01-01

    BACKGROUND: Patients with severe asthma experience problems in different areas of their health status. Identification of these areas will provide insight in the patients needs and perhaps what determines the burden of disease. The Nijmegen Clinical Screening Instrument (NCSI) was recently developed

  5. Improving health outcomes with better patient understanding and education.

    Science.gov (United States)

    Adams, Robert John

    2010-01-01

    A central plank of health care reform is an expanded role for educated consumers interacting with responsive health care teams. However, for individuals to realize the benefits of health education also requires a high level of engagement. Population studies have documented a gap between expectations and the actual performance of behaviours related to participation in health care and prevention. Interventions to improve self-care have shown improvements in self-efficacy, patient satisfaction, coping skills, and perceptions of social support. Significant clinical benefits have been seen from trials of self-management or lifestyle interventions across conditions such as diabetes, coronary heart disease, heart failure and rheumatoid arthritis. However, the focus of many studies has been on short-term outcomes rather that long term effects. There is also some evidence that participation in patient education programs is not spread evenly across socio economic groups. This review considers three other issues that may be important in increasing the public health impact of patient education. The first is health literacy, which is the capacity to seek, understand and act on health information. Although health literacy involves an individual's competencies, the health system has a primary responsibility in setting the parameters of the health interaction and the style, content and mode of information. Secondly, much patient education work has focused on factors such as attitudes and beliefs. That small changes in physical environments can have large effects on behavior and can be utilized in self-management and chronic disease research. Choice architecture involves reconfiguring the context or physical environment in a way that makes it more likely that people will choose certain behaviours. Thirdly, better means of evaluating the impact of programs on public health is needed. The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework has been

  6. The relationship between physician humility, physician-patient communication, and patient health.

    OpenAIRE

    Ruberton, PM; Huynh, HP; Miller, TA; Kruse, E.; Chancellor, J; Lyubomirsky, S

    2016-01-01

    Cultural portrayals of physicians suggest an unclear and even contradictory role for humility in the physician-patient relationship. Despite the social importance of humility, however, little empirical research has linked humility in physicians with patient outcomes or the characteristics of the doctor-patient visit. The present study investigated the relationship between physician humility, physician-patient communication, and patients' perceptions of their health during a planned medical vi...

  7. Orofacial function and oral health in patients with Parkinson's disease

    DEFF Research Database (Denmark)

    Bakke, Merete; Larsen, Stine L; Lautrup, Caroline;

    2011-01-01

    No comprehensive study has previously been published on orofacial function in patients with well-defined Parkinson's disease (PD). Therefore, the aim of this study was to perform an overall assessment of orofacial function and oral health in patients, and to compare the findings with matched......-matched controls. Orofacial function and oral health were assessed using the Nordic Orofacial Test, masticatory ability, performance and efficiency, oral stereognosis, jaw opening, jaw muscle tenderness, the Oral Health Impact Profile-49, number of natural teeth, and oral hygiene. Orofacial dysfunction was more...... prevalent, mastication and jaw opening poorer, and impact of oral health on daily life more negative, in patients with PD than in controls. The results indicate that mastication and orofacial function are impaired in moderate to advanced PD, and with progression of the disease both orofacial and dental...

  8. Health status in patients treated with cardiac resynchronization therapy

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Denollet, Johan; Pedersen, Susanne S.;

    2008-01-01

    Cardiac resynchronization therapy (CRT) is a promising treatment in chronic heart failure (CHF). However, a subgroup of patients still report impaired health status, cardiac symptoms, and feelings of disability following CRT. The aims of this study were to examine (1) whether CHF patients treated...... with CRT improved in patient-centered outcomes and functional capacity, and (2) whether personality traits exert a stable effect on these outcomes over two months....

  9. Issues in health care of Middle Eastern patients.

    Science.gov (United States)

    Lipson, J G; Meleis, A I

    1983-12-01

    Relationships between Middle Eastern patients and Western health care professionals are often troubled by mutual misunderstanding of culturally influenced values and communication styles. Although Middle Easterners vary ethnically, they do share a core of common values and behavior that include the importance of affiliation and family, time and space orientations, interactional style and attitudes toward health and illness. Problems in providing health care involve obtaining adequate information, "demanding behavior" by a patient's family, conflicting beliefs about planning ahead and differing patterns of communicating grave diagnoses or "bad news." There are guidelines that will provide an understanding of the cultural characteristics of Middle Easterners and, therefore, will improve rather than impede their health care. A personal approach and continuity of care by the same health care professional help to bridge the gap between Middle Eastern cultures and Western medical culture. In addition, periodic use of cultural interpreters helps ameliorate the intensity of some cultural issues. PMID:6364575

  10. Doctor-patient communication in the e-health era

    Directory of Open Access Journals (Sweden)

    Weiner Jonathan P

    2012-08-01

    Full Text Available Abstract The digital revolution will have a profound impact on how physicians and health care delivery organizations interact with patients and the community at-large. Over the coming decades, face-to-face patient/doctor contacts will become less common and exchanges between consumers and providers will increasingly be mediated by electronic devices. In highly developed health care systems like those in Israel, the United States, and Europe, most aspects of the health care and consumer health experience are becoming supported by a wide array of technology such as electronic and personal health records (EHRs and PHRs, biometric & telemedicine devices, and consumer-focused wireless and wired Internet applications. In an article in this issue, Peleg and Nazarenko report on a survey they fielded within Israel's largest integrated delivery system regarding patient views on the use of electronic communication with their doctors via direct-access mobile phones and e-mail. A previous complementary paper describes the parallel perspectives of the physician staff at the same organization. These two surveys offer useful insights to clinicians, managers, researchers, and policymakers on how best to integrate e-mail and direct-to-doctor mobile phones into their practice settings. These papers, along with several other recent Israeli studies on e-health, also provide an opportunity to step back and take stock of the dramatic impact that information & communication technology (ICT and health information technology (HIT will have on clinician/patient communication moving forward. The main goals of this commentary are to describe the scope of this issue and to offer a framework for understanding the potential impact that e-health tools will have on provider/patient communication. It will be essential that clinicians, managers, policymakers, and researchers gain an increased understanding of this trend so that health care systems around the globe can adapt, adopt

  11. Bone Health in Patients with Multiple Sclerosis

    OpenAIRE

    Vit Zikan

    2011-01-01

    Multiple sclerosis (MS) is a gait disorder characterized by acute episodes of neurological defects leading to progressive disability. Patients with MS have multiple risk factors for osteoporotic fractures, such as progressive immobilization, long-term glucocorticoids (GCs) treatment or vitamin D deficiency. The duration of motor disability appears to be a major contributor to the reduction of bone strength. The long term immobilization causes a marked imbalance between bone formation and reso...

  12. Negative health care experiences of immigrant patients: a qualitative study

    Directory of Open Access Journals (Sweden)

    Stronks Karien

    2011-01-01

    Full Text Available Abstract Background Negative events are abusive, potentially dangerous or life-threatening health care events, as perceived by the patient. Patients' perceptions of negative events are regarded as a potentially important source of information about the quality of health care. We explored negative events in hospital care as perceived by immigrant patients. Methods Semi-structured individual and group interviews were conducted with respondents about negative experiences of health care. Interviews were transcribed and analyzed using a framework method. A total of 22 respondents representing 7 non-Dutch ethnic origins were interviewed; each respondent reported a negative event in hospital care or treatment. Results Respondents reported negative events in relation to: 1 inadequate information exchange with care providers; 2 different expectations between respondents and care providers about medical procedures; 3 experienced prejudicial behavior on the part of care providers. Conclusions We identified three key situations in which negative events were experienced by immigrant patients. Exploring negative events from the immigrant patient perspective offers important information to help improve health care. Our results indicate that care providers need to be trained in adequately exchanging information with the immigrant patient and finding out specific patient needs and perspectives on illness and treatment.

  13. Primary health care to patients with gout

    Directory of Open Access Journals (Sweden)

    Maria Vladimirovna Sklyanova

    2012-09-01

    Full Text Available Gout is a systemic tophaceous disease that is becoming more and more prevalent. If untreated or poorly managed, gout can result in disability. The possible reason for inadequate gout control may be that the primary care physicians are unaware of diagnostic criteria and clinical guidelines for the management of these patients and diagnostic errors. Objective: to estimate the level of gout knowledge in primary care physicians. Subjects and methods. Fifty Irkutsk local therapists were questioned. A specially developed anonymous questionnaire included items on sex, age, work experience, and the principles of gout diagnosis and treatment. Results. Only 42% of the therapists know that the gold standard for diagnosis of gout is identification of monosodium urate crystals by polarizing microscopy. Only 6% of the therapists use the Wallace classification criteria for the early diagnosis of gout. 56 % of the physicians consider it possible to prescribe allopurinol in the acute period of the disease 26% think that allopurinol intake can be stopped after normouricemia is achieved; 10% of the physicians do not prescribe allopurinol for gout patients. These widespread errors lead to worsening arthritis and a negative attitude of patients towards allopurinol treatment in future. Conclusion. The findings suggest that the level of gout knowledge should be increased in primary care physicians.

  14. Primary health care to patients with gout

    Directory of Open Access Journals (Sweden)

    Maria Vladimirovna Sklyanova

    2012-01-01

    Full Text Available Gout is a systemic tophaceous disease that is becoming more and more prevalent. If untreated or poorly managed, gout can result in disability. The possible reason for inadequate gout control may be that the primary care physicians are unaware of diagnostic criteria and clinical guidelines for the management of these patients and diagnostic errors. Objective: to estimate the level of gout knowledge in primary care physicians. Subjects and methods. Fifty Irkutsk local therapists were questioned. A specially developed anonymous questionnaire included items on sex, age, work experience, and the principles of gout diagnosis and treatment. Results. Only 42% of the therapists know that the gold standard for diagnosis of gout is identification of monosodium urate crystals by polarizing microscopy. Only 6% of the therapists use the Wallace classification criteria for the early diagnosis of gout. 56 % of the physicians consider it possible to prescribe allopurinol in the acute period of the disease 26% think that allopurinol intake can be stopped after normouricemia is achieved; 10% of the physicians do not prescribe allopurinol for gout patients. These widespread errors lead to worsening arthritis and a negative attitude of patients towards allopurinol treatment in future. Conclusion. The findings suggest that the level of gout knowledge should be increased in primary care physicians.

  15. Evaluation of Oral Health in Type II Diabetes Mellitus Patients

    Directory of Open Access Journals (Sweden)

    Rathy Ravindran

    2015-01-01

    Full Text Available Background: Oral cav ity re flects the general health status of a person and diagnosing and treating oral manifestations of systemic disease pose a greater challenge. Even though there is strong evidence that supports the relationship between oral health and diabetes mellitus, oral health awareness is lacking among diabetic patients and health professionals. The present study was undertaken to determine the oral health status in type II diabetic patients and also to compare the oral changes in controlled diabetes and u ncontrolled diabetes. Materials and methods: Study population consists of 60 diabetic patients w hich is divided into 30 controlled and 30 uncontrolled diabetics; 60 healthy subjects. Each of these diabetic groups were again subdivided according to their duration as patients having a disease duration below 10 years 15 and patients having a disease duration above 10 years. 15 Various oral manifestations were examined and also CPI score and loss of attachment were recorded. Statistical analysis was done. Results: The most frequent oral signs and symptoms obser ved in both controlled and uncontrolled diabetic patients was perio­ dontitis followed by hyposalivation, taste dysfunction, halitosis, fissured tongue, burning mouth, angular cheilitis, ulcer and lichen planus. These oral manifestation showed an increase in distribution in diabetic patients when compared to nondia betic. Community periodo ntal index (CPI scores for assess ing periodontal status showed higher scores in diabetics than nondiabetics and also in uncontrolled diabetes than controlled diabetes. For periodontal s tatus assessment based on disease duration, patient with higher disease duration showed higher CPI scores than those with a lesser disease duration. Assess ment of loss of attachment in our study showed higher values in diabetic patients compared to healthy controls. Conclusion: From our present study, it was clear that oral manifestations in uncontrolled

  16. Mental health professionals’ attitudes toward patients with PTSD and depression

    Directory of Open Access Journals (Sweden)

    Thomas Maier

    2015-10-01

    Full Text Available Background: To date, mental health professionals’ attitudes toward posttraumatic stress disorder (PTSD, compared to other psychiatric disorders such as schizophrenia or depression, have rarely been studied. Objective: We assessed mental health professionals’ attitudes toward patients with PTSD compared to patients suffering from depression. Method: Case vignettes of a patient with either PTSD or depression were presented to two samples of mental health professionals: attendees of a conference on posttraumatic stress (N=226 or of a lecture for psychiatry residents (N=112. Participants subsequently completed a questionnaire that assessed their attitude reactions to the presented case. Results: Participants showed similarly positive attitudes toward depression and PTSD. PTSD elicited a more favorable attitude with regard to prosocial reactions, estimated dependency, attributed responsibility, and interest in the case, particularly in mental health professionals specializing in psychotraumatology. Across diagnoses, higher age and longer professional experience were associated with more positive attitudes toward patients. Conclusions: Mental health professionals’ positive attitudes toward patients with depression and PTSD correlate with their specific knowledge about the disorder, their level of professional training, and their years of professional experience. Limitations: The instruments used, although based on established theoretical concepts in attitude research, were not validated in their present versions.

  17. Lack of health maintenance examinations and risk in myeloma patients.

    Science.gov (United States)

    Tariman, Joseph D; Gleason, Charise; Faiman, Beth; Doss, Deborah; Catamero, Donna; Bishop-Royse, Jessica; Katz, Mike; Kurtin, Sandra; Moran, Diane; Lonial, Sagar

    2016-07-01

    Health maintenance (HM) practices are essential to prevent illness, promote well-being, and maximize health. Patients with multiple myeloma (MM) are at increased risk for cardiovascular disease and cancers, yet, research on HM practices and preventative care of MM survivors has limited report. The study comprised a descriptive, correlational, and cross-sectional online survey design. Survey of patients with MM was carried out through the International Myeloma Foundation (IMF) and the Association of Cancer Online Resources (ACOR) e-mail list services. The members of the IMF and ACOR e-mail list services were surveyed, of which 237 patients responded. The modified Medical Expenditure Preventive Survey-Preventive Care questionnaire was used; it included items that ask patients regarding their healthcare practices that relate to dental care, cancer prevention, addiction, lifestyles, sensory screening, immunizations, cardiovascular, endocrine, psychosocial, and bone health. Descriptive statistics, Pearson's chi-square, and Spearman's rho correlation coefficient were obtained. In this study, men had statistically significant inferior global health maintenance scores than women (P = 0.002). Being employed (P = 0.054) and married or partnered (P = 0.017) were significantly correlated with better health maintenance patterns among male respondents. In contrast, no statistically significant correlations between sociodemographic factors and health maintenance patterns were found in women. Patients with MM, particularly men, require continued education and close monitoring of health maintenance practices. These findings are consistent with publications looking at gender disparities in healthcare utilization in the United States. Studies show that men, in general, are less likely to seek preventative healthcare screenings. Healthcare providers must incorporate health maintenance promotion during clinic visits. PMID:27119422

  18. Lack of health maintenance examinations and risk in myeloma patients.

    Science.gov (United States)

    Tariman, Joseph D; Gleason, Charise; Faiman, Beth; Doss, Deborah; Catamero, Donna; Bishop-Royse, Jessica; Katz, Mike; Kurtin, Sandra; Moran, Diane; Lonial, Sagar

    2016-07-01

    Health maintenance (HM) practices are essential to prevent illness, promote well-being, and maximize health. Patients with multiple myeloma (MM) are at increased risk for cardiovascular disease and cancers, yet, research on HM practices and preventative care of MM survivors has limited report. The study comprised a descriptive, correlational, and cross-sectional online survey design. Survey of patients with MM was carried out through the International Myeloma Foundation (IMF) and the Association of Cancer Online Resources (ACOR) e-mail list services. The members of the IMF and ACOR e-mail list services were surveyed, of which 237 patients responded. The modified Medical Expenditure Preventive Survey-Preventive Care questionnaire was used; it included items that ask patients regarding their healthcare practices that relate to dental care, cancer prevention, addiction, lifestyles, sensory screening, immunizations, cardiovascular, endocrine, psychosocial, and bone health. Descriptive statistics, Pearson's chi-square, and Spearman's rho correlation coefficient were obtained. In this study, men had statistically significant inferior global health maintenance scores than women (P = 0.002). Being employed (P = 0.054) and married or partnered (P = 0.017) were significantly correlated with better health maintenance patterns among male respondents. In contrast, no statistically significant correlations between sociodemographic factors and health maintenance patterns were found in women. Patients with MM, particularly men, require continued education and close monitoring of health maintenance practices. These findings are consistent with publications looking at gender disparities in healthcare utilization in the United States. Studies show that men, in general, are less likely to seek preventative healthcare screenings. Healthcare providers must incorporate health maintenance promotion during clinic visits.

  19. Allied health team management of rheumatoid arthritis patients.

    Science.gov (United States)

    Feinberg, J R; Brandt, K D

    1984-09-01

    The use of a coordinated team of allied health professionals (AHPs) to treat patients with rheumatoid arthritis assigned to experimental groups (EG) and comparison groups (CG) was assessed. The EG patients were evaluated regularly by each AHP team member, whereas CG patients were seen by AHPs only upon referral. Of the 10 EG and 13 CG patients who remained in the study for 2 years, the EG patients initially exhibited somewhat greater disease activity than CG (as reflected by erythrocyte sedimentation rate and duration of morning stiffness). After 2 years, EG patients demonstrated less disease activity than at the outset, whereas CG patients either showed little change in these parameters or deteriorated during the study. Grip strength, which was initially similar in the two groups, improved in EG patients but decreased in CG patients, so that after 2 years a significant difference was noted between the two groups (p less than .05). Tendency to lose hand range of motion was also greater in CG than in EG patients. Some EG patients showed improvement in finger flexion deformities during the study. Furthermore, EG patients showed a greater tendency to acquire positive attitudes regarding themselves and family relationships. These results suggest that ongoing "team care" may be more efficacious than episodic use of AHPs in management of patients with mild rheumatoid arthritis.

  20. Quality of life, mental health and health beliefs: comparison between haemodialysis and peritoneal dialysis patients

    Directory of Open Access Journals (Sweden)

    Theofilou P

    2010-10-01

    Full Text Available Aim: The comparative study between in-centre haemodialysis (HD and continuous ambulatory peritoneal dialysis (PD patients regarding self-reported quality of life (QoL as well as some psychological dimensions that may affect and may be affected by the patient’s state of health, like health locus of control beliefs, depression and anxiety. Material and Method: The sample consists of 144 patients in-centre haemodialysis or continuous ambulatory peritoneal dialysis (CAPD. Patient-reported assessments included: a WHOQOL-BREF, b General Health Questionnaire (GHQ-28, c Multidimensional Health Locus of Control Questionnaire (MHLC, d State - Trait Anxiety Inventory (STAI I, II and e Center for Epidemiologic Studies Depression Scale (CES-D.Results: HD patients presented lower scores in WHOQOL-BREF domain of environment. Furthermore, they reported higher scores in the GHQ-28 sub-scales of anxiety/insomnia and severe depression as well as of the total score of the questionnaire. Regarding health beliefs, statistically significant difference was observed in HD patients, who presented higher scores in the internal health locus of control. Conclusions: Patients in HD treatment modality were experiencing a more compromised QoL indicating greater discontent with different aspects of their environment. Further, they reported more symptoms of anxiety, sleeping problems, depression or suicidal thoughts.

  1. Health literacy in patients dealing with gout: a qualitative study.

    Science.gov (United States)

    van Onna, Marloes; Hinsenveld, Elke; de Vries, Hein; Boonen, Annelies

    2015-09-01

    The objective of this study was to explore the health literacy of patients dealing with gout and to understand perceptions that might account for non-adherence to urate-lowering therapy (ULT). Semi-structured interviews involving patients with gout were conducted. The transcripts of the interviews were scored by two readers and a coding system to categorize the data was developed. Fifteen patients (14 men, mean age 63 years, mean disease duration 11 years) were interviewed; ten patients were recruited from secondary care and five from primary care. Six patients had gout tophi and 12 patients used ULT. Less than half of the patients were sufficiently aware of the pathophysiological processes that cause gout. Twelve patients indicated that treatment of gout only encompasses treatment of the acute attack. Patients were unaware of long-term treatment goals. Six patients admitted medication non-adherence at some point in time. Several reasons for non-adherence, such as healthcare professionals providing conflicting messages about medication, can be considered preventable. Half of the patients expressed that they, especially at the time of diagnosis, wanted to know more about the cause of gout, treatment goals and long-term consequences. In conclusion, the health literacy of patients dealing with gout was low in our study, especially with regard to medication. Yet, patients often recognized these knowledge gaps. Our data suggest that improving knowledge and addressing common misperceptions in training programmes, may ultimately contribute to adherence to ULT and an optimized outcome in patients with gout. This hypothesis needs to be confirmed in future research.

  2. Do health literacy and patient empowerment affect self-care behaviour? A survey study among Turkish patients with diabetes

    OpenAIRE

    Eyüboğlu, Ezgi; Schulz, Peter J

    2016-01-01

    Objective This study aimed to assess the impact of health literacy and patient empowerment on diabetes self-care behaviour in patients in metropolitan Turkish diabetes centres. The conceptual background is provided by the psychological health empowerment model, which holds that health literacy without patient empowerment comes down to wasting health resources, while empowerment without health literacy can lead to dangerous or suboptimal health behaviour. Design, setting and participants A cro...

  3. Using health psychology to help patients: theories of behaviour change.

    Science.gov (United States)

    Barley, Elizabeth; Lawson, Victoria

    2016-09-01

    Behaviour change theories and related research evidence highlight the complexity of making and sticking to health-related behaviour changes. These theories make explicit factors that influence behaviour change, such as health beliefs, past behaviour, intention, social influences, perceived control and the context of the behaviour. Nurses can use this information to understand why a particular patient may find making recommended health behaviour changes difficult and to determine factors that may help them. This article outlines five well-established theories of behaviour change: the health belief model, the theory of planned behaviour, the stages of change model, self-determination theory, and temporal self-regulation theory. The evidence for interventions that are informed by these theories is then explored and appraised. The extent and quality of evidence varies depending on the type of behaviour and patients targeted, but evidence from randomised controlled trials indicates that interventions informed by theory can result in behaviour change. PMID:27615529

  4. Using health psychology to help patients: theories of behaviour change.

    Science.gov (United States)

    Barley, Elizabeth; Lawson, Victoria

    2016-09-01

    Behaviour change theories and related research evidence highlight the complexity of making and sticking to health-related behaviour changes. These theories make explicit factors that influence behaviour change, such as health beliefs, past behaviour, intention, social influences, perceived control and the context of the behaviour. Nurses can use this information to understand why a particular patient may find making recommended health behaviour changes difficult and to determine factors that may help them. This article outlines five well-established theories of behaviour change: the health belief model, the theory of planned behaviour, the stages of change model, self-determination theory, and temporal self-regulation theory. The evidence for interventions that are informed by these theories is then explored and appraised. The extent and quality of evidence varies depending on the type of behaviour and patients targeted, but evidence from randomised controlled trials indicates that interventions informed by theory can result in behaviour change.

  5. Improving personal health records for patient-centered care

    Science.gov (United States)

    Feldman, Henry J; Ross, Stephen E; Safran, Charles

    2010-01-01

    Objective To assess the patient-centeredness of personal health records (PHR) and offer recommendations for best practice guidelines. Design Semi-structured interviews were conducted in seven large early PHR adopter organizations in 2007. Organizations were purposively selected to represent a variety of US settings, including medium and large hospitals, ambulatory care facilities, insurers and health plans, government departments, and commercial sectors. Measurements Patient-centeredness was assessed against a framework of care that includes: (1) respect for patient values, preferences, and expressed needs; (2) information and education; (3) access to care; (4) emotional support to relieve fear and anxiety; (5) involvement of family and friends; (6) continuity and secure transition between healthcare providers; (7) physical comfort; (8) coordination of care. Within this framework we used evidence for patient preferences (where it exists) to compare existing PHR policies, and propose a best practice model. Results Most organizations enable many patient-centered functions such as data access for proxies and minors. No organization allows patient views of clinical progress notes, and turnaround times for PHR reporting of normal laboratory results can be up to 7 days. Conclusion Findings suggest patient-centeredness for personal health records can be improved, and recommendations are made for best practice guidelines. PMID:20190063

  6. Patients as partners: a qualitative study of patients' engagement in their health care.

    Directory of Open Access Journals (Sweden)

    Marie-Pascale Pomey

    Full Text Available To advocate for patients to be more actively involved with the healthcare services they receive, particularly patients living with chronic illness, the Faculty of Medicine of the University of Montreal and its affiliated hospitals developed the Patients as Partners concept where the patient is considered a full-fledged partner of the health care delivery team and the patient's experiential knowledge is recognized. This study aims to show how patients view their engagement with healthcare professionals regarding their direct care. Using theoretical sampling, 16 semi-structured interviews were conducted with patients with chronic illness who were familiar with the concept of Patients as Partners. Data analysis followed a constructivist grounded theory approach. Patients describe themselves as proactively engaging in three types of practice, regardless of health professionals' openness to their role as partners. The first is a process of continuous learning that allows them to acquire experiential knowledge about their health, as well as scientific information and technical know-how. The second involves their assessment of the healthcare they receive, in terms of its quality and how it aligns with their personal preferences. It includes their assessment of the quality of their relationship with the health professional and of the latter's scientific knowledge and technical know-how. The third type, adaptation practices, builds on patients' learning and assessments to compensate for and adapt to what has been perceived as optimal or non-optimal health or healthcare circumstances. Patients appear to play a more active and less docile role in their own direct care than suggested so far in the literature, regardless of the degree of reciprocity of the partnership or the degree to which the health professional seeks to encourage patient engagement.

  7. Patients as partners: a qualitative study of patients' engagement in their health care.

    Science.gov (United States)

    Pomey, Marie-Pascale; Ghadiri, Djahanchah P; Karazivan, Philippe; Fernandez, Nicolas; Clavel, Nathalie

    2015-01-01

    To advocate for patients to be more actively involved with the healthcare services they receive, particularly patients living with chronic illness, the Faculty of Medicine of the University of Montreal and its affiliated hospitals developed the Patients as Partners concept where the patient is considered a full-fledged partner of the health care delivery team and the patient's experiential knowledge is recognized. This study aims to show how patients view their engagement with healthcare professionals regarding their direct care. Using theoretical sampling, 16 semi-structured interviews were conducted with patients with chronic illness who were familiar with the concept of Patients as Partners. Data analysis followed a constructivist grounded theory approach. Patients describe themselves as proactively engaging in three types of practice, regardless of health professionals' openness to their role as partners. The first is a process of continuous learning that allows them to acquire experiential knowledge about their health, as well as scientific information and technical know-how. The second involves their assessment of the healthcare they receive, in terms of its quality and how it aligns with their personal preferences. It includes their assessment of the quality of their relationship with the health professional and of the latter's scientific knowledge and technical know-how. The third type, adaptation practices, builds on patients' learning and assessments to compensate for and adapt to what has been perceived as optimal or non-optimal health or healthcare circumstances. Patients appear to play a more active and less docile role in their own direct care than suggested so far in the literature, regardless of the degree of reciprocity of the partnership or the degree to which the health professional seeks to encourage patient engagement. PMID:25856569

  8. How patients' review sites will change health care.

    Science.gov (United States)

    Hotopf, Max

    2013-10-01

    TripAdvisor has changed how the travel industry treats customers. Is the same likely to happen to health services? Review sites are growing fast across Europe, propelled by expansions in patient choice. What impact will they have on the medical profession and on providers, both public and private? How will they change the nature of health care? To address these questions, those at the forefront of developing review sites in Europe were interviewed. PMID:23904237

  9. Health Related Quality of Life May Increase when Patients with a Stoma Attend Patient Education

    DEFF Research Database (Denmark)

    Danielsen, Anne Kjaergaard; Rosenberg, Jacob

    2014-01-01

    INTRODUCTION: Adaptation to living with a stoma is complex, and studies have shown that stoma creation has a great impact on patients' health related quality of life. The objective was to explore the effect of a structured patient education program on health related quality of life. Therefore, we...... included 50 patients in the study. Health related quality of life was measured before hospital discharge, three months and six months after stoma creation. The program included educational interventions involving lay-teachers, alongside health professional teachers. RESULTS: We found a significant rise...... in health related quality of life baseline (p = 0.045) with lower scores in the intervention group compared with the intervention group. However, there were no significant differences in the demographic variables at baseline. CONCLUSIONS: Educational activities aimed at increase in knowledge and focusing...

  10. Knowledge levels of the health care employees working at the primary health institutions about patient rights

    Directory of Open Access Journals (Sweden)

    Handan Zincir

    2009-06-01

    Full Text Available The aim of the research was to examine the knowledge levels of the health care personnel working at the first step health institutions about patient rights. It was a descriptive research which was carried out in Melikgazi and Kocasinan Health Group Directorate of Kayseri Province between 1st. of October 2006 and 30th. of May 2007. 406 of 610 health care personnel participated in the study (% 66.5 participation rate. A questionnaire form of 39 questions was utilized. Kruskal-wallis test was used for statistical evaluation. % 56.2 of the health care personnel was 29 years old and younger. % 38.4 of the personnel had undergraduate diploma, % 37.9 was midwife, % 37.2 worked for 10 or 14 years. It was found out that % 42.4 of the personnel was unaware of the patient rights. It was seen in the statistical evaluation that there was a significant statistical difference between the scores of knowledge on patient rights of the personnel and age, educational status, professional group and working period. It was concluded that nearly half of the personnel working at the first step health institutions did not know nothing about patient rights and such variables as age, school from which they graduated, professional status and working period affected knowledge levels of patient rights.

  11. Primary Care–Mental Health Integration Programs in the Veterans Affairs Health System Serve a Different Patient Population Than Specialty Mental Health Clinics

    OpenAIRE

    Johnson-Lawrence, Vicki D.; Szymanski, Benjamin R.; Zivin, Kara; McCarthy, John F.; Valenstein, Marcia; Pfeiffer, Paul N.

    2012-01-01

    Objective: To assess whether Primary Care–Mental Health Integration (PC-MHI) programs within the Veterans Affairs (VA) health system provide services to patient subgroups that may be underrepresented in specialty mental health care, including older patients and women, and to explore whether PC-MHI served individuals with less severe mental health disorders compared to specialty mental health clinics.

  12. The Danish patient safety experience: the Act on Patient Safety in the Danish health care system

    OpenAIRE

    Mette Lundgaard; Louise Raboel; Elisabeth Broegger Jensen; Jacob Anhoej; Beth Lilja Pedersen; Danish Society for Patient Safety

    2005-01-01

    This paper describes the process that lead to the passing of the Act for Patient Safety in the Danish health care system, the contents of the act and how the act is used in the Danish health care system.

    The act obligates frontline health care personnel to report adverse events, hospital owners to act on the reports and the National Board of Health to communicate the learning nationally.

    The act protects health care providers from sanctions as a re...

  13. Do Physicians' Financial Incentives Affect Medical Treatment and Patient Health?

    Science.gov (United States)

    Clemens, Jeffrey; Gottlieb, Joshua D

    2014-04-01

    We investigate whether physicians' financial incentives influence health care supply, technology diffusion, and resulting patient outcomes. In 1997, Medicare consolidated the geographic regions across which it adjusts physician payments, generating area-specific price shocks. Areas with higher payment shocks experience significant increases in health care supply. On average, a 2 percent increase in payment rates leads to a 3 percent increase in care provision. Elective procedures such as cataract surgery respond much more strongly than less discretionary services. Non-radiologists expand their provision of MRIs, suggesting effects on technology adoption. We estimate economically small health impacts, albeit with limited precision. PMID:25170174

  14. Patient Activation and Mental Health Care Experiences Among Women Veterans

    OpenAIRE

    Kimerling, Rachel; Pavao, Joanne; Wong, Ava

    2016-01-01

    We utilized a nationally representative survey of women veteran primary care users to examine associations between patient activation and mental health care experiences. A dose–response relationship was observed, with odds of high quality ratings significantly greater at each successive level of patient activation. Higher activation levels were also significantly associated with preference concordant care for gender-related preferences (use of female providers, women-only settings, and women-...

  15. Patient Satisfaction Before and After Executing Health Sector Evolution Plan

    OpenAIRE

    Behrouz Hashemi; Alireza Baratloo; Mohammad Mehdi Forouzafar; Maryam Motamedi; Mohammadreza Tarkhorani

    2015-01-01

    Introduction: After long discussions, carrying out health sector evolution (HSE) plan began on May 5, 2014 throughout Iran. Shohadaye Tajrish Hospital, Tehran, was also included in this plan. This study aimed to evaluate the level of emergency department patient satisfaction, before and after running this plan. Methods: This cross-sectional study analyzed the data extracted from a standard questionnaire filled out by the patients presented to the emergency department of Shohadaye Tajrish Hosp...

  16. Interaction between functional health literacy, patient activation, and glycemic control

    Directory of Open Access Journals (Sweden)

    Woodard LD

    2014-07-01

    Full Text Available LeChauncy D Woodard, Cassie R Landrum, Amber B Amspoker, David Ramsey, Aanand D Naik Veterans Affairs Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey Veterans Affairs Medical Center, and Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA Background: Functional health literacy (FHL and patient activation can impact diabetes control through enhanced diabetes self-management. Less is known about the combined effect of these characteristics on diabetes outcomes. Using brief, validated measures, we examined the interaction between FHL and patient activation in predicting glycosylated hemoglobin (HbA1c control among a cohort of multimorbid diabetic patients.Methods: We administered a survey via mail to 387 diabetic patients with coexisting ­hypertension and ischemic heart disease who received outpatient care at one regional VA medical center between November 2010 and December 2010. We identified patients with the study conditions using the International Classification of Diseases-Ninth Revision-Clinical ­Modification (ICD-9-CM diagnoses codes and Current Procedure Terminology (CPT ­procedures codes. Surveys were returned by 195 (50.4% patients. We determined patient activation levels based on participant responses to the 13-item Patient Activation Measure and FHL levels using the single-item screening question, “How confident are you filling out medical forms by yourself?” We reviewed patient medical records to assess glycemic control. We used multiple logistic regression to examine whether activation and FHL were individually or jointly related to HbA1c control.Results: Neither patient activation nor FHL was independently related to glycemic control in the unadjusted main effects model; however, the interaction between the two was significantly associated with glycemic control (odds ratio 1.05 [95% confidence

  17. HIV-infected mental health patients: characteristics and comparison with HIV-infected patients from the general population and non-infected mental health patients

    Directory of Open Access Journals (Sweden)

    Schadé Annemiek

    2013-01-01

    Full Text Available Abstract Objectives HIV-infected patients are at increased risk of developing mental health symptoms, which negatively influence the treatment of the HIV-infection. Mental health problems in HIV-infected patients may affect public health. Psychopathology, including depression and substance abuse, can increase hazardous sexual behaviour and, with it, the chance of spreading HIV. Therefore, it is important to develop an optimal treatment plan for HIV-infected patients with mental health problems. The majority of HIV-infected patients in the Netherlands (almost 60% are homosexual men. The main objectives of this study were to describe the clinical and demographic characteristics of patients with HIV who seek treatment for their mental health symptoms in the Netherlands. Secondly, we tested whether HIV infected and non-infected homosexual patients with a lifetime depressive disorder differed on several mental health symptoms. Methods We compared a cohort of 196 patients who visited the outpatient clinic for HIV and Mental Health with HIV-infected patients in the general population in Amsterdam (ATHENA-study and with non-HIV infected mental health patients (NESDA-study. DSM-IV diagnoses were determined, and several self-report questionnaires were used to assess mental health symptoms. Results Depressive disorders were the most commonly occurring diagnoses in the cohort and frequent drug use was common. HIV-infected homosexual men with a depressive disorder showed no difference in depressive symptoms or sleep disturbance, compared with non-infected depressive men. However, HIV-positive patients did express more symptoms like fear, anger and guilt. Although they showed significantly more suicidal ideation, suicide attempts were not more prevalent among HIV-infected patients. Finally, the HIV-infected depressive patients displayed a considerably higher level of drug use than the HIV-negative group. Conclusion Habitual drug use is a risk factor for

  18. The Use of Health Functional Foods in Gastrointestinal Cancer Patients

    OpenAIRE

    Kang, Hwa Pyoung; Lee, Hosun; Oh, Tak Geun; Lee, Kyong Joo; Park, Soo Jung; Chung, Moon Jae; Kim, Seung Up; Lee, Hyuk; Park, Jun Chul; Hong, Sung Pil; Park, Jun Yong; Park, Jeong Youp; Bang, Seungmin; Kim, Do Young; Cheon, Jae Hee

    2013-01-01

    As an adjunct to cancer treatment, the use of health functional foods (HFFs) seems to be increasing. However, little is known for the use of HFFs among cancer patients in Korea. The aims of this study were to investigate the exposure rate of HFF use among gastrointestinal (GI) cancer patients and to examine the relationship of socio-demographic and disease-related characteristics with the use of HFFs. A total of 126 patients diagnosed with GI cancer participated in the study. A cross-sectiona...

  19. Health related quality of life in patients with actinic keratosis

    DEFF Research Database (Denmark)

    Tennvall, Gunnel Ragnarson; Norlin, J M; Malmberg, I;

    2015-01-01

    BACKGROUND: Actinic keratosis (AK) is a common skin condition that may progress to non-melanoma skin cancer (NMSC). The disease may influence Health Related Quality of Life (HRQoL), but studies of HRQoL in patients with AK are limited. The purpose of the study was to analyze HRQoL in patients......-center setting. Dermatologists assessed AK severity and patients completed: Actinic Keratosis Quality of Life Questionnaire (AKQoL), Dermatology Life Quality Index (DLQI), and EQ-5D-5 L including EQ-VAS. Differences between categorical subgroups were tested with Wilcoxon rank-sum test. The relationship between...

  20. Diabetic patients: their knowledge and perception of oral health

    Directory of Open Access Journals (Sweden)

    Aziza H. Eldarrat

    2011-05-01

    Full Text Available Objectives : The objectives of the study were to: 1 assess the knowledge and awareness of diabetic patients of their risk for systemic and oral diseases as complications associated with diabetes, 2 to assess their attitudes toward sustaining good oral health through proper oral hygiene and regular dental check-ups, and 3 to the extent that they are aware, to determine how they became aware. Methods : Two hundred self-administered questionnaires were distributed to assess the main objectives of the study. Only completed questionnaires were used in the current study data analysis. Results: A majority of the participants had Type 2 diabetes (58%. The awareness of diabetic patients of their increased risk for oral diseases is low compared to their awareness of systemic diseases. Their attitude toward maintaining good oral health was also not to desired standard. Of the participants, 50% brushed their teeth once daily and 66% never used dental floss. Regarding participants’ sources of awareness, 37% learned from dentists and 45% through other media sources. Conclusions : Diabetic patients are found to have little knowledge of their increased risk for oral diseases. In order to promote proper oral health and to reduce the risk of oral diseases, health professionals in both the dental and medical fields need to take the responsibility to develop programs to educate the public about the oral manifestations of diabetes and its complications on oral health.

  1. What can virtual patient simulation offer mental health nursing education?

    Science.gov (United States)

    Guise, V; Chambers, M; Välimäki, M

    2012-06-01

    This paper discusses the use of simulation in nursing education and training, including potential benefits and barriers associated with its use. In particular, it addresses the hitherto scant application of diverse simulation devices and dedicated simulation scenarios in psychiatric and mental health nursing. It goes on to describe a low-cost, narrative-based virtual patient simulation technique which has the potential for wide application within health and social care education. An example of the implementation of this technology in a web-based pilot course for acute mental health nurses is given. This particular virtual patient technique is a simulation type ideally suited to promoting essential mental health nursing skills such as critical thinking, communication and decision making. Furthermore, it is argued that it is particularly amenable to e-learning and blended learning environments, as well as being an apt tool where multilingual simulations are required. The continued development, implementation and evaluation of narrative virtual patient simulations across a variety of health and social care programmes would help ascertain their success as an educational tool. PMID:22070549

  2. Cancer, Health Literacy, and Happiness: Perspectives from Patients under Chemotherapy

    Directory of Open Access Journals (Sweden)

    Sara Maria Oliveira Pinto

    2013-01-01

    Full Text Available Cancer is a dreaded disease that affects all dimensions of human life. In this context, issues related to the quality of life—as happiness, perception about health status, or health literacy—are important. This study aims to analyze the following topics the perception: the Portuguese cancer patients have about their health status while undergoing chemotherapy, the satisfaction with the information relating to their health, their level of happiness, and their vision of the future. An observational, cross-sectional, and descriptive study was developed. Data were collected between May and July 2012 in the day hospital of a central hospital in northern Portugal. The sample was composed of 92 cancer patients who were asked to answer a questionnaire during chemotherapy. The results indicate that, despite this life-threatening disease, patients consider themselves fairly happy and have an optimistic view of the future. Information about their health condition and religious beliefs was important coping mechanisms to help dealing with the suffering caused by the disease. The study highlights the importance of providing care in a holistic way. Nurses must be alert and available to listen, answer questions, provide supporting structures, or refer to other professionals when needed.

  3. When Residents Need Health Care: Stigma of the Patient Role

    Science.gov (United States)

    Moutier, Christine; Cornette, Michelle; Lehrmann, Jon; Geppert, Cynthia; Tsao, Carol; DeBoard, Renee; Hammond, Katherine Green; Roberts, Laura Weiss

    2009-01-01

    Objective: Whether and under what circumstances medical residents seek personal health care is a growing concern that has important implications for medical education and patient welfare, but has not been thoroughly investigated. Barriers to obtaining care have been previously documented, but very little empirical work has focused on trainees who…

  4. Oral health related quality of life in diabetic patients.

    Science.gov (United States)

    Sadeghi, Rokhsareh; Taleghani, Ferial; Farhadi, Sareh

    2014-01-01

    Background and aims. Diabetic patients display an increased risk of oral disorders, and oral health related quality of life (OHRQL) might affect their management and treatment modalities. The aim of the present study was to determine OHRQL and associated parameters in patients with diabetes. Materials and methods. In this study two hundred patients were recruited from the diabetes clinic in Mustafa Khomeini Hospital in Tehran, Iran. OHRQL was assessed using Oral Health Impact Profile Questionnaire (OHIP-20). Also, another questionnaire was designed which contained questions regarding participants' knowledge about oral complications of diabetes and oral health behavior. OHRQL was categorized as low and good. Data were analyzed using logistic regression at P = 0.05. Results. Of the diabetic patients assessed, 77.5% were in good and 22.5% were in low categories of OHRQL. This quality was significantly associated with age (OR = 4.03, 95% CI = 1.63-11.29), knowledge about diabetes oral complications (OR = 18.17 95% CI = 4.42-158.6), educational level (OR = 26.31 95% CI = 4.2-1080.3), referred for dental visit by physician (OR = 3.16 95% CI = 1.48-6.69), frequency of brushing (OR = 10.29 95% CI = 3.96-31.2) and length of time diagnosed with diabetes (OR = 6.21 95% CI = 2.86-13.63). Conclusion. Oral health related quality of life was not negatively affected by diabetes mellitus in the assessed sample. PMID:25587385

  5. FOLLOWING HYPERTENSIVE PATIENTS IN PRIMARY HEALTH CARE SETTING

    Directory of Open Access Journals (Sweden)

    Sibel GOGEN

    2005-02-01

    Full Text Available Hypertension is one of the major risk factors of Coronary Heart Diseases. However, the control rates of hypertension is still below the targets of Healthy People 2010, both in the world and in our country. The aim of the study is; To achieve the target blood pressure levels of hypertensive patients applied to Primary Health Care Center, by informing and educating about hypertension. Methods: While taking antihypertensive medication for at least six months, 52 essential hypertension patients, who applied to Primary Health Care Center, are followed up for two weeks periods and evaluated for median blood pressure, Body Mass Index, medications they use, physical activity levels. After being given education about hypertension and healthy life-styles, the patients were evaluated at initiation, 1th. and 2nd. months of the study for achieving the target blood pressure levels. Results: Achieving of the target blood pressure levels was % 27 at the beginning, while it was % 37 and % 46 at the end of the 1st. and 2nd. Months respectively. Conclusion: The health education and close relation of the hypertensive patients in Primary Health Care Centers, will be effective on achieving target blood pressure levels. [TAF Prev Med Bull 2005; 4(1.000: 8-15

  6. Planning health care for patients with Graves’ orbitopathy

    NARCIS (Netherlands)

    Sasim, I.V.; Berendschot, T.T.J.M.; Isterdael, C. van; Mourits, M.P.

    2008-01-01

    Background: To describe disease parameters of patients with Graves’ orbitopathy in a tertiary referral center in order to plan health care resource allocations. To investigate whether the clinical activity and/or the severity of the disease can be used as a predictor of the duration of treatment. Me

  7. Poor health status and distress in cardiac patients

    DEFF Research Database (Denmark)

    Habibović, Mirela; Versteeg, Henneke; Pelle, Aline J M;

    2013-01-01

    Implantable cardioverter defibrillator (ICD) therapy, which includes the risk of shocks, is considered the primary culprit of reductions in patient reported outcomes (PROs; e.g. health status and distress), thereby negating the role of underlying disease severity. We examined the relative influence...

  8. The Influence of Health Literacy and Patient Activation on Patient Information Seeking and Sharing.

    Science.gov (United States)

    Ledford, Christy J W; Cafferty, Lauren A; Russell, Travis C

    2015-01-01

    This study provided an assessment of how patients looked for information to prepare for a clinical appointment and whether they shared those findings with their provider. A cross-sectional survey allowed insight into patient attitudes, motivations, and behavior in clinical real time. At two hospital-based clinics, 243 patients completed surveys before and after clinical appointments. Younger patients with higher communicative and critical health literacy prepared for clinical appointments with information searches. The predicted association of health literacy and patient activation with information sharing was not supported. This study shows that patients with higher patient activation perceived that their providers responded more positively to patient-obtained medical information. The role of critical health literacy may show that individuals choosing to seek information are considering not just their ability to conduct the search but also their ability to synthesize and critically analyze the results of the information search. An implication for providers is to become skilled in directly asking or passively surveying what outside information sources the patient has engaged with, no matter if the patient does or does not introduce the information.

  9. Dental abnormalities and oral health in patients with Hypophosphatemic rickets

    Directory of Open Access Journals (Sweden)

    Melissa Almeida Souza

    2010-01-01

    Full Text Available INTRODUCTION: Hypophosphatemic rickets represents a group of heritable renal disorders of phosphate characterized by hypophosphatemia, normal or low serum 1,25 (OH2 vitamin D and calcium levels. Hypophosphatemia is associated to interglobular dentine and an enlarged pulp chambers. AIM: Our goal was to verify the dental abnormalities and the oral health condition in these patients. MATERIAL AND METHODS: Prospective study of oral conditions in patients with Hypophosphatemic rickets. This report employed a simple method to be easily reproducible: oral clinical exam and radiographic evaluation. RESULTS: Fourteen patients were studied, 5 males, median age of 11years (4 to 26. Occlusion defects (85,7% and enamel hypoplasia (57,1% were significant more frequently than dental abscesses (one patient. We observed enlarged pulp chambers in 43% of the patients and hypoplasia and dentin abnormalities in 14,3%. We could not detect a significant correlation between dental abnormalities and delayed treatment (p>0,05. DMFT index for 6 to 12 years patients (n = 12 showed that the oral health is unsatisfactory (mean DMFT = 5. CONCLUSIONS: Patients with Hypophosphatemic Rickets frequently present dental alterations and these are not completely recovered with the treatment, unless dental abscess and they need a periodical oral examination.

  10. Practical guide on home health in heart failure patients

    Directory of Open Access Journals (Sweden)

    Tiny Jaarsma

    2013-11-01

    Full Text Available Introduction: Chronic heart failure is a common condition affecting up to 15 million people in the extended Europe. Heart failure is burdensome and costly for patients in terms of decreased quality of life and poor prognosis and it is also costly for society. Better integrated care is warranted in this population and specialized heart failure care can save costs and improve the quality of care. However, only a few European countries have implemented specialized home care and offered this to a larger number of patients with heart failure.Method: We developed a guide on Home Health in Heart Failure patients from a literature review, a survey of heart failure management programs, the opinion of researchers and practitioners, data from clinical trials and a reflection of an international expert meeting.Results: In integrated home care for heart failure patients it is advised to consider the following components: integrated multi-disciplinary care, patient and partner participation, care plans with clear goals of care, patient education, self-care management, appropriate access to care and optimized treatment.Discussion: We summarized the state of the art of home based care for heart failure patients in Europe, described the typical content of such care to provide a guide for health care providers.

