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Sample records for care pacic survey

  1. Validation of the Spanish Translation of the Patient Assessment of Chronic Illness Care (PACIC Survey

    Directory of Open Access Journals (Sweden)

    Abraham Aragones, MD, MSCI

    2008-10-01

    Full Text Available IntroductionThe Patient Assessment of Chronic Illness Care (PACIC survey is a patient-centered instrument for evaluating the quality and patient-centeredness of chronic illness care received according to the Chronic Care Model paradigm. This study validates the Spanish translation of the PACIC in an urban, Spanish-speaking population.MethodsOne hundred Spanish-speaking patients with diabetes completed the translated PACIC and sociodemographic and cultural questionnaires. Test-retest reliability was assessed in a subset of 20 patients who completed the questionnaire 2 to 4 months later. Internal consistency was evaluated with Cronbach α. PACIC score and subscale associations with sociodemographic characteristics were examined.ResultsTest-retest reliability for the overall translated PACIC scale was 0.77. Scores were not associated with patient sociodemographic characteristics, including age, country of birth, years living in the United States, or education level (P >.05.ConclusionThe Spanish translation of the PACIC survey demonstrated high reliability, internal consistency, and test-retest reliability. Scores showed no association with sociodemographic or cultural characteristics. The Spanish version can reliably be used to assess care delivered according to the Chronic Care Model in a heterogeneous Spanish-speaking population.

  2. Patient Assessment of Chronic Illness Care (PACIC) in Type 2 Diabetes: A Longitudinal Study.

    Science.gov (United States)

    Aung, Eindra; Ostini, Remo; Dower, Jo; Donald, Maria; Coll, Joseph R; Williams, Gail M; Doi, Suhail A R

    2016-06-01

    The Patient Assessment of Chronic Illness Care (PACIC) was designed to measure care congruent with several elements of the chronic care model (CCM), including self-management support and delivery system design. However, support for the a priori 5-subscale structure of the PACIC in previous research has been conflicting. Thus, we aim to investigate psychometric characteristics of the PACIC including the content and stability of its construct over time. A population-based prospective cohort study of patients with type 2 diabetes was conducted in Queensland, Australia, from 2008 (N = 3,761) to 2010 (N = 3,040). Participants completed annually the 20-item PACIC as well as measures of providers' adherence to guideline-recommended self-management support activities. We used exploratory factor analysis to determine its factor structure and examined internal consistency as well as agreement between the PACIC at baseline with repeated measurements at follow-up after 1 and 2 years. We also determined a criterion-related validity using multinomial logistic regression to explore PACIC's association with providers' self-management support. A one-factor structure was deemed optimal according to our findings. High internal consistency and moderate agreement within the scales over time were observed. Higher PACIC scores predicted better providers' self-management support. In conclusion, the PACIC is a reliable, valid, and reproducible instrument for assessment of diabetes care, and we recommend its promotion and use as a single scale rather than subscales as originally proposed. PMID:25380699

  3. The Patients Assessment Chronic Illness Care (PACIC questionnaire in The Netherlands: a validation study in rural general practice

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    Hermsen Jan

    2008-09-01

    Full Text Available Abstract Background Many patients with chronic illness receive health care in primary care settings, so a challenge is to provide well-structured chronic care in these settings. Our aim was to develop and test a Dutch version of the PACIC questionnaire, a measure for patient reported structured chronic care. Methods Observational study in 165 patients with diabetes or COPD from four general practices (72% response rate. Patients completed a written questionnaire, which included instruments for assessing chronic illness care (PACIC, evaluations of general practice (Europep, enablement (PEI, and individual characteristics. Results The patients had a mean age of 68.0 years and 47% comprised of women. Twenty-two to 35% of responding patients did not provide answers to specific items in the PACIC. In 11 items the lowest answering category was used by 30% or more of the responders and in 6 items the highest answering category was used by this number of responders. Principal factor analysis identified the previously defined five domains reasonably well. Cronbach's alpha per domain varied from 0.71 to 0.83, and the intraclass coefficient from 0.66 to 0.91. Diabetes patients reported higher presence of structured chronic care for 14 out of the 20 PACIC items. The effect of patient evaluations of general practice on the PACIC score was positive (b = 0.72, p Conclusion A translated and validated Dutch version of the PACIC questionnaire is now available. Further research on its validity is recommended.