  11. Emerging uses of patient generated health data in clinical research.

    Science.gov (United States)

    Wood, William A; Bennett, Antonia V; Basch, Ethan

    2015-05-01

    Recent advancements in consumer directed personal computing technology have led to the generation of biomedically-relevant data streams with potential health applications. This has catalyzed international interest in Patient Generated Health Data (PGHD), defined as "health-related data - including health history, symptoms, biometric data, treatment history, lifestyle choices, and other information-created, recorded, gathered, or inferred by or from patients or their designees (i.e. care partners or those who assist them) to help address a health concern."(Shapiro et al., 2012) PGHD offers several opportunities to improve the efficiency and output of clinical trials, particularly within oncology. These range from using PGHD to understand mechanisms of action of therapeutic strategies, to understanding and predicting treatment-related toxicity, to designing interventions to improve adherence and clinical outcomes. To facilitate the optimal use of PGHD, methodological research around considerations related to feasibility, validation, measure selection, and modeling of PGHD streams is needed. With successful integration, PGHD can catalyze the application of "big data" to cancer clinical research, creating both "n of 1" and population-level observations, and generating new insights into the nature of health and disease. PMID:25248998

  12. Factors affecting patients' ratings of health-care satisfaction

    DEFF Research Database (Denmark)

    Thygesen, Marianne K; Fuglsang, Marie; Miiller, Max Mølgaard

    2015-01-01

    INTRODUCTION: Surveys that include rating scales are commonly used to collect data about patients' experiences. We studied how patients associated their ratings with their experiences of care. METHODS: A survey and a qualitative study were conducted at a Danish hospital. Initially, 19 female...... patients completed a questionnaire using the response categories from very good to very bad; and subsequently they participated in a semi-structured interview held within two days after they completed the questionnaire. Additionally, 44 female patients participated in an interview within six weeks...... of completing a questionnaire. A phenomenological-hermeneutical approach was used in the analysis and interpretation. RESULTS: Two major themes emerged: experienced versus expected clinical quality and health-care professional attitude. Patients responded to each question by combining their experiences of both...

  13. Health food store recommendations: implications for breast cancer patients

    International Nuclear Information System (INIS)

    Many breast cancer patients use complementary and alternative medicine (CAM). We aimed to determine what advice health food store employees present to individuals seeking treatment options for breast cancer. Eight data gatherers asked employees of all retail health food stores in a major Canadian city, what they recommended for a patient with breast cancer. The data gatherers inquired about product safety, potential drug interactions, costs and efficacy. They also enquired about employee training related to the products. Thirty-four stores were examined. A total of 33 different products were recommended, none of which are supported by sufficient evidence of efficacy. The average cost of the products they recommended was $58.09 (CAD) (minimum $5.28, median $32.99, maximum $600) per month. Twenty-three employees (68%) did not ask whether the patient took prescription medications. Fifteen employees (44%) recommended visiting a healthcare professional (naturopaths (9), physicians (5), nutritionists (1). Three employees (8.8%) discussed potential adverse effects of the products. Eight employees (23.5%) discussed the potential for drug interactions. Two employees (5.9%) suggested a possible cure with the products and one employee (2.9%) suggested discontinuing Tamoxifen. Four employees (11.8%) recommended lifestyle changes and three employees (8.8%) recommended books for further reading on the products. This study draws attention to the heterogeneity of advice provided by natural health food stores to individuals seeking treatments for breast cancer, and the safety and cost implications of some of the products recommended. Physicians should enquire carefully about the use of natural health food products by patients with breast cancer. Regulators need to consider regulations to protect vulnerable patients from incurring significant costs in their purchasing of natural health food products lacking evidence of benefit and of questionable safety

  14. Carolinas HealthCare attends to patients, amenities; builds business.

    Science.gov (United States)

    Rees, T

    2000-01-01

    Carolinas HealthCare System has grown into a nearly two billion dollar entity by focusing on patient needs and amenities in its health care facilities. Growth of the system, the largest in North and South Carolina, is due in large part to Harry A. Nurkin, president and CEO, who started out with a run-down hospital for indigents. With the approval of the hospital board, Nurkin launched a marketing effort that included taking a lesson from the founders of the Holiday Inn hotel chain. He remodeled and developed facilities that are pleasing to patients and visitors, moved patient parking closer to the hospitals' front doors, taught key hospital personnel the basics about marketing, aligned the system with ABA and NFL teams and conducted an aggressive advertising program. PMID:11143133

  15. Using patient management as a surrogate for patient health outcomes in diagnostic test evaluation

    Directory of Open Access Journals (Sweden)

    Staub Lukas P

    2012-02-01

    Full Text Available Abstract Background Before a new test is introduced in clinical practice, evidence is needed to demonstrate that its use will lead to improvements in patient health outcomes. Studies reporting test accuracy may not be sufficient, and clinical trials of tests that measure patient health outcomes are rarely feasible. Therefore, the consequences of testing on patient management are often investigated as an intermediate step in the pathway. There is a lack of guidance on the interpretation of this evidence, and patient management studies often neglect a discussion of the limitations of measuring patient management as a surrogate for health outcomes. Methods We discuss the rationale for measuring patient management, describe the common study designs and provide guidance about how this evidence should be reported. Results Interpretation of patient management studies relies on the condition that patient management is a valid surrogate for downstream patient benefits. This condition presupposes two critical assumptions: the test improves diagnostic accuracy; and the measured changes in patient management improve patient health outcomes. The validity of this evidence depends on the certainty around these critical assumptions and the ability of the study design to minimise bias. Three common designs are test RCTs that measure patient management as a primary endpoint, diagnostic before-after studies that compare planned patient management before and after testing, and accuracy studies that are extended to report on the actual treatment or further tests received following a positive and negative test result. Conclusions Patient management can be measured as a surrogate outcome for test evaluation if its limitations are recognised. The potential consequences of a positive and negative test result on patient management should be pre-specified and the potential patient benefits of these management changes clearly stated. Randomised comparisons will provide

  16. Trajectories of Patient-Reported Health Status in Patients With an Implantable Cardioverter Defibrillator

    DEFF Research Database (Denmark)

    Mastenbroek, Mirjam H; Denollet, Johan; Versteeg, Henneke;

    2015-01-01

    failure, ICD shock, psychotropic medication, negative affectivity, and type D personality were identified as independent determinants of poorer physical health status. For mental health status, 6 trajectories were identified. Younger age, low educational level, symptomatic heart failure, renal failure......, no use of ACE inhibitors, psychotropic medication, negative affectivity, and type D personality were identified as independent determinants of poorer mental health status. In conclusion, the population with an ICD seems to be heterogeneous in terms of patient-reported physical and mental health status....... Patients with an ICD who present with poor health status and a distressed personality profile should be timely identified and monitored as they may benefit from cardiac rehabilitation in combination with behavioral intervention....

  17. The use of health functional foods in gastrointestinal cancer patients.

    Science.gov (United States)

    Kang, Hwa Pyoung; Lee, Hosun; Oh, Tak Geun; Lee, Kyong Joo; Park, Soo Jung; Chung, Moon Jae; Kim, Seung Up; Lee, Hyuk; Park, Jun Chul; Hong, Sung Pil; Park, Jun Yong; Park, Jeong Youp; Bang, Seungmin; Kim, Do Young; Cheon, Jae Hee; Ahn, Sang Hoon; Kim, Tae Il; Park, Seung Woo; Song, Si Young

    2013-01-01

    As an adjunct to cancer treatment, the use of health functional foods (HFFs) seems to be increasing. However, little is known for the use of HFFs among cancer patients in Korea. The aims of this study were to investigate the exposure rate of HFF use among gastrointestinal (GI) cancer patients and to examine the relationship of socio-demographic and disease-related characteristics with the use of HFFs. A total of 126 patients diagnosed with GI cancer participated in the study. A cross-sectional survey was conducted using a questionnaire. Over a half of all the patients surveyed (n = 67; 53.2%) used HFFs. Patients who were younger, had higher income, or longer duration of disease showed a trend to use HFFs more frequently, even though the tendency was not statistically significant. The most commonly used HFF was vitamin complex (n = 20; 16%), followed by red ginseng (n = 15; 12%), and sweet wormwood (Artemisia annua) (n = 11; 8.8%). About 26% of all responders expressed concerns for using HFFs. The primary concern was 'going against physician's recommendations' (36.8%). About 63% of respondents expressed a desire to consult with their physicians and follow their recommendations. More basic scientific data and educational materials regarding HFFs are required for both health-care professionals and cancer patients. A larger sample and size-controlled groups representing each cancer type will continue to be recruited for participation in this survey. PMID:23429665

  18. [Health locus of control of patients in disease management programmes].

    Science.gov (United States)

    Schnee, M; Grikscheit, F

    2013-06-01

    Health locus of control beliefs plays a major role in improving self-management skills of the chronically ill - a main goal in disease management programmes (DMP). This study aims at characterising participants in disease management regarding their health locus of control. Data are based on 4 cross-sectional postal surveys between spring and autumn of 2006 and 2007 within the Health Care Monitor of the Bertelsmann Foundation. Among the 6 285 respondents, 1 266 are chronically ill and not enrolled in a DMP and 327 are participating in a DMP. A high internal locus of control (HLC) occurs significantly less often in DMP patients than in normal chronically ill patients (and healthy people) controlling for age, gender and social class. With increasing age, a high internal locus of control is also significantly less likely. When comparing healthy people, the chronically ill and the DMP participants a social gradient of a high internal locus of control belief can be observed. The weaker internal and higher doctor-related external locus of control of DMP participants should be carefully observed by the physician when trying to strengthen the patients' self-management skills. Evaluators of DMP should take into account the different baselines of DMP patients and relevant control groups and incorporate these differences into the evaluation.

  19. Professionalism: good for patients and health care organizations.

    Science.gov (United States)

    Brennan, Michael D; Monson, Verna

    2014-05-01

    Professionalism is an indispensable element in the compact between the medical profession and society that is based on trust and putting the needs of patients above all other considerations. The resurgence of interest in professionalism dates back to the 1980s when health maintenance organizations were formed and proprietary influences in health care increased. Since then, a rich and comprehensive literature has emerged in defining professionalism, including desirable individual attributes and behaviors and how they may be taught, promoted, and assessed. More recently, scholarship has shifted from individual to organizational professionalism. This literature addresses the role that health care organizations can play to establish environments that are conducive to the consistent expression of professionalism by individuals and health care teams. We reviewed interdisciplinary empirical studies from health care effectiveness and outcomes, organizational sciences, positive psychology, and social psychology, finding evidence that organizational and individual professionalism is associated with a wide range of benefits to patients and the organization. We identify actionable organizational strategies and approaches that, if adopted, can foster and promote combined organizational and individual professionalism. In doing so, trust in the medical profession and its institutions can be enhanced, which in turn will reconfirm a commitment to the social compact. PMID:24797645

  20. Congruence or Discrepancy? Comparing Patients' Health Valuations and Physicians' Treatment Goals for Rehabilitation for Patients with Chronic Conditions

    Science.gov (United States)

    Nagl, Michaela; Farin, Erik

    2012-01-01

    The aim of this study was to test the congruence of patients' health valuations and physicians' treatment goals for the rehabilitation of chronically ill patients. In addition, patient characteristics associated with greater or less congruence were to be determined. In a questionnaire study, patients' health valuations and physicians' goals were…

  1. Practical guide on home health in heart failure patients

    DEFF Research Database (Denmark)

    Jaarsma, T.; Larsen, Torben; Stromberg, A.

    2013-01-01

    from a literature review, a survey of heart failure management programs, the opinion of researchers and practitioners, data from clinical trials and a reflection of an international expert meeting. Results: In integrated home care for heart failure patients, it is advised to consider the following......Introduction: Chronic heart failure is a common condition affecting up to 15 million people in the extended Europe. Heart failure is burdensome and costly for patients in terms of decreased quality of life and poor prognosis, and it is also costly for society. Better integrated care is warranted...... in this population and specialised heart failure care can save costs and improve the quality of care. However, only a few European countries have implemented specialised home care and offered this to a larger number of patients with heart failure. Method: We developed a guide on Home Health in Heart Failure patients...

  2. Exploration of patient evaluations of health care quality in 12 different European countries in relation to health system performance.

    NARCIS (Netherlands)

    Kerssens, J.J.; Groenewegen, P.P.; Sixma, H.J.; Boerma, W.G.W.; Eijk, I. van der

    2003-01-01

    Background: Large differences between countries exist in the use, costs, quality, accessibility etc. of health services. Also large differences exist between countries in patient evaluations of their health care system. But how do patient evaluations relate to health care performance? Aim: This stud

  3. When health systems are barriers to health care: challenges faced by uninsured Mexican kidney patients.

    Directory of Open Access Journals (Sweden)

    Ciara Kierans

    Full Text Available BACKGROUND: Chronic Kidney Disease disproportionately affects the poor in Low and Middle Income Countries (LMICs. Mexico exemplifies the difficulties faced in supporting Renal Replacement Therapy (RRT and providing equitable patient care, despite recent attempts at health reform. The objective of this study is to document the challenges faced by uninsured, poor Mexican families when attempting to access RRT. METHODS: The article takes an ethnographic approach, using interviewing and observation to generate detailed accounts of the problems that accompany attempts to secure care. The study, based in the state of Jalisco, comprised interviews with patients, their caregivers, health and social care professionals, among others. Observations were carried out in both clinical and social settings. RESULTS: In the absence of organised health information and stable pathways to renal care, patients and their families work extraordinarily hard and at great expense to secure care in a mixed public-private healthcare system. As part of this work, they must navigate challenging health and social care environments, negotiate treatments and costs, resource and finance healthcare and manage a wide range of formal and informal health information. CONCLUSIONS: Examining commonalities across pathways to adequate healthcare reveals major failings in the Mexican system. These systemic problems serve to reproduce and deepen health inequalities. A system, in which the costs of renal care are disproportionately borne by those who can least afford them, faces major difficulties around the sustainability and resourcing of RRTs. Attempts to increase access to renal therapies, therefore, need to take into account the complex social and economic demands this places on those who need access most. This paper further shows that ethnographic studies of the concrete ways in which healthcare is accessed in practice provide important insights into the plight of CKD patients and so

  4. Patient Abuse in the Health Care Setting: The Nurse as Patient Advocate.

    Science.gov (United States)

    Albina, Julie K

    2016-01-01

    Incidents of verbal and physical patient abuse in health care settings continue to occur, with some making headline news. Nurses have a professional and ethical responsibility to advocate for their patients when incidents of abuse occur. Tolerating or ignoring inappropriate behaviors occurs for multiple reasons, including ignorance, fear of retaliation, the need for peer acceptance, and concerns for personal advancement. Nurses need to reflect on their biases before they can truly respect patients' autonomy. Through the examination of reported cases of patient abuse, the need for a change in hospital culture becomes evident. The primary steps in eliminating patient abuse are opening communication, providing education, establishing competency, eliminating tolerance of unacceptable behavior, and creating a code of mutual respect. A change in culture to one of mutual respect and dignity for staff members and patients will lead to the best outcomes for all involved. PMID:26746029

  5. Periodontal health and diabetes awareness among Saudi diabetes patients

    Directory of Open Access Journals (Sweden)

    Bahammam MA

    2015-02-01

    Full Text Available Maha A BahammamDepartment of Periodontology, King Abdulaziz University Faculty of Dentistry, Jeddah, Kingdom of Saudi ArabiaPurpose: This study aimed to examine diabetic patients in Jeddah, Saudi Arabia, regarding their general diabetic and oral health-related awareness and practices, their awareness of the association of diabetes with periodontal disease, and their sources of diabetes-related information.Methods: Diabetic patients (n=454 who were receiving care at the diabetes clinic in King Abdulaziz University Hospital, Jeddah, Saudi Arabia, from October 2013 to May 2014, completed a six-part questionnaire assessing their sociodemographic characteristics, general and oral health awareness and practices, and sources of diabetes-related information. Descriptive statistics were used to report the results.Results: The responses indicated inadequate health-related practices in the surveyed group: 22.2% brushed their teeth twice daily, 73.6% never flossed their teeth, and while 80.2% visited a physician in the past year, only 12.6% visited a dentist during the same year. Of the respondents, 94.8% reported that they had never received advice on oral hygiene tasks in relation to diabetes from a health professional. Awareness about the diabetes and periodontal disease association was limited: 46.7% knew that diabetics have gum problems more often if their blood sugar stays very high, and only 21.8% knew that gum disease makes it harder to control blood sugar in diabetic patients. A significant association (P<0.05 was found between a higher level of education and greater general and oral awareness, as well as a significant association (P<0.05 between longer duration of disease, regular exercise, and regular visits to the physician and awareness about diabetes mellitus. Additionally, a significant association (P<0.05 was found between regular dental visits and both periodontal disease and diabetes awareness. Family and friends were the main source of

  6. Health related quality of life in patients with anogenital warts

    Directory of Open Access Journals (Sweden)

    Papadogeorgakis Helen

    2011-08-01

    Full Text Available Abstract Introduction The health-related quality-of-life (HRQoL instruments are an important tool for the evaluation of medical outcomes. Sexually transmitted diseases (STDs influence the patients' life. We aimed to evaluate the HRQoL in patients with anogenital warts at the time of and 1 month after the diagnosis. Materials and methods We used the short-form (SF-36 questionnaire to compare the HRQoL of 91 patients with anogenital warts to 53 control subjects with the same socioeconomic characteristics. Results There was no statistical difference in the overall HRQoL measurement between the anogenital wart patients and controls. However, there was an improvement in the scales of vitality (65.22 ± 15.70 vs. 69.04 ± 14.11, respectively; p Conclusions HRQoL does not appear to be influenced in anogenital wart patients, as measured by the generic instrument SF-36. It is therefore important to develop specific instruments for the measurement of HRQoL in this group of patients.

  7. Patient-powered research networks aim to improve patient care and health research.

    Science.gov (United States)

    Fleurence, Rachael L; Beal, Anne C; Sheridan, Susan E; Johnson, Lorraine B; Selby, Joe V

    2014-07-01

    The era of big data, loosely defined as the development and analysis of large or complex data sets, brings new opportunities to empower patients and their families to generate, collect, and use their health information for both clinical and research purposes. In 2013 the Patient-Centered Outcomes Research Institute launched a large national research network, PCORnet, that includes both clinical and patient-powered research networks. This article describes these networks, their potential uses, and the challenges they face. The networks are engaging patients, family members, and caregivers in four key ways: contributing data securely, with privacy protected; including diverse and representative groups of patients in research; prioritizing research questions, participating in research, and disseminating results; and participating in the leadership and governance of patient-powered research networks. If technical, regulatory, and organizational challenges can be overcome, PCORnet will allow research to be conducted more efficiently and cost-effectively and results to be disseminated quickly back to patients, clinicians, and delivery systems to improve patient health. PMID:25006148

  8. The role of health literacy and social networks in arthritis patients' health information-seeking behavior: a qualitative study.

    Science.gov (United States)

    Ellis, Janette; Mullan, Judy; Worsley, Anthony; Pai, Nagesh

    2012-01-01

    Background. Patients engage in health information-seeking behaviour to maintain their wellbeing and to manage chronic diseases such as arthritis. Health literacy allows patients to understand available treatments and to critically appraise information they obtain from a wide range of sources. Aims. To explore how arthritis patients' health literacy affects engagement in arthritis-focused health information-seeking behaviour and the selection of sources of health information available through their informal social network. Methods. An exploratory, qualitative study consisting of one-on-one semi-structured interviews. Twenty participants with arthritis were recruited from community organizations. The interviews were designed to elicit participants' understanding about their arthritis and arthritis medication and to determine how the participants' health literacy informed selection of where they found information about their arthritis and pain medication. Results. Participants with low health literacy were less likely to be engaged with health information-seeking behaviour. Participants with intermediate health literacy were more likely to source arthritis-focused health information from newspapers, television, and within their informal social network. Those with high health literacy sourced information from the internet and specialist health sources and were providers of information within their informal social network. Conclusion. Health professionals need to be aware that levels of engagement in health information-seeking behaviour and sources of arthritis-focused health information may be related to their patients' health literacy.

  9. Prioritizing the Preferences of Iranian Cancer Patients Regarding Acquisition of Health Information: Strategy for Patient Education.

    Science.gov (United States)

    Zadeh, Jamileh Mahdi; Fard, Farahnaz Ghahreman; Madani, Raihaneh; Iravani, Homa; Kahouei, Mehdi

    2016-01-01

    Recognizing cancer patients' preferences to obtain health information can help improve and reform the methods of communicating and providing proper services and consequently lead to effective patient education. The present cross-sectional study to prioritize the preferences of cancer patients regarding the acquisition of health informationwas conducted on cancer patients referred to hospitals affiliated to Semnan University of Medical Sciences in 2015. An anonymous self-administered questionnaire was developed. In the field of side effects of medications, 50 (46.7%) reported knowing about weight change, in the area of achieving relative health, 62(57.9%) announced awareness about diet, and 45 (42.1%) reported physical complications as a first regarding information needs. In the area of obtaining information, 50 (46.7%) tended to take their information through means outside of the hospital setting. These results can help with design of clinical information systems, as they inform the most relevant and useful coverage designed for cancer patients. Providing useful information through healthcare providers, the media and clinical information systems can act as a major source of social support for cancer patients. PMID:27356722

  10. Urinary Stone Disease: Advancing Knowledge, Patient Care, and Population Health.

    Science.gov (United States)

    Scales, Charles D; Tasian, Gregory E; Schwaderer, Andrew L; Goldfarb, David S; Star, Robert A; Kirkali, Ziya

    2016-07-01

    Expanding epidemiologic and physiologic data suggest that urinary stone disease is best conceptualized as a chronic metabolic condition punctuated by symptomatic, preventable stone events. These acute events herald substantial future chronic morbidity, including decreased bone mineral density, cardiovascular disease, and CKD. Urinary stone disease imposes a large and growing public health burden. In the United States, 1 in 11 individuals will experience a urinary stone in their lifetime. Given this high incidence and prevalence, urinary stone disease is one of the most expensive urologic conditions, with health care charges exceeding $10 billion annually. Patient care focuses on management of symptomatic stones rather than prevention; after three decades of innovation, procedural interventions are almost exclusively minimally invasive or noninvasive, and mortality is rare. Despite these advances, the prevalence of stone disease has nearly doubled over the past 15 years, likely secondary to dietary and health trends. The NIDDK recently convened a symposium to assess knowledge and treatment gaps to inform future urinary stone disease research. Reducing the public health burden of urinary stone disease will require key advances in understanding environmental, genetic, and other individual disease determinants; improving secondary prevention; and optimal population health strategies in an increasingly cost-conscious care environment. PMID:26964844

  11. Life satisfaction and health in cancer patients, orthopedic patients and healthy individuals.

    Science.gov (United States)

    Kreitler, S; Chaitchik, S; Rapoport, Y; Kreitler, H; Algor, R

    1993-02-01

    Life satisfaction (LS) is one of a set of constructs defining quality of life. Previous studies showed that LS was sometimes related to health and sometimes not. The study was designed to examine the relation of LS as a general construct to satisfaction in specific domains. We assumed that there is a tendency to maintain an acceptable level of LS even under stressful and threatening conditions, that it is related to optimism and that the likelihood of attaining satisfaction in a particular domain affected the selection of domains on which LS is based. We expected that in cancer patients LS would be related to more domains but not to health. The study was done with 55 head-and-neck cancer patients, of all stages and grades of tumor; 51 orthopedic patients, victims of accidents with good recovery chances; and 55 healthy individuals. The healthy individuals and orthopedic patients were matched (in terms of group values) to the cancer patients in age, gender and education. Single-item measures of LS and optimism, and a questionnaire with 49 multiple-choice items assessing adjustment in 13 domains were administered to all subjects. The results showed that in cancer patients LS was related to most domains but not to health and not to optimism, whereas in the other groups it was related to few domains including health, and also to optimism. The findings support the tendency to maintain LS with the materials available to the individual, and show that health is related to LS only if its maintenance or attainment are realistic goals. Thus, both bottom-up and top-down theories of LS are supported.

  12. Impact of national health care systems on patient evaluations of general practice in Europe.

    NARCIS (Netherlands)

    Wensing, M.J.P.; Baker, R.; Szecsenyi, J.; Grol, R.P.T.M.

    2004-01-01

    OBJECTIVE: To examine associations between patient evaluations of general practice and characteristics of national health care systems. METHODS: International comparative study in 17 countries, using international patient survey data (n= 25052) and data-bases for health care system characteristics.

  13. [Bribes in health care and the patients' opinions].

    Science.gov (United States)

    Masopust, V

    1989-07-01

    In May 1988 in the North Bohemian region an anonymous enquiry was made in which 3,767 respondents participated. The enquiry was focused among others on the problem of bribes in the health services. In the paper the author analyzes views of respondents why they give "small gifts" to health workers and why they assume that the patients get better treatment when they bribe. The reason for making "small gifts" or bribes is in 31.3% to manifest appreciation of treatment, in 27.7% an attempt to obtain better treatment and in 7.1% fear of receiving no treatment. People above 45 years, pensioners, employees of the services and chronic patients are more convinced of the positive motive of making "small gifts". Almost 10% of the entire group are convinced of the effect of bribes as a stimulant for provision of better care, 49% deny it and the remainder do not know. The most critically minded patient groups are those working in industry and respondents under 30 years. From the entire group 1.57% admitted making "small gifts", i.e. 59 of 3,767 respondents, the motive of almost half of them (42.3%) was appreciation of the care provided by the attending staff. An unequivocal bribe to obtain better care or fear that care will be refused was involved in 45.8% of the "bribing group". The views of patients who admitted "small gifts" as regards the health services are worse than the views of all respondents.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2791115

  14. [E-health for all: are we reaching the patients who really need it?].

    Science.gov (United States)

    Westerink, Jan; Hutten, Frank M

    2014-01-01

    The introduction and implementation of e-health into our healthcare system may have great benefits. E-health as a means of improving health and lowering healthcare expenditure may be especially efficacious when aimed specifically at older patients and those in lower income groups. However, older patients may not generally feel as comfortable using e-health as younger patients do, and sometimes lack the necessary skills. In addition, patients from lower income groups may not have the necessary access to e-health. New cost-effectiveness analyses of e-health should take into account costs necessary for improving computer skills as well as access to e-health.

  15. Assessing the Use of Mobile Health Technology by Patients: An Observational Study in Primary Care Clinics

    OpenAIRE

    Ramirez, Veronica; Johnson, Emily; Gonzalez, Cesar; Ramirez, Vanessa; Rubino, Barbara; Rossetti, Gina

    2016-01-01

    Background There is significant potential for mobile health technology to improve health outcomes for patients with chronic diseases. However, there is a need for further development of mobile health technology that would help to improve the health of lower-income communities. Objective The study objective was to assess mobile phone and app usage among a culturally diverse patient population, and to determine whether patients would be interested in using mobile health technology to help manag...

  16. Health care index score and risk of death following tuberculosis diagnosis in HIV-positive patients

    DEFF Research Database (Denmark)

    Podlekareva, D N; Grint, D; Post, F A;

    2013-01-01

    To assess health care utilisation for patients co-infected with TB and HIV (TB-HIV), and to develop a weighted health care index (HCI) score based on commonly used interventions and compare it with patient outcome.......To assess health care utilisation for patients co-infected with TB and HIV (TB-HIV), and to develop a weighted health care index (HCI) score based on commonly used interventions and compare it with patient outcome....

  17. Incidence of diabetes mellitus type 2 complications among Saudi adult patients at primary health care center

    OpenAIRE

    Alsenany, Samira; Al Saif, Amer

    2015-01-01

    [Purpose] This study analyzed type 2 diabetes and its role in complications among adult Saudi patients. [Subjects] Patients attending four primary health care centers in Jeddah were enrolled. [Methods] A cross-sectional design study among Saudi patients attending Ministry of Health primary health care centers in Jeddah was selected for use by the Primary Health Care administration. Patients were interviewed with structured questionnaires to determine the presence of diabetes and risk factors ...

  18. Understanding and Predicting Social Media Use Among Community Health Center Patients: A Cross-Sectional Survey

    OpenAIRE

    Hanson, Carl L; West, Josh; Thackeray, Rosemary; Barnes, Michael D; Downey, Jordan

    2014-01-01

    Background The use of social media by health care organizations is growing and provides Web-based tools to connect patients, caregivers, and providers. Objective The aim was to determine the use and factors predicting the use of social media for health care–related purposes among medically underserved primary care patients. Methods A cross-sectional survey was administered to 444 patients of a federally qualified community health center. Results Community health center patients preferred that...

  19. Understanding of definition and safety of oral health products among patients, physicians and pharmacists.

    Science.gov (United States)

    Asahina, Yasuko; Hori, Satoko; Sawada, Yasufumi

    2010-07-01

    Our objective was to clarify the current understanding of the definition and safety of oral health products among patients and health professionals, and patients' perception about their communication with physicians and pharmacists regarding those products. Self-administered questionnaires were completed by patients at 17 community pharmacies in 14 prefectures of Japan. For health professionals, we sent a questionnaire to pharmacists and physicians who were registered as members of the Internet-based Medical Doctor's and Pharmacist's Information-Sharing System. The respondents were 242 patients, 158 physicians and 407 pharmacists. Some patients did not categorize dietary supplements as health products, while they did so categorize conventional foods (e.g., fermented soybeans, yogurt). Their understanding of the definition of health products was different from that of health professionals. Less than half of the patients considered that health products might potentiate or attenuate the effects of concomitant drugs, and this view was especially common among the elderly. The percentage of patients who reported that they rarely or never asked for advice from a pharmacist about their use of health products was significantly higher among those who had an incorrect understanding about health products. In conclusion, some patients' recognition of oral health products was different from that of health professionals, and most patients do not discuss their use of such products unless they are asked. Therefore, it is important for health professionals to check a patient's use of health products and be sure what he or she means when using the term 'health product'.

  20. Patient Satisfaction Before and After Executing Health Sector Evolution Plan

    Directory of Open Access Journals (Sweden)

    Behrouz Hashemi

    2015-02-01

    Full Text Available Introduction: After long discussions, carrying out health sector evolution (HSE plan began on May 5, 2014 throughout Iran. Shohadaye Tajrish Hospital, Tehran, was also included in this plan. This study aimed to evaluate the level of emergency department patient satisfaction, before and after running this plan. Methods: This cross-sectional study analyzed the data extracted from a standard questionnaire filled out by the patients presented to the emergency department of Shohadaye Tajrish Hospital over 6-month periods before and after the beginning of HSE. Results: 3665 patients were surveyed. After the execution of the plan, satisfaction decreased significantly regarding pre-discharge training (p = 0.03, hospitalization room condition (p = 0.0002, restroom sanitation (p = 0.007, waiting time to be visited by the physician (p = 0.04, accuracy and duration of physical examination (p = 0.007, feeling confident and desirable outcome (p = 0.03, commitment to religious and moral principles (p = 0.01, and handling financial affairs (p = 0.03. Conclusion: Based on the results of the present study, after execution of HSE plan, patient satisfaction has decreased significantly regarding pre-discharge training, hospitalization room condition, restroom sanitation, timely visit of the physicians, accuracy and duration of physical examination, suggestions for wellbeing of the patient, handling financial affairs, and commitment to religious and moral principles.

  1. The patient as the pivot point for quality in health care delivery.

    Science.gov (United States)

    Lengnick-Hall, C A

    1995-01-01

    Health care enterprises make comprehensive and durable changes in people. This human-centered purpose defines the fundamental nature of quality in health care settings. Traditional perspectives of quality and familiar views of customer satisfaction are inadequate to manage the complex relationships between the health care delivery firm and its patients. Patients play four roles in health care systems that must be reflected when defining and measuring quality in these settings: patient as supplier, patient as product, patient as participant, and patient as recipient. This article presents a conceptual model of quality that incorporates these diverse patient roles. The strategic and managerial implications of the model are also discussed. PMID:10140872

  2. The patient as the pivot point for quality in health care delivery.

    Science.gov (United States)

    Lengnick-Hall, C A

    1995-01-01

    Health care enterprises make comprehensive and durable changes in people. This human-centered purpose defines the fundamental nature of quality in health care settings. Traditional perspectives of quality and familiar views of customer satisfaction are inadequate to manage the complex relationships between the health care delivery firm and its patients. Patients play four roles in health care systems that must be reflected when defining and measuring quality in these settings: patient as supplier, patient as product, patient as participant, and patient as recipient. This article presents a conceptual model of quality that incorporates these diverse patient roles. The strategic and managerial implications of the model are also discussed.

  3. Using health psychology to help patients: promoting wellbeing.

    Science.gov (United States)

    Barley, Elizabeth; Lawson, Victoria

    2016-08-11

    This article explores the construct of wellbeing. Research concerning the relationship between subjective wellbeing and health is discussed. Key components of wellbeing that are important to health include 'sense of coherence', 'optimism' and 'benefit finding and post-traumatic growth'. A range of positive psychology interventions that aim to increase positive thoughts, feelings and emotions in order to improve wellbeing have been developed. Mindfulness-based approaches to improving wellbeing are especially popular and are evidence based. These focus on helping the individual to develop an awareness of the present with acceptance and attention. Instead of trying to change uncomfortable thoughts or feelings, the individual practices accepting these, without judgement. Nurses can draw on the information in this article to provide evidence-based advice and guidance to help improve their patients' and their own wellbeing. PMID:27523757

  4. Using health psychology to help patients: promoting wellbeing.

    Science.gov (United States)

    Barley, Elizabeth; Lawson, Victoria

    2016-08-11

    This article explores the construct of wellbeing. Research concerning the relationship between subjective wellbeing and health is discussed. Key components of wellbeing that are important to health include 'sense of coherence', 'optimism' and 'benefit finding and post-traumatic growth'. A range of positive psychology interventions that aim to increase positive thoughts, feelings and emotions in order to improve wellbeing have been developed. Mindfulness-based approaches to improving wellbeing are especially popular and are evidence based. These focus on helping the individual to develop an awareness of the present with acceptance and attention. Instead of trying to change uncomfortable thoughts or feelings, the individual practices accepting these, without judgement. Nurses can draw on the information in this article to provide evidence-based advice and guidance to help improve their patients' and their own wellbeing.

  5. An evaluation of a health status measure and two health utility measures in patients with inflammatory polyarthritis

    OpenAIRE

    Harrison MJ

    2008-01-01

    Background: The ability to measure health and the value of improving or declining health is crucial to the evaluation of health care interventions. Many generic and disease specific health status measures exist for use in patients with rheumatoid arthritis (RA). The Overall Status in Rheumatoid Arthritis (OSRA) measure is a new and simple measure with early evidence of construct validity. Generic health profiles with attached utility weights such as the EuroQol EQ-5D and the SF-6D (calculated...

  6. Deep Patient: An Unsupervised Representation to Predict the Future of Patients from the Electronic Health Records

    Science.gov (United States)

    Miotto, Riccardo; Li, Li; Kidd, Brian A.; Dudley, Joel T.

    2016-01-01

    Secondary use of electronic health records (EHRs) promises to advance clinical research and better inform clinical decision making. Challenges in summarizing and representing patient data prevent widespread practice of predictive modeling using EHRs. Here we present a novel unsupervised deep feature learning method to derive a general-purpose patient representation from EHR data that facilitates clinical predictive modeling. In particular, a three-layer stack of denoising autoencoders was used to capture hierarchical regularities and dependencies in the aggregated EHRs of about 700,000 patients from the Mount Sinai data warehouse. The result is a representation we name “deep patient”. We evaluated this representation as broadly predictive of health states by assessing the probability of patients to develop various diseases. We performed evaluation using 76,214 test patients comprising 78 diseases from diverse clinical domains and temporal windows. Our results significantly outperformed those achieved using representations based on raw EHR data and alternative feature learning strategies. Prediction performance for severe diabetes, schizophrenia, and various cancers were among the top performing. These findings indicate that deep learning applied to EHRs can derive patient representations that offer improved clinical predictions, and could provide a machine learning framework for augmenting clinical decision systems. PMID:27185194

  7. Telepsychiatry program eases patient crowding in the ED, expedites mental health services to patients and providers.

    Science.gov (United States)

    2013-11-01

    With funding from the Duke Endowment, the Albemarle Hospital Foundation in Elizabeth City, NC, implemented a telepsychiatry program aimed at decreasing patient backlogs in the health system's EDs, while also quickly connecting patients with needed mental health care. The approach has more than halved LOS for patients who are discharged to inpatient treatment facilities. The approach is also credited with reducing recidivism rates and the need for involuntary commitments. Now the state has announced plans to employ a similar approach statewide. Patients in the ED are connected with psychiatric providers at a remote location through the use of telemedicine carts that are equipped with wireless technology. With expedited psychiatric treatment, administrators say that nearly 30% of patients with involuntary commitment (IVC) orders stabilize to the point that their IVC orders can be rescinded and they can be discharged from the ED to outpatient care. Since the start of the pilot program in March of 2011, project administrators report that the average LOS in the ED for patients discharged to inpatient treatment facilities has decreased from 48 hours to 22.5 hours.

  8. Patient-rated health status predicts prognosis following percutaneous coronary intervention with drug-eluting stenting

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Versteeg, Henneke; Denollet, Johan;

    2011-01-01

    In patients treated with percutaneous coronary intervention (PCI) with the paclitaxel-eluting stent, we examined whether patient-rated health status predicts adverse clinical events.......In patients treated with percutaneous coronary intervention (PCI) with the paclitaxel-eluting stent, we examined whether patient-rated health status predicts adverse clinical events....

  9. Improving patient flow at a family health clinic.

    Science.gov (United States)

    Bard, Jonathan F; Shu, Zhichao; Morrice, Douglas J; Wang, Dongyang Ester; Poursani, Ramin; Leykum, Luci

    2016-06-01

    This paper presents an analysis of a residency primary care clinic whose majority of patients are underserved. The clinic is operated by the health system for Bexar County and staffed primarily with physicians in a three-year Family Medicine residency program at The University of Texas School of Medicine in San Antonio. The objective of the study was to obtain a better understanding of patient flow through the clinic and to investigate changes to current scheduling rules and operating procedures. Discrete event simulation was used to establish a baseline and to evaluate a variety of scenarios associated with appointment scheduling and managing early and late arrivals. The first steps in developing the model were to map the administrative and diagnostic processes and to collect time-stamped data and fit probability distributions to each. In conjunction with the initialization and validation steps, various regressions were performed to determine if any relationships existed between individual providers and patient types, length of stay, and the difference between discharge time and appointment time. The latter two statistics along with resource utilization and closing time were the primary metrics used to evaluate system performance.The results showed that up to an 8.5 % reduction in patient length of stay is achievable without noticeably affecting the other metrics by carefully adjusting appointment times. Reducing the no-show rate from its current value of 21.8 % or overbooking, however, is likely to overwhelm the system's resources and lead to excessive congestion and overtime. Another major finding was that the providers are the limiting factor in improving patient flow. With an average utilization rate above 90 % there is little prospect in shortening the total patient time in the clinic without reducing the providers' average assessment time. Finally, several suggestions are offered to ensure fairness when dealing with out-of-order arrivals. PMID:25155098

  10. Development and evaluation of a patient centered cardiovascular health education program for insured patients in rural Nigeria (QUICK-II)

    NARCIS (Netherlands)

    A.O. Odusola; M. Hendriks; C. Schultsz; K. Stronks; J. Lange; A. Osibogun; T. Akande; S. Alli; P. Adenusi; K. Agbede; J. Haafkens

    2011-01-01

    BACKGROUND: In Sub Saharan Africa, the incidence of hypertension and other modifiable cardiovascular risk factors is growing rapidly. Poor adherence to prescribed prevention and treatment regimens by patients can compromise treatment outcomes. Patient-centered cardiovascular health education is like

  11. Integrating patients' views into health technology assessment: Analytic hierarchy process (AHP) as a method to elicit patient preferences

    NARCIS (Netherlands)

    Danner, Marion; Hummel, Marjan J.; Volz, Fabian; Manen, van Jeannette G.; Wiegard, Beate; Dintsios, Charalabos-Markos; Bastian, Hilda; Gerber, Andreas; IJzerman, Maarten J.

    2011-01-01

    Background: Patient involvement is widely acknowledged to be a valuable component in health technology assessment (HTA) and healthcare decision making. However, quantitative approaches to ascertain patients' preferences for treatment endpoints are not yet established. The objective of this study is

  12. The Impact of Validated, Online Health Education Resources on Patient and Community Members' Satisfaction and Health Behaviour

    Science.gov (United States)

    Atack, Lynda; Luke, Robert

    2012-01-01

    Objective: While access to health education information has become easier, the quality of information retrieved from the Internet varies considerably. In response to the need for accessible, quality health information that is tailored to meet individual patient needs, a patient education website, called PEPTalk, was developed. The site houses text…

  13. Embryonic health: new insights, mHealth and personalised patient care.

    Science.gov (United States)

    Steegers-Theunissen, Régine P M; Steegers, Eric A P

    2015-05-01

    The worldwide epidemic of non-communicable diseases (NCD), including obesity, is a burden to which poor lifestyles contribute significantly. Events in early life may enhance susceptibility to NCD, with transmission into succeeding generations. This may also explain, in part, why interventions in adulthood are less effective to reduce NCD risk. New insights reveal that the early embryo, in particular, is extremely sensitive to signals from gametes, trophoblastic tissue and periconception maternal lifestyles. Embryonic size and growth as determinants of embryonic health seem to impact future health. A relatively small embryo for gestational age is associated with pregnancy complications, as well as with the risk of early features of NCD in childhood. Although personal lifestyles are modifiable, they are extremely difficult to change. Therefore, adopting a life course approach from the periconception period onwards and integrated into patient care with short-term reproductive health benefits may have important implications for future prevention of NCD. The current reproductive population is used to Internet and social media. Therefore, they can be reached via mobile phone (mHealth) platforms that provide personalised lifestyle (pre)pregnancy programs. This will offer opportunities and possibly great benefits for the health of current and succeeding generations. PMID:25771352

  14. Cross-border mobility of health professionals: contesting patients' right to health.

    Science.gov (United States)

    Plotnikova, Evgeniya Vadimovna

    2012-01-01

    Cross-border labour mobility in the health sector is portrayed as both an opportunity for health professionals immigrating to developed countries, and as a challenge for patients remaining in low-income countries with restricted access to health care provision. In policy debate, this problem is articulated as the opposition between, 'the right to freedom of movement' and 'the right to health'. The underlying layers of this dilemma expose competing institutional interests for source and destination countries, international organisations, private recruitment agencies, trade unions and professional organisations. To resolve some of these tensions, a 'soft law' regulation (ethical recruitment policy) was adopted in the UK in the early 2000s. This article argues that this ethical recruitment policy produces an ambivalent effect. The qualitative content analysis refers to documents produced by international organisations, government bodies, professional organisations and trade unions in the UK and source countries. We found that ethical recruitment on the one hand proposes a practical mechanism to the realisation of the right to health in source countries, through encouraging employers' behaviour in accordance with ethical principles in international recruitment. On the other hand, this policy protects the reputation of institutional stakeholders changing rhetoric around international recruitment rather than the practice. The findings of this study contribute to a broader discussion of the international norms diffusion and the ambivalent role of 'soft law' in their implementation. PMID:21435766

  15. The First Study of Patient Safety Culture in Iranian Primary Health Centers

    OpenAIRE

    Mojtaba Sedaghat; Narges Tabrizchi

    2012-01-01

    Although the error in health care has received attention recently, patient safety culture in health centers has been relatively neglected. To measure the patient safety culture in primary health centers. A cross-sectional study, utilizing the modified version of the Hospital Survey on Patient Safety Culture (HSOPSC) developed by the Agency for Healthcare Research and Quality (AHRQ) and a demographic questionnaire. Healthcare staffs from health centers were participated in the survey. The pati...

  16. Mental health related Internet use among psychiatric patients: a cross-sectional analysis

    OpenAIRE

    Kalckreuth, Sophie; Trefflich, Friederike; Rummel-Kluge, Christine

    2014-01-01

    Background The Internet is of great importance in today’s health sector, as most Internet users utilize online functions for health related purposes. Concerning the mental health care sector, little data exist about the Internet use of psychiatric patients. It is the scope of this current study to analyze the quantity and pattern of Internet usage among mental health patients. Methods Patients from all services of the Department of Psychiatry at a university hospital were surveyed by completi...

  17. At the Bedside: Traditional Navajo practitioners in a patient-centered health care model.

    Science.gov (United States)

    Joe, Jennie R; Young, Robert S; Moses, Jill; Knoki-Wilson, Ursula; Dennison, Johnson

    2016-01-01

    The growing national racial and ethnic diversity has created a greater need for health care delivery systems and health care providers to be more responsive to unique patient needs, that goes beyond meeting the immediate health problems to include attention to other critical component of patient care that take into account cultural competency such as health literacy, health beliefs and behaviors, cultural practices, etc. PMID:27115131

  18. Improving diabetes management with electronic health records and patients' health records.

    Science.gov (United States)

    Benhamou, P-Y

    2011-12-01

    The lack of patient engagement and clinical inertia both contribute to suboptimal diabetes care. However, both obstacles are amenable to informatics- and Internet-based interventions. The use of electronic medical records (EMRs) is now established as being useful for improving diabetes care. Intelligent records that integrate computerized decision-support systems are now able to recommend care protocols tailored to risk levels. Web-based personal health record (PHR) systems, shared with healthcare providers, could also provide added value by promoting self-management of the behaviours related to diabetes. These Web-based programmes include patients' access to EMRs, uploading of glucose monitoring results, a glucose diary, secure e-mail with providers, manual or automated feedback on blood glucose readings and other risk factors, an educational website, and an online diary for entering personal information on exercise, diet and medication. The integration of Web-based patients' systems into the EMR used by physicians is the next frontier. In addition, the input from "smartphones" that are able to provide real-time support to patients could contribute to the reorganization of diabetes care. Convincing data on HbA(1c) improvements with such systems are available for type 2 diabetes, but are still equivocal for type 1 diabetes. Obstacles include patients' compliance with the technology, their ergonomic design and the need to reimburse providers for their care. Designing appropriate electronic tools and tailoring them to the conditions in France merits our attention. PMID:22208711

  19. The Motivating Function of Healthcare Professional in eHealth and mHealth Interventions for Type 2 Diabetes Patients and the Mediating Role of Patient Engagement

    Directory of Open Access Journals (Sweden)

    Guendalina Graffigna

    2016-01-01

    Full Text Available eHealth and mHealth interventions for type 2 diabetes are emerging as useful strategies to accomplish the goal of a high functioning integrated care system. However, mHealth and eHealth interventions in order to be successful need the clear endorsement from the healthcare professionals. This cross-sectional study included a sample of 93 Italian-speaking type 2 diabetes patients and demonstrated the role of the perceived ability of healthcare professionals to motivate patients’ initiative in improving the level of their engagement and activation in type 2 diabetes self-management. The level of type 2 diabetes patients’ activation resulted also in being a direct precursor of their attitude to the use of mHealth and eHealth. Furthermore, patient engagement has been demonstrated to be a mediator of the relationship between the perceived ability of healthcare professionals in motivating type 2 diabetes patients and patients’ activation. Finally, type 2 diabetes patients adherence did not result in being a direct consequence of the frequency of mHealth and eHealth use. Patient adherence appeared to be directly influenced by the level of perceived healthcare professionals ability of motivating patients’ autonomy. These results offer important insights into the psychosocial and organizational elements that impact on type 2 diabetes patients’ activation in self-management and on their willingness to use mHealth and eHealth devices.

  20. Helping Doctors and Patients Make Sense of Health Statistics.

    Science.gov (United States)

    Gigerenzer, Gerd; Gaissmaier, Wolfgang; Kurz-Milcke, Elke; Schwartz, Lisa M; Woloshin, Steven

    2007-11-01

    Many doctors, patients, journalists, and politicians alike do not understand what health statistics mean or draw wrong conclusions without noticing. Collective statistical illiteracy refers to the widespread inability to understand the meaning of numbers. For instance, many citizens are unaware that higher survival rates with cancer screening do not imply longer life, or that the statement that mammography screening reduces the risk of dying from breast cancer by 25% in fact means that 1 less woman out of 1,000 will die of the disease. We provide evidence that statistical illiteracy (a) is common to patients, journalists, and physicians; (b) is created by nontransparent framing of information that is sometimes an unintentional result of lack of understanding but can also be a result of intentional efforts to manipulate or persuade people; and (c) can have serious consequences for health. The causes of statistical illiteracy should not be attributed to cognitive biases alone, but to the emotional nature of the doctor-patient relationship and conflicts of interest in the healthcare system. The classic doctor-patient relation is based on (the physician's) paternalism and (the patient's) trust in authority, which make statistical literacy seem unnecessary; so does the traditional combination of determinism (physicians who seek causes, not chances) and the illusion of certainty (patients who seek certainty when there is none). We show that information pamphlets, Web sites, leaflets distributed to doctors by the pharmaceutical industry, and even medical journals often report evidence in nontransparent forms that suggest big benefits of featured interventions and small harms. Without understanding the numbers involved, the public is susceptible to political and commercial manipulation of their anxieties and hopes, which undermines the goals of informed consent and shared decision making. What can be done? We discuss the importance of teaching statistical thinking and

  1. Do health literacy and patient empowerment affect self-care behaviour? A survey study among Turkish patients with diabetes

    Science.gov (United States)

    Eyüboğlu, Ezgi; Schulz, Peter J

    2016-01-01

    Objective This study aimed to assess the impact of health literacy and patient empowerment on diabetes self-care behaviour in patients in metropolitan Turkish diabetes centres. The conceptual background is provided by the psychological health empowerment model, which holds that health literacy without patient empowerment comes down to wasting health resources, while empowerment without health literacy can lead to dangerous or suboptimal health behaviour. Design, setting and participants A cross-sectional study was conducted with 167 patients over the age of 18 from one of two diabetes clinics in a major Turkish City. Self-administered questionnaires were distributed to eligible outpatients who had an appointment in one of the clinics. Health literacy was measured by a newly translated Turkish version of the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and the Chew self-report scale. Patient empowerment was measured by a 12-item scale based on Spreitzer's conceptualisation of psychological empowerment in the workplace. Self-care behaviour was measured by the Self-care behaviours were measured by the Summary of Diabetes Self-Care Activities Measure (SDSCA). Level of diabetes knowledge was measured by Diabetes Knowledge Test. Results Two subscales of empowerment, impact and self-determination, predicted self-reported frequency of self-care behaviours. Neither health literacy nor diabetes knowledge had an effect on self-care behaviours. Conclusions Health literacy might be more effective in clinical decisions while empowerment might exert a stronger influence on habitual health behaviours. PMID:26975936

  2. Informal, Incidental and Ad Hoc: The Information-Seeking and Learning Strategies of Health Care Patients

    Science.gov (United States)

    Papen, Uta

    2012-01-01

    When people are ill, they want to know what is happening to them and how they can get better. Current health policies support patients' access to health information and encourage them to take part in decisions regarding their health. But little is known about how patients learn and the difficulties they may encounter in the process. This paper…

  3. E-health applications and services for patient empowerment: Directions for best practices in the Netherlands

    NARCIS (Netherlands)

    Alpay, L.L.; Henkemans, O.B.; Otten, W.; Rövekamp, T.A.J.M.; Dumay, A.C.M.

    2010-01-01

    Objective: E-health may enable the empowerment process for patients, particularly the chronically ill. However, e-health is not always designed with the requirements of patient empowerment in mind. Drawing on evidence-based e-health studies, we propose directions for best practices to develop e-heal

  4. E-health Applications and Services for Patient Empowerment: Directions for Best Practices in The Netherlands

    NARCIS (Netherlands)

    Alpay, L.L.; Blanson Henkemans, O.; Otten, W.; Rövekamp, T.A.J.M.; Dumay, A.C.M.

    2010-01-01

    Objective: E-health may enable the empowerment process for patients, particularly the chronically ill. However, e-health is not always designed with the requirements of patient empowerment in mind. Drawing on evidence-based e-health studies, we propose directions for best practices to develop e-heal

  5. A Qualitative Study on Patient Perceptions Towards mHealth Technology Among High Risk, Chronic Disease Patients

    OpenAIRE

    Martinez, Phillip Rico

    2015-01-01

    Background: For over 17 years, the Prevention and Access to Care and Treatment (PACT) Project has actively developed a Community Health Worker model for care of chronically ill, high risk patients. Given the high burden of chronic disease and associated rising health expenditures, mHealth technology has emerged as a promising low cost, high efficacy intervention for delivery of patient-centered care and as a tool for self-management of chronic disease Objective: Attitudes and perceptions r...

  6. Internet Use Frequency and Patient-Centered Care: Measuring Patient Preferences for Participation Using the Health Information Wants Questionnaire

    OpenAIRE

    Xie, Bo; Wang, Mo; Feldman, Robert; Zhou, Le

    2013-01-01

    Background The Internet is bringing fundamental changes to medical practice through improved access to health information and participation in decision making. However, patient preferences for participation in health care vary greatly. Promoting patient-centered health care requires an understanding of the relationship between Internet use and a broader range of preferences for participation than previously measured. Objective To explore (1) whether there is a significant relationship between...

  7. The psychological attitude of patients toward health practitioners in Lebanon

    Directory of Open Access Journals (Sweden)

    Fouad Ayoub

    2015-01-01

    Full Text Available Background: Patients often complain about their doctor′s attitude toward them. They describe the interaction that they have with some doctors as quick, cold, discourteous, or hardhearted. Although this does not apply to all Lebanese doctors, it does apply to some. Aims: The purpose of this study was to (1 examine the general perception of satisfaction, trust, and openness that Lebanese patients hold toward the work, office, personal, and social characteristics of their doctors - physician or dentist; and (2 identify the aspects on which a Lebanese health practitioner should focus to improve his/her practice. Materials and Methods: A convenient sample of 450 individuals from an area housing nine hospitals and hundreds of private clinics in Greater Beirut were surveyed regarding the qualities of their health practitioners. They were asked to complete a nine-page, 85-item, anonymous, and voluntary questionnaire that dealt with the medical and dental practice in Lebanon. Participants were older than 18 years and mentally competent. None was physicians, dentists, or nurses. The questionnaire was open-ended and initially pretested and piloted among a random sample. Results: Four hundred-fifteen (92% individuals responded. Participants were from different ages, genders, geographical areas, educational backgrounds, and professions. The doctor traits most preferred by the Lebanese public were found to be: Empathy (90%, professionalism (87%, miscellaneous traits (86%, and academics (81%. Conclusion: The results support the conventional wisdom that the idealized perception of a doctor as a care-giving, compassionate, knowledgeable, well-appearing, and healthy role model still holds true within the Lebanese community.

  8. Images of health among hospital patients in Jordan: A qualitative study

    Directory of Open Access Journals (Sweden)

    Noordeen Awath Shoqirat

    2012-08-01

    Full Text Available   The purpose of this study was to examine hospital patients’ understanding of health and its cultural constructions in Jordan. Focus group discussions (n=4 were carried out with hospital patients. The findings showed three images of health among patients in Jordan with different complexity levels. This included health as the freedom from illness, health as being in good social and psychological wellbeing, health as being physically, psychologically, socially and economically satisfied. Gender related conceptualisation of health have been associated with the role of men and women in the society. Hospital patients’ understanding of health is diverse, multidimensional, and affected by their gender. Therefore, hospital nurses are urged to incorporate patients’ conceptualisations of health and factors involved into the framework of the patient’s daily care plan and health promotion activity. The study limitations and recommendations for practice and future research are also outlined. Keywords: focus group discussions, health, hospital patients, culture, Jordan, nursing

  9. The perspective of patients with congenital heart disease: does health care meet their needs?

    NARCIS (Netherlands)

    Schoormans, D.; Sprangers, M.A.G.; Pieper, P.G.; Melle, J.P. van; Dijk, A.P. van; Sieswerda, G.T.; Hulsbergen-Zwarts, M.S.; Plokker, T.H.; Brunninkhuis, L.G.; Vliegen, H.W.; Mulder, B.J.

    2011-01-01

    OBJECTIVE: A first step in the delivery of tailored care is answering the following question: does health care meet the needs of patients? Therefore patients' perspective on health care use and their needs was examined. The design used was cross-sectional questionnaire study. PATIENTS: A total of 11

  10. The Perspective of Patients with Congenital Heart Disease: Does Health Care Meet Their Needs?

    NARCIS (Netherlands)

    D. Schoormans; M.A.G. Sprangers; P.G. Pieper; J.P. van Melle; A.P.J. van Dijk; G.T. Sieswerda; M.S. Hulsbergen-Zwarts; T.H.W.M. Plokker; L.G.H. Brunninkhuis; H.W. Vliegen; B.J.M. Mulder

    2011-01-01

    Objective. A first step in the delivery of tailored care is answering the following question: does health care meet the needs of patients? Therefore patients' perspective on health care use and their needs was examined. The design used was cross-sectional questionnaire study. Patients. A total of 11

  11. The Perspective of Patients with Congenital Heart Disease : Does Health Care Meet Their Needs?

    NARCIS (Netherlands)

    Schoormans, Dounya; Sprangers, Mirjam A. G.; Pieper, Petronella G.; van Melle, Joost P.; van Dijk, Arie P. J.; Sieswerda, Gertjan Tj; Hulsbergen-Zwarts, Mariet S.; Plokker, Thijs H. W. M.; Brunninkhuis, Leo G. H.; Vliegen, Hubert W.; Mulder, Barbara J. M.

    2011-01-01

    Objective. A first step in the delivery of tailored care is answering the following question: does health care meet the needs of patients? Therefore patients' perspective on health care use and their needs was examined. The design used was cross-sectional questionnaire study. Patients. A total of 11

  12. 76 FR 7853 - Patient Safety Organizations: Voluntary Delisting From HealthDataPSO

    Science.gov (United States)

    2011-02-11

    ... organizations whose mission and primary activity is to conduct activities to improve patient safety and the quality of health care delivery. HHS issued the Patient Safety Rule to implement the Patient Safety Act... collect, aggregate, and analyze confidential information regarding the quality and safety of health...

  13. Health and Utilities in Patients With Gout Under the Care of a Rheumatologist

    NARCIS (Netherlands)

    Spaetgens, B.; Tran-Duy, A.; Wijnands, J. M. A.; van der Linden, S.; Boonen, A.

    2015-01-01

    ObjectiveTo compare limitations in health between Dutch patients with gout and the general population and to determine factors influencing societal and patient values for health as assessed with different utility approaches. MethodsA cross-sectional study was done among 110 patients with gout under

  14. Does Uninsurance Affect the Health Outcomes of the Insured? Evidence from Heart Attack Patients in California

    NARCIS (Netherlands)

    Meltem Daysal, N.

    2012-01-01

    Abstract: In this paper, I examine the impact of uninsured patients on the health of the insured, focusing on one health outcome - the in-hospital mortality rate of insured heart attack patients. I employ panel data models using patient discharge and hospital financial data from California (1999-200

  15. Patient-Centered e-Health Record over the Cloud.

    Science.gov (United States)

    Koumaditis, Konstantinos; Themistocleous, Marinos; Vassilacopoulos, George; Prentza, Andrianna; Kyriazis, Dimosthenis; Malamateniou, Flora; Maglaveras, Nicos; Chouvarda, Ioanna; Mourouzis, Alexandros

    2014-01-01

    The purpose of this paper is to introduce the Patient-Centered e-Health (PCEH) conceptual aspects alongside a multidisciplinary project that combines state-of-the-art technologies like cloud computing. The project, by combining several aspects of PCEH, such as: (a) electronic Personal Healthcare Record (e-PHR), (b) homecare telemedicine technologies, (c) e-prescribing, e-referral, e-learning, with advanced technologies like cloud computing and Service Oriented Architecture (SOA), will lead to an innovative integrated e-health platform of many benefits to the society, the economy, the industry, and the research community. To achieve this, a consortium of experts, both from industry (two companies, one hospital and one healthcare organization) and academia (three universities), was set to investigate, analyse, design, build and test the new platform. This paper provides insights to the PCEH concept and to the current stage of the project. In doing so, we aim at increasing the awareness of this important endeavor and sharing the lessons learned so far throughout our work. PMID:25000049

  16. ORAL HEALTH OF EPILEPTIC PATIENTS IN RURAL RAJASTHAN

    Directory of Open Access Journals (Sweden)

    Rakshit

    2015-10-01

    Full Text Available BACKGROUND: Despite the increase in the awareness of Epilepsy, still people are not much aware of the oral health complications related to the intake of antiepileptic drugs. OBJECTIVE: To assess the most common oral health problems that people face while using the Anti-epileptic drugs and hence forth decide its remedy. To make people aware of the potential side effects of using the anti-epileptic drugs. MATERIALS AND METHODS: This study was conducted on 200 epileptic patients who were on anti-epileptic medication for one year or more. The study was conducted at Government Hospital in Ratan nagar dist churu. RESULTS: Gingival hyperplasia was seen as a common side effects of the Anti-epileptic Drug. Lips and cheek biting were the most common soft tissue injury, while tooth fracture was the most common hard tissue dental injury. CONCLUSION: General physicians and dentist should be well aware of the potential side effects of Anti-epileptic Drugs. A dentist should be well versed and trained to manage oro-facial injuries in the emergency department.

  17. Discussing the Effects of Poor Health Literacy on Patients Facing HIV: A Narrative Literature Review

    OpenAIRE

    Rocco Palumbo

    2015-01-01

    Background Scholars describe poor health literacy as a “silent epidemic,” which is challenging the functioning of healthcare systems all over the world. Health literacy is mainly meant as an individual trait which concerns the ability to obtain, process, and understand basic health information in order to effectively navigate the health system. Low health literate patients perceive poor self-efficacy dealing with their health conditions, are not willing to be involved in the provision of ...

  18. Health promotion services for lifestyle development within a UK hospital – Patients' experiences and views

    Directory of Open Access Journals (Sweden)

    Haynes Charlotte L

    2008-08-01

    Full Text Available Abstract Background UK public health policy requires hospitals to have in place health promotion services which enable patients to improve their health through adopting healthy behaviours, i.e. health education. This study investigated hospitalised patients' experiences of health education for smoking, alcohol use, diet, physical activity, and weight, and their views concerning the appropriateness of hospitals as a setting for the delivery of health education services. Methods Recently discharged adult hospital patients (n = 322 were sent a questionnaire asking about their smoking, alcohol use, diet, physical activity, and weight. For each of these risk factors, participants were asked whether they agreed with screening for the risk factor, whether they received health education, whether it was "helpful", and if they wanted to change their behaviour. Participants were also asked a set of general questions concerning health education within hospitals. Results 190 patients responded (59%. Over 80% agreed with screening for all risk factors. 80% of smokers, 52% consuming alcohol above recommended limits, 86% of obese, 66% consuming less than five fruit and vegetables a day, and 61% of physically inactive participants wanted to change their respective behaviour. However only a third reported receiving health education. While over 60% of patients wanted health education around discharge, the majority of those receiving health education did so at admission. The majority agreed that "hospital is a good place for patients to receive" health education (87% and that "the hospital should provide patients with details of community organisations that provide" health education (83%. Only a minority (31% reported a preference for health education from their GP instead of hospital. Conclusion While the delivery of health education to patients within hospital was poor, hospitals are viewed by patients as an appropriate, and in some cases preferred setting for

  19. The evolving role of health educators in advancing patient safety: forging partnerships and leading change.

    Science.gov (United States)

    Mercurio, Annette

    2007-04-01

    At least 1.5 million preventable injuries because of adverse drug events occur in the United States each year, according to an Institute of Medicine report. IOM and other organizations at the forefront of health care improvement emphasize that stronger partnerships between patients, their families, and health care providers are necessary to make health care safer. Health educators possess a skill set and an ethical framework that effectively equip them to advance patient and family-centered care and contribute in other significant ways to a safer health care system. Health educators in clinical settings are playing varied and significant roles in advancing patient safety. They are removing barriers to clear communication and forging partnerships between patients, their families, and staff. Health educators are leading patient safety culture change within their institutions and contributing to the shift from provider-centric to patient-centric systems. To expand their impact in improving patient safety, health educators in clinical settings are participating in public awareness campaigns. In seeking to enhance patient safety, health educators face a number of challenges. To successfully manage those, health educators must expand their knowledge, broaden connections, and engage patients and families in meaningful ways.

  20. Be More Involved in Your Health Care: Tips for Patients

    Science.gov (United States)

    ... Task Force Improving Primary Care Practice Health IT Integration Health Care/System Redesign Clinical-Community Linkages Care Coordination Capacity Building Behavioral and Mental Health Self-Management Support Resources Clinical Community Relationships ...

  1. Patient-professional interactions in mental health institutions in Denmark

    DEFF Research Database (Denmark)

    Ringer, Agnes

    Although qualitative research within the field of mental health is growing, few studies of everyday communication between service users and multidisciplinary professionals within mental health institutions exist. This study examines the everyday interactions between mental health professionals an...

  2. Cultural health capital and the interactional dynamics of patient-centered care.

    Science.gov (United States)

    Dubbin, Leslie A; Chang, Jamie Suki; Shim, Janet K

    2013-09-01

    As intuitive and inviting as it may appear, the concept of patient-centered care has been difficult to conceptualize, institutionalize and operationalize. Informed by Bourdieu's concepts of cultural capital and habitus, we employ the framework of cultural health capital to uncover the ways in which both patients' and providers' cultural resources, assets, and interactional styles influence their abilities to mutually achieve patient-centered care. Cultural health capital is defined as a specialized collection of cultural skills, attitudes, behaviors and interactional styles that are valued, leveraged, and exchanged by both patients and providers during clinical interactions. In this paper, we report the findings of a qualitative study conducted from 2010 to 2011 in the Western United States. We investigated the various elements of cultural health capital, how patients and providers used cultural health capital to engage with each other, and how this process shaped the patient-centeredness of interactions. We find that the accomplishment of patient-centered care is highly dependent upon habitus and the cultural health capital that both patients and providers bring to health care interactions. Not only are some cultural resources more highly valued than others, their differential mobilization can facilitate or impede engagement and communication between patients and their providers. The focus of cultural health capital on the ways fundamental social inequalities are manifest in clinical interactions enables providers, patients, and health care organizations to consider how such inequalities can confound patient-centered care. PMID:23906128

  3. Pharmacists' documentation in patients' hospital health records: Issues and educational implications

    OpenAIRE

    Pullinger, W.; Franklin, B. D.

    2010-01-01

    Objectives We aimed to identify potential barriers to hospital pharmacists' documentation in patients' hospital health records, and to explore pharmacists' training needs. Our objectives were to identify the methods used by pharmacists to communicate and document patient care issues, to explore pharmacists' attitudes towards documentation of patient care issues in health records, to identify and examine the factors influencing whether or not pharmacists document their care in health records a...

  4. Facilitating mental health research for patients, clinicians and researchers:a mixed-method study

    OpenAIRE

    Robotham, D.; Waterman, S.; Oduola, S; Papoulias, C.; Craig, T; Wykes, T.

    2016-01-01

    OBJECTIVES: Research registers using Consent for Contact (C4C) can facilitate recruitment into mental health research studies, allowing investigators to contact patients based on clinical records information. We investigated whether such a register was useful for mental health research, seeking the perspectives of patients and research investigators.SETTING AND DESIGN: In 2012, a C4C register was developed in a large secondary mental health provider within the UK; almost 9000 patients have jo...

  5. Empowering patients through eHealth: a case report of a pan-European project

    OpenAIRE

    Lettieri, Emanuele; Fumagalli, Lia P.; Radaelli, Giovanni; Bertele’, Paolo; Vogt, Jess; Hammerschmidt, Reinhard; Lara, Juan L.; Carriazo, Ana; Masella, Cristina

    2015-01-01

    Background This paper crystallises the experience developed by the pan-European PALANTE Consortium in dealing with the generation of relevant evidence from heterogeneous eHealth services for patient empowerment in nine European Regions. The European Commission (EC) recently funded a number of pan-European eHealth projects aimed at empowering European patients/citizens thus transforming the traditional patient/citizen role in the management of their health (e.g., PALANTE, SUSTAIN, CARRE, Heart...

  6. Self-esteem, stress and self-rated health in family planning clinic patients

    OpenAIRE

    Young Rodney; Rohrer James E

    2004-01-01

    Abstract Background The independent effects of stress on the health of primary care patients might be different for different types of clinic populations. This study examines these relationships in a low-income female population of patients attending a family planning clinic. Methods This study investigated the relevance of different sources of personal stress and social support to self-rated health, adjusting for mental health, health behavior and demographic characteristics of subjects. Fiv...

  7. INCREASED 30-DAY EMERGENCY DEPARTMENT REVISITS AMONG HOMELESS PATIENTS WITH MENTAL HEALTH CONDITIONS

    OpenAIRE

    Lam, Chun Nok; Arora, Sanjay; Menchine, Michael

    2016-01-01

    Background: Patients with mental health conditions frequently use emergency medical services.  Many suffer from substance use and homelessness. If they utilize the ED as their primary source of care, potentially preventable frequent ED revisits and hospital readmissions can worsen an already over-crowded health care system. However, the magnitude to which homelessness affects health service utilization among patients with mental health conditions remains unclear in the medical community. This...

  8. Algorithm linking patients and general practices in Denmark using the Danish National Health Service Register

    DEFF Research Database (Denmark)

    Kjaersgaard, Maiken Ina Siegismund; Vedsted, Peter; Parner, Erik Thorlund;

    2016-01-01

    the performance of an algorithm linking individual patients to their general practice by using information from the Danish National Health Service Register and the Danish Civil Registration System. MATERIALS AND METHODS: The National Health Service Register contains information on all services provided by general...... and general practices. The algorithm performs better in subgroups of patients with high health care needs. The algorithm constitutes a valuable tool for primary health care research....

  9. Health care service for ostomy patients: profile of the clientele

    Directory of Open Access Journals (Sweden)

    Vanessa Damiana Menis Sasaki

    2012-09-01

    Full Text Available The study aimed to identify the profile of ostomy patients in a Health Care Service in São José do Rio Preto, São Paulo, Brazil. This is an exploratory, descriptive and retrospective study. Data were obtained by registration forms of patients assisted from January 1st, 2000, to December 31st, 2010. Out of the 252 ostomy patients, 51.1% were females and 48.9% were males; the age group with the highest concentration was from 68 to 78 years old (26.3% for both genders, with mean age of 73 years old. The main reason for making the stoma was rectal (35.0% and colon neoplasm (14.1%. The prevalent stoma was temporary colostomy (41.4% and the period of permanence of the collecting equipment was longer than 36 months. Even though the service provides full assistance to the ostomy patients, it is necessary to review human resources aspects to provide appropriate assistance to its clientele.O estudo teve como objetivo identificar o perfil de pacientes estomizados de um Serviço de Atenção ao Estomizado de São José do Rio Preto e Região. A pesquisa é exploratória, descritiva e retrospectiva. Os dados foram obtidos das fichas cadastrais dos pacientes atendidos no período de 1º de janeiro de 2000 a 31 de dezembro de 2010. Dos 252 estomizados, 51,1% eram mulheres e 48,9% homens, a faixa etária de maior concentração encontrou-se, em ambos os sexos, entre 68 a 78 anos (26,3% com média de idade de 73 anos. O principal motivo da confecção do estoma foi a neoplasia de reto (35,0% e cólon (14,1%. O estoma prevalente foi a colostomia temporária (41,4% e o tempo de permanência do equipamento coletor foi superior a 36 meses. O Serviço, embora proporcione assistência integral ao estomizado, necessita rever aspectos de recursos humanos à assistência adequada à clientela.

  10. Addressing health disparities through patient education: the development of culturally-tailored health education materials at Puentes de Salud.

    Science.gov (United States)

    Harvey, Isobel; O'Brien, Matthew

    2011-10-01

    The availability of culturally appropriate written health information is essential for promoting health in diverse populations. Lack of English fluency has been shown to negatively impact health outcomes for Latinos in the United States. The authors conducted a needs assessment at a clinic serving Latino immigrants, focusing on patients' health and previous experiences with written health information. Based on these results and a literature review, we developed 10 Spanish language brochures to better serve the target population. This article outlines the process of developing and implementing this intervention, which can serve as a model for similar projects targeting diverse populations. PMID:22053763

  11. Brainstorming Design for Health: Helping Patients Utilize Patient-Generated Information on the Web.

    Science.gov (United States)

    Huh, Jina; Hartzler, Andrea; Munson, Sean; Anderson, Nick; Edwards, Kelly; Gore, John L; McDonald, David; O'Leary, Jim; Parker, Andrea; Streat, Derek; Yetisgen-Yildiz, Meliha; Pratt, Wanda; Ackerman, Mark S

    2012-01-01

    Researchers and practitioners show increasing sinterest in utilizing patient-generated information on the Web. Although the HCI and CSCW communities have provided many exciting opportunities for exploring new ideas and building broad agenda in health, few venues offer a platform for interdisciplinary and collaborative brainstorming about design challenges and opportunities in this space. The goal of this workshop is to provide participants with opportunities to interact with stakeholders from diverse backgrounds and practices-researchers, practitioners, designers, programmers, and ethnographers-and together generate tangible design outcomes that utilize patient-generated information on the Web. Through small multidisciplinary group work, we will provide participants with new collaboration opportunities, understanding of the state of the art, inspiration for future work, and ideally avenues for continuing to develop research and design ideas generated at the workshop.

  12. Brainstorming Design for Health: Helping Patients Utilize Patient-Generated Information on the Web

    Science.gov (United States)

    Huh, Jina; Hartzler, Andrea; Munson, Sean; Anderson, Nick; Edwards, Kelly; Gore, John L.; McDonald, David; O’Leary, Jim; Parker, Andrea; Streat, Derek; Yetisgen-Yildiz, Meliha; Pratt, Wanda; Ackerman, Mark S.

    2013-01-01

    Researchers and practitioners show increasing sinterest in utilizing patient-generated information on the Web. Although the HCI and CSCW communities have provided many exciting opportunities for exploring new ideas and building broad agenda in health, few venues offer a platform for interdisciplinary and collaborative brainstorming about design challenges and opportunities in this space. The goal of this workshop is to provide participants with opportunities to interact with stakeholders from diverse backgrounds and practices—researchers, practitioners, designers, programmers, and ethnographers—and together generate tangible design outcomes that utilize patient-generated information on the Web. Through small multidisciplinary group work, we will provide participants with new collaboration opportunities, understanding of the state of the art, inspiration for future work, and ideally avenues for continuing to develop research and design ideas generated at the workshop. PMID:24499843

  13. Health IT for Patient Safety and Improving the Safety of Health IT.

    Science.gov (United States)

    Magrabi, Farah; Ong, Mei-Sing; Coiera, Enrico

    2016-01-01

    Alongside their benefits health IT applications can pose new risks to patient safety. Problems with IT have been linked to many different types of clinical errors including prescribing and administration of medications; as well as wrong-patient, wrong-site errors, and delays in procedures. There is also growing concern about the risks of data breach and cyber-security. IT-related clinical errors have their origins in processes undertaken to design, build, implement and use software systems in a broader sociotechnical context. Safety can be improved with greater standardization of clinical software and by improving the quality of processes at different points in the technology life cycle, spanning design, build, implementation and use in clinical settings. Oversight processes can be set up at a regional or national level to ensure that clinical software systems meet specific standards. Certification and regulation are two mechanisms to improve oversight. In the absence of clear standards, guidelines are useful to promote safe design and implementation practices. Processes to identify and mitigate hazards can be formalised via a safety management system. Minimizing new patient safety risks is critical to realizing the benefits of IT. PMID:27198089

  14. Health IT for Patient Safety and Improving the Safety of Health IT.

    Science.gov (United States)

    Magrabi, Farah; Ong, Mei-Sing; Coiera, Enrico

    2016-01-01

    Alongside their benefits health IT applications can pose new risks to patient safety. Problems with IT have been linked to many different types of clinical errors including prescribing and administration of medications; as well as wrong-patient, wrong-site errors, and delays in procedures. There is also growing concern about the risks of data breach and cyber-security. IT-related clinical errors have their origins in processes undertaken to design, build, implement and use software systems in a broader sociotechnical context. Safety can be improved with greater standardization of clinical software and by improving the quality of processes at different points in the technology life cycle, spanning design, build, implementation and use in clinical settings. Oversight processes can be set up at a regional or national level to ensure that clinical software systems meet specific standards. Certification and regulation are two mechanisms to improve oversight. In the absence of clear standards, guidelines are useful to promote safe design and implementation practices. Processes to identify and mitigate hazards can be formalised via a safety management system. Minimizing new patient safety risks is critical to realizing the benefits of IT.

  15. Application of a marketing concept to patient-centered care: co-producing health with heart failure patients.

    Science.gov (United States)

    Leone, Robert P; Walker, Charles A; Curry, Linda Cox; Agee, Elizabeth J

    2012-05-01

    Increasing numbers of patients are being treated for heart failure each year. One out of four of the heart failure patients who receives care in a hospital is readmitted to the hospital within 30 days of discharge. Effective discharge instruction is critical to prevent these patient readmissions. Co-production is a marketing concept whereby the customer is a partner in the delivery of a good or service. For example, a patient and nurse may partner to co-produce a patient-centered health regimen to improve patient outcomes. In this article we review the cost of treating heart failure patients and current strategies to decrease hospital readmissions for these patients along with the role of the nurse and the concept of co-producing health as related to heart failure patients. Next we describe our study assessing the degree to which discharge processes were co-produced on two hospital units having a preponderance of heart failure patients, and present our findings indicating minimal evidence of co-production. A discussion of our findings, along with clinical implications of these findings, recommendations for change, and suggestions for future research are offered. We conclude that standardized discharge plans lead to a mindset of 'one size fits all,' a mindset inconsistent with the recent call for patient-centered care. We offer co-production as a patient-centered strategy for customizing discharge teaching and improving health outcomes for heart failure patients. PMID:22686115

  16. The relative effect of health literacy and patient activation on provider choice in the Netherlands.

    OpenAIRE

    Rademakers, J.; Nijman, J.; Brabers, A.E.M.; Jong, J.D. de; Hendriks, M.

    2014-01-01

    Active provider choice by patients has become an important policy theme in western, countries over the last decades. However, not many patients and consumers exercise their rightto, choose. Both health literacy and patient activation are likely to have an impact on the choiceprocess.In,this article the relative effect of health literacy and patient activation on provider choice in the, Netherlands is studied. A questionnaire was sentto a representative sample of 2000 Dutch citizens. The quest...

  17. An Empirical Examination of "Doctorship Styles": Do Clinicians' Styles of Care Predict Patient Health Outcomes?

    OpenAIRE

    Huynh, Ho Phi

    2014-01-01

    Effective clinicians need to motivate their patients to initiate and maintain beneficial health behaviors. Using transformational leadership theory as the theoretical framework, we proposed that clinicians' motivational behaviors can be organized into three "doctorship styles," or patterned approaches to patient care: passive-avoidant, transactional, and transformational. We also suggested that the styles differentially predict patient health outcomes. In Study 1, we used patient-reported que...

  18. Patient Preferences of a Low-Income Hispanic Population for Mental Health Services in Primary Care.

    Science.gov (United States)

    Herman, Patricia M; Ingram, Maia; Rimas, Heather; Carvajal, Scott; Cunningham, Charles E

    2016-09-01

    We used a discrete-choice conjoint experiment to model the mental health services preferences of patients of a federally-qualified health center serving a primarily low-income, Hispanic farmworker population in southwestern Arizona. The two attributes that had the largest influence on patient choices (i.e., received the highest importance scores) were where patients receive these services and the language and cultural awareness of the provider who prescribed their treatment. Simulations indicated that the clinic could substantially improve its patients' welfare with even a single change. The single most effective change in terms of patient preferences would be to offer behavioral health services onsite. PMID:26410547

  19. The Use of Humor in Forensic Mental Health Staff-Patient Interactions

    DEFF Research Database (Denmark)

    Hounsgaard, Lise; Alkier Gildberg, Frederik; Bradley, S. K.;

    2014-01-01

    Humor utilized in the practice of forensic mental health nursing might seem somehow inappropriate, given the serious circumstances surrounding most forensic mental health patients. However, some recent research has pointed to the use of humor as an important component in staff interactions...... with forensic mental health patients. This study reviews the existing international forensic mental health research literature on humor to investigate (a) what characterizes forensic mental health staff-patient use of humor and (b) what significance humor holds within the forensic mental health setting...... identified: (a) "humor as staff skill," showing that staff found humor to be important as an interpersonal ability; (b) "humor as a relational tool" with the purpose of establishing and maintaining staff-patient interactions; and (c) "the impact of humor on patients," describing impacts on conflicts...

  20. Health status, adherence with health recommendations, self-efficacy and social support in patients with rheumatoid arthritis

    NARCIS (Netherlands)

    Taal, Erik; Rasker, Johannes J.; Seydel, Erwin; Wiegman, Oene

    1993-01-01

    A study was performed in 86 patients with rheumatoid arthritis (RA) to assess their health problems, the problems they experience in adhering to health recommendations and the relationships of these problems with self-efficacy and social support. Feeling dependent, disability and pain were the most

  1. Treatment patterns, health state, and health care resource utilization of patients with radioactive iodine refractory differentiated thyroid cancer

    OpenAIRE

    Gianoukakis AG; Flores NM; Pelletier CL; Forsythe A; Wolfe GR; Taylor MH

    2016-01-01

    Andrew G Gianoukakis,1 Natalia M Flores,2 Corey L Pelletier,3 Anna Forsythe,3 Gregory R Wolfe,2 Matthew H Taylor41Division of Endocrinology and Metabolism, Harbor-UCLA Medical Center, The University of California, Los Angeles, 2Health Outcomes Research, Kantar Health, Foster City, CA, 3Global Value and Access, Eisai, Inc., Woodcliff Lakes, NJ, 4Division of Hematology and Medical Oncology, Oregon Health and Science University, Portland, OR, USABackground: Patients with differentiated thyroid c...

  2. A PRIVACY MANAGEMENT ARCHITECTURE FOR PATIENT-CONTROLLED PERSONAL HEALTH RECORD SYSTEM

    Directory of Open Access Journals (Sweden)

    MD. NURUL HUDA

    2009-06-01

    Full Text Available Patient-controlled personal health record systems can help make health care safer, cheaper, and more convenient by facilitating patients to 1 grant any care provider access to their complete personal health records anytime from anywhere, 2 avoid repeated tests and 3 control their privacy transparently. In this paper, we present the architecture of our Privacy-aware Patient-controlled Personal Health Record (P3HR system through which a patient can view her integrated health history, and share her health information transparently with others (e.g., healthcare providers. Access to the health information of a particular patient is completely controlled by that patient. We also carry out intuitive security and privacy analysis of the P3HR system architecture considering different types of security attacks. Finally, we describe a prototype implementation of the P3HR system that we developed reflecting the special view of Japanese society. The most important advantage of P3HR system over other existing systems is that most likely P3HR system provides complete privacy protection without losing data accuracy. Unlike traditional partially anonymous health records (e.g., using k-anonymity or l-diversity, the health records in P3HR are closer to complete anonymity, and yet preserve data accuracy. Our approach makes it very unlikely that patients could be identified by an attacker from their anonymous health records in the P3HR system.

  3. Making a Difference to Patients: Perspectives of Health Care Ethics

    Directory of Open Access Journals (Sweden)

    Kahiga Joseph Kiruki

    2012-03-01

    Full Text Available The aim of this study is to highlight the importance of healthcare ethics in addressing the alleviation of the suffering of the poor and sick patients by healthcare givers. One’s social, economic status, class, race, tribe, clan and gender become variables of branding or giving diminutive attributes to those different from ‘us’. Those ‘others’ are the most disadvantaged to the level that they are regarded as ‘things’ or ‘objects’ instead of humans or ‘subjects’ with dignity. The study seeks to unveil the mindset that is behind the suffering of the ‘others’ who are basically the poor and the sick and suggest the way forward in re-establishing the dignity of a person irrespective of the social status, class, race or gender and health condition. Through modern advancement in medical technology, we have made an attempt to vanquish all diseases and postpone death indefinitely to the advantage of the rich who can afford it while the poor die in droves from preventable and curable diseases. Our assumptions and perceptions make the foundation upon which we act thereby laying bare our ‘value systems’. The study focuses on healthcare ethics and will use a rational critical discourse to arrive at the conclusions. We use Martin Buber’s concept of the ‘I-Thou’ relationship as our conceptual framework that assists to contextualize the healthcare ethics in the consideration of the healthcare giver as the ‘I’ and the patient as the ‘Thou’. The Christian Scriptures form the basis upon which healthcare givers find the foundation of their values and actions. A human being irrespective of status is a subject ‘I’ and is the image of God who is the ‘Thou’. This relationship ought to be contextualized in interpersonal healthcare network forming an ‘IThou’ link between healthcare giver and patient thereby delivering quality healthcare service without discrimination on the basis of ‘status’ or class.

  4. The Relation between Awareness of Cancer Diagnosis and Spiritual Health among Cancer Patients

    Directory of Open Access Journals (Sweden)

    Shima Sadat Aghahosseini

    2012-05-01

    Full Text Available Introduction: Disclosure of cancer diagnosis is one the main challenges in caring of patients with cancer since it may have negative effects on the spiritual health of patients. No study has ever been performed in Iran to investigate the relationship between awareness of cancer diagnosis and spiritual health in cancer patients. Therefore, the present study aimed to review the effects of awareness of cancer on spiritual health in patients with cancer. Methods: This was a descriptive-comparative study conducted in Shahid Ghazi Tabatabaei University Hospital in 2009. The subjects included 150 patients aware of their cancer diagnosis and 150 unaware patients. The patients were selected through convenient sampling method. Using a questionnaire, the patient's spiritual health was assessed. Data analysis was conducted in SPSS17 using descriptive and inferential statistics. Results: Results showed the mean (SD of spiritual health among aware and unaware patients to be 75.1 (3.8 and 75.4 (3.9, respectively. Statistically, there was no significant difference between the spiritual health of the two groups (p = 0.96. Conclusion: These findings showed that awareness of cancer diagnosis had no effects on spiritual health of patients. It is not surprising considering Iranian culture. However, confirmation of this finding requires further studies.

  5. Providing patient information and education in practice: the role of the health librarian.

    Science.gov (United States)

    Truccolo, Ivana

    2016-06-01

    In this article, guest writer Ivana Truccolo presents an overview of her work at the Scientific and Patient Library of a Cancer Comprehensive Centre in Italy coordinating the patient education process. She discusses the historical evolution of the concept of patient education and how this has run alongside the role of the health librarian in the provision of consumer health information. Details are provided about various patient education programmes in place at the Centre. In particular, various activities are discussed including patient education classes, the development of patient education handouts and a narrative medicine programme which includes a literary competition. The article concludes with a specific outline of the role the health librarian can play in the provision of consumer health information and patient education. H.S. PMID:27168259

  6. The patient-as-partner approach in health care: a conceptual framework for a necessary transition.

    Science.gov (United States)

    Karazivan, Philippe; Dumez, Vincent; Flora, Luigi; Pomey, Marie-Pascale; Del Grande, Claudio; Ghadiri, Djahanchah Philip; Fernandez, Nicolas; Jouet, Emmanuelle; Las Vergnas, Olivier; Lebel, Paule

    2015-04-01

    The prevalence of chronic diseases today calls for new ways of working with patients to manage their care. Although patient-centered approaches have contributed to significant advances in care and to treatments that more fully respect patients' preferences, values, and personal experiences, the reality is that health care professionals still hold a monopoly on the role of healer. Patients live with their conditions every day and are experts when it comes to their own experiences of illness; this expertise should be welcomed, valued, and fostered by other members of the care team. The patient-as-partner approach embodies the ideal of making the patient a bona fide member of the health care team, a true partner in his or her care. Since 2010, the University of Montreal, through the Direction of Collaboration and Patient Partnership, has embraced this approach. Patients are not only active members of their own health care team but also are involved in research and provide valuable training to health sciences students. Including patients as full partners in the health care team entails a significant shift in both the medical practice and medical education cultures. In this perspective, the authors describe this innovative approach to patient care, including the conceptual framework used in its development and the main achievements of patient partners in education, health care, and research. PMID:25607943

  7. Patient satisfaction with task shifting of antiretroviral services in Ethiopia: implications for universal health coverage.

    Science.gov (United States)

    Asfaw, Elias; Dominis, Sarah; Palen, John G H; Wong, Wendy; Bekele, Abebe; Kebede, Amha; Johns, Benjamin

    2014-09-01

    Formalized task shifting structures have been used to rapidly scale up antiretroviral service delivery to underserved populations in several countries, and may be a promising mechanism for accomplishing universal health coverage. However, studies evaluating the quality of service delivery through task shifting have largely ignored the patient perspective, focusing on health outcomes and acceptability to health care providers and regulatory bodies, despite studies worldwide that have shown the significance of patient satisfaction as an indicator of quality. This study aimed to measure patient satisfaction with task shifting of antiretroviral services in hospitals and health centres in four regions of Ethiopia. This cross-sectional study used data collected from a time-motion study of patient services paired with 665 patient exit interviews in a stratified random sample of antiretroviral therapy clinics in 21 hospitals and 40 health centres in 2012. Data were analyzed using f-tests across provider types, and multivariate logistic regression to identify determinants of patient satisfaction. Most (528 of 665) patients were satisfied or somewhat satisfied with the services received, but patients who received services from nurses and health officers were significantly more likely to report satisfaction than those who received services from doctors [odds ratio (OR) 0.26, P < 0.01]. Investments in the health facility were associated with higher satisfaction (OR 1.07, P < 0.01), while costs to patients of over 120 birr were associated with lower satisfaction (OR 0.14, P < 0.05). This study showed high levels of patient satisfaction with task shifting in Ethiopia. The evidence generated by this study complements previous biomedical and health care provider/regulatory acceptability studies to support the inclusion of task shifting as a mechanism for scaling-up health services to achieve universal health coverage, particularly for underserved areas facing severe health worker

  8. Health promotion services for patients having non-comminicable diseases: Feedback from patients and health care providers in Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    Parker Whadi-ah

    2012-07-01

    Full Text Available Abstract Background Due to a paucity of data regarding the availability and efficacy of equipment, health promotion methods and materials currently used by health professionals for the management of patients with non-communicable diseases (NCDs at primary health care (PHC facilities in Cape Town, an audit was undertaken. Methods A multi-centre cross-sectional study was undertaken to interview patients (n = 580 with NCDs at 30 PHC facilities. A questionnaire was used to obtain information on preferences for health promotion methods for lifestyle modification. Individual semi-structured interviews were conducted with selected health professionals (n = 14 and captured using a digital recorder. Data were transferred to the Atlas ti software programme and analysed using a thematic content analysis approach. Results Blood pressure measurement (97.6% was the most common diagnostic test used, followed by weight measurement (88.3%, urine (85.7% and blood glucose testing (80.9%. Individual lifestyle modification counselling was the preferred health education method of choice for the majority of patients. Of the 64% of patients that selected chronic clubs/support groups as a method of choice, only a third rated this as their first choice. Pamphlets, posters and workshops/group counselling sessions were the least preferred methods with only 9%, 13% and 11% of patients choosing these as their first choice, respectively. In an individual counselling setting 44.7% of patients reported that they would prefer to be counselled by a doctor, followed by a nurse (16.9%, health educator (8.8% and nutrition advisor (4.8%. Health professionals identified numerous barriers to education and counselling. These can be summarised as a lack of resources, including time, space and equipment; staff-related barriers such as staff shortage and staff turnover; and patient-related barriers such as patient load and patient non-compliance. Conclusion The majority of patients

  9. Self-Rated Health and Quality of Life in Slovak Rheumatoid Arthritis Patients

    NARCIS (Netherlands)

    Nagyova, Iveta

    2005-01-01

    Self-rated health (SRH) and Quality of Life (QoL) have become very fashionable in medical research and patient care in the past two decades. The frequency of medical publications on these topics has expanded exponentially since the 1980s. Patient-reported self-evaluations, in particular on health-re

  10. Health-related problems and quality of life in patients with syndromic and complex craniosynostosis

    NARCIS (Netherlands)

    T. de Jong (Tim); M. Maliepaard (Marianne); N. Bannink (Natalja); H. Raat (Hein); I.M.J. Mathijssen (Irene)

    2012-01-01

    textabstractPurpose: We conducted this study to gauge the health-related problems, quality of life and the performance of the Health Utility Index Mark 3 (HUI-3) in patients with syndromic and complex craniosynostosis. Patients with syndromic and complex craniosynostosis have various physical and me

  11. Patient education: the role of the physician assistant and other allied health professionals

    OpenAIRE

    Alexander, Lisa Mustone

    1987-01-01

    The physician assistant (PA) has been on the leading edge in the development of midlevel health providers since the 1960s. As an allied health professional, PAs, along with nurse practitioners, midwives, nurse anesthetists, and others, emphasize patient education. Oftentimes, patient education can be introduced in the academic setting, but true learning comes with experience as a student in clinical training.

  12. 21 CFR 880.6300 - Implantable radiofrequency transponder system for patient identification and health information.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Implantable radiofrequency transponder system for... radiofrequency transponder system for patient identification and health information. (a) Identification. An implantable radiofrequency transponder system for patient identification and health information is a...

  13. Health Status and Psychological Distress in Patients with Non-compaction Cardiomyopathy

    DEFF Research Database (Denmark)

    Brouwers, Corline; Caliskan, Kadir; Bos, Sven;

    2015-01-01

    and increase in pscyhological distress. PURPOSE: This study determined the health status and psychological distress in NCCM patients. We also examined the potential contribution of genetic predisposition and cardiac symptoms to health status and distress in NCCM, by comparing NCCM patients with (1) patients...... levels of anxiety and depressive symptoms in NCCM, whereas the burden of having a genetic condition may contribute less to these health status and psychological measures.......BACKGROUND: Non-compaction cardiomyopathy (NCCM) is a cardiomyopathy characterized by left ventricular tribeculae and deep intertrabecular recesses. Because of its genetic underpinnings and physical disease burden, noncompaction cardiomyopathy is expected to be associated with a lower health status...

  14. Patient empowerment by the means of citizen-managed Electronic Health Records: web 2.0 health digital identity scenarios.

    Science.gov (United States)

    Falcão-Reis, Filipa; Correia, Manuel E

    2010-01-01

    With the advent of more sophisticated and comprehensive healthcare information systems, system builders are becoming more interested in patient interaction and what he can do to help to improve his own health care. Information systems play nowadays a crucial and fundamental role in hospital work-flows, thus providing great opportunities to introduce and improve upon "patient empowerment" processes for the personalization and management of Electronic Health Records (EHRs). In this paper, we present a patient's privacy generic control mechanisms scenarios based on the Extended OpenID (eOID), a user centric digital identity provider previously developed by our group, which leverages a secured OpenID 2.0 infrastructure with the recently released Portuguese Citizen Card (CC) for secure authentication in a distributed health information environment. eOID also takes advantage of Oauth assertion based mechanisms to implement patient controlled secure qualified role based access to his EHR, by third parties.

  15. Health Care Utilization and Expenditures Associated With Remote Monitoring in Patients With Implantable Cardiac Devices.

    Science.gov (United States)

    Ladapo, Joseph A; Turakhia, Mintu P; Ryan, Michael P; Mollenkopf, Sarah A; Reynolds, Matthew R

    2016-05-01

    Several randomized trials and decision analysis models have found that remote monitoring may reduce health care utilization and expenditures in patients with cardiac implantable electronic devices (CIEDs), compared with in-office monitoring. However, little is known about the generalizability of these findings to unselected populations in clinical practice. To compare health care utilization and expenditures associated with remote monitoring and in-office monitoring in patients with CIEDs, we used Truven Health MarketScan Commercial Claims and Medicare Supplemental Databases. We selected patients newly implanted with an implantable cardioverter defibrillators (ICD), cardiac resynchronization therapy defibrillator (CRT-D), or permanent pacemaker (PPM), in 2009, who had continuous health plan enrollment 2 years after implantation. Generalized linear models and propensity score matching were used to adjust for confounders and estimate differences in health care utilization and expenditures in patients with remote or in-office monitoring. We identified 1,127; 427; and 1,295 pairs of patients with a similar propensity for receiving an ICD, CRT-D, or PPM, respectively. Remotely monitored patients with ICDs experienced fewer emergency department visits resulting in discharge (p = 0.050). Remote monitoring was associated with lower health care expenditures in office visits among patients with PPMs (p = 0.025) and CRT-Ds (p = 0.006) and lower total inpatient and outpatient expenditures in patients with ICDs (p monitoring of patients with CIEDs may be associated with reductions in health care utilization and expenditures compared with exclusive in-office care.

  16. Latinos and Cancer Information: Perspectives of Patients, Health Professionals and Telephone Cancer Information Specialists

    Science.gov (United States)

    Kaplan, Celia P.; Nápoles, Anna; Davis, Sharon; Lopez, Monica; Pasick, Rena J.; Livaudais-Toman, Jennifer; Pérez-Stable, Eliseo J.

    2016-01-01

    Semi-structured interviews were conducted with 16 Latino cancer patients diagnosed in California; 10 health professionals from the San Francisco Bay Area and Fresno, California; and 10 Cancer Information Services (CIS) information specialists from the regional offices handling calls from Spanish-speakers. Interview guides were designed by the investigators to answer three main research questions: 1) How do Latinos obtain information about cancer and what types of information do they access?; 2) What sources of cancer information do they seek out and find credible?; and 3) What are the barriers and facilitators to Latinos obtaining cancer information? Stakeholders generally viewed health professionals as the most credible source of cancer information. All groups regarded family and friends as important sources of information. Patients and health professionals tended to differ on the value of print materials. Although patients found them generally useful, health professionals tended to view them as inadequate for meeting the informational needs of their Latino patients due to the challenge of low health literacy. Health professionals also tended to undervalue Internet resources compared to patients and CIS specialists. All stakeholders viewed language, ethnic discordance and the impact on patients of the initial diagnosis as barriers to effective communication of cancer information. Health professionals and CIS specialists, but not patients, mentioned low literacy as a barrier. Our findings underscore the importance of the physician-patient relationship as a point of intervention to address the unmet informational and psychosocial needs of Latino cancer patients.

  17. Health related quality of life in Critically ill Patients A study of health related quality of life in critically ill patients admitted on the Intensive Care

    OpenAIRE

    Hofhuis, José

    2008-01-01

    textabstractHealth related quality of life (HRQOL) is a relevant outcome measure for patients admitted to the intensive care unit (ICU). Long term outcome for physical and psychological factors, functional status and social interactions are becoming more and more important both for doctors and nurses as well as for patients and their relatives (1;2). Therefore doctors and nurses want to know what a “reasonable” quality of life means to their patients. The main reason for HRQOL research descri...