  4. Patient-Assessed Chronic Illness Care (PACIC) scenario in an Indian homeopathic hospital.

    Science.gov (United States)

    Koley, Munmun; Saha, Subhranil; Ghosh, Shubhamoy; Nag, Goutam; Kundu, Monojit; Mondal, Ramkumar; Purkait, Rajib; Patra, Supratim; Ali, Seikh Swaif

    2016-01-01

    Homeopathy research has focused on chronic conditions; however, the extent to which current homeopathic care is compliant with the Chronic Care Model (CCM) has been sparsely shown. As the Bengali Patient-Assessed Chronic Illness Care (PACIC)-20 was not available, the English questionnaire was translated and evaluated in a government homeopathic hospital in West Bengal, India. The translation was done in six steps, and approved by an expert committee. Face validity was tested by 15 people for comprehension. Test/retest reliability (reproducibility) was tested on 30 patients with chronic conditions. Internal consistency was tested in 377 patients suffering from various chronic conditions. The questionnaire showed acceptable test/retest reliability [intraclass correlation coefficient (ICC) 0.57-0.75; positive to strong positive correlations; p  0.05); however, monthly household income had a significant influence (p < 0.05) on the subscales except for "delivery system or practice design." Overall, chronic illness care appeared to be quite promising and CCM-compliant. The psychometric properties of the Bengali PACIC-20 were satisfactory, rendering it a valid and reliable instrument for assessing chronic illness care among the patients attending a homeopathic hospital. PMID:26933640

  5. Validation of the Danish version of the Patient Assessment of Care for Chronic Conditions questionnaire (PACIC)

    DEFF Research Database (Denmark)

    Sokolowski, Ineta; Maindal, Helle Terkildsen; Vedsted, Peter

    Objective: To evaluate the level of chronic care patients must be involved. The Danish version of the 20-item Patient Assessment of Care for Chronic Conditions PACIC questionnaire consisting of 5 scales and an overall summary score measuring patient reported assessment of structured chronic care...... has not been evaluated with regard to psychometric properties. This study aims to assess data quality and internal consistency and to validate the proposed factorial structure. Materials and methods: Setting: Diabetes population receiving chronic care in Denmark. Subjects: A total of 624 patients aged...... same questionnaire is constructed and applied to different countries with diverse cultural backgrounds and health care systems. It is decisive, that translated questionnaires are validated in country they are used....

  6. Psychometric properties of the patient assessment of chronic illness care measure: acceptability, reliability and validity in United Kingdom patients with long-term conditions

    Directory of Open Access Journals (Sweden)

    Rick Jo

    2012-08-01

    Full Text Available Abstract Background The Patient Assessment of Chronic Illness Care (PACIC is a US measure of chronic illness quality of care, based on the influential Chronic Care Model (CCM. It measures a number of aspects of care, including patient activation; delivery system design and decision support; goal setting and tailoring; problem-solving and contextual counselling; follow-up and coordination. Although there is developing evidence of the utility of the scale, there is little evidence about its performance in the United Kingdom (UK. We present preliminary data on the psychometric performance of the PACIC in a large sample of UK patients with long-term conditions. Method We collected PACIC, demographic, clinical and quality of care data from patients with long-term conditions across 38 general practices, as part of a wider longitudinal study. We assess rates of missing data, present descriptive and distributional data, assess internal consistency, and test validity through confirmatory factor analysis, and through associations between PACIC scores, patient characteristics and related measures. Results There was evidence that rates of missing data were high on PACIC (9.6% - 15.9%, and higher than on other scales used in the same survey. Most PACIC sub-scales showed reasonable levels of internal consistency (alpha = 0.68 – 0.94, responses did not demonstrate high skewness levels, and floor effects were more frequent (up to 30.4% on the follow up and co-ordination subscale than ceiling effects (generally Conclusion The importance of improving care for long-term conditions means that the development and validation of measures is a priority. The PACIC scale has demonstrated potential utility in this regard, but further assessment is required to assess low levels of completion of the scale, and to explore the performance of the scale in predicting outcomes and assessing the effects of interventions.