  18. Patient satisfaction with treatment for alcohol use disorders: comparing patients with and without severe mental health symptoms

    Science.gov (United States)

    McCallum, Stacey L; Andrews, Jane M; Gaughwin, Matthew D; Turnbull, Deborah A; Mikocka-Walus, Antonina A

    2016-01-01

    Background Previous studies suggest patients with co-occurring alcohol use disorders (AUDs) and severe mental health symptoms (SMHS) are less satisfied with standard AUD treatment when compared to patients with an AUD alone. This study compared patient satisfaction with standard AUD treatment among patients with and without SMHS and explored how standard treatment might be improved to better address the needs of these patients. Methods Eighty-nine patients receiving treatment for an AUD either at an inpatient hospital, outpatient clinic, inpatient detoxification, or residential/therapeutic community services were surveyed. Patient satisfaction with treatment was assessed using the Treatment Perception Questionnaire (range: 0–40). Patients were stratified according to their score on the Depression Anxiety Stress Scale. Forty patients scored in the extremely severe range of depression (score >14) and/or anxiety (score >10) (indicating SMHS) and 49 patients did not. An inductive content analysis was also conducted on qualitative data relating to areas of service improvement. Results Patients with SMHS were found to be equally satisfied with treatment (mean =25.10, standard deviation =8.12) as patients with an AUD alone (mean =25.43, standard deviation =6.91). Analysis revealed that being an inpatient in hospital was associated with reduced treatment satisfaction. Patients with SMHS were found to be significantly less satisfied with staffs’ understanding of the type of help they wanted in treatment, when compared to patients with AUDs alone. Five areas for service improvement were identified, including staff qualities, informed care, treatment access and continuity, issues relating to inpatient stay, and addressing patients’ mental health needs. Conclusion While findings suggest that AUD treatment services adequately meet the needs of patients with SMHS in treatment, patients with SMHS do feel that staff lack understanding of their treatment needs. Findings have

  19. Predictors of low self-rated health in patients aged 65+ after total hip replacement (THA)

    DEFF Research Database (Denmark)

    Hørdam, Britta; Hemmingsen, Lars

    2013-01-01

    measures eight domains of importance for health status. The measures are physical function, role physical, bodily pain, social function, role emotional, general health, vitality and mental health. Results: Patients living alone or being depend on help from others had a significantly increased risk...

  20. Communicating with limited English proficiency (LEP) patients: question of health-care access.

    Science.gov (United States)

    Murphy, Stephen

    2004-01-01

    In the United States, the ability to understand English plays an essential role in how well patients and health-care providers communicate. This article highlights the concerns of providers, differential health-care outcomes, and risk management concerns of providing health care in an increasingly diverse and polyglot population. PMID:15500018

  1. The Effects of Health Education on Patients with Hypertension in China: A Meta-Analysis

    Science.gov (United States)

    Xu, L. J.; Meng, Q.; He, S. W.; Yin, X. L.; Tang, Z. L.; Bo, H. Y.; Lan, X. Y.

    2014-01-01

    Objective: This study collected on from all research relating to health education and hypertension in China and, with the aid of meta-analysis tools, assessed the outcomes of such health education. The analysis provides a basis for the further development of health-education programmes for patients with hypertension. Methods: Literature searches…

  2. Online Health Information Tool Effectiveness for Older Patients : A Systematic Review of the Literature

    NARCIS (Netherlands)

    Bolle, Sifra; Van Weert, Julia C M; Daams, Joost G.; Loos, Eugène F.; De Haes, Hanneke C J M; Smets, Ellen M A

    2015-01-01

    Online health information tools (OHITs) have been found to be effective in improving health outcomes. However, the effectiveness of these tools for older patients has been far from clear. This systematic literature review therefore provides an overview of online health information tool effectiveness

  3. Spouse Confidence in Self-Efficacy for Arthritis Management Predicts Improved Patient Health

    Science.gov (United States)

    Martire, Lynn M.; Keefe, Francis J.; Stephens, Mary Ann Parris; Schulz, Richard

    2015-01-01

    Background In addition to patient self-efficacy, spouse confidence in patient efficacy may also independently predict patient health outcomes. However, the potential influence of spouse confidence has received little research attention. Purpose The current study examined the influence of patient and spouse efficacy beliefs for arthritis management on patient health. Methods Patient health (i.e., arthritis severity, perceived health, depressive symptoms, lower extremity function), patient self-efficacy, and spouse confidence in patients’ efficacy were assessed in a sample of knee osteoarthritis patients (N = 152) and their spouses at three time points across an 18-month period. Data were analyzed using structural equation models. Results Consistent with predictions, spouse confidence in patient efficacy for arthritis management predicted improvements in patient depressive symptoms, perceived health, and lower extremity function over 6 months and in arthritis severity over 1 year. Conclusions Our findings add to a growing literature that highlights the important role of spouse perceptions in patients’ long-term health. PMID:24604529

  4. Measuring Patient Satisfaction: A Case Study to Improve Quality of Care at Public Health Facilities

    OpenAIRE

    Sodani Prahlad; Kumar Rajeev; Srivastava Jayati; Sharma Laxman

    2010-01-01

    Objective: The main objective of the study is to measure the satisfaction of OPD (Outpatient Department) patients in public health facilities of Madhya Pradesh in India. Materials and Methods: Data were collected from OPD patients through pre-structured questionnaires at public health facilities in the sampled eight districts of Madhya Pradesh. The data were analyzed using SPSS. Settings: Outpatient Departments of district hospital, civil hospital, community health centre, and primary ...

  5. Informative value of Patient Reported Outcomes (PRO) in Health Technology Assessment (HTA)

    OpenAIRE

    Brettschneider, Christian; Lühmann, Dagmar; Raspe, Heiner

    2011-01-01

    Background "Patient-Reported Outcome" (PRO) is used as an umbrella term for different concepts for measuring subjectively perceived health status e. g. as treatment effects. Their common characteristic is, that the appraisal of the health status is reported by the patient himself. In order to describe the informative value of PRO in Health Technology Assessment (HTA) first an overview of concepts, classifications and methods of measurement is given. The overview is complemented by an empir...

  6. Health locus of control and self-care behaviors in diabetic foot patients

    OpenAIRE

    Abredari, Hamid; Bolourchifard, Fariba; Rassouli, Maryam; Nasiri, Navideh; Taher, Mohammad; Abedi, Ahmadreza

    2015-01-01

    Background: Diabetic foot affects more than 25% of diabetic patients and finally up to 20% of cases result in amputation. The most important factor resulting in severe complications or even death is lack of self-care. Health locus of control has been introduced as one of health factors and predicting factors of self-care. This research was performed for analyzing the correlation between self-care behaviors and health locus of control in diabetic foot patients. Methods: In this descriptive stu...

  7. Health Coaching and Glaucoma: A Qualitative Evaluation of the Patient Experience in a Preliminary Study

    OpenAIRE

    Rosdahl, Jullia A; Suzanne Schneider; Anita P. Vin

    2015-01-01

    Introduction: Successful medical treatment of glaucoma requires adherence to daily eye drop medications. Health coaching, which has been used successfully for other chronic diseases, may be helpful for glaucoma patients. Methods: Qualitative analysis of pre-coaching questionnaire, coaching notes, and post-coaching exit interviews, for four glaucoma patients who completed a 6-month health coaching interventional study. The health coaching intervention consisted of 4-6 coachin...

  8. Discussing the Effects of Poor Health Literacy on Patients Facing HIV: A Narrative Literature Review

    Directory of Open Access Journals (Sweden)

    Rocco Palumbo

    2015-07-01

    Full Text Available Background Scholars describe poor health literacy as a “silent epidemic,” which is challenging the functioning of healthcare systems all over the world. Health literacy is mainly meant as an individual trait which concerns the ability to obtain, process, and understand basic health information in order to effectively navigate the health system. Low health literate patients perceive poor self-efficacy dealing with their health conditions, are not willing to be involved in the provision of care, show larger risks of hospitalization and mortality, and are not aware about the determinants of well-being. Hence, limited health literacy has been associated with inadequate management of long-term conditions; nonetheless, several authors argue that health literacy has been an overlooked factor dealing with HIV. Methods This study is aimed at discussing the effects of poor health literacy on people living with HIV, drawing from the findings of a narrative literature review which involved 41 papers retrieved from the databases “Scopus-Elsevier” and “PubMed.” Results The scientific literature is not consistent dealing with the relationship between health literacy and HIV treatment. For example, health literate patients seem to better understand their health conditions; on the other hand, people living with poor health literacy are likely to report higher compliance with providers’ prescriptions, blindly trusting healthcare professionals. Conclusions Poor health literacy is a social barrier to access healthcare services and to appropriate health treatment among patients living with HIV. Tailored interventions should be aimed at enhancing the health skills of patients affected by HIV infection to improve their ability to navigate the health system.

  9. Shock and patient preimplantation type D personality are associated with poor health status in patients with implantable cardioverter-defibrillator

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; Tekle, Fetene B; Hoogwegt, Madelein T;

    2012-01-01

    Implantable cardioverter-defibrillator (ICD) shock is a critical event to patients associated with well-being after implantation, although other factors may play an equally important role. We compared the association of shock and the patient's preimplantation personality with health status, using...

  10. Measuring patient satisfaction: A case study to improve quality of care at public health facilities

    Directory of Open Access Journals (Sweden)

    Sodani Prahlad

    2010-01-01

    Full Text Available Objective: The main objective of the study is to measure the satisfaction of OPD (Outpatient Department patients in public health facilities of Madhya Pradesh in India. Materials and Methods: Data were collected from OPD patients through pre-structured questionnaires at public health facilities in the sampled eight districts of Madhya Pradesh. The data were analyzed using SPSS. Settings: Outpatient Departments of district hospital, civil hospital, community health centre, and primary health centre of the eight selected districts of Madhya Pradesh. Results: A total of 561 OPD patients were included in the study to know their perceptions towards the public health facilities, choosing health facility, registration process, basic amenities, perception towards doctors and other staff, perception towards pharmacy and dressing room services. It was found that most of the respondents were youth and having low level of education. The major reason of choosing the public health facility was inexpensiveness, infrastructure, and proximity of health facility. Measuring patient satisfaction were more satisfied with the basic amenities at higher health facilities compared to lower level facilities. It was also observed that the patients were more satisfied with the behavior of doctors and staff at lower health facilities compared to higher level facilities.

  11. Improving Health Outcomes for Patients with Depression: A Population Health Imperative. Report on an Expert Panel Meeting.

    Science.gov (United States)

    Clarke, Janice L; Skoufalos, Alexis; Medalia, Alice; Fendrick, A Mark

    2016-09-01

    Improving Health Outcomes for Patients with Depression: A Population Health Imperative. Report on an Expert Panel Meeting Janice L. Clarke, RN, Alexis Skoufalos, EdD, Alice Medalia, PhD, and A. Mark Fendrick, MD Editorial: A Call to Action : David B. Nash, MD, MBA   S-2 OVERVIEW: Depression and the Population Health Imperative    S-3 Promoting Awareness of the Issues and Opportunities for Improvement    S-5 Cognitive Dysfunction in Affective Disorders    S-5 Critical Role of Employers in Improving Health Outcomes for Employees with Depression    S-6 Closing the Behavioral Health Professional and Process Gaps    S-6 Achieving the Triple Aim for Patients with Depressive Disorders    S-6 Improving the Experience of Care for Patients with Depression    S-6 Improving Quality of Care and Health Outcomes for Patients with Depression    S-7 Changing the Cost of Care Discussion from How Much to How Well    S-8 Panel Insights and Recommendations    S-9 Conclusion    S-10. PMID:27636743

  12. Improving Health Outcomes for Patients with Depression: A Population Health Imperative. Report on an Expert Panel Meeting

    Science.gov (United States)

    Skoufalos, Alexis; Medalia, Alice; Fendrick, A. Mark

    2016-01-01

    Improving Health Outcomes for Patients with Depression: A Population Health Imperative. Report on an Expert Panel Meeting Janice L. Clarke, RN, Alexis Skoufalos, EdD, Alice Medalia, PhD, and A. Mark Fendrick, MD Editorial: A Call to Action: David B. Nash, MD, MBA   S-2 Overview: Depression and the Population Health Imperative   S-3 Promoting Awareness of the Issues and Opportunities for Improvement   S-5 Cognitive Dysfunction in Affective Disorders   S-5 Critical Role of Employers in Improving Health Outcomes for Employees with Depression   S-6 Closing the Behavioral Health Professional and Process Gaps   S-6 Achieving the Triple Aim for Patients with Depressive Disorders   S-6 Improving the Experience of Care for Patients with Depression   S-6 Improving Quality of Care and Health Outcomes for Patients with Depression   S-7 Changing the Cost of Care Discussion from How Much to How Well   S-8 Panel Insights and Recommendations   S-9 Conclusion   S-10 PMID:27636743

  13. Health related quality of life assessment in patients with hepatitis: a case of Pakistan

    OpenAIRE

    Awan, Masood Sarwar; Waqas, Muhammad; Aslam, Muhammad Amir; Abbas, Faisal

    2011-01-01

    The intention of this study is to dig out the demographic, medical, economic and psychosocial factors that affect the health related quality of life of the hepatitis B and C patient in district Sargodha. 120 patients of hepatitis B and C virus were interviewed. WHOQOL-BREF questionnaire was followed for the construction of health-related quality of life (HRQOL) instrument. Age of the patient, disease severity, use of drug, pain, depression, financial hindrance and threat of death negatively a...

  14. Patient choice at the point of GP referral: Department of Health

    OpenAIRE

    McDougall, A.; McDonald, T.; Koduah, H; Round, J.; Clark, F.; Bourn, J

    2005-01-01

    1 The Department of Health has a Public Service Agreement target to ensure that by the end of 2005 every hospital appointment in the National Health Service in England (the NHS) will be booked for the convenience of the patient, making it easier for patients and their General Practitioners (GPs) to choose the hospital and consultant that best meets their need. The Department aims to provide patients with the opportunity to choose between four to five healthcare provide...

  15. Type 2 diabetes management: Patient knowledge and health care team perceptions, South Africa

    OpenAIRE

    Nombeko Mshunqane; Aimee V. Stewart; Allan D. Rothberg

    2012-01-01

    Background: South African research indicates that the highest death rates between 2004 and 2005 were from diabetes mellitus. There is minimal research information on interactions between what patients know about their disease and what health professionals perceive that patients should know to control their disease well.Objectives: This study determined the knowledge that patients with type 2 diabetes have about the management of their disease, as well as the perceptions of the health care tea...

  16. Telephone-based health coaching for chronically ill patients: study protocol for a randomized controlled trial

    OpenAIRE

    Dwinger, Sarah; Dirmaier, Jörg; Herbarth, Lutz; König, Hans-Helmut; Eckardt, Matthias; Kriston, Levente; Bermejo, Isaac; Härter, Martin

    2013-01-01

    Background The rising prevalence of chronic conditions constitutes a major burden for patients and healthcare systems and is predicted to increase in the upcoming decades. Improving the self-management skills of patients is a strategy to steer against this burden. This could lead to better outcomes and lower healthcare costs. Health coaching is one method for enhancing the self-management of patients and can be delivered by phone. The effects of telephone-based health coaching are promising, ...

  17. The Abzooba Smart Health Informatics Platform (SHIP) TM - From Patient Experiences to Big Data to Insights

    OpenAIRE

    Ashish, Naveen; Biswas, Antarip; Das, Sumit; Nag, Saurav; Pratap, Rajiv

    2012-01-01

    This paper describes a technology to connect patients to information in the experiences of other patients by using the power of structured big data. The approach, implemented in the Abzooba Smart Health Informatics Platform (SHIP),is to distill concepts of facts and expressions from conversations and discussions in health social media forums, and use those distilled concepts in connecting patients to experiences and insights that are highly relevant to them in particular. We envision our work...

  18. Oral health status, knowledge, attitude and practice of patients with heart disease

    OpenAIRE

    Rasouli-Ghahroudi, Amir Alireza; Khorsand, Afshin; Yaghobee, Siamak; Rokn, AmirReza; Jalali, Mohammad; Masudi, Sima; Rahimi, Hamed; Kabir, Ali

    2016-01-01

    BACKGROUND The aim of this study was to investigate knowledge, attitude and practice (KAP) of cardiovascular disease (CVD) patients about their oral health status. METHODS In this cross-sectional study, we analyzed the data of 150 CVD patients that collected by a self-administered questionnaire consists of demographic characteristics and KAP. Oral health indicators calculated based on the results of oral examination by an expert dentist. RESULTS CVD patients had an overall moderate level of k...

  19. Are patient surveys valuable as a service-improvement tool in health services? An overview

    Directory of Open Access Journals (Sweden)

    Patwardhan A

    2012-05-01

    Full Text Available Anjali Patwardhan,1 Charles H Spencer21Nationwide Children’s Hospital Columbus, 2Ohio State University, Columbus, OH, USAAbstract: Improving the quality of care in international health services was made a high priority in 1977. The World Health Assembly passed a resolution to greatly improve “Health for all” by the year 2000. Since 1977, the use of patient surveys for quality improvement has become a common practice in the health-care industry. The use of surveys reflects the concept that patient satisfaction is closely linked with that of organizational performance, which is in turn closely linked with organizational culture. This article is a review of the role of patient surveys as a quality-improvement tool in health care. The article explores the characteristics, types, merits, and pitfalls of various patient surveys, as well as the impact of their wide-ranging application in dissimilar scenarios to identify gaps in service provision. It is demonstrated that the conducting of patient surveys and using the results to improve the quality of care are two different processes. The value of patient surveys depends on the interplay between these two processes and several other factors that can influence the final outcome. The article also discusses the business aspect of the patient surveys in detail. Finally, the authors make future recommendations on how the patient survey tool can be best used to improve the quality of care in the health-care sector.Keywords: patient surveys, quality improvement, service gaps 

  20. Current practice of glucocorticoid replacement therapy and patient-perceived health outcomes in adrenal insufficiency - a worldwide patient survey

    OpenAIRE

    Forss M; Batcheller G; Skrtic S; Johannsson G

    2012-01-01

    Abstract Background The aim was to survey current practice in glucocorticoid replacement therapy and self-perceived health outcomes in patients with adrenal insufficiency. Methods Participants were recruited via patient organizations to respond anonymously to a web-based survey developed by clinical experts. Unique entries were set up for each patient organization enabling geographical localization of the entries. Results 1245 participants responded (primary adrenal insufficiency: 84%; second...

  1. Self-care, foot problems and health in Tanzanian diabetic patients and comparisons with matched Swedish diabetic patients

    OpenAIRE

    Smide, Bibbi

    2000-01-01

    The overall aim was to study self-care, foot problems and self-perceived health in 150 consecutively invited Tanzanian diabetic patients and to compare them with gender- and age-matched Swedish diabetic patients (n=150) from a middle Sweden area. The main study was cross-sectional and took place at a diabetes clinic in Dar es Salaam. All patients answered questions about their self-care satisfaction, diabetes knowledge and skills, and educational needs. Foot examination also included question...

  2. Lesotho - Renovation of Health Centers and Out-Patient Departments

    Data.gov (United States)

    Millenium Challenge Corporation — The randomized rollout design that was developed for the Lesotho Health Centers was rendered infeasible due to infrastructure delays. Before pursuing an alternative...

  3. A Research on Patient Satisfaction with Primary Health Care in the Center of Afyonkarahisar

    Directory of Open Access Journals (Sweden)

    Nazli Sensoy

    2013-10-01

    Full Text Available Aim: Patient satisfaction is an important indicator to evaluate the quality of primary health care service. It is also significant to improve the quality of medical care, expectation from health staff, priority of patient needs, views and feedbacks about medical services in primary health care. Our objective in this study is to determine the patient satisfaction and the factors effecting this aspect in the evaluation of primary health care quality. Material and Method: This research was carried out in one Mother and Child Health and Family Planning Centre and nine Health Centers in January 2009 at Afyonkarahisar center. The questionnaire was performed to investigate the degree of satisfaction about health services, and socio-demographic characteristics of patients admitted to primary health care by face to face interview method. The data was evaluated by SPSS 15.00.Results: 1227 patients participating in the study, 809 women and 418 were male, married 878, 290 were single.Their education level was 408 graduated from primary school. At the same time, their job distributions were 596 housewives, 133 retired. When the patients had health problems, the most preferable institutione was health center, the choice of the reasons they were satisfied with the services in general, determined as to obtain quick results and confidence in solving problems.75% of the patients waiting time for admission and registration procedures were 0-5minutes. The admission reasons were mostly physical examination and prescription. Patients who are male, aged above 50 years and low educated had much higher satisfaction levels. Discussion: As a result, decreased satisfaction with higher education level, satisfaction increased with increasing age and a short waiting period for the application-registration and examination procedures were being influenced patient satisfaction.

  4. Compliance or patient empowerment in online communities: reformation of health care services?

    Science.gov (United States)

    Wentzer, Helle; Bygholm, Ann

    2010-01-01

    New technologies enable a different organization of the public's admission to health care services. The article discusses whether online support groups in patient treatment are to be understood in the light of patient empowerment or within the tradition of compliance. The back-ground material of the discussion is complementary data from quantitative research on characteristics of patient support groups, and from two qualitative, in depth studies of the impact of patient networks for lung patients and for women with fertility problems. We conclude that in spite of the potential of online communities of opening up health care to the critical voice of the public, the quantitative and qualitative studies surprisingly point to a synthesis of the otherwise opposite positions of empowerment and compliance in patient care. Thereby the critical potential of online communities in health care services seems reverted into configuring ideal patients from diverse users. PMID:20543380

  5. Oral health in institucionalizated elderly patients in two care centers in Passo Fundo - RS

    OpenAIRE

    Nicolau Silveira Neto; João Paulo de Carli; Maria Salete Sandini Linden; Micheline Sandini Trentin; Soluete Oliveira da Silva; Luciele Raquel Luft

    2008-01-01

    Objective: Considering that oral health, as well as general health are fundamental for maintaining the quality of life, the objective of this study was to investigate the oral health of the elderly population in the São José and Nossa Senhora da Luz Care Centers in Passo Fundo/ RS, Brazil. Methods: a clinical examination was performed in 107 elderly patients, to evaluate the oral health status as regards periodontal disease, edentulism, physiological alterations, and mucosa infection by the C...

  6. Health Literacy and Self-Care of Patients with Heart Failure

    OpenAIRE

    Chen, Aleda M.H.; Yehle, Karen S.; Plake, Kimberly S.; Murawski, Matthew M; Mason, Holly L.

    2011-01-01

    Background and Research Objective: Today’s complex health care system relies heavily on sophisticated self-care regimens. To navigate the system and follow self-care protocols, patients must be able to understand and use health information, which requires health literacy. However, nearly 90 million Americans lack the necessary health literacy skills to adequately care for themselves in the face of a complex healthcare system and self-care regimens. Understanding how to effectively care for on...

  7. The relative effect of health literacy and patient activation on provider choice in the Netherlands.

    NARCIS (Netherlands)

    Rademakers, J.; Nijman, J.; Brabers, A.E.M.; Jong, J.D. de; Hendriks, M.

    2014-01-01

    Active provider choice by patients has become an important policy theme in western, countries over the last decades. However, not many patients and consumers exercise their rightto, choose. Both health literacy and patient activation are likely to have an impact on the choiceprocess.In,this article

  8. Are health professionals' perceptions of patient safety related to figures on safety incidents?

    NARCIS (Netherlands)

    Martijn, L.M.; Harmsen, M.; Gaal, S.; Mettes, D.G.; Dulmen, S.A. van; Wensing, M.

    2013-01-01

    OBJECTIVE: The study aims to explore whether health care professionals' perceptions of patient safety in their practice were associated with the number of patient safety incidents identified in patient records. SETTING: Seventy primary care practices of general practice, general dental practice, mid

  9. Utilisation of health care system by chronic pain patients who applied for disability pensions.

    Science.gov (United States)

    Højsted, J; Alban, A; Hagild, K; Eriksen, J

    1999-09-01

    The objective of this study was to investigate how economic compensation for disability (disability pensions) to chronic pain patients affected their utilisation of health care services. The study was carried out as a register investigation. Inclusion of 144 study patients was based on records from 1989 and 1990 of the Rehabilitation and Pension Board in the Municipality of Copenhagen. Only patients of Danish origin with chronic non-malignant pain were included. The study period was divided into three: Subperiod 1: The year preceding the submission of the application for a disability pension. Subperiod 2: The period from the submission of the application to the decision was made. Subperiod 3: The year following the final decision of the health authorities. The patients were divided into 4 Subgroups according to whether disability pensions was awarded or rejected, or whether the patients accepted or appealed the decision. Based on number and charges of visits to the GPs the total costs of care in the primary sector were calculated. By means of number of bed days, visits to outpatients clinics, operations, blood samples, and various investigations, the total costs of hospital care were calculated. We found that application for a disability pension in chronic pain patients significantly influenced the health care utilisation. Chronic pain patients had a significantly lower health care utilisation after receiving a disability pension than before the pension was awarded. Chronic pain patients who did not get a disability pension and those who were not satisfied with the level of the pension awarded, maintained their health care utilisation after the decision. The mean health care use by the patients who appealed the level of the pension was three times higher than the mean health care use by the patients who accepted the level of the pension awarded. The study may indicate that lack of or insufficient economic compensation from the social system in chronic pain patients

  10. Assessment and clinical aspects of health-related quality of life in dialysis patients and patients with chronic kidney disease

    DEFF Research Database (Denmark)

    Molsted, Stig; Prescott, Lotte; Heaf, James;

    2007-01-01

    BACKGROUND/AIMS: It is relevant to investigate health-related quality of life (HRQOL) in dialysis and chronic kidney disease (CKD) patients in order to optimise treatment. The aim of this study was to investigate HRQOL in dialysis and CKD patients, to compare results from patients treated...... control parameters were measured and the patients completed the questionnaire Kidney Disease Quality Of Life. RESULTS: PD patients rated Dialysis Staff Encouragement and Patient Satisfaction better than HD patients (p... with hemodialysis (HD) and peritoneal dialysis (PD) and to investigate the prediction of dialysis quality control parameters (blood hemoglobin, plasma albumin, and Kt/V) and tobacco smoking in disease-specific HRQOL. METHODS: Seventy-one HD, 59 PD, and 63 CKD patients participated in the study. Dialysis quality...

  11. Study Protocol: A randomized controlled trial of patient navigation-activation to reduce cancer health disparities

    Directory of Open Access Journals (Sweden)

    Rousseau Sally

    2010-10-01

    Full Text Available Abstract Background Cancer health disparities affecting low-income and minority patients are well documented. Root-causes are multifactorial, including diagnostic and treatment delays, social and financial barriers, and poor communication. Patient navigation and communication coaching (activation are potential interventions to address disparities in cancer treatment. The purpose of this clinical trial is to test the effectiveness of an intervention combining patient navigation and activation to improve cancer treatment. Methods/Design The Rochester Patient Navigation Research Program (PNRP is a National Cancer Institute-sponsored, patient-level randomized trial (RCT of patient navigation and activation, targeting newly-diagnosed breast and colorectal cancer patients in Rochester, NY. The goal of the program is to decrease cancer health disparities by addressing barriers to receipt of cancer care and promoting patient self-efficacy. The intervention uses trained, paraprofessional patient navigators recruited from the target community, and a detailed training and supervisory program. Recruited patients are randomly assigned to receive either usual care (except for baseline and follow-up questionnaires and interviews or intervention. The intervention patients receive tailored assistance from their patient navigators, including phone calls, in-person meetings, and behind-the-scenes coordination of care. A total of 344 patients have been recruited. Outcomes measured at three month intervals include timeliness of care, patient adherence, patient satisfaction, quality of life, self-efficacy, health literacy, and cancer knowledge. Discussion This unique intervention combining patient navigation and patient activation is designed to address the multifactorial problem of cancer health disparities. If successful, this study will affect the design and implementation of patient navigation programs. Trials Registration clinicaltrials.gov identifier NCT

  12. "Community vital signs": incorporating geocoded social determinants into electronic records to promote patient and population health.

    Science.gov (United States)

    Bazemore, Andrew W; Cottrell, Erika K; Gold, Rachel; Hughes, Lauren S; Phillips, Robert L; Angier, Heather; Burdick, Timothy E; Carrozza, Mark A; DeVoe, Jennifer E

    2016-03-01

    Social determinants of health significantly impact morbidity and mortality; however, physicians lack ready access to this information in patient care and population management. Just as traditional vital signs give providers a biometric assessment of any patient, "community vital signs" (Community VS) can provide an aggregated overview of the social and environmental factors impacting patient health. Knowing Community VS could inform clinical recommendations for individual patients, facilitate referrals to community services, and expand understanding of factors impacting treatment adherence and health outcomes. This information could also help care teams target disease prevention initiatives and other health improvement efforts for clinic panels and populations. Given the proliferation of big data, geospatial technologies, and democratization of data, the time has come to integrate Community VS into the electronic health record (EHR). Here, the authors describe (i) historical precedent for this concept, (ii) opportunities to expand upon these historical foundations, and (iii) a novel approach to EHR integration. PMID:26174867

  13. The doctor-patient relation in the context of health seen as a product

    Directory of Open Access Journals (Sweden)

    Sérgio Bergmann Borges Vieira

    2010-11-01

    Full Text Available This article presents a theoretical review of the doctor-patient relation in the context of health as a socio-cultural product of postmodernity. We searched the data bases Pub Med, Lilacs and the Cochrane Library in the Internet, using the key words doctor-patient relation, health, product and post-modernity. We also searched medical textbooks as well as reference works in the fields of philosophy, sociology and marketing. The doctor-patient relation was analyzed based on the concepts health and product. Thus, by considering health a product of the consumer society, one discussed the changes that occurred in medical care and in the relation between the health professional (doctor and the patient (client.

  14. Patient education after stoma creation may reduce health-care costs

    DEFF Research Database (Denmark)

    Danielsen, Anne Kjærgaard; Rosenberg, Jacob

    2014-01-01

    AND METHODS: Following a previous case-control study that explored the effect of patient education for stoma patients, we set out to examine the costs related to such a patient education programme. The primary outcome was disease-specific health-related quality of life measured with the Ostomy Adjustment...... Scale six months after surgery. The secondary outcome was generic health-related quality of life measured with Short Form (SF)-36. In this secondary analysis, we calculated direct health-care costs for the first six months post-operatively from the perspective of the health-care system, including costs...... related to the hospital as well as primary health care. RESULTS: The overall cost related to establishing a patient education programme showed no significant increase in the overall average costs. However, we found a significant reduction in costs related to unplanned readmissions (p = 0.01) as well...

  15. "Community vital signs": incorporating geocoded social determinants into electronic records to promote patient and population health.

    Science.gov (United States)

    Bazemore, Andrew W; Cottrell, Erika K; Gold, Rachel; Hughes, Lauren S; Phillips, Robert L; Angier, Heather; Burdick, Timothy E; Carrozza, Mark A; DeVoe, Jennifer E

    2016-03-01

    Social determinants of health significantly impact morbidity and mortality; however, physicians lack ready access to this information in patient care and population management. Just as traditional vital signs give providers a biometric assessment of any patient, "community vital signs" (Community VS) can provide an aggregated overview of the social and environmental factors impacting patient health. Knowing Community VS could inform clinical recommendations for individual patients, facilitate referrals to community services, and expand understanding of factors impacting treatment adherence and health outcomes. This information could also help care teams target disease prevention initiatives and other health improvement efforts for clinic panels and populations. Given the proliferation of big data, geospatial technologies, and democratization of data, the time has come to integrate Community VS into the electronic health record (EHR). Here, the authors describe (i) historical precedent for this concept, (ii) opportunities to expand upon these historical foundations, and (iii) a novel approach to EHR integration.

  16. Association between time of pay-for-performance for patients and community health services use by chronic patients.

    Directory of Open Access Journals (Sweden)

    Xi Sun

    Full Text Available BACKGROUND: Pay-for-performance for patients is a cost-effective means of improving health behaviours. This study examined the association between the pay time for performance for patients and CHS use by chronic patients. METHODS: A cross-sectional study was undertaken to estimate distribution characteristics of CHS use in 2011 and collect data of socio-demographic characteristics (sex, age, education level, occupation, disposable personal income in 2011, distance between home and community health agency, chronic disease number, and time of pay-for-performance for patients. Participants were 889 rural adults with hypertension or type II diabetes aged 35 and above. Standardized CHS use means chronic patients use CHS at least once per quarter. RESULTS: Patients who received incentives prior to services had 2.724 times greater odds of using standardized CHS than those who received incentives after services (95%CI, 1.986-3.736, P<0.001. For all subgroups (socio-demographic characteristics and chronic disease number, patients who received incentives prior to services were more likely to use standardized CHS than those receiving incentives after services. CONCLUSIONS: Pay time for performance for patients was associated with CHS use by chronic patients. Patients receiving incentive prior to services were more likely to use standardized CHS. And pay time should not be ignored when the policy on pay-for-performance for patients is designed.

  17. Are patients' judgments of health status really different from the general population?

    Directory of Open Access Journals (Sweden)

    Ruers Theo JM

    2011-05-01

    Full Text Available Abstract Background Many studies have found discrepancies in valuations for health states between the general population (healthy people and people who actually experience illness (patients. Such differences may be explained by referring to various cognitive mechanisms. However, more likely most of these observed differences may be attributable to the methods used to measure these health states. We explored in an experimental setting whether such discrepancies in values for health states exist. It was hypothesized that the more the measurement strategy was incorporated in measurement theory, the more similar the responses of patients and healthy people would be. Methods A sample of the general population and two patient groups (cancer, rheumatoid arthritis were included. All three study groups judged the same 17 hypothetical EQ-5D health states, each state comprising the same five health domains. The patients did not know that apart from these 17 states their own health status was also included in the set of states they were assessing. Three different measurement strategies were applied: 1 ranking of the health states; 2 placing all the health states simultaneously on a visual analogue scale (VAS; 3 separately assessing the health states with the time trade-off (TTO technique. Regression analyses were performed to determine whether differences in the VAS and TTO can be ascribed to specific health domains. In addition, effect of being member of one of the two patient groups and the effect of the assessment of the patients' own health status was analyzed. Results Except for some moderate divergence, no differences were found between patients and healthy people for the ranking task or for the VAS. For the time trade-off technique, however, large differences were observed between patients and healthy people. The regression analyses for the effect of belonging to one of the patient groups and the effect of the value assigned to the patients' own

  18. Patient choice and mobility in the UK health system: internal and external markets.

    Science.gov (United States)

    Dusheiko, Mark

    2014-01-01

    The National Health Service (NHS) has been the body of the health care system in the United Kingdom (UK) for over 60 years and has sought to provide the population with a high quality service free of user charges for most services. The information age has seen the NHS rapidly transformed from a socialist, centrally planned and publicly provided system to a more market based system orientated towards patients as consumers. The forces of globalization have provided patients in the UK with greater choice in their health care provision, with NHS treatment now offered from any public or approved private provider and the possibility of treatment anywhere in the European Economic Area (EEA) or possibly further. The financial crisis, a large government deficit and austerity public spending policies have imposed a tight budget constraint on the NHS at a time of increasing demand for health care and population pressure. Hence, further rationing of care could imply that patients are incentivised to seek private treatment outside the constraints of the NHS, where the possibility of much greater choice exists in an increasingly globally competitive health care market. This chapter examines the evidence on the response of patients to the possibilities of increased choice and mobility within the internal NHS and external overseas health care markets. It also considers the relationships between patient mobility, health care provision and health policy. Patients are more mobile and willing to travel further to obtain better care outcomes and value for money, but are exposed to greater risk.

  19. The impact of the EU Directive on patients' rights and cross border health care in Malta.

    Science.gov (United States)

    Azzopardi-Muscat, Natasha; Aluttis, Christoph; Sorensen, Kristine; Pace, Roderick; Brand, Helmut

    2015-10-01

    The patients' rights and cross-border health care directive was implemented in Malta in 2013. Malta's transposition of the directive used the discretionary elements allowable to retain national control on cross-border care to the fullest extent. This paper seeks to analyse the underlying dynamics of this directive on the Maltese health care system through the lens of key health system stakeholders. Thirty-three interviews were conducted. Qualitative content analysis of the interviews reveals six key themes: fear from the potential impact of increased patient mobility, strategies employed for damage control, opportunities exploited for health system reform, moderate enhancement of patients' rights, negligible additional patient mobility and unforeseen health system reforms. The findings indicate that local stakeholders expected the directive to have significant negative effects and adopted measures to minimise these effects. In practice the directive has not affected patient mobility in Malta in the first months following its implementation. Government appears to have instrumentalised the implementation of the directive to implement certain reforms including legislation on patients' rights, a health benefits package and compulsory indemnity insurance. Whilst the Maltese geo-demographic situation precludes automatic generalisation of the conclusions from this case study to other Member States, the findings serve to advance our understanding of the mechanisms through which European legislation on health services is influencing health systems, particularly in small EU Member States.

  20. [Health education, patient education and health promotion: educational methods and strategies].

    Science.gov (United States)

    Sandrin, Brigitte

    2013-01-01

    The purpose of this paper is to help public health actors with an interest in health promotion and health care professionals involved in therapeutic education to develop and implement an educational strategy consistent with their vision of health and health care. First, we show that the Ottawa Charter for Health Promotion and the French Charter for Popular Education share common values. Second, an examination of the career and work of Paulo Freire, of Ira Shor's pedagogical model and of the person-centered approach of Carl Rogers shows how the work of educational practitioners, researchers and theorists can help health professionals to implement a truly "health-promoting" or "therapeutic" educational strategy. The paper identifies a number of problems facing health care professionals who become involved in education without reflecting on the values underlying the pedagogical models they use.

  1. Relationship between Spiritual Health and Quality of Life in Patients with Cancer.

    Science.gov (United States)

    Mohebbifar, Rafat; Pakpour, Amir H; Nahvijou, Azin; Sadeghi, Atefeh

    2015-01-01

    As the essence of health in humans, spiritual health is a fundamental concept for discussing chronic diseases such as cancer and a major approach for improving quality of life in patients is through creating meaningfulness and purpose. The present descriptive analytical study was conducted to assess the relationship between spiritual health and quality of life in 210 patients with cancer admitted to the Cancer Institute of Iran, selected through convenience sampling in 2014. Data were collected using Spiritual Health Questionnaire and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ). Patients' performance was assessed through the Karnofsky Performance Status Indicator and their cognitive status through the Mini-Mental State Examination (MMSE). Data were analyzed in SPSS-16 using descriptive statistics and stepwise linear regression. The results obtained reported the mean and standard deviation of the patients' spiritual health scoreas 78.4±16.1and the mean and standard deviation of their quality of life score as 58.1±18.7. The stepwise linear regression analysis confirmed a positive and significant relationship between spiritual health and quality of life in patients with cancer (β=0.688 and r=0.00). The results of the study show that spiritual health should be more emphasized and reinforced as a factor involved in improving quality of life in patients with cancer. Designing care therapies and spiritual interventions is a priority in the treatment of these patients. PMID:26514531

  2. General health and religious coping strategies in patients suffering from asthma

    Directory of Open Access Journals (Sweden)

    Seyyed Hassan Adeli

    2014-09-01

    Full Text Available Background and Objectives: Asthma is a chronic respiratory disease characterized by reversible contraction of airways. Coping strategies can reduce the negative impact of the disease in individuals or cause incompatible behaviors by negative effect. This study aimed to evaluate the religious coping strategies in asthma patients and the relationship of religious coping and general health. Methods: The study included 102 asthmatic patients referred to the pulmonary clinic of Shahid Beheshti hospital of Qom. Brief religious coping strategy questionnaire and the general health questionnaire were used in this study. Results: The mean positive religious coping strategy was 26.24±9.89 and 60% of the patients had higher than average scores. The mean negative religious coping strategy was 10.56±3.99 and 35% of patients had a mean score higher than average scores. The mean total general health score was 23.91±11.9. Conclusion: The study results showed that asthmatic patients are at greater risk of depression and a negative correlation exists between positive religious coping and general health scores. It can be concluded that in asthmatic patients, depression should be suspected sooner. Also, during the course of treatment and in cases of resistant to treatment, this issue should be considered. It can be concluded that the patients who use more positive coping strategies and have a strong spiritual beliefs may have higher mental health that leads to higher physical health and a better response to treatment. Religious coping strategies; general health; depression.

  3. Optimizing Patient Preparation and Surgical Experience Using eHealth Technology.

    Science.gov (United States)

    Waller, Amy; Forshaw, Kristy; Carey, Mariko; Robinson, Sancha; Kerridge, Ross; Proietto, Anthony; Sanson-Fisher, Rob

    2015-09-01

    With population growth and aging, it is expected that the demand for surgical services will increase. However, increased complexity of procedures, time pressures on staff, and the demand for a patient-centered approach continue to challenge a system characterized by finite health care resources. Suboptimal care is reported in each phase of surgical care, from the time of consent to discharge and long-term follow-up. Novel strategies are thus needed to address these challenges to produce effective and sustainable improvements in surgical care across the care pathway. The eHealth programs represent a potential strategy for improving the quality of care delivered across various phases of care, thereby improving patient outcomes. This discussion paper describes (1) the key functions of eHealth programs including information gathering, transfer, and exchange; (2) examples of eHealth programs in overcoming challenges to optimal surgical care across the care pathway; and (3) the potential challenges and future directions for implementing eHealth programs in this setting. The eHealth programs are a promising alternative for collecting patient-reported outcome data, providing access to credible health information and strategies to enable patients to take an active role in their own health care, and promote efficient communication between patients and health care providers. However, additional rigorous intervention studies examining the needs of potential role of eHealth programs in augmenting patients' preparation and recovery from surgery, and subsequent impact on patient outcomes and processes of care are needed to advance the field. Furthermore, evidence for the benefits of eHealth programs in supporting carers and strategies to maximize engagement from end users are needed.

  4. Patient perspectives on post-discharge surgical site infections: towards a patient-centered mobile health solution.

    Directory of Open Access Journals (Sweden)

    Patrick C Sanger

    Full Text Available Post-discharge surgical site infections (SSI are a major source of morbidity, expense and anxiety for patients. However, patient perceptions about barriers experienced while seeking care for post-discharge SSI have not been assessed in depth. We explored patient experience of SSI and openness to a mobile health (mHealth wound monitoring "app" as a novel solution to address this problem.Mixed method design with semi-structured interviews and surveys. Participants were patients who had post-discharge surgical wound complications after undergoing operations with high risk of SSI, including open colorectal or ventral hernia repair surgery. The study was conducted at two affiliated teaching hospitals, including an academic medical center and a level 1 trauma center.From interviews with 13 patients, we identified 3 major challenges that impact patients' ability to manage post-discharge surgical wound complications, including required knowledge for wound monitoring from discharge teaching, self-efficacy for wound monitoring at home, and accessible communication with their providers about wound concerns. Patients found an mHealth wound monitoring application highly acceptable and articulated its potential to provide more frequent, thorough, and convenient follow-up that could reduce post-discharge anxiety compared to the current practice. Major concerns with mHealth wound monitoring were lack of timely response from providers and inaccessibility due to either lack of an appropriate device or usability challenges.Our findings reveal gaps and frustrations with post-discharge care after surgery which could negatively impact clinical outcomes and quality of life. To address these issues, we are developing mPOWEr, a patient-centered mHealth wound monitoring application for patients and providers to collaboratively bridge the care transition between hospital and home.

  5. Let's Talk About Sex! - Improving sexual health for patients in stroke rehabilitation.

    Science.gov (United States)

    Guo, Meiqi; Bosnyak, Stephanie; Bontempo, Tiziana; Enns, Amie; Fourie, Candice; Ismail, Farooq; Lo, Alex

    2015-01-01

    Sexual health contributes greatly to quality of life. Research shows that stroke survivors want to learn and talk about sexual health, but are not given information. In keeping with the Canadian Best Practice Recommendations for Stroke Care, this project aimed to provide all stroke rehabilitation inpatients with the opportunity to discuss sexual health concerns with healthcare providers at West Park Healthcare Centre, a rehabilitation and complex continuing care centre in Toronto. Gap analysis conducted via staff member interviews and retrospective chart reviews showed that close to no patients were given the opportunity to discuss sexual health concerns at baseline. Plan-Do-Study-Act (PDSA) methodology was used as the project framework. The changes implemented included a reminder system, standardization of care processes for sexual health, patient-centred time points for the delivery of sexual health discussions, and the development of a sexual health supported conversation tool for patients with aphasia. By the end of the ten month project period and after three PDSA cycles, the percentage of patients provided with the opportunity to discuss sexual health during inpatient rehabilitation increased to 80%. This quality improvement project successfully implemented the Canadian Best Practice Recommendations for Stroke Care with respect to sexual health. Lessons learned included the importance of early baseline data collection and advance planning for tools used in QI projects. Future projects may focus on improving the discussion of sexual health concerns during outpatient stroke rehabilitation.

  6. mHealth is an Innovative Approach to Address Health Literacy and Improve Patient-Physician Communication – An HIV Testing Exemplar

    OpenAIRE

    Kumar, Disha; Arya, Monisha

    2015-01-01

    Low health literacy is a barrier for many patients in the U.S. Patients with low health literacy have poor communication with their physicians, and thus face worse health outcomes. Several government agencies have highlighted strategies for improving and overcoming low health literacy. Mobile phone technology could be leveraged to implement these strategies to improve communication between patients and their physicians. Text messaging, in particular, is a simple and interactive platform that ...

  7. Impact of health literacy in patients with chronic musculoskeletal disease--systematic review.

    Directory of Open Access Journals (Sweden)

    Yoon K Loke

    Full Text Available OBJECTIVES: To estimate the prevalence of low health literacy, and evaluate the impact of low health literacy on outcomes in patients with chronic musculoskeletal conditions. DATA SOURCES: We searched Embase, Pubmed, PsycInfo, and CINAHL in January 2011 for relevant studies, restricted to English-language articles. STUDY SELECTION AND DATA EXTRACTION: Studies were included if they measured health literacy and/or reported on the link between outcomes and health literacy levels in patients with osteoporosis, osteoarthritis, or rheumatoid arthritis. We assessed risk of bias from participant selection, methods of measuring health literacy and functional outcomes, missing data, and potential for confounding. DATA SYNTHESIS: We reviewed 1863 citations and judged 8 studies to be relevant. Most were cross-sectional in nature, and five were based in the United States. Diversity in measurements, participant characteristics, and settings meant that results had to be synthesized narratively. Prevalence of low health literacy varied from 7% to 42%. Of the five studies that reported on musculoskeletal outcomes, only one showed an association (unadjusted between low health literacy and greater pain and limitations in physical functioning. However, other studies, including those with multivariate analyses, found no significant relationship between health literacy and measures of pain or disease specific questionnaires. One clinical trial found short-term improvements in the mental health of patients with musculoskeletal conditions after an intervention to improve health literacy. LIMITATIONS: Most of the studies were cross-sectional in nature, which precludes interpretation of a causal relationship. The sample sizes may not have been sufficiently large to enable detection of significant associations. CONCLUSIONS: The current evidence does not show a consistent association between low health literacy and poorer functional outcomes in patients with chronic

  8. Increased 30-Day Emergency Department Revisits Among Homeless Patients with Mental Health Conditions

    Directory of Open Access Journals (Sweden)

    Chun Nok Lam

    2016-09-01

    Full Text Available Introduction: Patients with mental health conditions frequently use emergency medical services. Many suffer from substance use and homelessness. If they use the emergency department (ED as their primary source of care, potentially preventable frequent ED revisits and hospital readmissions can worsen an already crowded healthcare system. However, the magnitude to which homelessness affects health service utilization among patients with mental health conditions remains unclear in the medical community. This study assessed the impact of homelessness on 30-day ED revisits and hospital readmissions among patients presenting with mental health conditions in an urban, safety-net hospital. Methods: We conducted a secondary analysis of administrative data on all adult ED visits in 2012 in an urban safety-net hospital. Patient demographics, mental health status, homelessness, insurance coverage, level of acuity, and ED disposition per ED visit were analyzed using multilevel modeling to control for multiple visits nested within patients. We performed multivariate logistic regressions to evaluate if homelessness moderated the likelihood of mental health patients’ 30-day ED revisits and hospital readmissions. Results: Study included 139,414 adult ED visits from 92,307 unique patients (43.5±15.1 years, 51.3% male, 68.2% Hispanic/Latino. Nearly 8% of patients presented with mental health conditions, while 4.6% were homeless at any time during the study period. Among patients with mental health conditions, being homeless contributed to an additional 28.0% increase in likelihood (4.28 to 5.48 odds of 30-day ED revisits and 38.2% increase in likelihood (2.04 to 2.82 odds of hospital readmission, compared to non-homeless, non-mental health (NHNM patients as the base category. Adjusted predicted probabilities showed that homeless patients presenting with mental health conditions have a 31.1% chance of returning to the ED within 30-day post discharge and a 3

  9. The Abzooba Smart Health Informatics Platform (SHIP) TM - From Patient Experiences to Big Data to Insights

    CERN Document Server

    Ashish, Naveen; Das, Sumit; Nag, Saurav; Pratap, Rajiv

    2012-01-01

    This paper describes a technology to connect patients to information in the experiences of other patients by using the power of structured big data. The approach, implemented in the Abzooba Smart Health Informatics Platform (SHIP),is to distill concepts of facts and expressions from conversations and discussions in health social media forums, and use those distilled concepts in connecting patients to experiences and insights that are highly relevant to them in particular. We envision our work, in progress, to provide new and effective tools to exploit the richness of content in social media in health for outcomes research.

  10. Prevention by Design: Construction and Renovation of Health Care Facilities for Patient Safety and Infection Prevention.

    Science.gov (United States)

    Olmsted, Russell N

    2016-09-01

    The built environment supports the safe care of patients in health care facilities. Infection preventionists and health care epidemiologists have expertise in prevention and control of health care-associated infections (HAIs) and assist with designing and constructing facilities to prevent HAIs. However, design elements are often missing from initial concepts. In addition, there is a large body of evidence that implicates construction and renovation as being associated with clusters of HAIs, many of which are life threatening for select patient populations. This article summarizes known risks and prevention strategies within a framework for patient safety. PMID:27515144

  11. The association of patients' oral health literacy and dental school communication tools: a pilot study.

    Science.gov (United States)

    Tam, Amy; Yue, Olivia; Atchison, Kathryn A; Richards, Jessica K; Holtzman, Jennifer S

    2015-05-01

    The aim of this pilot study was to assess adult patients' ability to read and understand two communication tools at the University of California, Los Angeles, School of Dentistry: the dental school clinic website and a patient education brochure pertaining to sedation in children that was written by dental school personnel. A convenience sample of 100 adults seeking treatment at the school's general dental clinic during 2012-13 completed a health literacy screening instrument. They were then asked to read clinic educational and informational materials and complete a survey. Analyses were conducted to determine the association between the subjects' oral health literacy and sociodemographics and their ability to locate and interpret information in written oral health information materials. SMOG and Flesch-Kincade formulas were used to assess the readability level of the electronic and written communication tools. The results demonstrated an association between these adults' oral health literacy and their dental knowledge and ability to navigate health information website resources and understand health education materials. Health literacy was not associated with age or gender, but was associated with education and race/ethnicity. The SMOG Readability Index determined that the website and the sedation form were written at a ninth grade reading level. These results suggest that dental schools and other health care organizations should incorporate a health-literate approach for their digital and written materials to enhance patients' ability to navigate and understand health information, regardless of their health literacy. PMID:25941146

  12. The association of patients' oral health literacy and dental school communication tools: a pilot study.

    Science.gov (United States)

    Tam, Amy; Yue, Olivia; Atchison, Kathryn A; Richards, Jessica K; Holtzman, Jennifer S

    2015-05-01

    The aim of this pilot study was to assess adult patients' ability to read and understand two communication tools at the University of California, Los Angeles, School of Dentistry: the dental school clinic website and a patient education brochure pertaining to sedation in children that was written by dental school personnel. A convenience sample of 100 adults seeking treatment at the school's general dental clinic during 2012-13 completed a health literacy screening instrument. They were then asked to read clinic educational and informational materials and complete a survey. Analyses were conducted to determine the association between the subjects' oral health literacy and sociodemographics and their ability to locate and interpret information in written oral health information materials. SMOG and Flesch-Kincade formulas were used to assess the readability level of the electronic and written communication tools. The results demonstrated an association between these adults' oral health literacy and their dental knowledge and ability to navigate health information website resources and understand health education materials. Health literacy was not associated with age or gender, but was associated with education and race/ethnicity. The SMOG Readability Index determined that the website and the sedation form were written at a ninth grade reading level. These results suggest that dental schools and other health care organizations should incorporate a health-literate approach for their digital and written materials to enhance patients' ability to navigate and understand health information, regardless of their health literacy.

  13. Digitally enabled patients, professionals and providers: making the case for an electronic health record in mental health services

    Science.gov (United States)

    Richardson, Jonathan; McDonald, Joe

    2016-01-01

    The move to a digital health service may improve some components of health systems: information, communication and documentation of care. This article gives a brief definition and history of what is meant by an electronic health record (EHR). There is some evidence of benefits in a number of areas, including legibility, accuracy and the secondary use of information, but there is a need for further research, which may need to use different methodologies to analyse the impact an EHR has on patients, professionals and providers. PMID:27752348

  14. Patient information provision: its effect on patient anxiety and the role of health information services and libraries.

    Science.gov (United States)

    Bolton, V; Brittain, M

    1994-06-01

    This article is concerned with the importance of communicating information to patients as an aid to recovery by decreasing anxiety. Recent research suggests that pre-operative information helps to decrease post-operative stress and leads to a quicker recovery. The health belief model has proven to be an effective predictor of individuals' responses towards health-related matters. It is described as a useful theoretical framework for medical professionals in deciding the content and quantity of information that each patient should receive. A study for further research is suggested, exploring the hypothesis that reading about illness significantly helps to reduce anxiety when the patient has added emotional support from a health professional. The existing problem of who is ultimately responsible for giving information to patients is highlighted in the general practice, hospital and public settings. Recommendations are made for the improvement of patient information provision in these three areas. Librarians are seen as being in a good position to liaise with medical professionals to provide the most effective health information service possible for patients and the consumer in general. PMID:10172100

  15. Towards Automatic Improvement of Patient Queries in Health Retrieval Systems

    Directory of Open Access Journals (Sweden)

    Nesrine KSENTINI

    2016-07-01

    Full Text Available With the adoption of health information technology for clinical health, e-health is becoming usual practice today. Users of this technology find it difficult to seek information relevant to their needs due to the increasing amount of the clinical and medical data on the web, and the lack of knowledge of medical jargon. In this regards, a method is described to improve user's needs by automatically adding new related terms to their queries which appear in the same context of the original query in order to improve final search results. This method is based on the assessment of semantic relationships defined by a proposed statistical method between a set of terms or keywords. Experiments were performed on CLEF-eHealth-2015 database and the obtained results show the effectiveness of our proposed method.

  16. Family physicians improve patient health care quality and outcomes.

    Science.gov (United States)

    Bowman, Marjorie A; Neale, Anne Victoria

    2013-01-01

    This issue exemplifies family physicians' ability to provide great care and to continuously improve. For example, beyond other specialty care, the care provided by family physicians is associated with improved melanoma diagnosis and outcomes and improved preventive services for those with a history of breast cancer. Electronic health records are providing new avenues to both assess outcomes and influence care. However, to truly reward quality care, simplistic and readily measurable items such as laboratory results or assessment of the provision of preventive services must be adjusted for risk. Health insurance influences classic preventive care services more than personal health behaviors. The care provided at federally qualified health centers throughout the nation is highly appreciated by the people they serve and is not plagued by the types of disparities in other settings.

  17. Health beliefs and perceived need for mental health care of anxiety and depression--the patients' perspective explored.

    Science.gov (United States)

    Prins, Marijn A; Verhaak, Peter F M; Bensing, Jozien M; van der Meer, Klaas

    2008-07-01

    Patients' illness representations and beliefs about treatment for depression and anxiety, as well as their perceived needs, are important for treatment. A systematic review was conducted of 71 studies describing the beliefs or perceived needs of patients and non-patients. Patients give multi-dimensional explanations for depression and see both psychological and medication treatment as helpful. People who suffer from depression have more positive beliefs about biological etiology and medication treatment than healthy people, or those with less severe depressive symptoms. Anxiety patients view psychological interventions as their best treatment option. Between 49% and 84% of the patients with depression or anxiety perceive a need for treatment, mostly for counseling and medication. All patients prefer psychological treatment forms to medication. A majority of patients view antidepressants as addictive and many perceive stigma and see practical and economic barriers to care. The most vulnerable groups in terms of seeking and receiving mental health care for depression and anxiety seem to be minority groups, as well as younger and older patients. More research is required into the specific needs of anxiety and depression patients. Open communication between patient and provider could lead to valuable improvements in treatment.

  18. The use of patients in health care education: the need for ethical justification.

    OpenAIRE

    Bindless, L

    1998-01-01

    This paper addresses ethical concerns emanating from the practice of using patients for health care education. It shows how some of the ways that patients are used in educational strategies to bridge theory-practice gaps can cause harm to patients and patient-practitioner relationships, thus failing to meet acceptable standards of professional practice. This will continue unless there is increased awareness of the need for protection of human rights in teaching situations. Unnecessary exposur...

  19. Patients' increasing search for health information on internet.

    OpenAIRE

    Schee, E. van der; Delnoij, D.

    2004-01-01

    Background: The number of web sites on the internet, providing health information, discussion groups, internet doctors or selling drugs is increasing fast. In 2001, the number was rated over 100.000 (Risk and Dzenowagis, 2001). The growing number of websites on these topics might be expected to match growing numbers of people using the internet to search for health information. However, no knowledge is available on this development. Aim: To monitor the development in the use of internet by th...

  20. Patient Experiences of Access to Mental Health Records

    OpenAIRE

    Geraci, Noah

    2016-01-01

    This thesis seeks to shift the discussion of mental health records in archives and records management literature by foregrounding the autonomy and experiences of records subjects, drawing from the scholarship surrounding archival activism, human rights and disability studies. Using qualitative content analysis of in-depth interviews with five people who have accessed their own records in California, this exploratory study shows evidence that mental health records serve significant practical a...

  1. Health service utilization by indigenous cancer patients in Queensland: a descriptive study

    Directory of Open Access Journals (Sweden)

    Bernardes Christina M

    2012-10-01

    Full Text Available Abstract Introduction Indigenous Australians experience more aggressive cancers and higher cancer mortality rates than other Australians. Cancer patients undergoing treatment are likely to access health services (e.g. social worker, cancer helpline, pain management services. To date Indigenous cancer patients’ use of these services is limited. This paper describes the use of health services by Indigenous cancer patients. Methods Indigenous cancer patients receiving treatment were recruited at four major Queensland public hospitals (Royal Brisbane Women’s Hospital, Princess Alexandra, Cairns Base Hospital and Townsville Hospital. Participants were invited to complete a structured questionnaire during a face-to-face interview which sought information about their use of community and allied health services. Results Of the 157 patients interviewed most were women (54.1%, of Aboriginal descent (73.9%, lived outer regional areas (40.1% and had a mean age of 52.2 years. The most frequent cancer types were breast cancer (22.3%, blood related (14.0%, lung (12.1% and gastroenterological (10.8%. More than half of the participants reported using at least one of the ‘Indigenous Health Worker/Services’ (76.4%, ‘Allied Health Workers/Services’ (72.6% and ‘Information Sources’ (70.7%. Younger participants 19–39 years were more likely to use information sources (81.0% than older participants who more commonly used community services (48.8%. The cancer patients used a median of three health services groups while receiving cancer treatment. Conclusions Indigenous cancer patients used a range of health services whilst receiving treatment. Indigenous Health Workers/Services and Allied Health Workers/Services were the most commonly used services. However, there is a need for further systematic investigation into the health service utilization by Indigenous cancer patients.

  2. Health policy considerations for our sexual minority patients.

    Science.gov (United States)

    O'Hanlan, Katherine A

    2006-03-01

    Homosexuality and transsexuality are still widely viewed by lay individuals as morally negative and deserving of legal proscription. Peer-reviewed data confirm that experiences of legal discrimination are associated with stress-related health problems, reduced utilization of health care, and financial and legal challenges for individuals and families, especially those with children. In the last 3 years, the American Psychiatric Association, American Psychological Association, and American Psychoanalytic Association have each reviewed the research on sexual orientation and identity, and each has confirmed that sexual orientation and gender identity do not correlate with mental illness or immorality. They have each endorsed laws that confer equality to sexual minorities, including nondiscrimination in employment, medical insurance coverage, adoption, and access to civil marriage. The American College of Obstetricians and Gynecologists (ACOG), by virtue of its history of advocacy for women's health, is in a position to promote policy and make similar recommendations, recognizing that sexual minority women's health and their family issues are an integral component of taking care of all women. The College should review the policies of America's premier mental health associations and consider including sexual orientation and gender identity in its own nondiscrimination policy, and ACOG should issue a policy statement in support of laws to provide safety from violence and discrimination, equal employment opportunities, equal health insurance coverage, and equal access to civil marriage.

  3. Patient emancipation by health education: An impossible goal?

    NARCIS (Netherlands)

    Fahrenfort, M.

    1987-01-01

    The development of patient education in hospitals received its first impetus in the U.S. For this reason, countries like the Netherlands where these developments tend to lag behind a bit, look to U.S. hospitals and literature for guidance on how to proceed in this matter. Although patient education

  4. Predictors of perceived health status in patients after kidney transplantation

    NARCIS (Netherlands)

    Rosenberger, J.; van Dijk, J.P.; Nagyova, I.; Zezula, I.; Geckova, A.M.; Roland, R.; van den Heuvel, W.J.A.; Groothoff, J.W.

    2006-01-01

    Background. Patients after kidney transplantation have decreased mortality, morbidity and better quality of life compared to people on dialysis. Major efforts are being directed towards research into graft and patient survival. Research into quality of life is less intensive. The aim of this study w

  5. Willingness to consume health care abroad: patient mobility around Europe.

    NARCIS (Netherlands)

    Loermans, M.; Jong, J.D. de

    2008-01-01

    Background: Provisional plans of the European Union aim for increasing the right for patients to travel abroad for healthcare. Desired and expected impact of this future ruling is to achieve enhanced patient mobility and to realize effective cooperation and better sharing capacities between differen

  6. Determinants and Equity Evaluation for Health Expenditure Among Patients with Rare Diseases in China

    Institute of Scientific and Technical Information of China (English)

    Xiao-Xiong Xin; Liang Zhao; Xiao-Dong Guan; Lu-Wen Shi

    2016-01-01

    Background:China has not established social security system for rare diseases.Rare diseases could easily impoverish patients and their families.Little research has studied the equity and accessibility of health services for patients with rare diseases in China.This study aimed to explore the factors that influence health expenditure of rare diseases and evaluate its equity.Methods:Questionnaire survey about living conditions and cost burden of patients with rare diseases was conducted.Individual and family information,health expenditure and reimbursement in 2014 of 982 patients were collected.The impact of medical insurance,individual sociodemographic characteristics,family characteristics,and healthcare need on total and out-of-pocket (OOP) health expenditures was analyzed through the generalized linear model.Equity of health expenditure was evaluated by both concentration index and Lorenz curve.Results:Of all the surveyed patients,11.41% had no medical insurance and 92.10% spent money to seek medical treatment in 2014.It was suggested female (P =0.048),over 50 years of age (P =0.062),high-income group (P =0.021),hospitalization (P =0.000),and reimbursement ratio (RR) (P =0.000) were positively correlated with total health expenditure.Diseases not needing long-term treatment (P =0.000) was negatively correlated with total health expenditure.Over 50 years of age (P =0.065),high-income group (P =0.018),hospitalization (P =0.000) and having Urban Employee Basic Medical Insurance (UEBMI) (P =0.022) were positively correlated with OOP health expenditure.Patient or the head of the household having received higher education (P =0.044 and P =0.081) and reimbursement ratio (P =0.078) were negatively correlated with OOP health expenditure.The equity evaluation found concentration indexes of health expenditure before and after reimbursement were 0.0550 and 0.0539,respectively.Conclusions:OOP health expenditure of patients with UEBMI was significantly more than that of

  7. Texas passes first law for safe patient handling in America: landmark legislation protects health-care workers and patients from injury related to manual patient lifting.

    Science.gov (United States)

    Hudson, Mary Anne

    2005-01-01

    On June 17,2005, Texas Governor Rick Perry (R) signed into law Senate Bill 1525, making Texas the first state in the nation to require hospitals and nursing homes to implement safe patient handling and movement programs. Governor Perry is to be commended for this heroic first stand for safe patient handling in America. The landmark legislation will take effect January 1, 2006, requiring the establishment of policy to identify, assess, and develop methods of controlling the risk of injury to patients and nurses associated with lifting, transferring, repositioning, and movement of patients; evaluation of alternative methods from manual lifting to reduce the risk of injury from patient lifting, including equipment and patient care environment; restricting, to the extent feasible with existing equipment, manual handling of all or most of a patient's weight to emergency, life-threatening, or exceptional circumstances; and provision for refusal to perform patient handling tasks believed to involve unacceptable risks of injury to a patient or nurse. Manually lifting patients has been called deplorable, inefficient, dangerous to nurses, and painful and brutal to patients; manual lifting can cause needless suffering and injury to patients, with dangers including pain, bruising, skin tears, abrasions, tube dislodgement, dislocations, fractures, and being dropped by nursing staff during attempts to manually lift. Use of safe, secure, mechanical lift equipment and gentle friction-reducing devices for patient maneuvering tasks could eliminate such needless brutality. Research has proven that manual patient lifting is extremely hazardous to health-care workers, creating substantial risk of low-back injury, whether with one or two patient handlers. Studies on the use of mechanical patient lift equipment, by either nursing staff or lift teams, have proven repeatedly that most nursing staff back injury is preventable, leading to substantial savings to employers on medical and

  8. Mental Health in Multiple Sclerosis Patients without Limitation of Physical Function: The Role of Physical Activity

    Directory of Open Access Journals (Sweden)

    Alexander Tallner

    2015-07-01

    Full Text Available Multiple sclerosis (MS patients, in general, show reduced physical function, physical activity, and quality of life. Positive associations between physical activity and quality of life have been reported. In particular, we were interested in the relation between physical activity and mental health in MS patients without limitation of physical function, since limitations of physical function may influence both physical activity and quality of life. Assessment comprised the Baecke questionnaire on physical activity, the Short Form 36 Health Survey (SF-36, and Beck Depression Inventory (BDI. We ranked our sample according to physical activity into four groups and performed an ANOVA to analyze the relationship between levels of physical activity and health-related quality of life (HRQoL. Then we performed a subgroup analysis and included patients with unlimited walking distance and a score of less than 18 in the BDI. Most active vs. inactive patients were compared for the mental subscales of the SF-36 and depression scores. From 632 patients, 265 met inclusion criteria and hence quartiles were filled with 67 patients each. Active and inactive patients did not differ considerably in physical function. In contrast, mental subscales of the SF-36 were higher in active patients. Remarkable and significant differences were found regarding vitality, general health perception, social functioning and mental health, all in favor of physically active patients. Our study showed that higher physical activity is still associated with higher mental health scores even if limitations of physical function are accounted for. Therefore, we believe that physical activity and exercise have considerable health benefits for MS patients.

  9. Mental Health in Multiple Sclerosis Patients without Limitation of Physical Function: The Role of Physical Activity.

    Science.gov (United States)

    Tallner, Alexander; Waschbisch, Anne; Hentschke, Christian; Pfeifer, Klaus; Mäurer, Mathias

    2015-07-02

    Multiple sclerosis (MS) patients, in general, show reduced physical function, physical activity, and quality of life. Positive associations between physical activity and quality of life have been reported. In particular, we were interested in the relation between physical activity and mental health in MS patients without limitation of physical function, since limitations of physical function may influence both physical activity and quality of life. Assessment comprised the Baecke questionnaire on physical activity, the Short Form 36 Health Survey (SF-36), and Beck Depression Inventory (BDI). We ranked our sample according to physical activity into four groups and performed an ANOVA to analyze the relationship between levels of physical activity and health-related quality of life (HRQoL). Then we performed a subgroup analysis and included patients with unlimited walking distance and a score of less than 18 in the BDI. Most active vs. inactive patients were compared for the mental subscales of the SF-36 and depression scores. From 632 patients, 265 met inclusion criteria and hence quartiles were filled with 67 patients each. Active and inactive patients did not differ considerably in physical function. In contrast, mental subscales of the SF-36 were higher in active patients. Remarkable and significant differences were found regarding vitality, general health perception, social functioning and mental health, all in favor of physically active patients. Our study showed that higher physical activity is still associated with higher mental health scores even if limitations of physical function are accounted for. Therefore, we believe that physical activity and exercise have considerable health benefits for MS patients.

  10. Patient Satisfaction, Empowerment, and Health and Disability Status Effects of a Disease Management-Health Promotion Nurse Intervention among Medicare Beneficiaries with Disabilities

    Science.gov (United States)

    Friedman, Bruce; Wamsley, Brenda R.; Liebel, Dianne V.; Saad, Zabedah B.; Eggert, Gerald M.

    2009-01-01

    Purpose: To report the impact on patient and informal caregiver satisfaction, patient empowerment, and health and disability status of a primary care-affiliated disease self-management-health promotion nurse intervention for Medicare beneficiaries with disabilities and recent significant health services use. Design and Methods: The Medicare…

  11. Denial of Treatment to Obese Patients-the Wrong Policy on Personal Responsibility for Health.

    Science.gov (United States)

    Eyal, Nir

    2013-08-01

    In many countries around the world, including Iran, obesity is reaching epidemic proportions. Doctors have recently taken, or expressed support for, an extreme 'personal responsibility for health' policy against obesity: refusing services to obese patients. This policy may initially seem to improve patients' incentives to fight obesity. But turning access to medical services into a benefit dependent on health improvement is bad policy. It conditions the very aid that patients need in order to become healthier on success in becoming healthier. Whatever else we may think of personal responsibility for health policies, this particular one is absurd. Unfortunately, quite a few personal responsibility for health policies use similar absurd conditioning. They mistakenly use as 'carrots' or 'sticks' for adherence the basic means to the same health outcomes that they seek to promote. This perspective proposes the following rule of thumb: any conditional incentive for healthy choice should be in a currency other than the basic means to that healthy choice.

  12. Development testing of mobile health interventions for cancer patient self-management: A review.

    Science.gov (United States)

    Darlow, Susan; Wen, Kuang-Yi

    2016-09-01

    As the vision of mobile health (mHealth) is beginning to be realized, rigorous intervention development protocols are needed in order to draw optimal efficacy and effectiveness to support patient-centered oncology care. The purpose of the current study was to conduct a review of published articles that describe the development process of mHealth interventions for patients' cancer care self-management. The review search yielded 11 interventions, reported by 14 manuscripts. The following trends emerged: importance of stakeholder engagement during the development process, addressing the unique needs and experiences of cancer patients and care providers, ensuring user satisfaction with the system, and identifying perceived benefits and limitations of the system. This review provides practical suggestions for mHealth intervention development. Assessments of user perceptions should be both qualitative and quantitative, and researchers should follow an established framework when developing a randomized controlled trial employing mHealth. PMID:25916831

  13. Using a patient-centered approach for health and social care integration.

    Science.gov (United States)

    Poulymenopoulou, Mikaela; Papakonstantinou, Despoina; Malamateniou, Flora; Vassilacopoulos, George

    2012-01-01

    The drive in using health and social care resources more effectively has resulted in undertaking various efforts towards better coordination in order to improve patient-centered and personalized care for the individuals. This requires horizontal integration in terms of processes among health and social care organizations existing information systems (ISs) and personal health records (PHRs) in order to enable integrated patient information sharing among all the health and social care staff and individuals involved. Service-oriented and business process management (BPM) technologies are considered most appropriate for achieving such integration especially when is required to change existing processes and to integrate diverse information systems. On these grounds, a patient-centered approach is proposed for redesigning health and social care processes and for integrating diverse ISs and PHRs with the objective to meet holistic care goals.

  14. Efficacy of lifestyle interventions in physical health management of patients with severe mental illness

    Directory of Open Access Journals (Sweden)

    Gervás-Ríos Alicia

    2011-09-01

    Full Text Available Abstract Awareness of the importance of maintaining physical health for patients with severe mental illnesses has recently been on the increase. Although there are several elements contributing to poor physical health among these patients as compared with the general population, risk factors for cardiovascular disease such as smoking, diabetes mellitus, hypertension, dyslipidemia, metabolic syndrome, and obesity are of particular significance due to their relationship with mortality and morbidity. These patients present higher vulnerability to cardiovascular risk factors based on several issues, such as genetic predisposition to certain pathologies, poor eating habits and sedentary lifestyles, high proportions of smokers and drug abusers, less access to regular health care services, and potential adverse events during pharmacological treatment. Nevertheless, there is ample scientific evidence supporting the benefits of lifestyle interventions based on diet and exercise designed to minimize and reduce the negative impact of these risk factors on the physical health of patients with severe mental illnesses.

  15. What determines patients' satisfaction with their mental health care and quality of life?

    OpenAIRE

    Blenkiron, P.; Hammill, C

    2003-01-01

    Objectives: This study investigated whether patients' satisfaction with their mental health care and quality of life is related to their age, gender, psychiatric diagnosis, and duration of mental disorder.

  16. 78 FR 69418 - Patient Protection and Affordable Care Act; Exchanges and Qualified Health Plans, Quality Rating...

    Science.gov (United States)

    2013-11-19

    ... endorsed...... X Persistent Medications. Antidepressant Medication Management...... 0105 X Appropriate... Composite Medication Management for People With Asthma. Behavioral Health..... Antidepressant Medication... Prescribed ADHD Medication: Initiation Phase. Cardiovascular Care... Cholesterol Management for Patients...

  17. Designing a patient-centered personal health record to promote preventive care

    Directory of Open Access Journals (Sweden)

    Krist Alex H

    2011-11-01

    Full Text Available Abstract Background Evidence-based preventive services offer profound health benefits, yet Americans receive only half of indicated care. A variety of government and specialty society policy initiatives are promoting the adoption of information technologies to engage patients in their care, such as personal health records, but current systems may not utilize the technology's full potential. Methods Using a previously described model to make information technology more patient-centered, we developed an interactive preventive health record (IPHR designed to more deeply engage patients in preventive care and health promotion. We recruited 14 primary care practices to promote the IPHR to all adult patients and sought practice and patient input in designing the IPHR to ensure its usability, salience, and generalizability. The input involved patient usability tests, practice workflow observations, learning collaboratives, and patient feedback. Use of the IPHR was measured using practice appointment and IPHR databases. Results The IPHR that emerged from this process generates tailored patient recommendations based on guidelines from the U.S. Preventive Services Task Force and other organizations. It extracts clinical data from the practices' electronic medical record and obtains health risk assessment information from patients. Clinical content is translated and explained in lay language. Recommendations review the benefits and uncertainties of services and possible actions for patients and clinicians. Embedded in recommendations are self management tools, risk calculators, decision aids, and community resources - selected to match patient's clinical circumstances. Within six months, practices had encouraged 14.4% of patients to use the IPHR (ranging from 1.5% to 28.3% across the 14 practices. Practices successfully incorporated the IPHR into workflow, using it to prepare patients for visits, augment health behavior counseling, explain test results

  18. Effect of Counseling on Health Related Quality of Life on Haemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Ramakrishanan Sivakumar

    2012-09-01

    Full Text Available End stage renal disease affects two million patients worldwide. Health related quality of life (HRQoL has recently become a major indicator of health and well-being of patients with kidney disease. The present goal for the treatment of patients with ESRD is not simply to prolong life, but also to provide a better HRQoL. This goal can be achieved through patient counseling. A simple prospective study was used to examine the effect of patient counseling on HRQoL of hemodialysis patients. In the study, a Short Form-36 (SF-36 questionnaire and clinical parameters were used for 52 hemodialysis patients to assess the HRQoL before and after patient counseling. All the Patients were kept under observation for a period of three months to study the effect of patient counseling. After three months period of counseling a significant (p<0.05 improvement was observed for hemodialysis patients. Also HRQoL score was higher for hemodialysis patients after counseling. This study concluded that knowledge of the disease and its management through patient counseling could improve the HRQoL of hemodialysis patients.

  19. Health-related quality of life and health care use in cancer survivors compared with patients with chronic diseases.

    NARCIS (Netherlands)

    Heins, M.J.; Korevaar, J.C.; Hopman, E.P.C.; Donker, G.A.; Schellevis, F.G.; Rijken, P.M.

    2016-01-01

    BACKGROUND: The number of cancer survivors is steadily increasing and these patients often experience long-lasting health problems. To make care for cancer survivors sustainable for the future, it would be relevant to put the effects of cancer in this phase into perspective. Therefore, the authors c

  20. Using secondary analysis of qualitative data of patient experiences of health care to inform health services research and policy.

    Science.gov (United States)

    Ziebland, Sue; Hunt, Kate

    2014-02-26

    Qualitative research is recognized as an important method for including patients' voices and experiences in health services research and policy-making, yet the considerable potential to analyse existing qualitative data to inform health policy and practice has been little realized. This failure may partly be explained by: a lack of awareness amongst health policy makers of the increasing wealth of qualitative data available; and around 15 years of internal debates among qualitative researchers on the strengths, limitations and validity of re-use of qualitative data. Whilst acknowledging the challenges of qualitative secondary data analysis, we argue that there is a growing imperative to be pragmatic and to undertake analysis of existing qualitative data collections where they have the potential to contribute to health policy formulation. Time pressures are inherent in the policy-making process and in many circumstances it is not possible to seek funding, conduct and analyse new qualitative studies of patients' experiences in time to inform a specific policy. The danger then is that the patient voice, and the experiences of relatives and carers, is either excluded or included in a way that is easily dismissed as 'unrepresentative'. We argue that secondary analysis of qualitative data collections may sometimes be an effective means to enable patient experiences to inform policy decision-making.

  1. Factors associated with a patient-centered medical home among children with behavioral health conditions.

    Science.gov (United States)

    Knapp, Caprice; Woodworth, Lindsey; Fernandez-Baca, Daniel; Baron-Lee, Jacqueline; Thompson, Lindsay; Hinojosa, Melanie

    2013-11-01

    At some point in their lives, nearly one-half of all American children will have a behavioral health condition. Many will not receive the care they need from a fragmented health delivery system. The patient-centered medical home is a promising model to improve their care; however, little evidence exists. Our study aim was to examine the association between several behavioral health indicators and having a patient-centered medical home. 91,642 children's parents or guardians completed the 2007 National Survey of Children's Health. An indicator for patient-centered medical home was included in the dataset. Descriptive statistics, bivariate tests, and multivariate regression models were used in the analyses. Children in the sample were mostly Male (52 %), White (78 %), non-Hispanic (87 %), and did not have a special health care need (80 %). 6.2 % of the sample had at least one behavioral health condition. Conditions ranged from ADHD (6 %) to Autism Spectrum Disorder (ASD) (1 %). Frequency of having a patient-centered medical home also varied for children with a behavioral health condition (49 % of children with ADHD and 33 % of children with ASD). Frequency of having a patient-centered medical home decreased with multiple behavioral health conditions. Higher severity of depression, anxiety, and conduct disorder were associated with a decreased likelihood of a patient-centered medical home. Results from our study can be used to target patient-centered medical home interventions toward children with one or more behavioral health conditions and consider that children with depression, anxiety, and conduct disorder are more vulnerable to these disparities.

  2. Health literacy screening of patients attending a student-led osteopathy clinic: A pilot investigation.

    Science.gov (United States)

    Vaughan, Brett; Mulcahy, Jane; Fitzgerald, Kylie

    2016-08-01

    Adequate levels of health literacy (HL) are required for patients to access appropriate health services and develop an understanding of the options for managing their healthcare needs. There is limited literature on HL of patients seeking care for a musculoskeletal complaint. The present study sought to screen the HL of patients presenting to an Australian osteopathy student-led clinic using a single screening question 'Are you confident completing medical forms?'. Less than 10% of patients attending the clinic were considered to have below adequate levels of HL using this question, consistent with other work in Australian populations. Logistic regression analysis identified that the most significant demographic variables associated with lower HL were patients who did not speak English at home, those with lower education levels, and those who were less satisfied with their life. Evaluation of a patients' HL may assist practitioners to improve patient education and management strategies. PMID:27502799

  3. The emotional experience of patient care: a case for innovation in health care design.

    Science.gov (United States)

    Altringer, Beth

    2010-07-01

    This paper considers recent developments in health care facility design and in the psychology literature that support a case for increased design sensitivity to the emotional experience of patient care. The author discusses several examples of innovative patient-centred health care design interventions. These generally resulted in improvements in the patient and staff experience of care, at less cost than major infrastructural interventions. The paper relates these developments in practice with recent neuroscience research, illustrating that the design of the built environment influences patient emotional stress. In turn, patient emotional stress appears to influence patient satisfaction, and in some instances, patient outcomes. This paper highlights the need for further research in this area.

  4. More Than Meets the Eye: Relationship Between Low Health Literacy and Poor Vision in Hospitalized Patients

    OpenAIRE

    Press, Valerie G.; Shapiro, Madeleine I.; Mayo, Ainoa M.; Meltzer, David O.; Arora, Vineet M.

    2013-01-01

    Patient-centered care includes involving patients and their families in self-management of chronic diseases. Identifying and addressing barriers to self-management, including those related to health literacy and vision limitations, may enhance one's ability to self-manage. A set of brief verbal screening questions (BV SQ) that does not rely on sufficient vision to assess health literacy was developed by Chew and colleagues in the outpatient setting. The authors aimed to evaluate the usefulnes...

  5. Health-related quality of life in a sample of Iranian patients on hemodialysis

    DEFF Research Database (Denmark)

    Pakpour, Amir H; Saffari, Mohsen; Yekaninejad, Mir Saeed;

    2010-01-01

    This study evaluated the health-related quality of life (HRQOL) in a sample of Iranian patients undergoing maintenance hemodialysis. The data were compared with the HRQOL for the Iranian general population.......This study evaluated the health-related quality of life (HRQOL) in a sample of Iranian patients undergoing maintenance hemodialysis. The data were compared with the HRQOL for the Iranian general population....

  6. Practicing preventive ethics, protecting patients: challenges of the electronic health record.

    Science.gov (United States)

    Satkoske, Valerie B; Parker, Lisa S

    2010-01-01

    Implementation of guidelines regarding breaches of electronic health information requires an anticipatory stance and physician and patient education regarding security and monitoring measures and methods of redress. Adopting a preventive ethics, rather than a crisis management, model may also increase physician awareness of how the information they choose to include and privilege within the health record may expose patients to added harms if not done mindfully.

  7. Coping of health care providers with the death of a patient

    Directory of Open Access Journals (Sweden)

    Aleksander Mlinšek

    2012-10-01

    Full Text Available RQ: With an aging population, health care professionals are often faced with the death of a patient in acute hospitals. The experience of dying patients’ to health care professionals and to the health care system brings many challenges that need to be faced.Purpose: The present study was to determine how health care providers are faced with the death of a patient, what is the care needed for the dying patient and how to participate in interdisciplinary team care of among themselves and family members of dying patients.Method: We conducted a small-scale quantitative survey of nursing care in a Slovenian acute hospital. To analyze the results, we used frequency statistics and Pearson's correlation coefficient.Results: Health care providers need additional skills needed to care for a dying patient as well as to the family of the dying patient.They try to control distress of the dying experience reasonably and less with conversation. The effect on the loss of a patient affects work experience, but we did not notice any other effects. Theinvolvement of an interdisciplinary team in the care of the dying patient is satisfactory; family members are under-involved in the care.Organization: Health organizations that are more focused on acute treatment have to become aware of palliative care that needs to be included in nursing care as an integral process of care for the terminally ill. Health care staff need to communicate more with one another and go through additional training.Society: Attitudes to death in a broader cultural environment also affects the attitude of health workers towards death. Involvement of the social environment, especially family members, is very important.Originality: The survey was conducted on the basis of comparing two surveys.Limitations: The survey was conducted on a small sample size.

  8. What patients think about E-health: patients' perspective on internet-based cognitive behavioral treatment for patients with rheumatoid arthritis and psoriasis

    NARCIS (Netherlands)

    Ferwerda, M.; Beugen, S. van; Burik, A. van; Middendorp, H. van; Jong, E.M.G.J. de; Kerkhof, P.C.M. van de; Riel, P.L.C.M. van; Evers, A.W.M.

    2013-01-01

    In the past decade, the use of internet-based cognitive behavioral treatments (internet-based CBT) for a wide range of patients has grown intensively. Incorporating the patients' opinions and perspective into new health care innovations might improve the quality and applicability of these innovation

  9. Development and evaluation of a patient centered cardiovascular health education program for insured patients in rural Nigeria (QUICK - II

    Directory of Open Access Journals (Sweden)

    Osibogun Akin

    2011-03-01

    Full Text Available Abstract Background In Sub Saharan Africa, the incidence of hypertension and other modifiable cardiovascular risk factors is growing rapidly. Poor adherence to prescribed prevention and treatment regimens by patients can compromise treatment outcomes. Patient-centered cardiovascular health education is likely to improve shortcomings in adherence. This paper describes a study that aims to develop a cardiovascular health education program for patients participating in a subsidized insurance plan in Nigeria and to evaluate the applicability and effectiveness in patients at increased risk for cardiovascular disease. Methods/Design Design: The study has two parts. Part 1 will develop a cardiovascular health education program, using qualitative interviews with stakeholders. Part 2 will evaluate the effectiveness of the program in patients, using a prospective (pre-post observational design. Setting: A rural primary health center in Kwara State, Nigeria. Population: For part 1: 40 patients, 10 healthcare professionals, and 5 insurance managers. For part 2: 150 patients with uncontrolled hypertension or other cardiovascular risk factors after one year of treatment. Intervention: Part 2: patient-centered cardiovascular health education program. Measurements: Part 1: Semi-structured interviews to identify stakeholder perspectives. Part 2: Pre- and post-intervention assessments including patients' demographic and socioeconomic data, blood pressure, body mass index and self-reporting measures on medication adherence and perception of care. Feasibility of the intervention will be measured using process data. Outcomes: For program development (part 1: overview of healthcare professionals' perceptions on barriers and facilitators to care, protocol for patient education, and protocol implementation plan. For program evaluation (part 2: changes in patients' scores on adherence to medication and life style changes, blood pressure, and other physiological and self

  10. Assessing Patient Participation in Health Policy Decision-Making in Cyprus

    Directory of Open Access Journals (Sweden)

    Kyriakos Souliotis

    2016-08-01

    Full Text Available Although the importance of patient participation in the design and evaluation of health programs and services is well-documented, there is scarcity of research with regard to patient association (PA participation in health policy decision-making processes. To this end, the present study aimed to validate further a previously developed instrument as well as to investigate the degree of PA participation in health policy decision-making in Cyprus. A convenient sample of 114 patients-members of patients associations took part in the study. Participants were recruited from an umbrella organization, the Pancyprian Federation of Patient Associations and Friends (PFPA. PA participation in health policy decision-making was assessed with the Health Democracy Index (HDI, an original 8-item tool. To explore its psychometric properties, Cronbach α was computed as regards to its internal consistency, while its convergent validity was tested against a self-rated question enquiring about the degree of PA participation in health policy decision-making. The findings revealed that the HDI has good internal consistency and convergent validity. Furthermore, PAs were found to participate more in consultations in health-related organizations and the Ministry of Health (MoH as well as in reforms or crucial decisions in health policy. Lower levels were documented with regard to participation in hospital boards, ethics committees in clinical trials and health technology assessment (HTA procedures. Overall, PA participation levels were found to be lower than the mid-point of the scale. Targeted interventions aiming to facilitate patients’ involvement in health policy decision-making processes and to increase its impact are greatly needed in Cyprus.

  11. Assessing Patient Participation in Health Policy Decision-Making in Cyprus

    Science.gov (United States)

    Souliotis, Kyriakos; Agapidaki, Eirini; Peppou, Lily Evangelia; Tzavara, Chara; Samoutis, George; Theodorou, Mamas

    2016-01-01

    Although the importance of patient participation in the design and evaluation of health programs and services is well-documented, there is scarcity of research with regard to patient association (PA) participation in health policy decision-making processes. To this end, the present study aimed to validate further a previously developed instrument as well as to investigate the degree of PA participation in health policy decision-making in Cyprus. A convenient sample of 114 patients-members of patients associations took part in the study. Participants were recruited from an umbrella organization, the Pancyprian Federation of Patient Associations and Friends (PFPA). PA participation in health policy decision-making was assessed with the Health Democracy Index (HDI), an original 8-item tool. To explore its psychometric properties, Cronbach α was computed as regards to its internal consistency, while its convergent validity was tested against a self-rated question enquiring about the degree of PA participation in health policy decision-making. The findings revealed that the HDI has good internal consistency and convergent validity. Furthermore, PAs were found to participate more in consultations in health-related organizations and the Ministry of Health (MoH) as well as in reforms or crucial decisions in health policy. Lower levels were documented with regard to participation in hospital boards, ethics committees in clinical trials and health technology assessment (HTA) procedures. Overall, PA participation levels were found to be lower than the mid-point of the scale. Targeted interventions aiming to facilitate patients’ involvement in health policy decision-making processes and to increase its impact are greatly needed in Cyprus.

  12. Patient Involvement: A New Source of Stress in Health Care Work?

    Science.gov (United States)

    Arnetz, Judith E; Zhdanova, Ludmila; Arnetz, Bengt B

    2016-12-01

    Patients have become increasingly well informed with higher expectations to be involved in decision-making processes regarding their care and treatment. However, few studies have examined the impact of patient involvement on health care providers' partnership-building communication. The aim of this study was to measure and explore the self-reported effects of patient involvement on the work of physicians and nurses. A questionnaire survey was distributed among cardiology staff in 12 Swedish hospitals (N = 488, response rate 67%). The sample was comprised of registered nurses (RNs, n = 303), licensed practical nurses (LPNs, n = 132), and physicians (MDs, n = 53). Confirmatory factor analysis was used to examine seven questionnaire statements concerning implications of patient involvement for one's clinical work. Regression analyses were used to examine factors associated with staff's partnership-building communication. Analysis confirmed two distinct factors accounting for 57% of the total variance, representing both negative-"Hassles"-and positive-"Uplifts"-aspects of patient involvement. Regression analyses revealed that only positive aspects (i.e., uplifts) of patient involvement predicted staff behavior aimed at involving patients. Working with actively involved patients may be a source of stress, both negative and positive, for health care professionals. By developing work routines for involving patients in their care, health care workplaces may help health care professionals to buffer the negative effects, and enhance the positive effects, of that stress. PMID:27054396

  13. Health related quality of life in Critically ill Patients A study of health related quality of life in critically ill patients admitted on the Intensive Care

    NARCIS (Netherlands)

    J.G.M. Hofhuis (José)

    2008-01-01

    textabstractHealth related quality of life (HRQOL) is a relevant outcome measure for patients admitted to the intensive care unit (ICU). Long term outcome for physical and psychological factors, functional status and social interactions are becoming more and more important both for doctors and nurse

  14. Satisfaction with Access to Health Services: The Perspective of Estonian Patients with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Kaja Põlluste

    2012-01-01

    Full Text Available In this cross-sectional study we explained the possible determinants of satisfaction with access to health services in patients with rheumatoid arthritis (RA. Of the 2000 randomly selected Estonian adult patients with RA, a total 1259 completed the survey. Regression analysis was used to analyse the predictors of patients' satisfaction with access to health services. Half of the respondents were satisfied with their access to health services. Factors that had a negative impact on satisfaction included pain intensity, longer waiting times to see the doctors, as well as low satisfaction with the doctors. Transportation costs to visit a rheumatologist and higher rehabilitation expenses also affected the degree of satisfaction. Patients who could choose the date and time at which they could visit the rheumatologist or who could visit their “own” doctor were more likely to be satisfied than patients whose appointment times were appointed by a healthcare provider.

  15. The role of public relations for image creating in health services: a sample patient satisfaction survey.

    Science.gov (United States)

    Kirdar, YalçIn

    2007-01-01

    This study discusses the role of public relations for image creating in health services. Hospitals require public relations activities to distinguish them from competitors, provide bidirectional communication between the society and the hospital, and assist to create of a strong hospital image and culture. A satisfaction survey was conducted on 264 patients who have received health services at Maltepe University Hospital. The research focused on how the Hospital's examination, care, catering and physical services; doctor and nurse politeness towards patients and patient relatives, their attitudes and behaviors; examination, check-in, bedding and discharge operations; public relations activities in and out of the hospital were perceived. Another subject of the study was the degree of recommendation of patients who have been served by the hospital's health services to prospective patients seeking treatment. PMID:19042527

  16. Shortfalls identified in the management of tuberculosis for Mozambican patients obtaining health care services in Malawi.

    Science.gov (United States)

    Muula, Adamson S; Nyasulu, Yohane; Feluzi, Henry; Magalasi, Collins

    2003-06-01

    We report findings of a pilot qualitative study in which we aimed to determine management gaps among TB patients from Mozambique obtaining health care services in Malawi. The study was conducted between April and May 2002 involved twelve health workers and 4 Mozambican patients. Semi-structured questionnaires were used and responses were followed up with in-depth interviews. Several areas of management gaps were identified. These included; language barrier if patients are formally referred with documents in Portuguese; lack of follow-up system in case of patients defaulting; no structured contact-tracing possibilities and no initiation of Isoniazid prophylaxis in the case of children living in households with a sputum smear positive adult case. We conclude that logistical management gaps exist in the management of TB patients from Mozambique obtaining care in Malawian health care facilities.

  17. Developing a Framework for Evaluating the Patient Engagement, Quality, and Safety of Mobile Health Applications.

    Science.gov (United States)

    Singh, Karandeep; Drouin, Kaitlin; Newmark, Lisa P; Rozenblum, Ronen; Lee, Jaeho; Landman, Adam; Pabo, Erika; Klinger, Elissa V; Bates, David W

    2016-02-01

    Rising ownership of smartphones and tablets across social and demographic groups has made mobile applications, or apps, a potentially promising tool for engaging patients in their health care, particularly those with high health care needs. Through a systematic search of iOS (Apple) and Android app stores and an analysis of apps targeting individuals with chronic illnesses, we assessed the degree to which apps are likely to be useful in patient engagement efforts. Usefulness was determined based on the following criteria: description of engagement, relevance to the targeted patient population, consumer ratings and reviews, and most recent app update. Among the 1,046 health care-related, patient-facing applications identified by our search, 43 percent of iOS apps and 27 percent of Android apps appeared likely to be useful. We also developed criteria for evaluating the patient engagement, quality, and safety of mobile apps.

  18. Norovirus epidemiology in community and health care settings and association with patient age, denmark

    DEFF Research Database (Denmark)

    Franck, Kristina T; Fonager, Jannik; Ersbøll, Annette K;

    2014-01-01

    . In community and health care settings, we found an association between infection with GII.4 and increasing age. Norovirus GII.4 predominated in patients ≥60 years of age and in health care settings. A larger proportion of children than adults were infected with NoV GII.3 or GII.P21. Susceptibility to No......Norovirus (NoV) is a major cause of gastroenteritis. NoV genotype II.4 (GII.4) is the predominant genotype in health care settings but the reason for this finding is unknown. Stool samples containing isolates with a known NoV genotype from 2,109 patients in Denmark (patients consulting a general...... practitioner or outpatient clinic, inpatients, and patients from foodborne outbreaks) were used to determine genotype distribution in relation to age and setting. NoV GII.4 was more prevalent among inpatients than among patients in community settings or those who became infected during foodborne outbreaks...

  19. The role of public relations for image creating in health services: a sample patient satisfaction survey.

    Science.gov (United States)

    Kirdar, YalçIn

    2007-01-01

    This study discusses the role of public relations for image creating in health services. Hospitals require public relations activities to distinguish them from competitors, provide bidirectional communication between the society and the hospital, and assist to create of a strong hospital image and culture. A satisfaction survey was conducted on 264 patients who have received health services at Maltepe University Hospital. The research focused on how the Hospital's examination, care, catering and physical services; doctor and nurse politeness towards patients and patient relatives, their attitudes and behaviors; examination, check-in, bedding and discharge operations; public relations activities in and out of the hospital were perceived. Another subject of the study was the degree of recommendation of patients who have been served by the hospital's health services to prospective patients seeking treatment.

  20. Medicare home health payment reform may jeopardize access for clinically complex and socially vulnerable patients.

    Science.gov (United States)

    Rosati, Robert J; Russell, David; Peng, Timothy; Brickner, Carlin; Kurowski, Daniel; Christopher, Mary Ann; Sheehan, Kathleen M

    2014-06-01

    The Affordable Care Act directed Medicare to update its home health prospective payment system to reflect more recent data on costs and use of services-an exercise known as rebasing. As a result, the Centers for Medicare and Medicaid Services will reduce home health payments 3.5 percent per year in the period 2014-17. To determine the impact that these reductions could have on beneficiaries using home health care, we examined the Medicare reimbursement margins and the use of services in a national sample of 96,621 episodes of care provided by twenty-six not-for-profit home health agencies in 2011. We found that patients with clinically complex conditions and social vulnerability factors, such as living alone, had substantially higher service delivery costs than other home health patients. Thus, the socially vulnerable patients with complex conditions represent less profit-lower-to-negative Medicare margins-for home health agencies. This financial disincentive could reduce such patients' access to care as Medicare payments decline. Policy makers should consider the unique characteristics of these patients and ensure their continued access to Medicare's home health services when planning rebasing and future adjustments to the prospective payment system.

  1. Medicare home health payment reform may jeopardize access for clinically complex and socially vulnerable patients.

    Science.gov (United States)

    Rosati, Robert J; Russell, David; Peng, Timothy; Brickner, Carlin; Kurowski, Daniel; Christopher, Mary Ann; Sheehan, Kathleen M

    2014-06-01

    The Affordable Care Act directed Medicare to update its home health prospective payment system to reflect more recent data on costs and use of services-an exercise known as rebasing. As a result, the Centers for Medicare and Medicaid Services will reduce home health payments 3.5 percent per year in the period 2014-17. To determine the impact that these reductions could have on beneficiaries using home health care, we examined the Medicare reimbursement margins and the use of services in a national sample of 96,621 episodes of care provided by twenty-six not-for-profit home health agencies in 2011. We found that patients with clinically complex conditions and social vulnerability factors, such as living alone, had substantially higher service delivery costs than other home health patients. Thus, the socially vulnerable patients with complex conditions represent less profit-lower-to-negative Medicare margins-for home health agencies. This financial disincentive could reduce such patients' access to care as Medicare payments decline. Policy makers should consider the unique characteristics of these patients and ensure their continued access to Medicare's home health services when planning rebasing and future adjustments to the prospective payment system. PMID:24889943

  2. Care coordination for patients with complex health profiles in inpatient and outpatient settings.

    Science.gov (United States)

    Berry, Leonard L; Rock, Beth L; Smith Houskamp, Beth; Brueggeman, Joan; Tucker, Lois

    2013-02-01

    Patients with the most complex health profiles consume a disproportionate percentage of health care expenditures, yet often receive fragmented, suboptimal care. Since 2003, Wisconsin-based Gundersen Health has improved the quality of life and reduced the cost burden of patients with complex health profiles with an integrated care coordination program. Those results are consistent with data from the most successful care coordination demonstration projects funded by the Centers for Medicare and Medicaid Services. Specifically, Gundersen's program has been associated with reduced hospital stays, lower costs for inpatients, less use of inpatient services, and increased patient satisfaction. Gundersen's success is rooted in its team-based approach to coordinated care. Teams, led by a subspecialty-trained nurse, have regular, face-to-face contact with patients and their physicians in both inpatient and outpatient settings; involve patients deeply in care-related decisions; access a system-wide electronic medical record database that tracks patients' care; and take a macrolevel view of care-related factors and costs. Gundersen's model offers specific take-home lessons for institutions interested in coordinated care as they design programs aimed at improving quality and lowering costs. This institutional case study provides a window into well-executed care coordination at a large health care system in an era when major changes in health care provision and reimbursement mechanisms are on the horizon.