  7. National Health Care Survey

    Science.gov (United States)

    This survey encompasses a family of health care provider surveys, including information about the facilities that supply health care, the services rendered, and the characteristics of the patients served.

  8. Adaptation, data quality and confirmatory factor analysis of the Danish version of the PACIC questionnaire

    DEFF Research Database (Denmark)

    Maindal, Helle Terkildsen; Sokolowski, Ineta; Vedsted, Peter

    2012-01-01

    Internationalt bruges PACIC-spørgeskemaet til at måle patienter med kronisk sygdom til evaluering af sundhedsvæsenets indsats. Vi lavede en videnskabelig og standardiseret oversættelse af den engelske version. Vi genfandt de fem skalaer, som endvidere viste gode egenskaber for et spørgeskema. Der...

  9. National Hospital Ambulatory Medical Care Survey

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Hospital Ambulatory Medical Care Survey (NHAMCS) is designed to collect data on the utilization and provision of ambulatory care services in hospital...

  10. National Ambulatory Medical Care Survey (NAMCS)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Ambulatory Medical Care Survey (NAMCS) is a national survey designed to meet the need for objective, reliable information about the provision and use...

  11. Integration of early specialist palliative care in cancer care: Survey of oncologists, oncology nurses, and patients

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    Naveen Salins

    2016-01-01

    Conclusion: Oncologists, oncology nurses, and patients felt that integration of early specialist palliative care in cancer improves symptom control, end-of-life care, health-related communication, and continuity of care. The perceptions of benefit of the palliative care intervention in the components surveyed, differed among the three groups.

  12. Integrated working between residential care homes and primary care: a survey of care homes in England

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    Gage Heather

    2012-11-01

    Full Text Available Abstract Background Older people living in care homes in England have complex health needs due to a range of medical conditions, mental health needs and frailty. Despite an increasing policy expectation that professionals should operate in an integrated way across organisational boundaries, there is a lack of understanding between care homes and the National Health Service (NHS about how the two sectors should work together, meaning that residents can experience a poor "fit" between their needs, and services they can access. This paper describes a survey to establish the current extent of integrated working that exists between care homes and primary and community health and social services. Methods A self-completion, online questionnaire was designed by the research team. Items on the different dimensions of integration (funding, administrative, organisational, service delivery, clinical care were included. The survey was sent to a random sample of residential care homes with more than 25 beds (n = 621 in England in 2009. Responses were analysed using quantitative and qualitative methods. Results The survey achieved an overall response rate of 15.8%. Most care homes (78.7% worked with more than one general practice. Respondents indicated that a mean of 14.1 professionals/ services (other than GPs had visited the care homes in the last six months (SD 5.11, median 14; a mean of .39 (SD.163 professionals/services per bed. The most frequent services visiting were district nursing, chiropody and community psychiatric nurses. Many (60% managers considered that they worked with the NHS in an integrated way, including sharing documents, engaging in integrated care planning and joint learning and training. However, some care home managers cited working practices dictated by NHS methods of service delivery and priorities for care, rather than those of the care home or residents, a lack of willingness by NHS professionals to share information, and low

  13. National workplace health promotion surveys: the Affordable Care Act and future surveys.

    Science.gov (United States)

    DeJoy, David M; Dyal, Mari-Amanda; Padilla, Heather M; Wilson, Mark G

    2014-01-01

    This commentary reviews findings from the four previous national surveys of workplace health promotion activities (1985, 1992, 1999, and 2004, respectively) and offers recommendations for future surveys mandated under the Affordable Care Act of 2010. Future surveys should place greater emphasis on assessing program quality, reach, and effectiveness. Both employer and employee input should be sought. In addition, sampling plans should differentiate worksites from employers, and results should include public as well as private sector organizations. Ideas are offered for addressing these limitations and for creating a sustainable survey process and multifunctional database of results. PMID:24380423

  14. Working conditions in home care: a survey of Washington state's home care workers.

    Science.gov (United States)

    Hayashi, R; Gibson, J W; Weatherley, R A

    1994-01-01

    Home care services make it possible for millions of older Americans to continue living in the community. Such services may enhance the recipients' quality of life while providing essential respite to family caregivers. But while there has been increasing recognition of the burden borne by the predominantly female family caregivers, there has been less attention to the plight of the home care workforce. With the growth of the home care industry, the burden of care has to some extent shifted from one category of female caregivers to another. This paper, based on a survey of 16 agencies and 1,900 workers, examines the employment conditions of home care workers in Washington state. The study reveals a pattern of harsh working conditions, low wages, and few benefits. The findings raise questions about the ethics and efficacy of government policies that are based on the exploitation of home care workers. PMID:10134029

  15. Supplier-Induced Demand in Japan's At-home Care Industry: Evidence from Micro-level Survey on Care Receivers

    OpenAIRE

    NOGUCHI Haruko; SATOSHI Shimizutani

    2005-01-01

    We observed a remarkable increase in elderly care expenses in Japan after the introduction of public elderly care insurance in 2000. This study explores the possibility that a greater number of care providers under the deregulation of the entry policy stimulated care utilization. We take advantage of an original household-level survey data on care receivers to address the existence of supplier-induced demand in Japan's elderly at-home care market, by distinguishing between demand for care rec...

  16. African primary care research: Performing surveys using questionnaires

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    Indiran Govender

    2014-01-01

    Full Text Available The aim of this article is to provide practical guidance on conducting surveys and the use of questionnaires for postgraduate students at a Masters level who are undertaking primary care research. The article is intended to assist with writing the methods section of the research proposal and thinking through the relevant issues that apply to sample size calculation, sampling strategy, design of a questionnaire and administration of a questionnaire. The articleis part of a larger series on primary care research, with other articles in the series focusing on the structure of the research proposal and the literature review, as well as quantitative data analysis.

  17. 2010 Critical Care Transport Workplace and Salary Survey.

    Science.gov (United States)

    Greene, Michael J

    2010-01-01

    Critical care transport (CCT) leaders and managers from 300 organizations were invited to participate in an online survey (participation rate, 34%) with approximately 150 questions covering a broad base of CCT organizational, workplace, personnel, and salary matters. In addition to medical team composition, recruitment and retention, training, education, and benefits, the survey presents CCT crew salary data by job class by Bowley's seven-figure summary, as well as average, minimum, and maximum hourly rates. Salaries are reported in a national aggregate and by Association of Air Medical Services region. PMID:20826354

  18. 2011 critical care transport workplace and salary survey.

    Science.gov (United States)

    Greene, Michael J

    2011-01-01

    Critical care transport (CCT) leaders from 260 organizations were invited to participate in an online, hosted survey of industry compensation and workplace practices. Approximately 150 questions were presented to participants, soliciting a broad base of information on CCT organizations, personnel, compensation, and workplace practices, notably alertness and fatigue management. CCT organizational salaries are represented by common job class and reported by summary with minimum, middle, and maximum hourly rates in a national aggregate and by Association of Air Medical Services region. PMID:22055178

  19. African primary care research: performing surveys using questionnaires

    OpenAIRE

    Indiran Govender; Mabuza, Langalibalele H.; Ogunbanjo, Gboyega A.; Bob Mash

    2014-01-01

    The aim of this article is to provide practical guidance on conducting surveys and the use of questionnaires for postgraduate students at a Masters level who are undertaking primary care research. The article is intended to assist with writing the methods section of the research proposal and thinking through the relevant issues that apply to sample size calculation, sampling strategy, design of a questionnaire and administration of a questionnaire. The articleis part of a larger series on pri...

  20. Surveying Consumer Satisfaction to Assess Managed-Care Quality: Current Practices

    OpenAIRE

    Gold, Marsha; Wooldridge, Judith

    1995-01-01

    Growing interest in using consumer satisfaction information to enhance quality of care and promote informed consumer choice has accompanied recent expansions in managed care. This article synthesizes information about consumer satisfaction surveys conducted by managed-care plans, government and other agencies, community groups, and purchasers of care. We discuss survey content, methods, and use of consumer survey information. Differences in the use of consumer surveys preclude one instrument ...