  3. Measurement of patient-derived utility values for periodontal health using a multi-attribute scale.

    Science.gov (United States)

    Bellamy, C A; Brickley, M R; McAndrew, R

    1996-09-01

    Periodontal health states are difficult to quantify and no formal scale quantifying patients' utilities for periodontal health states exits. Multi-attribute utility (MAU) techniques were used to develop such a scale. The MAU scale may be used to quantify patients' assessment of their current periodontal health and that of possible treatment outcomes. Such data, combined with probability values in formal decision analysis techniques would result in improved rationality of treatment planning for periodontal disease. 20 patients attending for routine undergraduate care were interviewed. Data from these interviews were sorted into groups of common interest (domains). Intra-domain health statements were complied from the interview content. 21 patients ranked the intra-domain statements on a scale of 0-100. This same group of patients also performed an inter-domain weighting. Mean results showed that patients were 2X as concerned with how they felt and with the prognosis of possible outcomes, than with how they looked and what facts they knew about their oral health. However, the real value of utilities research lies in application of individual results to treatment planning as there is a wide range of opinion regarding outcome health states. PMID:8891929

  4. Speaking up for patient safety by hospital-based health care professionals: a literature review.

    NARCIS (Netherlands)

    Okuyama, A.; Wagner, C.; Bijnen, B.

    2014-01-01

    Background: Speaking up is important for patient safety, but often, health care professionals hesitate to voice concerns. Understanding the influencing factors can help to improve speaking-up behaviour and team communication. This review focused on health care professionals’ speaking-up behaviour fo

  5. Emerging mHealth innovations for patient self-management support

    DEFF Research Database (Denmark)

    Wac, Katarzyna; Rivas, Homero

    2016-01-01

    mHealth solutions enable connected patients to take care of their health and care needs while `on the move'. There exist a variety of emerging innovative technologies supporting them in their goal of symptoms tracking, medication adherence, or connecting with others, either peers suffering from t...

  6. Health care costs, work productivity and activity impairment in non-malignant chronic pain patients

    DEFF Research Database (Denmark)

    Kronborg, Christian; Handberg, Gitte; Axelsen, Flemming

    2009-01-01

    This study explores the costs of non-malignant chronic pain in patients awaiting treatment in a multidisciplinary pain clinic in a hospital setting. Health care costs due to chronic pain are particular high during the first year after pain onset, and remain high compared with health care costs...

  7. Patient and public involvement in scope development for a palliative care health technology assessment in europe

    NARCIS (Netherlands)

    Brereton, L.; Goyder, E.; Ingleton, C.; Gardiner, C.; Chilcott, J.; Wilt, G.J. van der; Oortwijn, W.; Mozygemba, K.; Lysdahl, K.B.; Sacchini, D.; Lepper, W.

    2014-01-01

    BACKGROUND: Patient and Public Involvement (PPI) helps to ensure that study findings are useful to end users but is under-developed in Health Technology Assessment (HTA). "INTEGRATE-HTA, (a co-funded European Union project -grant agreement 30614) is developing new methods to assess complex health te

  8. Thoughts about death and perceived health status in elderly patients with heart failure

    NARCIS (Netherlands)

    Stroemberg, Anna; Jaarsma, Tiny

    2008-01-01

    Aim: To explore thoughts about death and perceived health status in elderly patients with heart failure during a 6 month period after a deterioration needing hospitalisation. Methods: A descriptive, mixed methods design was used. Health was measured with EuroQol-5D, thoughts about death with multipl

  9. How Does Sensitivity Training of Health Care Workers Impact Patient Satisfaction?

    Science.gov (United States)

    De Vinci, Katrina Marie

    2010-01-01

    Health care of the 21st century is undergoing major changes due to a myriad of social factors affecting every level of society. From financial desperation due to the high cost of health care to the increased awareness of a generation asking for better services, the importance of patient satisfaction is paramount. The Centers for Medicare and…

  10. Patient perception of understanding health education and instructions has moderating effect on glycemic control

    OpenAIRE

    Chen, Gin-Den; Huang, Chien-Ning; Yang, Yi-Sun; Lew-Ting, Chin-Yin

    2014-01-01

    Background Whether health literacy is independently associated with processes or outcomes of diabetes-related care is controversial. We tried to demonstrate the interaction of health literacy and understanding of health education and instructions in achieving glycemic control. Methods Five hundred and one consecutive patients with type 2 diabetes mellitus (DM) in the outpatient clinic of the metabolism department were recruited into this pilot study. The demographic data were collected from p...

  11. Can Patient Self-Management Help Explain the SES Health Gradient?

    OpenAIRE

    Goldman, Dana P.; Smith, James P.

    2004-01-01

    There are large differences in health outcomes by socioeconomic status (SES) that cannot be explained fully by traditional arguments, such as access to care or poor health behaviors. We consider a different explanation—better self-management of disease by the more educated. We examine differences by education in treatment adherence among patients with two illnesses, diabetes and HIV, and then assess the subsequent impact of differential adherence on health status. One unique component of this...

  12. The HIV-positive dentist: balancing the rights of the health care worker and the patient

    OpenAIRE

    Gardam, Michael A.; Flanagan, William F.; Salit, Irving E

    2001-01-01

    WE DESCRIBE A HYPOTHETICAL CASE OF AN HIV-POSITIVE DENTIST without cognitive impairment who uses proper infection control procedures. The dentist's physician notifies the medical officer of health without the dentist's consent. Although HIV-positive health care workers, including dentists, have been identified in the past, proven HIV transmission to patients is very rare. Most authorities recommend that an HIV-positive health care worker be monitored by an expert panel, which could then, if n...

  13. The Process of Patient Empowerment in Integrative Health Coaching: How Does it Happen?

    OpenAIRE

    Caldwell, Karen L.; Gray, Jennifer; Wolever, Ruth Q.

    2013-01-01

    Emerging healthcare delivery models suggest that patients benefit from being engaged in their care. Integrative health coaching (IHC) is designed to be a systematic, collaborative, and solution-focused process that facilitates the enhancement of life experience and goal attainment regarding health, but little research is available to describe the mechanisms through which empowerment occurs in the health coaching process. The purpose of this qualitative study is to describe apparent key compon...

  14. Health-related quality of life in patients waiting for major joint replacement. A comparison between patients and population controls

    Directory of Open Access Journals (Sweden)

    Seitsalo Seppo

    2006-01-01

    Full Text Available Abstract Background Several quality-of-life studies in patients awaiting major joint replacement have focused on the outcomes of surgery. Interest in examining patients on the elective waiting list has increased since the beginning of 2000. We assessed health-related quality of life (HRQoL in patients waiting for total hip (THR or knee (TKR replacement in three Finnish hospitals, and compared patients' HRQoL with that of population controls. Methods A total of 133 patients awaiting major joint replacement due to osteoarthritis (OA of the hip or knee joint were prospectively followed from the time the patient was placed on the waiting list to hospital admission. A sample of controls matched by age, gender, housing and home municipality was drawn from the computerised population register. HRQoL was measured by the generic 15D instrument. Differences between patients and the population controls were tested by the independent samples t-test and between the measurement points by the paired samples t-test. A linear regression model was used to explain the variance in the 15D score at admission. Results At baseline, 15D scores were significantly different between patients and the population controls. Compared with the population controls, patients were worse off on the dimensions of moving (P Conclusion Although patients' HRQoL did not deteriorate while waiting, a consistently worse HRQoL was observed in patients waiting for major joint replacement compared with population controls.

  15. Patients' increasing search for health information on internet.

    NARCIS (Netherlands)

    Schee, E. van der; Delnoij, D.

    2004-01-01

    Background: The number of web sites on the internet, providing health information, discussion groups, internet doctors or selling drugs is increasing fast. In 2001, the number was rated over 100.000 (Risk and Dzenowagis, 2001). The growing number of websites on these topics might be expected to matc

  16. Designing Patient-facing Health Information Technologies for the Outpatient Settings: A Literature Review

    Directory of Open Access Journals (Sweden)

    Yushi Yang

    2016-04-01

    Full Text Available Introduction: The implementation of health information technologies (HITs has changed the dynamics of doctor–patient communication in outpatient settings. Designing patient-facing HITs provides patients with easy access to healthcare information during the visit and has the potential to enhance the patient-centred care.   Objectives: The objectives of this study are to systematically review how the designs of patient-facing HITs have been suggested and evaluated, and how they may potentially affect the doctor–patient communication and patient-centred care.   Method: We conducted an online database search to identify articles published before December 2014 relevant to the objectives of this study. A total of nine papers have been identified and reviewed in this study.   Results: Designing patient-facing HITs is at an early stage. The current literature has been exploring the impact of HITs on doctor–patient communication dynamics. Based on the findings of these studies, there is an emergent need to design more patient-centred HITs. There are also some papers that focus on the usability evaluation of some preliminary prototypes of the patient-facing HITs. The design styles of patient-facing HITs included sharing the health information with the patients on: (1 a separate patient display, (2 a projector, (3 a portable tablet, (4 a touch-based screen and (5 a shared computer display that can be viewed by both doctors and patients. Each of them had the strengths and limitations to facilitate the patient-centred care, and it is worthwhile to make a comparison of them in order to identify future research directions.   Conclusion: The designs of patient-facing HITs in outpatient settings are promising in facilitating the doctor-patient communication and patient engagement. However, their effectiveness and usefulness need to be further evaluated and improved from a systems perspective.

  17. Health care professional development: Working as a team to improve patient care.

    Science.gov (United States)

    Babiker, Amir; El Husseini, Maha; Al Nemri, Abdurrahman; Al Frayh, Abdurrahman; Al Juryyan, Nasir; Faki, Mohamed O; Assiri, Asaad; Al Saadi, Muslim; Shaikh, Farheen; Al Zamil, Fahad

    2014-01-01

    In delivering health care, an effective teamwork can immediately and positively affect patient safety and outcome. The need for effective teams is increasing due to increasing co-morbidities and increasing complexity of specialization of care. Time has gone when a doctor or a dentist or any other health practitioner in whatsoever health organization would be able to solely deliver a quality care that satisfies his or her patients. The evolution in health care and a global demand for quality patient care necessitate a parallel health care professional development with a great focus on patient centred teamwork approach. This can only be achieved by placing the patient in the centre of care and through sharing a wide based culture of values and principles. This will help forming and developing an effective team able to deliver exceptional care to the patients. Aiming towards this goal, motivation of team members should be backed by strategies and practical skills in order to achieve goals and overcome challenges. This article highlights values and principles of working as a team and principles and provides team players with a practical approach to deliver quality patient care.

  18. The Changing Locus of Health Data Production and Use: Patient-Generated Health Data, Observations of Daily Living, and Personal Health Information Management

    OpenAIRE

    Piras, Enrico Maria

    2016-01-01

    Despite the growing attention of researcher, healthcare managers and policy makers, data gathering and information management practices are largely untheorized areas. In this work are presented and discussed some early-stage conceptualizations: Patient-Generated Health Data (PGHD), Observations of Daily Living (ODLs) and Personal Health Information Management (PHIM). As I shall try to demonstrate, these labels are not neutral rather they underpin quite different perspectives with respect to h...

  19. Health-related quality of life and long-term mortality in patients treated with percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Schenkeveld, Lisanne; Pedersen, Susanne S.; van Nierop, Josephine W I;

    2010-01-01

    Health status has become increasingly important as an outcome measure in patients with cardiovascular disease. Poor patient-rated health status has been shown to predict mortality in patients with coronary artery disease and heart failure. In patients treated with percutaneous coronary interventi...

  20. Health literacy, health information seeking behaviors and internet use among patients attending a private and public clinic in the same geographic area.

    Science.gov (United States)

    Gutierrez, Natalia; Kindratt, Tiffany B; Pagels, Patti; Foster, Barbara; Gimpel, Nora E

    2014-02-01

    Despite the growing body of health information available online, patients with limited health literacy may lack either internet access or skills necessary to utilize this information. Nonetheless, patients at all health literacy levels may prefer other primary sources to obtain health information. We conducted a cross-sectional study to measure health literacy of patients attending two clinics in Dallas, TX and determine associations between health literacy, health information access and internet usage before and after controlling for confounders. Patients from both clinics (county N = 265; private N = 233) completed a brief survey which included sociodemographics, internet patterns, confidence in filling out medical forms and a self-administered Newest Vital Sign to measure health literacy. In the county clinic, most patients (61.5 %) were Hispanic, had low income (literacy (68.5 %). In the private clinic, participants were mostly black (40.4 %) or white (38.6 %), had higher incomes (≥$46,000), higher education (technical college or college) and adequate health literacy (75.1 %). The primary source of obtaining health information in both clinics was their health care professional (50.6 % county; 40.1 % private). In multivariate analyses to determine differences by health literacy level, there were no statistically significant differences between patients with limited and adequate health literacy and their primary information source. Regardless of health literacy, patients rely on their health care providers to obtain health information. These results showcase the importance of providers' effective communication with patients to make shared decisions about their health regardless of other factors.

  1. Patient-Centered Communication: Exploring the Dentist's Role in the Era of e-Patients and Health 2.0.

    Science.gov (United States)

    Seymour, Brittany; Yang, Helen; Getman, Rebekah; Barrow, Jane; Kalenderian, Elsbeth

    2016-06-01

    In today's digital era, people are increasingly relying on the Internet-including social media-to access health information and inform their health decisions. This article describes an exploratory initiative to better understand and define the role of dentists in patient education in the context of e-patients and Health 2.0. This initiative consisted of four phases. In Phase I, an interdisciplinary expert advisory committee was assembled for a roundtable discussion about patients' health information-seeking behaviors online. In Phase II, a pilot case study was conducted, with methods and analysis informed by Phase I recommendations. Phase III consisted of a debriefing conference to outline future areas of research on modernizing health communication strategies. In Phase IV, the findings and working theories were presented to 75 dental students, who then took a survey regarding their perspectives with the objective of guiding potential curriculum design for predoctoral courses. The results of the survey showed that the validity of online content was often secondary to the strength of the network sharing it and that advocacy online could be more effective if it allowed for emotional connections with peers rather than preserving accuracy of the information. Students expressed high interest in learning how to harness modern health communications in their clinical care since the role of the dentist is evolving from giving information to giving personalized guidance against the backdrop of an often contradictory modern information environment. The authors recommend that the dental profession develop patient-centered health communication training for predoctoral students and professional development and continuing education for practicing professionals. PMID:27251352

  2. The voluntary sector and health policy: the role of national level health consumer and patients' organisations in the UK.

    Science.gov (United States)

    Baggott, Rob; Jones, Kathryn

    2014-12-01

    This article explores the policy role of health consumer and patients' organisations (HCPOs), an important subset of the UK voluntary health sector. Based on research findings from two surveys, the article examines the activities, resources and contacts of HCPOs. It also assesses their impact on health policy and reform. There is some evidence that HCPOs can influence policy and reform. However, much depends on the alliances they build with other policy actors (including other HCPOs), their resources and leadership. HCPOs seem to have more impact on the detail of policy than on the direction of travel. In addition, there are potentially adverse consequences for HCPOs that do engage with the policy process, which may partly explain why some are wary of such involvement. For example, it is possible that HCPOs can be manipulated by government and other powerful policy actors such as health professionals and the drugs industry.

  3. Serious game scores as health condition indicator for cancer patients.

    Science.gov (United States)

    Peters, Konrad; Kayali, Fares; Reithofer, Andrea; Wölfle, Rebecca; Mateus-Berr, Ruth; Kuczwara, Jens; Lehner, Zsuzsanna; Lawitschka, Anita; Brunmaier, Barbara; Martinek, Daniel; Silbernagl, Marisa; Hlavacs, Helmut

    2015-01-01

    In this paper we present INTERACCT (Integrating Entertainment and Reaction Assessment into Child Cancer Therapy), a multidisciplinary research project aiming at creating a communication tool for pediatric patients after cancer treatment with HSCT (hematopoietic stem cell transplantation) in after care. The communication platform should foster communication between patients and clinicians, but also increase motivation for treatment compliance by using appropriate designs and gamification elements. A state of the art web interface enables the physicians to evaluate data submitted by the patients, joining data from various sources (lab data, survey data, physiotherapy performance) using HL7 and visualizing imporant changes. This contribution outlines the challenges of designing such a system and presents a solution for the medical data interface and evaluation. PMID:25991284

  4. Smartphone derived movement profiles to detect changes in health status in COPD patients - A preliminary investigation.

    Science.gov (United States)

    Kelly, Daniel; Donnelly, Seamas; Caulfield, Brian

    2015-08-01

    Over 3.2 million people in the UK alone have the lung disease Chronic Obstructive Pulmonary Disease. Identifying when COPD patients are at risk of an exacerbation is a major problem and there is a need for smart solutions that provide us with a means of tracking patient health status. Smart-phone sensor technology provides us with an opportunity to automatically monitor patients. With sensors providing the ability to measure aspects of a patient's daily life, such a motion, methods to interpret these signals and infer health related information are needed. In this work we aim to investigate the feasibility of utilizing motion sensors, built within smartphones, to measure patient movement and to infer the health related information about the patient. We perform experiments, based on 7 COPD patients using data collected over a 12 week period for each patient, and identify a measure to distinguish between periods when a patient feels well Vs periods when a patient feels unwell. PMID:26736299

  5. Patients' perceptions of service quality dimensions: an empirical examination of health care in New Zealand.

    Science.gov (United States)

    Clemes, M D; Ozanne, L K; Laurensen, W L

    2001-01-01

    The 1984 liberalization of the New Zealand economy has resulted in a health care sector that has become very competitive (Zwier and Clarke, 1999). The private sector is now able to supply health care services and, as a result, a greater value is being placed on patient satisfaction (Zwier and Clarke, 1999). However, despite the increasing focus on customer satisfaction, research into health care patients' perceptions of the dimensions of service quality is scarce. This can be problematic, as quality of care is an essential issue in the strategic marketing of health care services (Turner and Pol, 1995). This study takes a step towards addressing this deficiency by identifying patients' perceptions of the dimensions of service quality in health care. The findings of this study are based on the empirical analysis of a sample of 389 respondents interviewed by telephone. The findings indicate that the service quality dimensions identified in this health care specific study differ in number and dimensional structure from the widely adopted service quality dimensions first identified by Parasuraman, Berry and Zeithaml (1988): reliability, responsiveness, assurance, empathy and tangibles. The service quality dimensions identified in this study were: reliability, tangibles, assurance, empathy, food, access, outcome, admission, discharge and responsiveness. In addition, health care patients perceive the service quality dimensions relating to the core product in health care delivery (for example, outcome and reliability) as more important than the service quality dimensions relating to the peripheral product in health care delivery (for example, food, access and tangibles). Finally, the results of this study suggest that patients with different geographic, demographic, and behavioristic characteristics have different needs and wants during health care delivery and therefore perceive different service quality dimensions as important.

  6. Health-related quality of life in multiple sclerosis patients with bladder, bowel and sexual dysfunction

    NARCIS (Netherlands)

    Vitkova, Marianna; Rosenberger, Jaroslav; Krokavcova, Martina; Szilasiova, Jarmila; Gdovinova, Zuzana; Groothoff, Johan W.; van Dijk, Jitse P.

    2014-01-01

    Purpose: Bladder, bowel and sexual dysfunction are often overlooked symptoms in patients with multiple sclerosis (MS) and can be associated with lower health-related quality of life (HRQoL). The aim is to explore the association of bladder, bowel and sexual dysfunction with HRQoL in MS patients stra

  7. Empowering the chronically ill? Patient collectives in the new Dutch health insurance system.

    Science.gov (United States)

    Bartholomée, Yvette; Maarse, Hans

    2007-12-01

    On January 1, 2006, the Dutch government instituted major reforms to the country's health insurance scheme. One of the features of the new system is the opportunity for groups to form collectives that may negotiate and enter into group contracts with health insurers. This article discusses one particular type of collective, namely patient collectives. The purpose of this paper is to investigate if, and to what extent, patient collectives empower chronically ill patients. The results of the study show that some patient groups were able to contract collective agreements with health insurers, whereas others were not. The eligibility of a group's disease for compensation through the risk equalisation fund (which subsidises the costs for many but not all disorders) seems to determine whether or not a patient organisation is able to successfully negotiate a collective contract for its members. Another key factor for success is the presence of a large membership whose constituents have similar healthcare needs. If both of these factors are present, insurers are more likely to develop specific products for particular groups of patients, as is the case for people with diabetes. Furthermore, the presence of patient collectives accords patient associations with a new role. It may be possible for them to become powerful players in the health insurance market. However, this new role may also lead to tensions, both within and between associations. PMID:17485132

  8. Undiagnosed cognitive impairment, health status and depressive symptoms in patients with type 2 diabetes

    NARCIS (Netherlands)

    Koekkoek, Paula S.; Biessels, Geert Jan; Kooistra, Minke; Janssen, Jolien; Kappelle, L. Jaap; Rutten, Guy E H M

    2015-01-01

    Aims Type 2 diabetes (T2DM) is associated with cognitive impairment. We examined whether undiagnosed cognitive impairment in T2DM-patients is associated with a reduced health status and depressive symptoms. Methods In an observational study, 225 T2DM-patients aged < 70 years were examined at their h

  9. E-Health to Manage Distress in Patients With an Implantable Cardioverter-Defibrillator

    DEFF Research Database (Denmark)

    Habibović, Mirela; Denollet, Johan; Cuijpers, Pim;

    2014-01-01

    UNLABELLED: The Web-based distress management program for patients with an implantable cardioverter-defibrillator (ICD; WEBCARE) was developed to mitigate distress and enhance health-related quality of life in ICD patients. This study investigated the treatment effectiveness at 3-month follow-up ...

  10. Patient- versus physician-reporting of symptoms and health status in chronic myeloid leukemia

    NARCIS (Netherlands)

    F. Efficace; G. Rosti; N. Aaronson; F. Cottone; E. Angelucci; S. Molica; M. Vignetti; F. Mandelli; M. Baccarani

    2013-01-01

    The main objective of this study was to compare the reporting of health status and symptom severity, for a set of core symptoms related to imatinib therapy, between chronic myeloid leukemia patients and their treating physicians. Patients were asked to complete a questionnaire including questions on

  11. Oral health status in patients with brain injury: a systematic review

    DEFF Research Database (Denmark)

    Kothari, Mohit; Pillai, Rajath; Futarmal Kothari, Simple;

    2016-01-01

    Med, Embase, and Scopus electronic databases until January 2016 to identify studies presenting the assessment of the oral health status of patients afflicted with any kind of ABI. The search strategy was restricted to English-language publications, enrolling patients above 18 years. Studies on the association...

  12. Health-related quality of life and treatment satisfaction in Dutch patients with type 2 diabetes

    NARCIS (Netherlands)

    Redekop, WK; Rutten, GEHM; Koopmanschap, MA; Wolffenbuttel, BHR; Stolk, RP; Niessen, LW

    2002-01-01

    Objective-To estimate the health-related quality of life (HRQOL) and treatment satisfaction for patients with type 2 diabetes in the Netherlands and to examine which patient characteristics are associated with quality of life and treatment satisfaction. Research Design and Methods-For a sample of 1,

  13. Health-related quality of life in Iranian patients with multiple sclerosis

    DEFF Research Database (Denmark)

    Pakpour, Amir H.; Yekaninejad, Mir Saeed; Mohammadi, Nastaran Keshavarz;

    2009-01-01

    Background and purpose: This study aimed to evaluate aspects of health-related quality of life (HRQoL) of patients with multiple sclerosis (MS) who live in Tehran and to compare data with evaluations of both the general population and MS patients in other countries Material and methods: One hundr...

  14. Defining and measuring integrated patient care: promoting the next frontier in health care delivery.

    NARCIS (Netherlands)

    Singer, S.J.; Burgers, J.S.; Friedberg, M.; Rosenthal, M.B.; Leape, L.; Schneider, E.

    2011-01-01

    Integration of care is emerging as a central challenge of health care delivery, particularly for patients with multiple, complex chronic conditions. The authors argue that the concept of "integrated patient care" would benefit from further clarification regarding (a) the object of integration and (b

  15. The effectiveness of allied health care in patients with ataxia: a systematic review

    NARCIS (Netherlands)

    Fonteyn, E.M.R.; Keus, S.H.J.; Verstappen, C.C.P.; Schols, L.; Groot, I.J.M. de; Warrenburg, B.P.C. van de

    2014-01-01

    Many patients with cerebellar ataxia have serious disabilities in daily life, while pharmacological treatment options are absent. Therefore, allied health care is considered to be important in the management of these patients. The goal of this review is to evaluate scientific evidence for allied hea

  16. Practice nurses mental health provide space to patients to discuss unpleasant emotions.

    NARCIS (Netherlands)

    Griep, E.C.M.; Noordman, J.; Dulmen, A.M. van

    2016-01-01

    WHAT IS KNOWN ON THE SUBJECT? A core skill of practice nurses' mental health is to recognize and explore patients' unpleasant emotions. Patients rarely express their unpleasant emotions directly and spontaneously, but instead give indirect signs that something is worrying them.

  17. Patient reported outcomes in chronic skin diseases: eHealth applications for clinical practice

    NARCIS (Netherlands)

    O.D. van Cranenburgh

    2016-01-01

    The overall aim of this thesis was to examine and integrate patient reported outcomes (PROs) in dermatological care. In part I, we specifically examined health-related quality of life (HRQoL), treatment satisfaction, and experiences with care in patients with chronic skin diseases. Our results indic

  18. Health-related quality of life, employment and disability in patients with Sjogren's syndrome

    NARCIS (Netherlands)

    Meijer, Jiska M.; Meiners', Petra M.; Slater, James J. R. Huddleston; Spijkervet, Fred K. L.; Kallenberg, Cees G. M.; Vissink, Arjan; Bootsma, Hendrika

    2009-01-01

    Objective. To compare health-related quality of life (HR-QOL), employment and disability of primary and secondary SS (pSS and sSS, respectively) patients with the general Dutch population. Methods. HR-QOL, employment and disability were assessed in SS patients regularly attending the University Medi

  19. Health service interventions targeting relatives of heart patients: a review of the literature

    DEFF Research Database (Denmark)

    Nissen, Nina Konstantin; Madsen, Mette; Olsen Zwisler, Ann-Dorthe

    2008-01-01

    AIMS: Relatives of heart patients experience anxiety, uncertainty, and low quality of life, and the hospitalization of a heart patient is associated with increased risk of death for the partner. Relatives' physical and mental problems may be rectified by activities established by the health...

  20. Health-related quality of life and anemia in hospitalized patients with heart failure

    NARCIS (Netherlands)

    Kraai, I. H.; Luttik, M. L. A.; Johansson, P.; De Jong, R. M.; Van Veldhuisen, D. J.; Hillege, H. L.; Jaarsma, T.

    2012-01-01

    Background: Anemia is a serious and highly prevalent co-morbidity in chronic heart failure (HF) patients. Its influence on health-related quality of life (HR-QoL) has rarely been studied, and no data is available regarding the role it plays in hospitalized HF patients. Methods: Baseline data from th

  1. Health care providers underestimate symptom intensities of cancer patients: A multicenter European study

    NARCIS (Netherlands)

    E.A. Laugsand; M.A.G. Sprangers; K. Bjordal; F. Skorpen; S. Kaasa; P. Klepstad

    2010-01-01

    ABSTRACT: BACKGROUND: Many patients with advanced cancer depend upon health care providers for symptom assessment. The extent of agreement between patient and provider symptom assessments and the association of agreement with demographic- and disease-related factors was examined. METHODS: This cross

  2. Health-related quality of life and treatment satisfaction in Dutch patients with type 2 diabetes

    NARCIS (Netherlands)

    W.K. Redekop (Ken); M.A. Koopmanschap (Marc); R.P. Stolk (Ronald); G.E.H.M. Rutten (Guy); B.H.R. Wolffenbuttel (Bruce); L.W. Niessen (Louis Wilhelmus)

    2002-01-01

    textabstractOBJECTIVE: To estimate the health-related quality of life (HRQOL) and treatment satisfaction for patients with type 2 diabetes in the Netherlands and to examine which patient characteristics are associated with quality of life and treatment satisfaction. RESEARCH DESIGN

  3. Type 2 diabetes management: Patient knowledge and health care team perceptions, South Africa

    Directory of Open Access Journals (Sweden)

    Nombeko Mshunqane

    2012-02-01

    Full Text Available Background: South African research indicates that the highest death rates between 2004 and 2005 were from diabetes mellitus. There is minimal research information on interactions between what patients know about their disease and what health professionals perceive that patients should know to control their disease well.Objectives: This study determined the knowledge that patients with type 2 diabetes have about the management of their disease, as well as the perceptions of the health care team about the services given to patients.Method: Qualitative data were collected using two focus groups and in-depth interviews. Patient focus group (n = 10 explored patients’ knowledge about management of type 2 diabetes. Patients were recruited from Dr George Mukhari Hospital outpatients’ diabetes clinic. Professional focus group (n = 8 explored the health care team’s experiences, barriers and facilitators in managing the disease. Professional focus group participants were recruited because of their expertise in chronic disease management, working in the community (public health or working directly with patients with type 2 diabetes. Five health care professionals were interviewed using the same guide of questions as for the focus group.Results: Participants identified type 2 diabetes as a chronic disease that needs behaviour change for good control. Five major themes were identified: patients’ knowledge; education programmes; behaviour change; support; and a patient-centred approach.Conclusion: Management of type 2 diabetes may be enhanced by reinforcing patients’ knowledge, encouraging behaviour change whilst taking into consideration patients’ backgrounds. The health care team needs to utilise a patient-centred approach.

  4. Relationship of Mental Health and Illness in Substance Abuse Patients

    OpenAIRE

    Alterman, Arthur I.; Cacciola, John S.; Ivey, Megan A.; Coviello, Donna M.; Lynch, Kevin G.; Dugosh, Karen L.; Habing, Brian

    2010-01-01

    This study examined the latent structure of a number of measures of mental health (MH) and mental illness (MI) in substance use disorder outpatients to determine whether they represent two independent dimensions, as Keyes (2005) found in a community sample. Seven aspects of MI assessed were assessed - optimism, personal meaning, spirituality/religiosity, social support, positive mood, hope, and vitality. MI was assessed with two measures of negative psychological moods/states, a measure of an...

  5. Health-related quality of life and self-related health in patients with type 2 diabetes: effects of group-based rehabilitation versus individual counselling

    DEFF Research Database (Denmark)

    Vadstrup, Eva S; Frølich, Anne; Perrild, Hans;

    2011-01-01

    Type 2 diabetes can seriously affect patients' health-related quality of life and their self-rated health. Most often, evaluation of diabetes interventions assess effects on glycemic control with little consideration of quality of life. The aim of the current study was to study the effectiveness ...... of group-based rehabilitation versus individual counselling on health-related quality of life (HRQOL) and self-rated health in type 2 diabetes patients....

  6. Patient's perception, compliance to treatment and health education of antiretroviral therapy among HIV patients at a tertiary healthcare setting

    International Nuclear Information System (INIS)

    Objective: To illustrate perceptions, compliance to treatment and satisfaction levels regarding health education services pertaining to the anti-retrovival therapy among HIV and AIDS patients. Methods: The cross-sectional survey was carried out at the HIV Treatment Centre, Pakistan Institute of Medical Sciences (PIMS), Islamabad, from September 2009 to February 2010 in which patients were interviewed separately regarding their perceptions, compliance to treatment and satisfaction levels regarding health education services pertaining to the anti-retrovival therapy. All data collected was entered into SPSS version 15.0. The data was re-validated and analysed. Results: One hundred and forty patients were interviewed; there were 99 (70.7%) males.. Of the total, 28 (20%) had no knowledge about the beneficial effects of the therapy, and 45 (32 %) ranked health education services extremely beneficial in understanding the anti-retrovival therapy. Conclusion: While a significant proportion of patients considered ART either somewhat beneficial or beneficial in treating their ailment, they were unclear about the impact of health education provided at the treatment centre and different forms of print media. (author)

  7. Personalized Patient Education and the Internet: Linking health information to the Electronic Patient Record (STEPPS in burn care)

    NARCIS (Netherlands)

    P.V. Doupi (Persephone)

    2005-01-01

    markdownabstract__Abstract__ For patients and their carers, information seeking and processing is an integral part of managing disease or coping with a health condition. The nature and content of that information may vary widely; from general medical knowledge, to practical details on diagnosis and

  8. [Health maintenance, relaxation and hypnosis for chronic pain patients].

    Science.gov (United States)

    Boiron, Clare

    2014-10-01

    The treatment of chronic pain patients integrates more and more complementary therapies such as relaxation and hypnosis, implemented by specially trained nurses. These techniques are offered on the basis of nurses' diagnoses carried out in the framework of a clinical approach. PMID:25518140

  9. Experiences of patients and healthcare professionals of NHS cardiovascular health checks: a qualitative study

    Science.gov (United States)

    Riley, R.; Coghill, N.; Montgomery, A.; Feder, G.; Horwood, J.

    2016-01-01

    Background NHS Health Checks are a national cardiovascular risk assessment and management programme in England and Wales. We examined the experiences of patients attending and healthcare professionals (HCPs) conducting NHS Health Checks. Methods Interviews were conducted with a purposive sample of 28 patients and 16 HCPs recruited from eight general practices across a range of socio-economic localities. Interviews were audio recorded, transcribed, anonymized and analysed thematically. Results Patients were motivated to attend an NHS Health Check because of health beliefs, the perceived value of the programme, a family history of cardiovascular and other diseases and expectations of receiving a general health assessment. Some patients reported benefits including reassurance and reinforcement of healthy lifestyles. Others experienced confusion and frustration about how results and advice were communicated, some having a poor understanding of the implications of their results. HCPs raised concerns about the skill set of some staff to competently communicate risk and lifestyle information. Conclusions To improve the satisfaction of patients attending and improve facilitation of lifestyle change, HCPs conducting the NHS Health Checks require sufficient training to equip them with appropriate skills and knowledge to deliver the service effectively. PMID:26408822

  10. Patient-provider connectivity and the role of e-health.

    Science.gov (United States)

    Holmes, Suzanne C; Kearns, Ellen Hope

    2003-01-01

    Patient-provider connectivity (PPC) offers innovative approaches to control costs, improve quality, and sustain a healthy workforce. The application of e-commerce to health care is one facet of PPC and provides solutions to educating, informing, and more efficiently using scarce resources to sustain the nation's health. Technology is available to provide real-time access to clinical results, medical records, health-care providers, and other time-sensitive patient information. This is the first article in a series on PPC that explores the application of e-commerce to the health-care industry from the consumers' and providers' points of view and examines and assesses trends and data from various interdisciplinary sources and studies. Two models exemplifying PPC are explored including the Science Business & Education, Inc., proof-of-concept patient demonstration project, and the emerging application of peer-to-peer (P2P) technology. PPC promises to improve efficiency, facilitate communication between physician and patient, monitor compliance with medical regimens, and positively affect the quality of health care provided and the overall health of the patient. Future articles will address the growth of telemedicine, issues of confidentiality and e-risk, and other PPC applications. PMID:12813954

  11. Patient-provider connectivity and the role of e-health.

    Science.gov (United States)

    Holmes, Suzanne C; Kearns, Ellen Hope

    2003-01-01

    Patient-provider connectivity (PPC) offers innovative approaches to control costs, improve quality, and sustain a healthy workforce. The application of e-commerce to health care is one facet of PPC and provides solutions to educating, informing, and more efficiently using scarce resources to sustain the nation's health. Technology is available to provide real-time access to clinical results, medical records, health-care providers, and other time-sensitive patient information. This is the first article in a series on PPC that explores the application of e-commerce to the health-care industry from the consumers' and providers' points of view and examines and assesses trends and data from various interdisciplinary sources and studies. Two models exemplifying PPC are explored including the Science Business & Education, Inc., proof-of-concept patient demonstration project, and the emerging application of peer-to-peer (P2P) technology. PPC promises to improve efficiency, facilitate communication between physician and patient, monitor compliance with medical regimens, and positively affect the quality of health care provided and the overall health of the patient. Future articles will address the growth of telemedicine, issues of confidentiality and e-risk, and other PPC applications.

  12. What Influences Patients' Decisions When Choosing a Health Care Provider? : Measuring Preferences of Patients with Knee Arthrosis, Chronic Depression, or Alzheimer's Disease, Using Discrete Choice Experiments

    NARCIS (Netherlands)

    A.S. Groenewoud (Stef); N.J.A. van Exel (Job); A. Bobinac (Ana); M. Berg (Marc); R. Huijsman (Robbert); E.A. Stolk (Elly)

    2015-01-01

    textabstractObjective: To investigate what influences patients' health care decisions and what the implications are for the provision of information on the quality of health care providers to patients. Data Sources/Study Setting: Dutch patient samples between November 2006 and February 2007. Study D

  13. A health information system in radiotherapy to support health personnel in evaluation of standard pain in patients with bone metastases

    International Nuclear Information System (INIS)

    Radiation therapy is a medical specialty that uses ionizing radiation sources, and can be applied to relieve the pain. The Numerical Dosimetry Group (GDN) of Recife-PE, Brazil presented in June 2012 the SISRAD (Health information system in radiotherapy), developed to organize information about data of patients with bone metastasis, aiming to evaluate patterns of pain after radiation treatment. They have since been carried out interviews with this type of patient and the answers have been added to a data file of the software. Were developed some graphical visualization tools as well as data sheets. The current version of SISRAD reads the data file and displays graphics and numerical results, with options to save them or print them. In this paper is presented a roadmap for the health care professional use with efficiency the SISRAD to form quantitative profiles of intensity of pain that their patients, on their responsibility, feel after the radiation treatment. A hypothesis used in SISRAD consists of organizing the responses of the patients supposing them free from other effects other than those arising from the permanence of the pain he felt before treatment or modification by the treatment. So the way the information is handled in the SISRAD enable the trader can discern patterns of pain and, consequently, improve the quality of treatment. In this sense the computational tool here presented can be classified as educational software for health professionals

  14. The Relationship between Health-Promoting Behaviors and Resilience in Patients with Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Li-Ching Ma

    2013-01-01

    Full Text Available This cross-sectional research study explored differences in health-promoting behavior and resilience among three groups of chronic kidney disease patients (high-risk, early chronic kidney disease; early CKD and pre-end stage renal disease; pre-ESRD treated at the Nephrology outpatient clinic in northern Taiwan. A total of 150 CKD outpatients were interviewed using structured questionnaires including a CKD Health to Promote Lifestyle Scale, and resilience scale. We found that the pre-ESRD group had lower resilience than either high-risk or early CKD groups. Factors affecting pre-ESRD resilience were gender, occupational status, diabetes and health-promoting behaviors. Factors affecting resilience of the high-risk group included level of education and health-promoting behaviors while factors affecting resilience in the early CKD group involved whether they are employed and health promoting behaviors. A significant positive correlation was found between health promoting behavior and resilience in all study subjects. Multiple regression analysis found that factors which could effectively predict resilience in patients at high-risk for CKD were gender, whether the patient had a job, nutrition, self-actualization, and stress level, accounting for 69.7% of the variance. Therefore, nursing education should focus on health promotion advocacy throughout the life of not only patients but also their families.

  15. The impact of smoking status on the health status of heart failure patients.

    LENUS (Irish Health Repository)

    Conard, Mark W

    2012-02-01

    Smoking is a major risk factor for the development of heart failure (HF). Yet, little is known about smoking\\'s effects on the health status of established HF patients. HF patients were recruited from outpatient clinics across North America. The Kansas City Cardiomyopathy Questionnaire (KCCQ) was used to assess disease-specific health status. Smoking behaviors were classified as never having smoked, prior smoker, and as having smoked within the past 30 days. Risk-adjusted multivariable regression was used to evaluate the association of smoking status with baseline and 1-year KCCQ overall summary scores. Smoking was not associated with baseline health status. However, a significant effect was observed on 1-year health status among outpatients with HF with current smokers reporting significantly lower KCCQ scores than never smokers or ex-smokers. These findings highlight an additional adverse consequence of smoking in HF patients not previously discussed.

  16. Six health care trends that will reshape the patient-provider dynamic.

    Science.gov (United States)

    Liao, Joshua M; Emanuel, Ezekiel J; Navathe, Amol S

    2016-09-01

    Six trends - movement towards value-based payment, rapid adoption of digital health technology, care delivery in non-traditional settings, development of individualized clinical guidelines, increased transparency, and growing cultural awareness about the harms of medical overuse - are driving the US health care system towards a future defined by quality- and patient-centric care. Health care organizations are responding to these changes by implementing provider and workforce changes, pursuing stronger payer-provider integration, and accelerating the use of digital technology and data. While these efforts can also improve the clinical relationship and create positive system redesign among health care organizations, they require alignment between organizational and physician incentives that can inadvertently harm the dynamic between patients and providers. Organizations can utilize several strategies to preserve the patient-physician relationship and advance the positive benefits of new organizational strategies while guarding against unintended consequences.

  17. Identifying primary care patients at risk for future diabetes and cardiovascular disease using electronic health records

    OpenAIRE

    Shrader Peter; Grant Richard W; Hivert Marie-France; Meigs James B

    2009-01-01

    Abstract Background Prevention of diabetes and coronary heart disease (CHD) is possible but identification of at-risk patients for targeting interventions is a challenge in primary care. Methods We analyzed electronic health record (EHR) data for 122,715 patients from 12 primary care practices. We defined patients with risk factor clustering using metabolic syndrome (MetS) characteristics defined by NCEP-ATPIII criteria; if missing, we used surrogate characteristics, and validated this approa...

  18. How I do it: managing bone health in patients with prostate cancer.

    Science.gov (United States)

    Barkin, Jack

    2014-08-01

    Urologists have two scenarios where they have to address bone loss or increased risk of fractures in men with prostate cancer. In the first setting, a patient who has been started on androgen deprivation therapy may develop cancer-treatment-induced bone loss. In the second setting, a patient's prostate cancer may have metastasized to the bone. This article describes six steps to manage bone health in patients diagnosed with prostate cancer in a community practice.

  19. The Patient Centered Assessment Method (PCAM: integrating the social dimensions of health into primary care

    Directory of Open Access Journals (Sweden)

    Rebekah Pratt

    2015-07-01

    Full Text Available Background: Social dimensions of health are known to contribute to what is often termed “patient complexity”, which is particularly common among patients with multimorbidity. Health-care professionals require tools to help them identify and manage these aspects of patient needs. Objectives: To examine: (i the Patient Centered Assessment Method (PCAM, a tool for assessing patient complexity in ways that are sensitive to the biopsychosocial dimensions of health, in primary care settings in Scotland; (ii the impact of the PCAM on referral patterns and its perceived value; and (iii the PCAM’s perceived applicability for use in a complex patient population. Design: Two studies are described: (i a mixed-methods prospective cohort study of the implementation of the PCAM in primary care clinics; and (ii a qualitative exploratory study that evaluated the value of the PCAM in a complex patient population. Results: Use of the PCAM did not impact patient satisfaction or perception of practitioners’ empathy, but it did increase both the number of onward referrals per referred patient (9–12% and the proportion of referrals to non-medical services addressing psychological, social, and lifestyle needs. Nurses valued the PCAM, particularly its ability to help them address psychological and social domains of patients’ lives, and found it to be highly relevant for use in populations with known high complexity. Conclusions: The PCAM represents a feasible approach for assessing patient needs with consideration to the social dimensions of health, and allows practitioners to refer patients to a broader range of services to address patient complexity.

  20. Adopting a critical intercultural communication approach to understanding health professionals' encounter with ethnic minority patients

    DEFF Research Database (Denmark)

    Jæger, Kirsten

    2012-01-01

    professionals and their approach to ethnic minority patients influence the accessibility of healthcare and availability of health prevention resources of ethnic minorities. When adapting healthcare practice to minority patients, healthcare professionals draw on insights from intercultural communication...... paradigms and advocates the adoption of a critical intercultural communication approach in relation to ethnicity-based health inequality....... and anthropology. However, within these disciplines such concepts as culture, interculturality, and ethnicity are subjected to contestation due to co-existing, but competing paradigms. This paper demonstrates how healthcare discourses on ethnic minority patients reflect shifting intercultural communication...

  1. Practical Management of Patients with Diabetes Mellitus in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Elodia María Rivas Alpizar

    2011-11-01

    Full Text Available Diabetes mellitus is a disease of major importance for public health throughout the world. This is mainly caused by its status as one of the most common non-communicable diseases and the severity and diversity of its chronic complications. An updated literary review on the management of patients with diabetes mellitus was conducted. It includes definition, diagnosis and classification, algorithm for disease’s screening, appropriate management of a patient with diabetes mellitus in primary health care, treatment pillars and goals for metabolic control. This review is aimed at exposing practical elements when approaching a patient suffering from diabetes mellitus.

  2. Health profiles for patients with Ménière's disease.

    Science.gov (United States)

    Holgers, Kajsa-Mia; Finizia, Caterina

    2001-01-01

    The Nottingham Health Profile (NHP) has been used to investigate the health profiles for many medical conditions, such as herpes zoster infection, migraine, cancer and epilepsy. However, so far, it has not been used to investigate the health profile for patients suffering from Ménière's disease, but only for patients with dizziness, severe hearing loss and tinnitus. Each of these three symptoms have shown to have a significant impact on the quality of life. In the present study, 116 consecutive patients with Ménière's disease, diagnosed according to the AAO-HNS guidelines, visiting at the department of Audiology were included in the study. The NHP was used to measure the health related quality of life and includes the following subscales: "Sleep", "Energy", "Emotional reaction", "Pain", "Physical mobility", "Social isolation" and items concerning daily activity. The Tinnitus Severity Questionnaire (TSQ) was used to measure symptoms specific to tinnitus. The results showed that the perceived severity of tinnitus in patients with Ménière's disease had a significant negative influence on their health related quality of life. The patients with Ménière's disease suffered from more sleep disturbances and social isolation than patients referred to our clinic due to tinnitus. The quality of life was, on the whole, worse for patients of working age compared to retired pensioners. Emotional disturbances could explain 40.3 % of the variance of the tinnitus severity in patients with Ménière's disease. This can be compared with 20.6% in patients with tinnitus. This underscores the importance of providing psychological and psychiatric interventions and support to patients with Ménière's disease. PMID:12678936

  3. A healthful experience? A patient practice development journey

    Directory of Open Access Journals (Sweden)

    Erna Snelgrove Clarke

    2016-05-01

    Full Text Available While facilitating the first practice development school for our local healthcare authorities in Nova Scotia, Canada, recently, I was simultaneously preparing for my second hip replacement. Focusing workshop participants on the principles of practice development, collaboration, inclusion and participation, I wondered if, in my upcoming journey through the healthcare system, I would experience the processes and outcomes we were promoting in the school. I would like to share this commentary as a reflection of my practice development experience as a patient. Overall, I received care that was inclusive and collaborative – as well as care that was provider focused and system driven. It goes without saying that as a patient, I felt valued when I was included and felt part of the team when my wishes and expectations were taken into consideration. For me, inclusion in care correlates with valuing that patient as a participant in their care journey, as set out by practice development principle 6 (Manley, McCormack and Wilson, 2008 (Table 1. My recent healthcare experience has led me to reflect further on the principles of practice development and its implications and challenges for local healthcare authorities. For example, my anaesthetist comes to mind as embodying practice development principles 2, 4, 6 and 8. The anaesthetist supported my wishes surrounding narcotics, and provided research- and practice-based evidence for each of his actions. Although the offering of additional narcotics is routine practice in hip surgery, I did not want this, so we discussed my expectations and developed a plan together that reflected my wishes. He actually chatted throughout the entire two-hour procedure. I was pleasantly surprised when he told me he provides care that focuses on the patient (practice development principle 1. Nevertheless, inconsistencies in the attention to person-centred practices across the microsystem reminded me that the system is not yet set

  4. Psychiatric patients' return for HIV/STI test results in mental health centers

    Directory of Open Access Journals (Sweden)

    Ana Paula Souto Melo

    2012-04-01

    Full Text Available OBJECTIVE: To assess individual and/or health service factors associated with patients returning for results of HIV or sexually transmitted infection (STI tests in mental health centers. METHODS: Cross-sectional national multicenter study among 2,080 patients randomly selected from 26 Brazilian mental health centers in 2007. Multilevel logistic regression was used to assess the effect of individual (level 1 and mental health service characteristics (level 2 on receipt of test results. RESULTS: The rate of returning HIV/STI test results was 79.6%. Among health service characteristics examined, only condom distribution was associated with receiving HIV/STI test results, whereas several individual characteristics were independently associated including living in the same city where treatment centers are; being single; not having heard of AIDS; and not having been previously HIV tested. CONCLUSIONS: It is urgent to expand HIV/STI testing in health services which provide care for patients with potentially increased vulnerability to these conditions, and to promote better integration between mental health and health services.

  5. Willingness of Patients to Use Computers for Health Communication and Monitoring Following Myocardial Infarction.

    Science.gov (United States)

    Shaw, Ryan J; Zullig, Leah L; Crowley, Matthew J; Grambow, Steven C; Lindquist, Jennifer H; Shah, Bimal R; Peterson, Eric; Bosworth, Hayden B

    2015-09-01

    We describe the computer use characteristics of 406 post-myocardial infarction (MI) patients and their willingness to engage online for health communication and monitoring. Most participants were computer users (n = 259; 63.8%) and half (n = 209; 51.5%) read health information online at least monthly. However, most participants did not go online to track health conditions (n = 283; 69.7%), look at medical records (n = 287; 70.7%), or e-mail doctors (n = 351; 86.5%). Most participants would consider using a Web site to e-mail doctors (n = 275; 67.7%), share medical information with doctors (n = 302; 74.4%), send biological data to their doctor (n = 308; 75.9%), look at medical records (n = 321; 79.1%), track health conditions (n = 331; 81.5%), and read about health conditions (n = 332; 81.8%). Sharing health information online with family members (n = 181; 44.6%) or for support groups (n = 223; 54.9%) was not of much interest. Most post-MI participants reported they were interested in communicating with their provider and tracking their health conditions online. Because patients with a history of MI tend to be older and are disproportionately minority, researchers and clinicians must be careful to design interventions that embrace post-MI patients of diverse backgrounds that both improve their access to care and health outcomes. PMID:26176640

  6. Admission Volume and Quality of Mental Health Care Among Danish Patients With Recently Diagnosed Schizophrenia

    DEFF Research Database (Denmark)

    Jørgensen, Mette; Mainz, Jan; Johnsen, Søren Paaske

    2016-01-01

    OBJECTIVE: The relationship between admission volume and the quality of mental health care remains unclear. This study examined the association between admission volume of psychiatric hospital units and quality of mental health care among patients with recently diagnosed schizophrenia (past year......) admitted to units in Denmark. METHODS: In a nationwide population-based cohort study, 3,209 patients admitted to psychiatric hospital units between 2004 and 2011 were identified from the Danish Schizophrenia Registry. Admission volume was categorized into four quartiles according to the individual unit...... care was defined as having received processes of care recommended in guidelines. RESULTS: Compared with patients admitted to low-volume psychiatric hospital units, patients admitted to very-high-volume units were more likely to receive high overall quality of mental health care (≥80% of recommended...

  7. Taciturn patients in health counseling at a hospital: passive recipients or active participators?

    Science.gov (United States)

    Kettunen, T; Poskiparta, M; Liimatainen, L; Sjögren, A; Karhila, P

    2001-05-01

    This study explored patients' taciturnity as observed on videotape during hospital health counseling situations with a nurse. Health counseling sessions, 38 in number, were videotaped, transcribed verbatim, and analyzed by using an adaptation of conversation analysis. The data analysis included information on 18 selected patients who spoke little and did not introduce new topics, but rather supported the discussion on the theme chosen by the nurse. When we examined nurses' and patients' speech word by word, we discovered four participation frames that produced taciturnity: in the hands of professionals, compliant, guilty, and polite. These could fluctuate during interaction. The findings indicate that there is a need for a more extensive description of taciturn, or silent, patients. What has been interpreted as passivity in the literature can be interpreted more constructively. This insight can be useful for developing health counseling practice in hospitals.

  8. White coat hypertension: improving the patient-health care practitioner relationship.

    Science.gov (United States)

    Cobos, Briana; Haskard-Zolnierek, Kelly; Howard, Krista

    2015-01-01

    White coat hypertension is characterized by the variability of a patient's blood pressure measurements between the physician's office and the patient's home environment. A patient with white coat hypertension has high blood pressure levels in the physician's office and normal blood pressure levels in their typical environment. This condition is likely caused by the patient's anxiety within the physician's office and in the presence of the physician. Research has shown that improving the relationship between a patient and their health care provider can decrease the patient's anxiety, with the implication of decreasing the patient's likelihood of demonstrating white coat hypertension. This review provides an overview of the previous literature regarding white coat hypertension, its prevalence, and the consequences for those who develop persistent hypertension. Furthermore, this review discusses the implications of improving patient and health care provider interactions through effective communication, empathy, and trust, as well as the implications for future research studies in improving the patient and health care provider's relationship. PMID:25999772

  9. Distinct trajectories of disease-specific health status in heart failure patients undergoing cardiac resynchronization therapy

    DEFF Research Database (Denmark)

    Mastenbroek, Mirjam H.; Pedersen, Susanne S.; Meine, Mathias;

    2016-01-01

    of 139 patients with a CRT-defibrillator (70 % men; age 65.7 ± 10.1 years) completed the Kansas City Cardiomyopathy Questionnaire (KCCQ) prior to implantation (baseline) and at 2, 6, and 12-14 months post-implantation. Latent class analyses were used to identify trajectories and associates of disease......-specific health status over time. RESULTS: All health status trajectories showed an initial small to large improvement from baseline to 2-month follow-up, whereafter most trajectories displayed a stable pattern between short- and long-term follow-up. Low educational level, NYHA class III/IV, smoking, no use...... of beta-blockers, use of psychotropic medication, anxiety, depression, and type D personality were found to be associated with poorer health status in unadjusted analyses. Interestingly, subgroups of patients (12-20 %) who experienced poor health status at baseline improved to stable good health status...

  10. Implementation of virtual patients in the training for occupational health in Latin America.

    Science.gov (United States)

    Radon, Katja; Carvalho, Denise; Calvo, Maria Julia; Struempell, Stephanie; Herrera, Veronica; Wengenroth, Laura; Kausel, Gudrun; Marchetti, Nella; Rojas, Daniel Segura; Russ, Paul; Hege, Inga

    2011-01-01

    Health professionals trained in occupational health are essential to reduce the burden of occupational accidents and diseases. However, training resources are limited globally. We aimed to promote occupational health and safety (OHS) using virtual patients (VPs) in Brazil, Chile, and Germany. Virtual patients were created in three Latin-American health centers. So-called "partner VPs" comparing the distinct health care systems were designed. Translation, adaptation to different medical and legal systems, expert review, implementation into under- and postgraduate teaching, and user evaluation were performed. Twelve VPs covering traditional and contemporary OHS issues are available in Spanish, Portuguese, and English. Overall, 2371 students used the VPs. The number of Latin American users who evaluated VP content and relevance for their professional career was statistically significantly higher than the number of German students. VPs are a feasible learning method for OHS in middle-income countries. Partner VPs seem to be useful for teaching global aspects.

  11. Improving sexual health for HIV patients by providing a combination of integrated public health and hospital care services; a one-group pre- and post test intervention comparison

    Directory of Open Access Journals (Sweden)

    Dukers-Muijrers Nicole HTM

    2012-12-01

    Full Text Available Abstract Background Hospital HIV care and public sexual health care (a Sexual Health Care Centre services were integrated to provide sexual health counselling and sexually transmitted infections (STIs testing and treatment (sexual health care to larger numbers of HIV patients. Services, need and usage were assessed using a patient perspective, which is a key factor for the success of service integration. Methods The study design was a one-group pre-test and post-test comparison of 447 HIV-infected heterosexual individuals and men who have sex with men (MSM attending a hospital-based HIV centre serving the southern region of the Netherlands. The intervention offered comprehensive sexual health care using an integrated care approach. The main outcomes were intervention uptake, patients’ pre-test care needs (n=254, and quality rating. Results Pre intervention, 43% of the patients wanted to discuss sexual health (51% MSM; 30% heterosexuals. Of these patients, 12% to 35% reported regular coverage, and up to 25% never discussed sexual health topics at their HIV care visits. Of the patients, 24% used our intervention. Usage was higher among patients who previously expressed a need to discuss sexual health. Most patients who used the integrated services were new users of public health services. STIs were detected in 13% of MSM and in none of the heterosexuals. The quality of care was rated good. Conclusions The HIV patients in our study generally considered sexual health important, but the regular counselling and testing at the HIV care visit was insufficient. The integration of public health and hospital services benefited both care sectors and their patients by addressing sexual health questions, detecting STIs, and conducting partner notification. Successful sexual health care uptake requires increased awareness among patients about their care options as well as a cultural shift among care providers.

  12. Dual Use of Veterans Health Administration and Indian Health Service: Healthcare Provider and Patient Perspectives

    OpenAIRE

    Kramer, B. Josea; Vivrette, Rebecca L.; Satter, Delight E.; Jouldjian, Stella; McDonald, Leander Russell

    2009-01-01

    ABSTRACT BACKGROUND Many American Indian and Alaska Native veterans are eligible for healthcare from Veterans Health Administration (VHA) and from Indian Health Service (IHS). These organizations executed a Memorandum of Understanding in 2003 to share resources, but little was known about how they collaborated to deliver healthcare. OBJECTIVE To describe dual use from the stakeholders’ perspectives, including incentives that encourage cross-use, which organization’s primary care is “primary,”...

  13. Suicide ideation, plans, and attempts among general practice patients with chronic health conditions in Puerto Rico

    Directory of Open Access Journals (Sweden)

    Sarah Huertas

    2011-03-01

    Full Text Available Mildred Vera2,4, María L Reyes-Rabanillo1, Sarah Huertas3, Deborah Juarbe4, Coralee Pérez-Pedrogo4, Aracelis Huertas5, Marisol Peña61Veterans Affairs Caribbean Healthcare System, San Juan, Puerto Rico; 2Department of Health Services Administration, School of Public Health; 3Department of Psychiatry, School of Medicine; 4Center for Evaluation and Sociomedical Research, School of Public Health; 5School of Health Professions; 6Center for Preparedness in Public Health, School of Public Health, Medical Sciences Campus, University of Puerto Rico San Juan, Puerto Rico.Background: Little is known about suicidal ideation among general practice patients in Puerto Rico. In this study we examined the rates, severity, and correlates of suicidal ideation, plans, and attempts among general practice patients with chronic illnesses. This is important in targeting appropriate interventions and management approaches to minimize and prevent suicide.Methods: We screened patients with chronic physical conditions at general practices. Suicidal ideation was assessed with the suicidality module of the Mini International Neuropsychiatric Interview. Major depression was assessed with the Patient Health Questionnaire depression module. The relationship between sociodemographic factors, depression and suicidal ideation was examined with multiple logistic regression analysis. Among the subgroup that acknowledged suicidal ideation, we used multinomial logistic regression analysis to estimate simultaneously the multivariate associations of depression and sociodemographic factors with suicidality risk levels.Results: Of the 2068 patients screened, 15.4% acknowledged recent suicidal ideation. Among this group, 8.6% reported passive ideation, 3.7% active ideation without a plan, and 3.1% active ideation with a plan or attempt. According to multivariate logistic regression, suicidal ideation was higher among patients with moderately severe depression and severe depression than

  14. Drug repurposing in oncology--patient and health systems opportunities.

    Science.gov (United States)

    Bertolini, Francesco; Sukhatme, Vikas P; Bouche, Gauthier

    2015-12-01

    In most countries, healthcare service budgets are not likely to support the current explosion in the cost of new oncology drugs. Repurposing the large arsenal of approved, non-anticancer drugs is an attractive strategy to offer more-effective options to patients with cancer, and has the substantial advantages of cheaper, faster and safer preclinical and clinical validation protocols. The potential benefits are so relevant that funding of academically and/or independently driven preclinical and clinical research programmes should be considered at both national and international levels. To date, successes in oncology drug repurposing have been limited, despite strong evidence supporting the use of many different drugs. A lack of financial incentives for drug developers and limited drug development experience within the non-profit sector are key reasons for this lack of success. We discuss these issues and offer solutions to finally seize this opportunity in the interest of patients and societies, globally. PMID:26483297

  15. 31B. Health Coaching: Empowering Patients for Behavior Change

    OpenAIRE

    Manning, Linda; Morriss, Blaire

    2013-01-01

    Focus Area: Supporting Behavioral Change Up to half of all premature deaths in the United States are caused by unhealthy lifestyle choices (smoking, poor diet, physical inactivity). The seven “modifiable” chronic diseases (cancer, diabetes, hypertension, stroke, heart disease, pulmonary conditions, and mental disorders) cost $270 billion annually to treat. Patients who are trying to make lifestyle changes often feel overwhelmed and discouraged. As a result, admonishment and education alone ar...

  16. Dynamic Adaptive Remote Health Monitoring for Patients with Chronic Disease

    OpenAIRE

    Suh, Myung-kyung

    2012-01-01

    Chronic diseases are the leading causes of death and disability in the United States. More than 70% of deaths among Americans are caused by chronic diseases and more than 133 million Americans have at least one chronic disease. Due to the prevalence of chronic disease-related issues, it is prudent to seek out methodologies that would facilitate the prevention, monitoring, and feedback for patients with chronic diseases.This dissertation describes WANDA (Weight and Activity with Other Vital Si...

  17. Practical guide on home health in heart failure patients

    OpenAIRE

    Jaarsma, Tiny; Strömberg, Anna; Larsen, Torben

    2013-01-01

    Introduction: Chronic heart failure is a common condition affecting up to 15 million people in the extended Europe. Heart failure is burdensome and costly for patients in terms of decreased quality of life and poor prognosis and it is also costly for society. Better integrated care is warranted in this population and specialized heart failure care can save costs and improve the quality of care. However, only a few European countries have implemented specialized home care and offered this to a...

  18. Unmet health needs in patients with coronary heart disease: implications and potential for improvement in caring services

    OpenAIRE

    Packham Chris; Asadi-Lari Mohsen; Gray David

    2003-01-01

    Abstract Background Improving the quality of health care services requires tailoring facilities to fulfil patients' needs. Satisfying patients' healthcare needs, listening to patients' opinions and building a closer provider-user partnership are central to the NHS. Few published studies have discussed cardiovascular patients' health needs, but they are not comprehensive and fail to explore the contribution of outcome to needs assessment. Method A comprehensive self-administered health needs a...

  19. Health, economic, psychological and social impact of educating carers of patients with advanced pulmonary disease (protocol).

    Science.gov (United States)

    Sladek, R M; Jones, T; Phillips, P A; Luszcz, M; Rowett, D; Eckermann, S; Woodman, R J; Frith, P

    2011-09-01

    People with advanced pulmonary disease (APD), such as those with chronic obstructive pulmonary disease, have markedly impaired quality of life. Home Oxygen Therapy (HOT) itself is burdensome, although it often improves survival duration and quality of life in these patients. The exact burdens on informal caregivers of these patients are unknown. The central purpose of the pragmatic randomized controlled study described in this protocol is to determine the effectiveness of improving the skills and knowledge of carers of patients with APD who use HOT. Specifically we aimed to estimate the incremental impact of this carer intervention above usual care on health, economic, psychological and social domains for patient and carer dyads relative to the level of current burden. Eligible patients and their carers were recruited through three major hospitals, and randomized to an intervention or control group. The carers in the intervention group received two home-delivered education sessions based on the principles of academic detailing. Participants are currently being followed over 12 months. The primary outcome will be the proportion of patients surviving without a chronic obstructive pulmonary disease-related readmission / residential (non respite) care over 12 months. Carer secondary outcomes include perceived caregiver burden, level of expected and received social support, perceived level of mastery, self esteem, health related quality of life and disability, and ability to conduct domestic chores and household maintenance, social activities and provide service to others, and fatigue. Secondary patient outcomes include health related quality of life and disability, and current respiratory health status.

  20. Patient-Staff Interactions and Mental Health in Chronic Dialysis Patients

    Science.gov (United States)

    Swartz, Richard D.; Perry, Erica; Brown, Stephanie; Swartz, June; Vinokur, Amiram

    2008-01-01

    Chronic dialysis imposes ongoing stress on patients and staff and engenders recurring contact and long-term relationships. Thus, chronic dialysis units are opportune settings in which to investigate the impact of patients' relationships with staff on patient well-being. The authors designed the present study to examine the degree to which…

  1. General practitioners' and district nurses' conceptions of the encounter with obese patients in primary health care

    Directory of Open Access Journals (Sweden)

    Rasmussen Finn

    2011-02-01

    Full Text Available Abstract Background Primary health care specialists have a key role in the management of obesity. Through understanding how they conceive the encounter with patients with obesity, treatment may be improved. The aim of this study was thus to explore general practitioners' and district nurses' conceptions of encountering patients with obesity in primary health care. Method Data were collected through semi-structured interviews, and analysed using a phenomenographic approach. The participants were 10 general practitioners (6 women, 4 men and 10 district nurses (7 women, 3 men from 19 primary health care centres within a well-defined area of Sweden. Results Five descriptive categories were identified: Adequate primary health care, Promoting lifestyle change, Need for competency, Adherence to new habits and Understanding patient attitudes. All participants, independent of gender and profession, were represented in the descriptive categories. Some profession and gender differences were, however, found in the underlying conceptions. The general staff view was that obesity had to be prioritised. However, there was also the contradictory view that obesity is not a disease and therefore not the responsibility of primary health care. Despite this, staff conceived it as important that patients were met with respect and that individual solutions were provided which could be adhered to step-by-step by the patient. Patient attitudes, such as motivation to change, evasive behaviour, too much trust in care and lack of self-confidence, were, however, conceived as major barriers to a fruitful encounter. Conclusions Findings from this study indicate that there is a need for development and organisation of weight management in primary health care. Raising awareness of staff's negative views of patient attitudes is important since it is likely that it affects the patient-staff relationship and staff's treatment efforts. More research is also needed on gender and

  2. Type 2 diabetes management: Patient knowledge and health care team perceptions, South Africa

    Directory of Open Access Journals (Sweden)

    Nombeko Mshunqane

    2012-10-01

    Full Text Available Background: South African research indicates that the highest death rates between 2004 and 2005 were from diabetes mellitus. There is minimal research information on interactions between what patients know about their disease and what health professionals perceive thatpatients should know to control their disease well.Objectives: This study determined the knowledge that patients with type 2 diabetes have about the management of their disease, as well as the perceptions of the health care team about the services given to patients.Method: Qualitative data were collected using two focus groups and in-depth interviews. Patient focus group (n = 10 explored patients’ knowledge about management of type 2 diabetes. Patients were recruited from Dr George Mukhari Hospital outpatients’ diabetes clinic. Professional focus group (n = 8 explored the health care team’s experiences, barriers and facilitators in managing the disease. Professional focus group participants were recruited because of their expertise in chronic disease management, working in the community (public health or working directly with patients with type 2 diabetes. Five health care professionals were interviewed using the same guide of questions as for the focus group.Results: Participants identified type 2 diabetes as a chronic disease that needs behaviour change for good control. Five major themes were identified: patients’ knowledge; education programmes; behaviour change; support; and a patient-centred approach.Conclusion: Management of type 2 diabetes may be enhanced by reinforcing patients’ knowledge, encouraging behaviour change whilst taking into consideration patients’ backgrounds. The health care team needs to utilise a patient-centred approach.

  3. mHealth tools for the pediatric patient-centered medical home.

    Science.gov (United States)

    Slaper, Michael R; Conkol, Kimberly

    2014-02-01

    The concept of the pediatric patient-centered medical home (PCMH) as a theory has been evolving since it was initially conceived more than 40 years ago. When the American Academy of Pediatrics' (AAP) Council on Pediatric Practice first wrote about this model, "medical home" was defined solely as the central location of a pediatric patient's medical records. Approximately two decades later, the AAP published its inaugural policy statement on this topic. Through this policy statement, the medical home was defined as a place where care for pediatric patients would be accessible, continuous, comprehensive, family-centered, coordinated, compassionate, and culturally effective. Although the lack of access to providers, especially in rural communities, may inhibit the adoption of the PCMH or chronic care models, technology has evolved to the point where many of the gaps in care can be bridged. mHealth, defined by the National Institutes of Health (NIH) as the use of mobile and wireless devices to improve health outcomes, health care services, and health research, can be one specific example of how technology can address these issues. One early study has shown that patients who use mHealth tools are more likely to adhere to self-monitoring requirements and, in turn, have significantly improved outcomes. A rapidly evolving and scalable mHealth technology that has the ability to address these issues are self-management mobile applications, or apps. It has been estimated that there are currently more than 40,000 health care-related apps available. Furthermore, use of these apps is growing, as more than 50% of smartphone users surveyed responded that they have used their device to gather health information, and almost 20% of this population has at least one health care app on their device.

  4. Self-esteem, stress and self-rated health in family planning clinic patients

    Science.gov (United States)

    Rohrer, James E; Young, Rodney

    2004-01-01

    Background The independent effects of stress on the health of primary care patients might be different for different types of clinic populations. This study examines these relationships in a low-income female population of patients attending a family planning clinic. Methods This study investigated the relevance of different sources of personal stress and social support to self-rated health, adjusting for mental health, health behavior and demographic characteristics of subjects. Five hundred women who attended family planning clinics were surveyed and 345 completed the form for a response rate of 72 percent. Results Multiple logistic regression analysis revealed that liking oneself was related to good self-rated health (Odds ratio = 7.11), but stress or support from children, parents, friends, churches or spouses were not significant. White non-Hispanic and non-white non-Hispanic respondents had lower odds of reporting good self-rated health than Hispanic respondents (odds ratios were 2.87 and 2.81, respectively). Exercising five or more days per week also was related to good self-rated health. Smoking 20 or more cigarettes per day, and obese III were negatively related to good self-rated health (odds ratios were .19 and .22, respectively with corresponding p-values equal to .0043 and .0332). Conclusions Among younger low-income women, addressing low self-esteem might improve health status. PMID:15176984

  5. Bringing electronic patient records into health professional education: towards an integrative framework.

    Science.gov (United States)

    Kushniruk, Andre W; Borycki, Elizabeth M; Armstrong, Brian; Joe, Ron; Otto, Tony

    2009-01-01

    In this paper we discuss our approach for integrating electronic patient records into health professional education. Electronic patient record (EPR) use is increasing globally. The EPR is considered the cornerstone of the modernization and streamlining of healthcare worldwide. However, despite the importance of the EPR, health professional education in much of the world provides health professional students (who will become the practicing health professionals of the future) with limited access or knowledge about the EPR. New ways of exposing students to EPRs will be needed in order to ensure that health professionals will adopt and use this complex technology wisely and effect the positive benefits EPRs are expected to bring to healthcare globally. In this paper we describe: (a) a framework we have developed for integrating EPRs into health professional education and (b) an innovative Web portal, known as the University of Victoria Electronic Health Record (EHR) Educational Portal (which houses a number of EPRs) that can be used to explore the integration of EPRs in health professional education. It is hoped that adoption and use of EPRs will ultimately be improved through the use of the portal to allow students virtual and ubiquitous access to example EPRs, coupled with principled educational approaches for integrating EPR technology into health professional curricula.

  6. Self-esteem, stress and self-rated health in family planning clinic patients

    Directory of Open Access Journals (Sweden)

    Young Rodney

    2004-06-01

    Full Text Available Abstract Background The independent effects of stress on the health of primary care patients might be different for different types of clinic populations. This study examines these relationships in a low-income female population of patients attending a family planning clinic. Methods This study investigated the relevance of different sources of personal stress and social support to self-rated health, adjusting for mental health, health behavior and demographic characteristics of subjects. Five hundred women who attended family planning clinics were surveyed and 345 completed the form for a response rate of 72 percent. Results Multiple logistic regression analysis revealed that liking oneself was related to good self-rated health (Odds ratio = 7.11, but stress or support from children, parents, friends, churches or spouses were not significant. White non-Hispanic and non-white non-Hispanic respondents had lower odds of reporting good self-rated health than Hispanic respondents (odds ratios were 2.87 and 2.81, respectively. Exercising five or more days per week also was related to good self-rated health. Smoking 20 or more cigarettes per day, and obese III were negatively related to good self-rated health (odds ratios were .19 and .22, respectively with corresponding p-values equal to .0043 and .0332. Conclusions Among younger low-income women, addressing low self-esteem might improve health status.

  7. Health Related Quality of Life May Increase when Patients with a Stoma Attend Patient Education – A Case-Control Study

    OpenAIRE

    Anne Kjaergaard Danielsen; Jacob Rosenberg

    2014-01-01

    INTRODUCTION: Adaptation to living with a stoma is complex, and studies have shown that stoma creation has a great impact on patients' health related quality of life. The objective was to explore the effect of a structured patient education program on health related quality of life. Therefore, we implemented interventions aimed at increasing health related quality of life during and after hospital admission. MATERIALS AND METHODS: We designed a case/control study aimed at adult patients admit...

  8. Health-related behavior, profile of health locus of control and acceptance of illness in patients suffering from chronic somatic diseases.

    Directory of Open Access Journals (Sweden)

    Konrad Janowski

    Full Text Available PURPOSE: The purpose of the study was to determine health-related behaviors, profile of health locus of control (HLC, and to assess the relationships between these constructs among patients suffering from chronic somatic diseases. MATERIAL AND METHODS: Three-hundred adult patients suffering from various chronic diseases participated in the study. The patients' mean age was 54.6 years (SD = 17.57. RESULTS: No statistically significant differences were found between the different clinical groups in health-related behavior, acceptance of illness, internal HLC or chance HLC. Patients with neurologic conditions showed slightly lower powerful others HLC than did some other clinical groups. Health-related behavior was significantly positively related to all three categories of HLC, with most prominent associations observed with powerful others HLC. Only one type of health-related behavior--preventive behavior--correlated significantly and negatively with acceptance of illness. Differences in the frequency of health-related behavior were also found due to gender (women showing more healthy nutritional habits than men, age (older subjects showing more frequent health-promoting behavior, education (higher education was associated with less frequent health-promoting behavior and marital status (widowed subjects reporting more frequent health-promoting behavior. CONCLUSIONS: Health-related behavior in patients with chronic diseases seems to be unrelated to a specific diagnosis; however it shows associations with both internal and external HLC. Sociodemographic factors are also crucial factors determining frequency of health-related behavior in such patients.

  9. A Population Health Approach to Clinical Social Work with Complex Patients in Primary Care.

    Science.gov (United States)

    Rose, Stephen M; Hatzenbuehler, Stephanie; Gilbert, Erika; Bouchard, Mark P; McGill, Debra

    2016-05-01

    Chronic diseases disproportionately occur among people from disadvantaged backgrounds. These backgrounds correlate with poor health in adulthood. Capacity for patients' to collaborate in their care tends to be lower than among other patients, leading to inefficient uses in medical services and higher risk of adverse events. In the course of this study, social workers engaged patients with increased inpatient and emergency department (ED) use and barriers to self-management, and evaluated them for lifetime exposure to material disadvantage and violence. Intervention focused on creating a primary care team that improved patients' self-efficacy, increased locus of control, and improved capacity for engagement. Results include a 49 percent decrease in admissions and a 5 percent decrease in ED utilization with significant cost savings. Authors recommend further study to analyze social, clinical, and financial risk in a larger sample, which may yield information about a health care provider's most at-risk patients for early targeted intervention. PMID:27263199

  10. Self-rated health and employment status in chronic haemodialysis patients

    DEFF Research Database (Denmark)

    Molsted, Stig; Aadahl, Mette; Schou, Lone;

    2004-01-01

    OBJECTIVE: Along with survival and other types of clinical outcome, physical, mental and social well-being are important indicators of the effectiveness of the medical care that haemodialysis (HD) patients receive. The present cross-sectional study was designed to assess self-rated health in HD...... obtained from hospital records. RESULTS: A total of 112 patients completed the questionnaire, giving a response rate of 75%. Compared to the general population sample, HD patients scored significantly lower on all eight SF-36 scales (p ... concerning physical functioning. No correlation was found between any of the eight scales and estimates of dialysis adequacy. Of patients aged 18-60 years, 22% were in employment. CONCLUSION: In a large group of Danish HD patients, self-rated health (and especially physical function) was found...

  11. The Unsuspecting CAM User: Cancer patients and the changing nature of holistic health

    Directory of Open Access Journals (Sweden)

    A M. Kabel

    2014-05-01

    Full Text Available The number of cancer patients using complementary and alternative medicine (CAM in the United States is growing, yet little is known about the meaning these activities have for users. Current literature supports the assumption that stigma surrounding CAM and holistic health practices are responsible for the reluctance of many cancer patients to self-identify as CAM users. This study explored the frequency of use, and familiarity with CAM among 25 female patients at a Midwestern oncology clinic. Findings suggest that patients need to be asked about CAM use multiple times and in multiple formats to gain an accurate assessment. Also, the assumptions about stigma may no longer be the reason patients are less than forthcoming about CAM use. The rise of integrative medicine and shifting boundaries of the holistic health movement may be equally, or in some cases, more responsible for the reluctance for CAM users to self-identify.

  12. Health status of diabetes type 2 patients in Thailand contradicts their perception and admitted compliance.

    Science.gov (United States)

    Srivanichakorn, Supattra; Sukpordee, Nattaporn; Yana, Tassanee; Sachchaisuriya, Pattara; Schelp, Frank Peter

    2011-10-01

    A nationwide data set about the health status of diabetes mellitus type 2 (DM) patients and a questionnaire of a sub-sample of the DM patients about their know-how, behavior and perception about health care had been re-assessed. Laboratory results revealed that in average 70% of the patients had been over nourished, over 50% had abnormal cholesterol-, over 55% had high triglyceride levels and 51% had high density lipid (HDL) values below 45 mg/dl. Sixty percent of patients had glycated hemoglobin (HbA1c) levels over 7%. About 60% of study participants answered a questionnaire. In contrast to the laboratory findings about 90% claimed to take the medicine as the doctor advised, 60% said that they adjusted their food intake as advised and more than 80% said that they know well how to take care of themselves. They were only superficially informed about the complications of DM. Almost 95% were satisfied with the health service they receive and over 70% were satisfied with their health status. The results are discussed in connection with the need to control DM on the basis of primary health care (PHC). It is argued that the assessment of health programs solely through questionnaires might be misleading, if the findings are not confirmed by clinical and biochemical parameters.

  13. Comparing health locus of control in patients with Spasmodic Dysphonia, Functional Dysphonia and Nonlaryngeal Dystonia.

    Science.gov (United States)

    Haselden, Karen; Powell, Theresa; Drinnan, Mike; Carding, Paul

    2009-11-01

    Locus of Control (LoC) refers to an individuals' perception of whether they are in control of life events. Health Locus of Control refers to whether someone feels they have influence over their health. Health Locus of Control has not been studied in any depth in voice-disordered patients. The objective of this study was to examine Health Locus of Control in three patient groups: (1) Spasmodic Dysphonia, (2) Functional Dysphonia and (3) a nondysphonic group with Nonlaryngeal Dystonia. LoC was measured and compared in a total of 57 patients using the Multidimensional Health Locus of Control Scales (diagnostic specific) Form C. Internal, Chance, and Powerful others LoC were measured and comparisons were made using one-way analysis of variance. Contrary to expectations Internal LoC was found to be significantly higher in the Functional Dysphonia group when compared to the other two groups. There was no significant difference between the groups in Chance or Powerful others LoC. The two organic groups, Spasmodic Dysphonia and Nonlaryngeal Dystonia, were more alike in Internal Health Locus of Control than the Functional Dysphonia group. The diagnostic nature of the groups was reflected in their LoC scores rather than their voice loss. These results contribute to the debate about the etiology of Spasmodic Dysphonia and will be of interest to those involved in the psychology of voice and those managing voice-disordered patients.

  14. Spanish consensus on the physical health of patients with depressive disorders.

    Science.gov (United States)

    Giner, José; Saiz Ruiz, Jerónimo; Bobes, Julio; Zamorano, Enric; López, Francisco; Hernando, Teresa; Rico-Villademoros, Fernando; Álamo, Cecilio; Cervilla, Jorge A; Ibáñez Cuadrado, Ángela; Ibáñez Guerra, Elena; López, Silvia; Morán, Pedro; Palao, Diego J; Romacho, Montserrat

    2014-01-01

    Comorbidity between depression and physical illnesses is very common and has a significant impact on the health and management of the patient. With the support of the Sociedades Españolas de Psiquiatría y Psiquiatría Biológica, and Sociedad Española de Médicos de Atención Primaria (SEMERGEN) a consensus was prepared on physical health in patients with depression and is summarized in the present work. The literature review highlighted the high frequency of cardiovascular and endocrine-metabolic disorders in patients with depression such as diabetes and obesity, thus making the primary and secondary prevention recommendations for patients with cardiovascular or metabolic risk applicable to patients with depression. Comorbidity between depression and chronic pain is also frequent, and requires an integrated therapeutic approach. The presence of physical illness in patients with depression may condition, but not preclude, the pharmacological treatment; drug selection should take into account potential side-effect and drug-drug interactions. On the other hand, psychotherapy may contribute to the patient's recovery. Overall, coordination between the primary care physician, the psychiatrist and other health professionals involved is essential for the management of patients with depression and concomitant physical illness.

  15. Health literacy and computer-assisted instruction: usability and patient preference.

    Science.gov (United States)

    Duren-Winfield, Vanessa; Onsomu, Elijah O; Case, Douglas L; Pignone, Michael; Miller, David

    2015-04-01

    The authors investigated the feasibility of using computer-assisted instruction in patients of varying literacy levels by examining patients' preferences for learning and their ability to use 2 computer-based educational programs. A total of 263 participants 50-74 years of age with varying health literacy levels interacted with 1 of 2 educational computer programs as part of a randomized trial of a colorectal cancer screening decision aid. A baseline and postprogram evaluation survey were completed. More than half (56%) of the participants had limited health literacy. Regardless of literacy level, doctors were the most commonly used source of medical information-used frequently by 85% of limited and adequate literacy patients. In multivariate logistic regression, only those with health insurance (OR = 2.35, p = .06) and computer use experience (OR = 0.39, p = .03) predicted the ability to complete the programs without assistance compared with those without health insurance or prior computer use, respectively. Although patients with limited health literacy had less computer experience, the majority completed the programs without any assistance and stated that they learned more than they would have from a brochure. Future research should investigate ways that computer-assisted instruction can be incorporated in medical care to enhance patient understanding. PMID:25719814

  16. Glycaemic control of diabetic patients in an urban primary health care setting in Sarawak: the Tanah Puteh Health Centre experience.

    Science.gov (United States)

    Wong, J S; Rahimah, N

    2004-08-01

    Achieving glycaemic goals in diabetics has always been a problem, especially in a developing country with inadequate facilities such as in Sarawak in Malaysia. There are no reported studies on the control of diabetes mellitus in a diabetic clinic in the primary health care setting in Sarawak. This paper describes the profile of 1031 patients treated in Klinik Kesihatan Tanah Puteh Health Centre. The mean age was 59 years, the mean BMI 27 kg/m2. There was a female preponderance and mainly type-2 diabetes. Mean HbA1c was 7.4%. Glycaemic control was optimal in 28% (HbA1c 7.5%). Reasonable glycaemic control can be achieved in the primary health care setting in Sarawak. PMID:15727390

  17. Treatment patterns, health state, and health care resource utilization of patients with radioactive iodine refractory differentiated thyroid cancer

    Science.gov (United States)

    Gianoukakis, Andrew G; Flores, Natalia M; Pelletier, Corey L; Forsythe, Anna; Wolfe, Gregory R; Taylor, Matthew H

    2016-01-01

    Background Patients with differentiated thyroid cancer (DTC) often respond well to treatment but some become refractory to radioactive iodine (RAI) treatment, and treatment options are limited. Despite the humanistic and economic burden RAI refractory disease imposes on patients, published research concerning treatment patterns and health care resource utilization is sparse. Methods Data were collected from an online retrospective chart review study in the US and five European Union (EU) countries (France, Germany, Italy, Spain, and UK) with physicians recruited from an online panel. Physicians (N=211) provided demographics, disease history, treatment information, and health care resource utilization for one to four of their patients with radioactive iodine refractory differentiated thyroid cancer (RR-DTC). Results The majority of the patients with RR-DTC (N=623) were female (56%), and their mean age was 58.2 years. In this sample, 63.2% had papillary thyroid cancer and 57.0% were in Stage IV when deemed RAI refractory. Patients with RR-DTC experienced regional recurrence in the thyroid bed/central neck area (25.3%) and had distant metastatic disease (53.6%). At the time data were collected, 50.7% were receiving systemic treatment. Of those, 78.5% were on first-line treatment and 62.7% were receiving multikinase inhibitors. Regional differences for prescribed treatments were observed; the US was more likely to have patients receiving multikinase inhibitors (79.2%) compared with UK (41.2%) and Italy (17.1%). Additional details regarding treatment patterns and resource utilization are discussed. Conclusion The current study aimed to obtain a greater understanding of RR-DTC treatment globally. These results can assist in the development and implementation of treatment guidelines and ultimately enhance the care of patients with RR-DTC. PMID:27313476

  18. Front-line worker engagement: greening health care, improving worker and patient health, and building better jobs.

    Science.gov (United States)

    Chenven, Laura; Copeland, Danielle

    2013-01-01

    Frontline workers have a great deal to contribute to improving environmental sustainability of their employers and the health of workers and patients. This article discusses a national project of the Healthcare Career Advancement Program, funded by the U.S. Department of Labor to support green jobs development. Implementation was accomplished through a labor/management collaboration between union locals and 11 employers in four regions throughout the United States. The project developed and implemented a model of training and education for environmental service workers and other frontline health-care workers in hospital settings that supported systems change and built new roles for these workers. It empowered them to contribute to triple bottom line outcomes in support of People (patients, workers, the community), Planet (environmental sustainability and a lower carbon footprint), and Profit (cost savings for the institutions). In the process workers more clearly articulated their important role as a part of the healthcare team and learned how they could contribute to improved patient and worker health and safety.

  19. Health System Quality Improvement: Impact of Prompt Nutrition Care on Patient Outcomes and Health Care Costs.

    Science.gov (United States)

    Meehan, Anita; Loose, Claire; Bell, Jvawnna; Partridge, Jamie; Nelson, Jeffrey; Goates, Scott

    2016-01-01

    Among hospitalized patients, malnutrition is prevalent yet often overlooked and undertreated. We implemented a quality improvement program that positioned early nutritional care into the nursing workflow. Nurses screened for malnutrition risk at patient admission and then immediately ordered oral nutritional supplements for those at risk. Supplements were given as regular medications, guided and monitored by medication administration records. Post-quality improvement program, pressure ulcer incidence, length of stay, 30-day readmissions, and costs of care were reduced. PMID:26910129

  20. Current practice of glucocorticoid replacement therapy and patient-perceived health outcomes in adrenal insufficiency - a worldwide patient survey

    Directory of Open Access Journals (Sweden)

    Forss M

    2012-06-01

    Full Text Available Abstract Background The aim was to survey current practice in glucocorticoid replacement therapy and self-perceived health outcomes in patients with adrenal insufficiency. Methods Participants were recruited via patient organizations to respond anonymously to a web-based survey developed by clinical experts. Unique entries were set up for each patient organization enabling geographical localization of the entries. Results 1245 participants responded (primary adrenal insufficiency: 84%; secondary adrenal insufficiency: 11%; unsure: 5%. Therapies included hydrocortisone (75%, prednisone/prednisolone (11%, cortisone acetate (6% and dexamethasone (4%. Dosing regimens were once daily (10%, twice daily (42%, thrice daily (32% or other (17%. Compromised subjective health necessitating changes to physical activity or social-, work- or family life was reported by 64% of the participants. 40% of the participants reported absence from work/school in the last 3 months. Irrespective of diagnosis, 76% were concerned about long-term side-effects of therapy, mainly osteoporosis (78%, obesity (64% and cardiovascular morbidity (46%. 38% of the participants had been hospitalized in the last year. Conclusions Glucocorticoid replacement therapy among the respondents consisted primarily of hydrocortisone administered twice or thrice daily. A majority reported impact of their disease or treatment on subjective health requiring alterations in e.g. physical activity or family life. Three quarters reported concerns about long-term side-effects of the treatment. These data demonstrate - from the patients' perspective - a need for improvement in the management of adrenal insufficiency.

  1. Physician Cross-Cultural Nonverbal Communication Skills, Patient Satisfaction and Health Outcomes in the Physician-Patient Relationship

    Directory of Open Access Journals (Sweden)

    Ken Russell Coelho

    2012-01-01

    Full Text Available Recent empirical findings document the role of nonverbal communication in cross-cultural interactions. As ethnic minority health disparities in the United States continue to persist, physician competence in this area is important. We examine physicians' abilities to decode nonverbal emotions across cultures, our hypothesis being that there is a relationship between physicians' skill in this area and their patients' satisfaction and outcomes. First part tested Caucasian and South Asian physicians' cross-cultural emotional recognition ability. Physicians completed a fully balanced forced multiple-choice test of decoding accuracy judging emotions based on facial expressions and vocal tones. In the second part, patients reported on satisfaction and health outcomes with their physicians using a survey. Scores from the patient survey were correlated with scores from the physician decoding accuracy test. Physicians, regardless of their ethnicity, were more accurate at rating Caucasian faces and vocal tones. South Asian physicians were no better at decoding the facial expressions or vocal tones of South Asian patients, who were also less likely to be satisfied with the quality of care provided by their physicians and to adhere to their physicians' recommendations. Implications include the development of cultural sensitivity training programs in medical schools, continuing medical education and public health programs.

  2. Public and/or private health care: Tuberculosis patients' perspectives in Myanmar

    Directory of Open Access Journals (Sweden)

    Sein Than

    2009-07-01

    Full Text Available Abstract Background Tuberculosis is a major public health problem in Myanmar as in other developing countries. About 73% of TB patients seek care at private general practitioners' clinics before presenting to the public TB centre, raising questions about how best to prevent transmission and maintain treatment regimens. Method The study was conducted in two townships in Yangon Division in Myanmar in 2004, and examined treatment seeking behaviour of TB patients and their views towards public and private health care services. This was an exploratory descriptive study. Both quantitative and qualitative research methods were employed in data collection from TB patients, health care professionals, and members of various agencies involved in TB Control Programme. Results A considerable delay was found between the onset of symptoms of TB and seeking treatment (five days – two months. General practitioners were the first point of contact in all cases. Old TB patients influenced the treatment seeking behaviour and choice of treatment clinics of new TB patients. Most patients viewed the public health sector as a place to obtain free treatment and the private sector as a fee-paying, convenient and better place to seek treatment. Conclusion The involvement of private general practitioners is crucial for effective TB control in Myanmar. The selection of GPs for partnership with the public sector is vital to the success of public-private partnership in controlling TB.

  3. Is Canada ready for patient accessible electronic health records? A national scan

    Directory of Open Access Journals (Sweden)

    Eysenbach Gunther

    2008-07-01

    Full Text Available Abstract Background Access to personal health information through the electronic health record (EHR is an innovative means to enable people to be active participants in their own health care. Currently this is not an available option for consumers of health. The absence of a key technology, the EHR, is a significant obstacle to providing patient accessible electronic records. To assess the readiness for the implementation and adoption of EHRs in Canada, a national scan was conducted to determine organizational readiness and willingness for patient accessible electronic records. Methods A survey was conducted of Chief Executive Officers (CEOs of Canadian public and acute care hospitals. Results Two hundred thirteen emails were sent to CEOs of Canadian general and acute care hospitals, with a 39% response rate. Over half (54.2% of hospitals had some sort of EHR, but few had a record that was predominately electronic. Financial resources were identified as the most important barrier to providing patients access to their EHR and there was a divergence in perceptions from healthcare providers and what they thought patients would want in terms of access to the EHR, with providers being less willing to provide access and patients desire for greater access to the full record. Conclusion As the use of EHRs becomes more commonplace, organizations should explore the possibility of responding to patient needs for clinical information by providing access to their EHR. The best way to achieve this is still being debated.

  4. [Why do cardiologists disregard sexual health of their patients? A critical review].

    Science.gov (United States)

    Scardi, Sabino

    2016-05-01

    Sexual activity is an essential aspect of normal human function, well-being and quality of life. Sexual dysfunction is a common problem of increasing incidence in patients with cardiovascular disease, particularly younger and male, and continues over time in life, but these issues are not often discussed in daily practice both for a limited patient-physician relationship and clinicians' poor knowledge. Many studies suggest that the majority of patients and their partners have questions or concerns about their sexual health. Healthcare providers can help their patients if they are aware of the problem. Cardiologists need more knowledge and specific practical training in providing information on sexual concerns and sexual counseling to cardiac patients. This review aims at providing clinicians with most recent evidence about sexual dysfunction, and its management in patients with cardiac disease. Sexual couseling of cardiac patients is an important role for healthcare providers.

  5. Urostomy and health-related quality of life in patients with lower urinary tract dysfunction

    DEFF Research Database (Denmark)

    Schultz, Alexander; Boye, Birgitte; Jonsson, Olof;

    2015-01-01

    complications, loss of kidney function and hospital stay, in these patients. Material and methods. This prospective study included 52 consecutive patients (nine men and 43 women) with various benign disorders. Twenty-six patients received an ileal conduit and 26 a continent cutaneous diversion. The patients...... improvement between patients with continent and those with incontinent diversion. Mean hospital stay was 14 days. Early and late complications required open surgery in 12 patients (23%). GFR was unchanged postoperatively. Conclusions.Urinary diversion improves health-related and disease-specific quality of......Abstract Objective.Urinary diversion may be an option in patients with disabling lower urinary tract dysfunction (DLUTD), refractory to conservative and minor invasive treatment. The aim of this study was to evaluate whether urostomy improves quality of life and cost of surgery, in terms of...

  6. Valuation of transfusion-free living in MDS: results of health utility interviews with patients

    Directory of Open Access Journals (Sweden)

    Lübbert Michael

    2009-09-01

    Full Text Available Abstract Background This study measured how myelodysplastic syndrome (MDS patients value transfusion independence (TI, reduced transfusions (RT and transfusion-dependence (TD using health utility assessment methodology. Methods 47 MDS patients were interviewed, US (n = 8, France (n = 9, Germany (n = 9 and the UK (n = 21, to elicit the utility value of TI, RT and TD. Health states were developed based on literature; patient forum discussions; and were validated by a hematologist. Face-to-face interviews used the feeling thermometer Visual Analogue Scale (VAS and the Time Trade-Off (TTO method to value the health states on a 0 (dead to 1 (perfect health scale. Socio-demographic, clinical, and quality-of-life (EQ-5D characteristics were surveyed to describe the patient sample. Results and Discussion The mean age was 67 years (range: 29-83; 45% male, 70% retired; 40% had secondary/high school education, or higher (32%, and 79% lived with family, a partner or spouse, or friends. The mean time from MDS diagnosis was 5 years (range:1-23. Most patients (87% received previous transfusions and 49% had received a transfusion in the last 3 months. Mean EQ-5D index score was 0.78; patients reported at least some problem with mobility (45%, usual activities (40%, pain/discomfort (47%, and anxiety/depression (34%. Few patients had difficulty understanding the VAS (n = 3 and TTO (n = 4 exercises. Utility scores for TI were higher than for RT (0.84 vs. 0.77; p Conclusion Patients value TI, suggesting an important role for new treatments aiming to achieve greater TI in MDS. These results can be used in preference-based health economic evaluation of new MDS treatments, such as in future cost-utility studies.

  7. Effect of Educational Level on Oral Health in Peritoneal and Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Gulsen Bayraktar

    2009-01-01

    Results. Significantly higher numbers of filled teeth (P<.001 and lower PI values (P<.01 in the PD group were detected with higher educational levels, whereas no significance was detected in the HD group. Higher DMFT index values were assessed in the lower educated and high school levels in PD than HD patients (P<.05. Higher numbers of filled teeth (P<.05 were detected in the secondary school level in PD patients. This difference was even more significant in the high school level (P<.001. Conclusion. We assume that PD patients, who were found to be in a higher educational level, are more caring for their oral health as compared to HD patients.

  8. Development of scales to assess patients' perception of physicians' cultural competence in health care interactions.

    Science.gov (United States)

    Ahmed, Rukhsana; Bates, Benjamin R

    2012-07-01

    This study describes the development of scales to measure patients' perception of physicians' cultural competence in health care interactions and thus contributes to promoting awareness of physician-patient intercultural interaction processes. Surveys were administrated to a total of 682 participants. Exploratory factor analyses were employed to assess emergent scales and subscales to develop reliable instruments. The first two phases were devoted to formative research and pilot study. The third phase was devoted to scale development, which resulted in a five-factor solution to measure patient perception of physicians' cultural competence for patient satisfaction. PMID:22477717

  9. Development of scales to assess patients' perception of physicians' cultural competence in health care interactions.

    Science.gov (United States)

    Ahmed, Rukhsana; Bates, Benjamin R

    2012-07-01

    This study describes the development of scales to measure patients' perception of physicians' cultural competence in health care interactions and thus contributes to promoting awareness of physician-patient intercultural interaction processes. Surveys were administrated to a total of 682 participants. Exploratory factor analyses were employed to assess emergent scales and subscales to develop reliable instruments. The first two phases were devoted to formative research and pilot study. The third phase was devoted to scale development, which resulted in a five-factor solution to measure patient perception of physicians' cultural competence for patient satisfaction.

  10. Health-related quality of life in patients with Chagas disease

    OpenAIRE

    Bruna Guimarães Oliveira; Mery Natali Silva Abreu; Claudia Drummond Guimarães Abreu; Manoel Otavio da Costa Rocha; Antonio Luiz Ribeiro

    2011-01-01

    INTRODUCTION: Chagas disease (ChD) is a chronic illness related to significant morbidity and mortality that can affect the quality of life (QoL) of infected patients. However, there are few studies regarding QoL in ChD. The objectives of this study are to construct a health-related QoL (HRQoL) profile of ChD patients and compare this with a non-ChD (NChD) group to identify factors associated with the worst HRQoL scores in ChD patients. METHODS: HRQoL was investigated in 125 patients with ChD ...

  11. Empowered patient or empowered physician: an analysis of the importance of the empowered patient in the health delivery system.

    Science.gov (United States)

    Barham, Vicky; Devlin, Rose Anne; Wang, Xiaochuan

    2008-01-01

    This paper develops a simple theoretical model which compares resource allocation in the health care system when physicians are empowered with the decisions taken when patients are empowered. We show that even when there is no asymmetry of information, the institutional arrangement (empowered patient or empowered physician) matter. Ceteris paribus, we find that patients demand more time with physicians when they are empowered (relative to the situation when physicians are empowered), whereas physicians want to spend more time developing their expertise when they are empowered. The reaction of physicians and patients to changes in policy instruments also differs across institutional arrangements. The analysis draws attention to the design of the compensation scheme for physicians, and shows that a non-linear scheme is generally optimal for access to resources if physicians are empowered. PMID:18447064

  12. Teaching Health Sciences Students about Culturally Sensitive Communication between Health Professionals and Patients from Diverse Cultures

    Science.gov (United States)

    Olivares, Mónica; Pena, Carmen

    2015-01-01

    As members of a nationally accredited research project (I?+?D+i) InterMED (ref.: FF2011-25500) being carried out in the field of Intercultural Mediation, we are aware of the mediator's delicate role in communicative interactions between health professionals and foreign population. Sales has pointed out the dangers of stereotyping minorities…

  13. Patient-reported health as a prognostic factor for adverse events following percutaneous coronary intervention

    Directory of Open Access Journals (Sweden)

    Biering K

    2014-01-01

    Full Text Available Karin Biering,1 Hans Erik Bøtker,2 Troels Niemann,3 Niels Henrik Hjollund4,51Department of Occupational Medicine, Regional Hospital West Jutland, Herning, 2Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, 3Department of Cardiology, Regional Hospital West Jutland, Herning, 4WestChronic, Regional Hospital West Jutland, Herning, 5Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, DenmarkObjective: A relation may exist between self-reported health and adverse events in coronary heart disease. Previous studies have been vulnerable to possible selection bias. In the study reported here, we examined the association between self-rated health and adverse events in terms of cardiac events, cardiac readmissions, and all-cause mortality in a complete cohort of patients treated with percutaneous coronary intervention (PCI.Study design and setting: A cohort of patients with coronary heart disease treated with PCI was followed up with questionnaires 4 weeks after PCI to measure self-rated health and in registers to identify adverse events. Of 1,752 eligible patients under 67 years, 26 died during the first 4 weeks. A total of 224 patients were excluded from the analysis because they were readmitted with a cardiac diagnosis before answering the first questionnaire. We received complete SF-12 Health Survey component summaries from 984 of the remaining 1,502 patients. We used multiple imputation to establish a complete cohort, including nonrespondents.Results: During follow-up, 83 patients died, 220 patients experienced a new cardiac event, and 526 patients experienced a hospital readmission related to coronary heart disease. Poor self-rated health was related to cardiac events, cardiac readmission, and all-cause mortality. The associations were stronger for all-cause mortality than for events and readmissions. Physical health was more important than mental health, but both revealed an exposure–response pattern

  14. Meta-synthesis exploring barriers to health seeking behaviour among Malaysian breast cancer patients.

    Science.gov (United States)

    Yu, Foo Qing; Murugiah, Muthu Kumar; Khan, Amer Hayat; Mehmood, Tahir

    2015-01-01

    Barriers to health seeking constitute a challenging issue in the treatment of breast cancer. The current meta- synthesis aimed to explore common barriers to health seeking among Malaysian breast cancer patients. From the systematic search, nine studies were found meeting the inclusion criteria. Data extraction revealed that health behavior towards breast cancer among Malaysia women was influenced by knowledge, psychological, sociocultural and medical system factors. In terms of knowledge, most of the Malaysian patients were observed to have cursory information and the reliance on the information provided by media was limiting. Among psychological factors, stress and sense of denial were some of the common factors leading to delay in treatment seeking. Family member's advice, cultural beliefs towards traditional care were some of the common sociocultural factors hindering immediate access to advanced medical diagnosis and care. Lastly, the delay in referral was one of the most common health system-related problems highlighted in most of the studies. In conclusion, there is an immediate need to improve the knowledge and understanding of Malaysian women towards breast cancer. Mass media should liaise with the cancer specialists to disseminate accurate and up-to-date information for the readers and audience, helping in modification of cultural beliefs that hinder timing health seeking. However, such intervention will not improve or rectify the health system related barriers to treatment seeking. Therefore, there is an immediate need for resource adjustment and training programs among health professional to improve their competency and professionalism required to develop an efficient health system.

  15. Commentary: Personalized health planning and the Patient Protection and Affordable Care Act: an opportunity for academic medicine to lead health care reform.

    Science.gov (United States)

    Dinan, Michaela A; Simmons, Leigh Ann; Snyderman, Ralph

    2010-11-01

    The Patient Protection and Affordable Care Act of 2010 (PPACA) mandates the exploration of new approaches to coordinated health care delivery--such as patient-centered medical homes, accountable care organizations, and disease management programs--in which reimbursement is aligned with desired outcomes. PPACA does not, however, delineate a standardized approach to improve the delivery process or a specific means to quantify performance for value-based reimbursement; these details are left to administrative agencies to develop and implement. The authors propose that coordinated care can be implemented more effectively and performance quantified more accurately by using personalized health planning, which employs individualized strategic health planning and care relevant to the patient's specific needs. Personalized health plans, developed by providers in collaboration with their patients, quantify patients' health and health risks over time, identify strategies to mitigate risks and/or treat disease, deliver personalized care, engage patients in their care, and measure outcomes. Personalized health planning is a core clinical process that can standardize coordinated care approaches while providing the data needed for performance-based reimbursement. The authors argue that academic health centers have a significant opportunity to lead true health care reform by adopting personalized health planning to coordinate care delivery while conducting the research and education necessary to enable its broad clinical application. PMID:20844424

  16. The Empowerment of Patients with Mental Conditions and Addictions through e-Health.

    Science.gov (United States)

    Nakos, Giorgos; Magita, Andrianna; Mechili, Aggelos E; Diomidous, Marianna; Mantas, John

    2015-01-01

    The aim of the current paper is the imparting of useful information to both patients and people in general regarding the development of mental conditions based on drug addictions, through e-health. It will provide all related information in order to achieve the empowerment of the selected sample regarding their conditions in terms of conceptualizing their health status. The general part is consisting of an overview on patient empowerment and e-health. The special part refers to the details of developing and presenting the above mentioned website. The information presented in the web site is addressing the general population and not only patients suffering a mental condition or addiction. The website contains the related articles and information obtained from the related bibliographical search. The main goal of the website is to impart concise information on the related issues.

  17. Reflections on the development of health care and patients' rights in Croatia.

    Science.gov (United States)

    Rusinovic-Sunara, Dula; Finka, Dubravka

    2008-06-01

    Nowadays, in the world of markets and market economy, not only health care but medicine and medical practice in general, are looked upon more and more through the eyes of profit-making and financial interests. At the same time, there is an increasing number of initiatives intended to emphasise that human medicine should be at the service of society and that this fact should have priority over any market and financial interests of individuals even in "the market oriented world". The experience of the Croatian non-governmental organization to which the authors belong and which deals with patients' rights and helps in the development of partnership relations between patients and other subjects in the health care system, can be of a wider interest. This short review is the result of eight years' experience of the Croatian Association for Patients' Rights (CAPR), and its possible effects on the health care system in the future from the authors' points of view.

  18. Evaluating patients' health using a hierarchical multi-attribute decision model.

    Science.gov (United States)

    Sustersic, O; Rajkovic, U; Dinevski, D; Jereb, E; Rajkovic, Vladislav

    2009-01-01

    Evaluation of a patient's health status is an essential part of the healthcare process. For this purpose, Henderson's model of basic living activities (BLA) is often proposed as a set of criteria to be used in nursing. Despite its clarity and theoretical background, the model is only partially used in clinical practice. In this paper, we present the methodology for a hierarchical multi-attribute decision model to increase the practical efficiency of the BLA model. The result is a computerized model for the evaluation of a patient's health status. This model was tested in clinical practice by 17 nurses in two health centres in Slovenia and a strengths, weaknesses, opportunities and threats (SWOT) analysis was carried out. The strengths included providing a holistic understanding of the nature and level of the nursing problems, enriching the documentation and reducing the possibility of overlooking something important. As a part of electronic documentation, this computerized model supports systematic patient data gathering and evaluation. PMID:19930874

  19. Distinguishing service quality from patient satisfaction in developing health care marketing strategies.

    Science.gov (United States)

    Taylor, S A

    1994-01-01

    The marketing function in health care is increasingly becoming strategic in nature. The quality of care provided and the level of patient satisfaction are emerging as the core of many marketing strategies in health services as a means to achieve a distinctive competency in ever-more competitive markets. Therefore, it is not surprising that few issues have generated more discussion in both practitioner and research circles. Nonetheless, according to the health services literature, service quality and patient satisfaction have confounded many, the outcome of which may be an inability of health care managers to effectively derive, implement, and control marketing strategies. This article identifies emerging literature that assists in overcoming these limitations. PMID:10134419

  20. Intervention of Collective Exercise on the Mental Health of El¬derly Hypertensive Patients

    Directory of Open Access Journals (Sweden)

    Wenxin XU

    2016-03-01

    Full Text Available Background: Anxiety, depression, and other adverse psychological reactions are often observed in elderly hypertensive patients. Appropriate exercise is a safe form of adjuvant therapy without causing side effects among these patients, with consistent effects on patients’ mental health. In this study, a collective exercise intervention experiment was conducted to evaluate the mental health of elderly hypertensive patients and to verify the effect of the psychological intervention of collective exercise.Method: A total of 115 elderly hypertensive patients aged 60–70 years old were selected as study subjects from May 2012 to January 2015 in Fuzhou City, Fujian Province, China. A total of 57 patients were included in the control group and 58 patients were assigned in the experimental group. Patients in the experimental group participated in a 12 weeks exercise intervention, while patients in the control group didn’t participate in any regular physical exercise.Results: After intervention, the Symptom Checklist-90 (SCL-90, total score, somatization, obsessive-compulsive symptom, interpersonal sensitivity, depression, anxiety, hostility, and paranoia scores of the experimental group were significantly lower than those of the control group (P < 0.05. The positive coping style score of the experimental group was significantly higher than that of the control group (P<0.05; by contrast, the negative coping style score of the experimental group was significantly lower than that of the control group (P < 0.05.Conclusion: The mental health level and coping ability of elderly hypertensive patients can be effectively improved with the proposed treatment. Keywords: Collective exercise, Hypertension, Mental health, Elderly people

  1. [Patients' complaints of verbal abuse by health professionals during hospital care in Northeast Brazil].

    Science.gov (United States)

    Nations, Marilyn K; Gomes, Annatália Meneses de Amorim

    2007-09-01

    The current anthropological study focuses on the assessment by patients/citizens concerning the conduct of health professionals in a public general hospital in Fortaleza, Ceará State, Brazil. From January to July 2005 we tracked 13 key informants during hospitalization and analyzed their narratives of the experience. According to our observations, patients develop definite opinions of the caregivers' gestures and expressions during the entire process. In the health professionals, patients appreciate the human ability to express affect, to talk, and to include them in clinical decisions, above and beyond the professionals' technical skills. Patients criticize aloof, cold, and rude attitudes by health professionals, whom patients compare metaphorically to "human quadrupeds". They recommend an affective, empathetic, and ethical approach and clinical communications backed by straight talk, friendly conversation, and respect for daily customs related to life in Northeast Brazil. We contend that this legitimate and critical voice of the patient/citizen provides valuable clues for transforming professional conduct, rehabilitating patients' morale, and building a humane hospital within a context of social inequalities. PMID:17700945

  2. A Recommendation for the Management of Illness Anxiety Disorder Patients Abusing the Health Care System.

    Science.gov (United States)

    Almalki, Mohammad; Al-Tawayjri, Ibrahim; Al-Anazi, Ahmed; Mahmoud, Sami; Al-Mohrej, Ahmad

    2016-01-01

    Introduction. Illness anxiety disorder (IAD) entails a preoccupation with having a serious, undiagnosed illness in which somatic symptoms are, if present, mild in intensity (American Psychiatric Association, 2013). Case Report. This is a case of seventy-three-year-old Saudi man who started visiting the primary health care center around twenty-five years ago. With concerns of having cancer, the patient continuously visited the hospital, costing over $170,000. Throughout this period, the patient has been exposed to extensive unnecessary imaging studies and laboratory tests that have effects on his life in all aspects with such concerns. Five years ago, a family doctor has put an end to that by directing the patient to the right path. The doctor made several actions; most importantly, he directed the patient to a cognitive behavioral therapy which significantly improved a range of hypochondriacal beliefs and attitudes. This patient's case demonstrates the fundamental importance of a proper health system that limits such patients from abusing the health system and depleting the medical resources. Moreover, this case emphasizes the important role of the family physician who can be the first physician to encounter such patients. Thus, proper understanding of the nature of such disorder is a key element for better diagnosis and management. PMID:27313939

  3. Predictors of health-related quality of life in adult ambulatory independence neuromuscular disease patients

    International Nuclear Information System (INIS)

    To evaluate the health related quality of life (HRQoL) of totally independent ambulatory neuromuscular disease (NMD) patients in comparison with age matched healthy control subjects, and to assess associations between socio demographic variables and HRQoL in totally independent NMD patients. Ninety-nine adult patients with a diagnosis of NMD referred to the Physical Therapy Department of the Health Sciences Faculty of Hacettepe University, Ankara, Turkey between 2007 and 2009 were included in the study. The Functional Independence Measurement and the Nottingham Health Profile (NHP) were the main outcomes to assess independence level in activities of daily living and quality of life. The HRQoL score as measured by NHP was high (worse) in patients than healthy controls, and the difference between the 2 groups was significant for energy, physical mobility, and total score. Employed NMD patients scored significantly lower (better) than those unemployed in the majority of NHP domains. The genders and duration of illness displayed no significant difference in all dimension scores. All NMD patients had a poorer HRQoL than with healthy subjects with respect to energy, physical mobility dimensions, and total score. Furthermore, occupation was found to be a main factor that affects HRQoL in adult ambulatory NMD patients. (author)

  4. ABC for Nursing Care to Terminal Patients in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Angelina Basilia Estela Díaz

    2013-04-01

    Full Text Available Background: Terminal patients suffer from an acute or chronic process that immerses them in a critical situation leading to death. When providing a cure is no longer possible, the focus is on providing comfort and relief for the dying. Therefore, it is very important to provide an appropriate orientation to the staff nurses taking care of these patients. Objective: To develop an ABC for nursing care to terminally ill patients in Primary Health Care. Methods: A research was conducted in Area VI Polyclinic, in the municipality of Cienfuegos, from January to June 2012, in order to conform the ABC for nursing care to terminally ill patients in Primary Health Care. Theoretical methods of analysis and synthesis and induction-deduction as well as empirical methods were used: document analysis and brainstorming. Results: The ABC for nursing care to terminal patients was conformed for the following stages: initial or stability, symptomatic or state, and decline and final agony. In each of them possible diagnoses, objectives and actions were included. The document was created in such a way that it can be used by all nurses who attend these patients, regardless of their occupational category. Conclusions: This ABC could be useful to facilitate nursing care to terminally ill patients in primary health care.

  5. A Recommendation for the Management of Illness Anxiety Disorder Patients Abusing the Health Care System.

    Science.gov (United States)

    Almalki, Mohammad; Al-Tawayjri, Ibrahim; Al-Anazi, Ahmed; Mahmoud, Sami; Al-Mohrej, Ahmad

    2016-01-01

    Introduction. Illness anxiety disorder (IAD) entails a preoccupation with having a serious, undiagnosed illness in which somatic symptoms are, if present, mild in intensity (American Psychiatric Association, 2013). Case Report. This is a case of seventy-three-year-old Saudi man who started visiting the primary health care center around twenty-five years ago. With concerns of having cancer, the patient continuously visited the hospital, costing over $170,000. Throughout this period, the patient has been exposed to extensive unnecessary imaging studies and laboratory tests that have effects on his life in all aspects with such concerns. Five years ago, a family doctor has put an end to that by directing the patient to the right path. The doctor made several actions; most importantly, he directed the patient to a cognitive behavioral therapy which significantly improved a range of hypochondriacal beliefs and attitudes. This patient's case demonstrates the fundamental importance of a proper health system that limits such patients from abusing the health system and depleting the medical resources. Moreover, this case emphasizes the important role of the family physician who can be the first physician to encounter such patients. Thus, proper understanding of the nature of such disorder is a key element for better diagnosis and management.

  6. The Knowledge Level of Hypertension Patients for Drug Therapy in the Primary Health Care of Malang

    Directory of Open Access Journals (Sweden)

    Hananditia R. Pramestutie

    2016-04-01

    Full Text Available Hypertension is a persistent blood pressure in which systolic pressure ≥140 mmHg and diastolic pressure ≥90 mmHg. The knowledge that should be owned by patients with hypertension is the meaning, causes, symptoms and treatment of hypertension. This knowledge is important to support the success of hypertension therapy. The aim of this research was to determine the knowledge level of hypertension patients about their drug therapy in the primary health care of Malang. This research used observational study methods. The selection of the patients and the primary health care was done using non-random sampling technique (purposive sampling. The subject who meet the inclusion criteria were involved. The result of this study revealed that the patients with hypertension who have a sufficient level of knowledge were 69 respondents (72,63%. Patients who have a good criteria were 26 respondents (27,3763%. There is no patient with low level of knowledge in this research. The conclusion from this study is most patients with hypertension in Primary Health Care Malang have enough knowledge about their treatment.

  7. Should medical students track former patients in the electronic health record? An emerging ethical conflict.

    Science.gov (United States)

    Brisson, Gregory E; Neely, Kathy Johnson; Tyler, Patrick D; Barnard, Cynthia

    2015-08-01

    Medical students are increasingly using electronic health records (EHRs) in clerkships, and medical educators should seek opportunities to use this new technology to improve training. One such opportunity is the ability to "track" former patients in the EHR, defined as following up on patients in the EHR for educational purposes for a defined period of time after they have left one's direct care. This activity offers great promise in clinical training by enabling students to audit their diagnostic impressions and follow the clinical history of illness in a manner not possible in the era of paper charting. However, tracking raises important questions about the ethical use of protected health information, including concerns about compromising patient autonomy, resulting in a conflict between medical education and patient privacy. The authors offer critical analysis of arguments on both sides and discuss strategies to balance the ethical conflict by optimizing outcomes and mitigating harms. They observe that tracking improves training, thus offering long-lasting benefits to society, and is supported by the principle of distributive justice. They conclude that students should be permitted to track for educational purposes, but only with defined limits to safeguard patient autonomy, including obtaining permission from patients, having legitimate educational intent, and self-restricting review of records to those essential for training. Lastly, the authors observe that this conflict will become increasingly important with completion of the planned Nationwide Health Information Network and emphasize the need for national guidelines on tracking patients in an ethically appropriate manner.

  8. The MRC dyspnoea scale by telephone interview to monitor health status in elderly COPD patients.

    Science.gov (United States)

    Paladini, Luciana; Hodder, Rick; Cecchini, Isabella; Bellia, Vincenzo; Incalzi, Raffaele Antonelli

    2010-07-01

    Dyspnoea is the most common symptom associated with poor quality of life in patients affected by Chronic Obstructive Pulmonary Disease (COPD). While COPD severity is commonly staged by lung function, the Medical Research Council (MRC) dyspnoea scale has been proposed as a more clinically meaningful method of quantifying disease severity in COPD. We wished to assess whether this scale might also be useful during telephone surveys as a simple surrogate marker of perceived health status in elderly patients with COPD. We conducted a comprehensive health status assessment by telephone survey of 200 elderly patients who had a physician diagnosis of COPD. The telephone survey contained 71 items and explored such domains as educational level, financial status, living arrangements and social contacts, co-morbid illness, and the severity and the impact of COPD on health status. Patients were categorized according to the reported MRC score: mild dyspnoea (MRC scale of 1), moderate dyspnoea (MRC scale of 2 and 3), or severe dyspnoea (MRC of 4 and 5). Deterioration in most of the recorded indicators of health status correlated with an increasingly severe MRC score. This was most evident for instrumental activities of daily living (IADL), perceived health and emotional status, pain-related limitations, limitations in social life, hospital admissions in preceding year and prevalence of most co-morbidities. The MRC dyspnoea scale is a reliable index of disease severity and health status in elderly COPD patients which should prove useful for remote monitoring of COPD and for rating health status for epidemiological purposes. PMID:20116231

  9. Health related quality of life in pregeriatric patients with chronic diseases at urban, public supported clinics

    Directory of Open Access Journals (Sweden)

    Nguyen Kim M

    2003-10-01

    Full Text Available Abstract Background Understanding health-related quality of life (HRQOL leads to more effective and focused healthcare. America's growing health disparities makes it is increasingly necessary to understand the HRQOL of pregeriatric individuals who are now 55–64 years old, i.e. before they are eligible for federally mandated health care at age 65. Our study measured the self-perceived HRQOL of pregeriatric, poor patients with multiple chronic diseases treated at 2 public clinics. Methods Consecutive patients aged 55–64 years, many with multiple chronic diseases, responded in an interview to the 36-Item Short-Form Health Survey (SF–36 as a general measure of HRQOL during a regular visit to one of two university-staffed urban public clinics. Results The perceived physical and mental functioning of 316 pregeriatric patients was tabulated from SF–36 scores to yield their HRQOL. Their scores were statistically significantly lower than those of the general US pregeriatric population and lower than averages for US patients with multiple chronic diseases. All eight subscale scores of SF–36 were 16% to 36% lower compared with the averages of the general US pregeriatric population. Further, as the number of chronic diseases increased, the lower was the HRQOL. Lower physical and mental scores were associated with a lower income, unemployment, and higher numbers of multiple chronic diseases. Conclusion Chronic diseases have a powerful negative impact on perceived mental and physical functioning in pregeriatric patients. HRQOL information can assist health care providers to gain a more complete picture of their pregeriatric patients' health.

  10. Assessment of Perceived Health Status in Hypertensive and Diabetes Mellitus Patients at Primary Health Centers in Oman

    Science.gov (United States)

    Al-Mandhari, Ahmed; Al-Zakwani, Ibrahim; Al-Hasni, Alya; Al-Sumri, Nada

    2011-01-01

    Objectives: This study aimed to assess the impact of diabetes mellitus and hypertension as well as other demographic and clinical characteristics on perceived health status in primary health centers in Oman. Methods: In a cross-sectional retrospective study, 450 patients (aged ≥ 18 years) seen at six primary health centers in Wilayat A’ Seeb in the Muscat region, Oman, were selected. Perceived health status of the physical (PSCC) and mental (MSCC) components of quality-of-life were assessed using the 12-item short form health survey (SF-12). The analyses were performed using univariate statistical techniques. Results: The mean age of the participants was 54 ± 12 years and they were mostly female (62%). The presence of both diabetes mellitus and hypertension was associated with lower physical scores compared to those with diabetes alone (p = 0.001) but only marginally lower than those with hypertension alone (p = 0.066). No significant differences were found across the disease groups in mental scores (P = 0.578). Age was negatively correlated (p < 0.001) but male gender (P < 0.001), married (p < 0.001), literate (p < 0.001) and higher income (p = 0.002) were all associated with higher physical scores. Moreover, longer disease duration was associated with lower physical scores (p < 0.001). With regards to the mental status, male (p = 0.005), marriage (P = 0.017) and higher income (p < 0.001) were associated with higher mental scores. Polypharmacy was associated with lower physical (p < 0.001) and mental (p = 0.005) scores. Conclusions: The presence of both diseases was associated with lower physical scores of perceived health status. Health status was also affected by various demographic and clinical characteristics. However, the results should be interpreted in light of the study's limitations. PMID:22174966

  11. Enhancing readiness of health profession students to address tobacco cessation with patients through online training

    OpenAIRE

    Anne Maynard; Maripat Metcalf; Lyla Hance

    2012-01-01

    Objectives: To evaluate effectiveness of an online training program in preparing health care students to address tobacco use with patients. Methods: The program was evaluated on knowledge, attitude, self-efficacy, intended behavior, and user satisfaction. Participants consisted of 4,180 medical, nursing, dentistry, pharmacy, and other allied health professions students. Multiple choice questions assessed knowledge before and after the educational experience. Likert scales were used for self-r...

  12. The Relationship between Health-Promoting Behaviors and Resilience in Patients with Chronic Kidney Disease

    OpenAIRE

    Li-Ching Ma; Hong-Jer Chang; Yueh-Min Liu; Hsiang-Li Hsieh; Lan Lo; Mei-Yu Lin; Kuo-Cheng Lu

    2013-01-01

    This cross-sectional research study explored differences in health-promoting behavior and resilience among three groups of chronic kidney disease patients (high-risk, early chronic kidney disease; early CKD and pre-end stage renal disease; pre-ESRD) treated at the Nephrology outpatient clinic in northern Taiwan. A total of 150 CKD outpatients were interviewed using structured questionnaires including a CKD Health to Promote Lifestyle Scale, and resilience scale. We found that the pre-ESRD gro...

  13. Health-related quality of life among colorectal cancer patients in Malaysia: a study protocol

    OpenAIRE

    Magaji Bello; Moy Foong; Roslani April; Sagap Ismail; Zakaria Jasiah; Blazeby Jane M; Law Chee

    2012-01-01

    Abstract Background Colorectal cancer is a major public health problem in Malaysia. However, it is also one of the most treatable cancers, resulting in significant numbers of survivors. Therefore, the impact of surviving treatment for colorectal cancer on health related quality of life is important for the patients, clinicians and policy makers, and may differ in different cultures and populations. The aim of this study was to validate the Malaysian versions of the European Organization for R...

  14. Assessment of Patient, Family and Staff Satisfaction in a Mental Health Service

    OpenAIRE

    Kênia Izabel David Silva de Resende; Marina Bandeira; Daniela Carine Ramires de Oliveira

    2016-01-01

    Abstract Psychosocial Care Centers (CAPS) provide care to people with psychiatric disorders and aim to reinsert them into the community. Assessing these services is important to maintaining quality. This study assessed the satisfaction level of 84 patients, 84 family caregivers and 67 professionals from a large center of mental health care center (CAPS-III). Structured interviews were individually held by applying the Satisfaction with Mental Health Services Scales (SATIS-BR) and socio-demogr...

  15. The movement of patients across borders: challenges and opportunities for public health

    OpenAIRE

    Helble, Matthias

    2010-01-01

    In a globalizing world, public health is no longer confined to national borders. In recent years we have observed an increasing movement of patients across international borders. The full extent of this trend is yet unknown, as data are sparse and anecdotal. If this trend continues, experts are convinced that it will have major implications for public health systems around the globe. Despite the growing importance of medical travel, we still have little empirical evidence on its impact on pub...

  16. Ebola US Patient Zero: lessons on misdiagnosis and effective use of electronic health records

    OpenAIRE

    Upadhyay, Divvy K.; Sittig, Dean F; Singh, Hardeep

    2014-01-01

    On September 30th, 2014, the Centers for Disease Control and Prevention (CDC) confirmed the first travel-associated case of US Ebola in Dallas, TX. This case exposed two of the greatest concerns in patient safety in the US outpatient health care system: misdiagnosis and ineffective use of electronic health records (EHRs). The case received widespread media attention highlighting failures in disaster management, infectious disease control, national security, and emergency department (ED) care....

  17. Health-Related Quality of Life in HIV-Infected Patients: The Role of Substance Use

    OpenAIRE

    Korthuis, P. Todd; ZEPHYRIN, Laurie C.; Fleishman, John A.; Saha, Somnath; Josephs, Joshua S.; McGrath, Moriah M.; Hellinger, James; Gebo, Kelly A.

    2008-01-01

    HIV infection and substance use disorders are chronic diseases with complex contributions to health-related quality of life (HRQOL). We conducted a cross-sectional survey of 951 HIV-infected adults receiving care at 14 HIV Research Network sites in 2003 to estimate associations between HRQOL and specific substance use among HIV-infected patients. HRQOL was assessed by multi-item measures of physical and role functioning, general health, pain, energy, positive affect, anxiety, and depression. ...

  18. Responses of Mental Health Clinicians to Patients with Borderline Personality Disorder

    OpenAIRE

    Sansone, Randy A.; Sansone, Lori A.

    2013-01-01

    Borderline personality disorder is a complex psychiatric syndrome that is characterized by a number of pathological interpersonal and behavioral symptoms. Because of these symptoms, individuals with borderline personality disorder tend to have difficulties in their relationships with others, including mental health clinicians. Through a literature review, we examined the perceptions and reactions of mental health clinicians toward patients with borderline personality disorder. Our findings in...

  19. Complementary and Alternative Medicine use in oncology: A questionnaire survey of patients and health care professionals

    LENUS (Irish Health Repository)

    Chang, Kah Hoong

    2011-05-24

    Abstract Background We aimed to investigate the prevalence and predictors of Complementary and Alternative Medicine (CAM) use among cancer patients and non-cancer volunteers, and to assess the knowledge of and attitudes toward CAM use in oncology among health care professionals. Methods This is a cross-sectional questionnaire survey conducted in a single institution in Ireland. Survey was performed in outpatient and inpatient settings involving cancer patients and non-cancer volunteers. Clinicians and allied health care professionals were asked to complete a different questionnaire. Results In 676 participants including 219 cancer patients; 301 non-cancer volunteers and 156 health care professionals, the overall prevalence of CAM use was 32.5% (29.1%, 30.9% and 39.7% respectively in the three study cohorts). Female gender (p < 0.001), younger age (p = 0.004), higher educational background (p < 0.001), higher annual household income (p = 0.001), private health insurance (p = 0.001) and non-Christian (p < 0.001) were factors associated with more likely CAM use. Multivariate analysis identified female gender (p < 0.001), non-Christian (p = 0.001) and private health insurance (p = 0.015) as independent predictors of CAM use. Most health care professionals thought they did not have adequate knowledge (58.8%) nor were up to date with the best evidence (79.2%) on CAM use in oncology. Health care professionals who used CAM were more likely to recommend it to patients (p < 0.001). Conclusions This study demonstrates a similarly high prevalence of CAM use among oncology health care professionals, cancer and non cancer patients. Patients are more likely to disclose CAM usage if they are specifically asked. Health care professionals are interested to learn more about various CAM therapies and have poor evidence-based knowledge on specific oncology treatments. There is a need for further training to meet to the escalation of CAM use among patients and to raise awareness of

  20. Is patient confidentiality compromised with the electronic health record?: a position paper.

    Science.gov (United States)

    Wallace, Ilse M

    2015-02-01

    In order for electronic health records to fulfill their expected benefits, protection of privacy of patient information is key. Lack of trust in confidentiality can lead to reluctance in disclosing all relevant information, which could have grave consequences. This position paper contemplates whether patient confidentiality is compromised by electronic health records. The position that confidentiality is compromised was supported by the four bioethical principles and argued that despite laws and various safeguards to protect patients' confidentiality, numerous data breaches have occurred. The position that confidentiality is not compromised was supported by virtue ethics and a utilitarian viewpoint and argued that safeguards keep information confidential and the public feels relatively safe with the electronic health record. The article concludes with an ethically superior position that confidentiality is compromised with the electronic health record. Although organizational and governmental ways of enhancing the confidentiality of patient information within the electronic health record facilitate confidentiality, the ultimate responsibility of maintaining confidentiality rests with the individual end-users and their ethical code of conduct. The American Nurses Association Code of Ethics for nurses calls for nurses to be watchful with data security in electronic communications. PMID:25532832

  1. Health Care Use by Patients with Somatoform Disorders A Register-Based Follow-Up Study*

    DEFF Research Database (Denmark)

    Andersen, Nadia Lyhne Trærup; Eplov, Lene Falgaard; Andersen, Jon Trærup;

    2012-01-01

    OBJECTIVE: Studies have shown a greater use of medical than mental health services in patients with somatoform disorders. However, not many studies are based on structured interviews and include the entire somatoform spectrum of diagnoses. We conducted a register-based case-control study to...... background population. Data from the Danish National Registers were used to assess health care use in both primary and secondary care. RESULTS: Somatoform patients incurred 2.11 (2.09-2.12) times the primary care visits of controls. They had 3.12 (3.08-3.16) times as many somatic bed-days than controls and 3...

  2. Comparison of EQ-5D and SF-6D utilities in mental health patients

    OpenAIRE

    Lamers, L M; Bouwmans, C.A.; Straten, van, FE; Donker, M. C.; Hakkaart, L.

    2006-01-01

    Various preference-based measures of health are available for use as an outcome measure in cost–utility analysis. The aim of this study is to compare two such measures EQ-5D and SF-6D in mental health patients. Baseline data from a Dutch multi-centre randomised trial of 616 patients with mood and/or anxiety disorders were used. Mean and median EQ-5D and SF-6D utilities were compared, both in the total sample and between severity subgroups based on quartiles of SCL-90 scores. Utilities were ex...

  3. Depression and health related quality of life in breast cancer patients

    International Nuclear Information System (INIS)

    Objective: To investigate the prevalence of depression in women with breast cancer and relate it to their health-related quality of life. Methods: The cross-sectional study was conducted at the Imam Khomeini Hospital in Iran between January and December 2009, and comprised 60 women with breast cancer with a mean age of 43.8+-47.12 years. In order to assess the health-related quality of life, the study used the parameters of the Iranian version of the Functional Assessment of Cancer Therapy for Breast Cancer. To identify expressive symptoms, the Beck Depression Inventory was used. General linear model regression and SPSS 14 were used to analyse the data. Results: Significant differences in the prevalence of depression between treatment types was found. The presence of depression was significantly correlated with poorer overall health-related quality of life and the four subscales of the protocol. The patients reported statistically significant effects of depression in the overall category (p= 0.001). Participants with depression were more likely to have a poorer overall health-related quality of life, the exception being the social/family well-being subscale. Conclusions: Depression affects health-related quality of life in breast cancer patients. Although further studies are necessary to confirm our findings, but our results emphasise the necessity for better mental health strategies for such patients. (author)

  4. Assessing the accuracy of an inter-institutional automated patient-specific health problem list

    Directory of Open Access Journals (Sweden)

    Taylor Laurel

    2010-02-01

    Full Text Available Abstract Background Health problem lists are a key component of electronic health records and are instrumental in the development of decision-support systems that encourage best practices and optimal patient safety. Most health problem lists require initial clinical information to be entered manually and few integrate information across care providers and institutions. This study assesses the accuracy of a novel approach to create an inter-institutional automated health problem list in a computerized medical record (MOXXI that integrates three sources of information for an individual patient: diagnostic codes from medical services claims from all treating physicians, therapeutic indications from electronic prescriptions, and single-indication drugs. Methods Data for this study were obtained from 121 general practitioners and all medical services provided for 22,248 of their patients. At the opening of a patient's file, all health problems detected through medical service utilization or single-indication drug use were flagged to the physician in the MOXXI system. Each new arising health problem were presented as 'potential' and physicians were prompted to specify if the health problem was valid (Y or not (N or if they preferred to reassess its validity at a later time. Results A total of 263,527 health problems, representing 891 unique problems, were identified for the group of 22,248 patients. Medical services claims contributed to the majority of problems identified (77%, followed by therapeutic indications from electronic prescriptions (14%, and single-indication drugs (9%. Physicians actively chose to assess 41.7% (n = 106,950 of health problems. Overall, 73% of the problems assessed were considered valid; 42% originated from medical service diagnostic codes, 11% from single indication drugs, and 47% from prescription indications. Twelve percent of problems identified through other treating physicians were considered valid compared to 28

  5. Evaluation of a health literacy screening tool in primary care patients: evidence from Serbia.

    Science.gov (United States)

    Jović-Vraneš, Aleksandra; Bjegović-Mikanović, Vesna; Marinković, Jelena; Vuković, Dejana

    2014-12-01

    Improving health literacy skills is important for patient comprehension of health-related topics and their ability to attend to their medical problems. Promoting health literacy is a pivotal policy for maintaining and promoting health. The objective of the present study was to translate the Test of Functional Health Literacy in Adults (TOFHLA; long and short versions) into Serbian and evaluate the translated and cross-culturally adapted questionnaires in Serbian primary care patients. The translated TOFHLA questionnaires were administered to 120 patients. Additionally, a self-completed questionnaire was used. Both descriptive and inferential statistics were measured. The mean score for the TOFHLA was 73.49 (median, 78; SD = 17.94; range, 0-100) and the mean score for the Short Test of Functional Health Literacy in Adults (STOFHLA) was 29.28 (median, 32; SD = 6.16; range, 0-36). Sex, age, education, self-perceived health and presence of any chronic disease were associated with health literacy scores. The internal consistency (Cronbach's alpha) was 0.73 for the TOFHLA numeracy subset, 0.95 for reading comprehension, 0.94 for the TOFHLA and 0.90 for the STOFHLA. The Pearson correlation between the TOFHLA and STOFHLA was 0.89. The area under the curve of these two tests was 0.79 (95% CI, 0.602-0.817). The Serbian translated versions of the TOHFLA questionnaires offer valid measures of functional health literacy. There were no differences between the reliability and validity of the short and long TOFHLA forms.

  6. Physician Cross-Cultural Nonverbal Communication Skills, Patient Satisfaction and Health Outcomes in the Physician-Patient Relationship

    OpenAIRE

    Ken Russell Coelho; Chardee Galan

    2012-01-01

    Recent empirical findings document the role of nonverbal communication in cross-cultural interactions. As ethnic minority health disparities in the United States continue to persist, physician competence in this area is important. We examine physicians' abilities to decode nonverbal emotions across cultures, our hypothesis being that there is a relationship between physicians' skill in this area and their patients' satisfaction and outcomes. First part tested Caucasian and South Asian physici...

  7. Identifying key domains of health-related quality of life for patients with Chronic Obstructive Pulmonary Disease: the patient perspective

    OpenAIRE

    Paap, Muirne C S; Bode, Christina; Lenferink, Lonneke I.M.; Groen, Lianne C; Terwee, Caroline B.; Ahmed, Sara; Eilayyan, Owis; Palen, van der, Job

    2014-01-01

    Background Numerous instruments are available to measure health-related quality of life (HRQoL) in patients with Chronic Obstructive Pulmonary Disease (COPD), covering a wide array of domains ranging from symptoms such as dyspnea, cough and wheezing, to social and emotional functioning. Currently no information or guide is available yet to aid the selection of domains for a particular study or disease population. The aim of this paper is to identify which domains of HRQoL are most important w...

  8. Online Health Information Tool Effectiveness for Older Patients: A Systematic Review of the Literature.

    Science.gov (United States)

    Bolle, Sifra; van Weert, Julia C M; Daams, Joost G; Loos, Eugène F; de Haes, Hanneke C J M; Smets, Ellen M A

    2015-01-01

    Online health information tools (OHITs) have been found to be effective in improving health outcomes. However, the effectiveness of these tools for older patients has been far from clear. This systematic literature review therefore provides an overview of online health information tool effectiveness for older patients using a two-dimensional framework of OHIT functions (i.e., providing information, enhancing information exchange, and promoting self-management) and outcomes (i.e., immediate, intermediate, and long-term outcomes). Comprehensive searches of the PubMed, EMBASE, and PsycINFO databases are conducted to identify eligible studies. Articles describing outcomes of patient-directed OHITs in which a mean sample or subgroup of age ≥65 years was used are included in the literature review. A best evidence synthesis analysis provides evidence that OHITs improve self-efficacy, blood pressure, hemoglobin levels, and cholesterol levels. Limited evidence is found in support of OHIT effects on knowledge, perceived social support, health service utilization, glycemic control, self-care adherence, exercise performance, endurance, and quality of life. OHITs seem promising tools to facilitate immediate, intermediate, and long-term outcomes in older patients by providing information, enhancing information exchange, and promoting self-management. However, future studies should evaluate the effectiveness of OHITs for older patients to achieve stronger levels of evidence. PMID:26165846

  9. The role of provider-patient communication and trust in online sources in Internet use for health-related activities.

    Science.gov (United States)

    Hou, Jiran; Shim, Minsun

    2010-01-01

    Provider-patient communication is an important factor influencing patients' satisfaction and health outcomes. This study draws upon the uses and gratification theory to examine how individuals' perception of communication with healthcare providers is associated with their Internet use for health-related activities. Using the data from the 2007 Health Information National Trends Survey (HINTS), we found that as individuals perceived their communication with providers to be less patient-centered, they were more likely to engage in various types of online health activities, such as using websites for healthy lifestyles, searching for healthcare providers, and seeking health information. Trust in online health information was also found to be a significant predictor of online health activities. The results of this study emphasized the important role of provider-patient communication in motivating individuals to turn to the Internet for health purposes. PMID:21154093

  10. Health Anxiety Levels in Patients Admitted to Internal Medicine Outpatient Clinic for Several Times

    Directory of Open Access Journals (Sweden)

    Ali Gul

    2014-12-01

    Full Text Available Aim: Health anxiety (HA in patients consist of incorrect reference to normal bodily sensations as a signs of a serious disease. The aim of this study is to investigate the HA in patients admitted to internal medicine outpatient clinic for several times within one year. Material and Method: 60 patients who admitted more than one time to internal medicine outpatient clinic within one year and the control group consisted of 60 people were enrolled in this study. Short-form of health anxiety inventory (SAE-KF was given to these groups, The results were compared statistically. Results: SAE-KF scores were significantly higher in the patient group (11.17 ± 6.07 than the control group (10.71±4.44 (Z=-5.96, P

  11. [Simulated patients in health care training: the human side of simulation].

    Science.gov (United States)

    Moore, Philippa; Leighton, María Inés; Alvarado, Constanza; Bralic, Cecilia

    2016-05-01

    Simulated patients (SP) are now used in the majority of the institutions that train health care professionals in patient-centered care. This article summarizes the information about the use of SP in health education using information from the literature and from the 15 years’ experience in the medical school of the Pontificia Universidad Católica de Chile. It describes the different definitions in use, the roles and scenarios that can be used when teaching with SP and the organization that any institution working with SP should have in order to promote the optimal use of SP. Working with SP allows faculty to center their teaching on their students while keeping the focus on the patient. Students appreciate learning with SP and particularly value feedback from the patients’ perspective. PMID:27552013

  12. Quality of life, mental health and health beliefs in haemodialysis and peritoneal dialysis patients: Investigating differences in early and later years of current treatment

    OpenAIRE

    Ginieri-Coccossis, M; Theofilou, P; Synodinou, C; Tomaras, V; Soldatos, C

    2008-01-01

    Background The study examines differences regarding quality of life (QoL), mental health and illness beliefs between in-centre haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD/PD) patients. Differences are examined between patients who recently commenced treatment compared to patients on long term treatment. Methods 144 End-Stage Renal Disease (ESRD) patients were recruited from three treatment units, of which 135 provided full data on the variables studied. Patients con...

  13. Health Care Use and Quality of Life Among Patients with Asthma and Panic Disorder

    OpenAIRE

    Feldman, Jonathan M.; Lehrer, Paul M.; Borson, Soo; Hallstrand, Teal S.; Siddique, Mahmood I.

    2005-01-01

    The purpose of this study was to assess the associations between panic disorder (PD) and health services use, health-related quality of life, and use of short-acting β2-agonists among individuals with asthma. We studied 21 adults with comorbid asthma and panic disorder (asthma-PD) and 27 asthma patients without PD (asthma-only). Participants attended a single session at a laboratory to complete the study. A retrospective chart review was conducted to assess use of health care resources for as...

  14. Patient safety culture in hospital settings : Measurements, health care staff perceptions and suggestions for improvement

    OpenAIRE

    Nordin, Anna

    2015-01-01

    The aim was to psychometrically test the S-HSOPSC and HSOPSC, investigate health care staff’s perceptions of patient safety culture and their suggestions for improvement. Methods: A three-time cross-sectional study with data from health care staff (N= 3721) in a Swedish county council was conducted in 2009 (N = 1,023), 2011 (N = 1,228) and 2013 (N =1,470) using the S-HSOPSC (I, II, III). Health care staff’s suggestions for improvement were analyzed in a qualitative content analysis study (IV)...

  15. Personality assessment in today's health care environment: therapeutic alliance and patient satisfaction.

    Science.gov (United States)

    Quirk, Michael P; Erdberg, Philip; Crosier, Marlan; Steinfeld, Bradley

    2007-10-01

    This article addresses the role of personality assessment-specifically the Rorschach (Exner, 2002)-]in the context of the health care industry's increased focus on patient satisfaction. When providing psychotherapy, a challenge to providing patient-centered care turns on understanding and acting on the key aspects of the patient's personality that are crucial to forming an effective alliance. This article includes a description and examples of how personality assessment can enhance therapists' understanding of the ideational, affective, and self-control aspects of complicated patients' problem-solving styles. This enhanced understanding in turn can lead to improved therapeutic alliance between therapists and patients and to increased patient satisfaction with their care. How to provide feedback to the therapist also is addressed.

  16. Consumerism in action: how patients and physicians negotiate payment in health care.

    Science.gov (United States)

    Oh, Hyeyoung

    2013-03-01

    Drawing from the medical sociology literature on the patient-doctor relationship and microeconomic sociological scholarship about the role of money in personal relationships, I examined patient-physician interactions within a clinic that offered eye health and cosmetic facial services in the United States. Relying on ethnographic observations conducted in 2008, I evaluated how financial pressures shape the patient-physician relationship during the clinical encounter. To gain a financial advantage, patients attempted to reshape the relationship toward a socially intimate one, where favor and gift exchanges are more common. To ensure the rendering of services, the physician in turn allied herself with the patient, demonstrating how external parties are the barriers to affordable care. This allied relationship was tested when conflicts emerged, primarily because of the role of financial intermediaries in the clinical encounter. These conflicts resulted in the disintegration of the personal relationship, with patient and physician pitted against one another.

  17. From Practice Culture to Patient Outcomes: Improving Primary Care Through Interdisciplinary Health Care Teams

    OpenAIRE

    Grace, Sherry M.

    2013-01-01

    Background: In 2011, a large integrated healthcare organization implemented a primary care team redesign in five pilot practices to improve the delivery of patient-centered chronic illness care and augment the physician-medical assistant dyads by adding two new primary care team roles for each practice - a nurse care manager (NCM) and a patient health coach (PHC). This work examines three aspects of implementing the care team redesign: 1) The facilitators and barriers of implementation, 2) Th...

  18. Scheduled telephone visits in the veterans health administration patient-centered medical home

    OpenAIRE

    Sperber, Nina R; King, Heather A.; Steinhauser, Karen; Ammarell, Natalie; Danus, Susanne; Powers, Benjamin J

    2014-01-01

    Background The Veterans Health Administration (VHA) patient-centered medical home model, Patient Aligned Care Teams (PACT), includes telephone visits to improve care access and efficiency. Scheduled telephone visits can replace in-person care for some focused issues, and more information is needed to understand how this mode can best work for primary care. We conducted a study at the beginning of PACT implementation to elicit stakeholder views on this mode of healthcare delivery, including po...

  19. Impact of Managed Care Health Insurance System for Indigent Patients with Rheumatoid Arthritis in Puerto Rico

    OpenAIRE

    Santiago-Casas, Yesenia; González-Rivera, Tania; Castro-Santana, Lesliane; Ríos, Grissel; Martínez, David; Rodríguez, Vanessa; González-Alcover, Rafael; Mayor, Ángel M.; Vilá, Luis M.

    2013-01-01

    The aim of this study was to determine the clinical outcome among indigent patients with rheumatoid arthritis (RA) in Puerto Rico receiving their healthcare in a managed care system, as compared to non-indigent patients treated in fee-for-service settings. A cross-sectional study was conducted in 214 Puerto Ricans with RA (per American College of Rheumatology classification criteria). Demographic features, health-related behaviors, cumulative clinical manifestations, disease...

  20. Impact of pain on health-related quality of life in patients with inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Anja; Schirbel; Anne; Reichert; Stephanie; Roll; Daniel; C; Baumgart; Carsten; Büning; Bianca; Wittig; Bertram; Wiedenmann; Axel; Dignass; Andreas; Sturm

    2010-01-01

    AIM: To evaluate intensity, localization and cofactors of pain in Crohn’s disease and ulcerative colitis patients in connection with health-related quality of life (HRQOL) and disease activity. METHODS: We reviewed and analyzed the responses of 334 patients to a specifically designed questionnairebased on the short inflammatory bowel disease questionnaire (SIBDQ) and the German pain questionnaire. Pain intensity, HRQOL, Crohn’s disease activity index (CDAI) and colitis activity index (CAI) were correlated a...