  1. Family Child Care Providers’ Compliance With State Physical Activity Regulations, Delaware Child Care Provider Survey, 2011

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    Sarah Williams Leng, MA

    2013-07-01

    Full Text Available Introduction Delaware is one state that has implemented comprehensive child care regulations to foster healthy dietary and physical activity behaviors of young children. This study describes the Delaware family child care environment and providers’ knowledge of and compliance with physical activity regulations. We analyzed the data to determine characteristics associated with predictors of knowledge of and compliance with these regulations. Methods A random stratified sample of 663 licensed Delaware family child care providers was mailed a survey on family child care characteristics and providers’ awareness and practices of the child care regulations. Three logistic regression models were used to explore the association between provider characteristics and their knowledge of and compliance with the regulations. Results Ultimately, 313 of the 663 eligible family child care providers participated in the survey (47.2% response rate. Controlling for covariates, we found that family child care providers’ education level was significantly associated with knowledge of the physical activity regulation. Another model showed that family child care providers with larger amounts of outdoor space were more likely to report compliance with the recommendation for unstructured physical activity than those without this described space (odds ratio, 2.45. A third model showed a significant association between available indoor space for all activities including running and reported greater compliance with the recommendation for structured physical activity than was reported by caregivers with less indoor space (odds ratio, 11.2. Conclusion To provide the recommended levels of physical activity for children in child care, the available physical space environment is an important area of focus for advocates of physical activity recommendations within the family child care environment.

  2. Radiotherapy skin care: A survey of practice in the UK

    International Nuclear Information System (INIS)

    Aim: The primary objective of the survey was to evaluate clinical skin care practice in radiotherapy departments across the United Kingdom. Methods and sample: A questionnaire containing sixty-one questions grouped into eight themed sections was developed and a link to an on-line survey, using the Survey Monkey™ tool, was e-mailed to all radiotherapy department managers in the United Kingdom (N = 67). Each recipient was invited to provide one response per department. Key results: Fifty-four departments responded within the allocated timeframe giving a final response rate of 81%. Products and their use for skin conditions varied and some outdated and unfounded practices were still being used which did not always reflect the current evidence base. The amount of data routinely collected on skin toxicity was limited making it difficult to quantify the extent of skin morbidity following radiotherapy. Conclusion: The survey demonstrated variability in skin care practice in radiotherapy departments across the UK, with limited practice based on evidence or on skin toxicity measurement and monitoring.

  3. An overview of neurocritical care in China: a nationwide survey

    Institute of Scientific and Technical Information of China (English)

    SU Ying-ying; WANG Miao; FENG Huan-huan; CHEN Wei-bi; YE Hong; GAO Dai-quan; ZHANG Yan

    2013-01-01

    Background Little quantitative evidence was available regarding the development of NICUs in China.The purpose of this survey was to evaluate the current situation of neurointensive care units (NICUs) across China.Methods The directors of NICUs from 100 tertiary care hospitals across China were contacted and asked to complete a closed response questionnaire regarding their NICUs.Basic information,equipment,and technology information available in the units,as well as staffing information were investigated.Results Seventy-six questionnaires were returned (a 68% response rate).Of 76 NICUs,43 units constituted the majority.The number of each NICU bed varied from 4 to 45,occupying 2%-30% of the total department beds.Over 70% of NICUs were equipped with many emergency treatment equipments as well as physiological and biochemical monitoring equipments,while 34%-70% of NICUs still lacked some kinds of equipments such as defibrillators.Some specialist equipments were still partially lacking in 62%-95% of NICUs.A vast majority of the NICUs were equipped with neurocritical care directors,full-time attending physicians,and head nurses,but full-time NICU residents and neurocritical care nurses were still lacking in nearly half (53%) and one-third (33%-37%) of NICUs,respectively.In 76 NICUs,full-time neurointensivists and nurses added up to 359 and 852,respectively.In addition,78%-97% of all the surveyed NICUs were severely short of non-neurological professional staffs.Conclusion In China,neurocritical care has developed rapidly,but there is still a shortage of well-equipped and wellstaffed NICUs across the nation currently.

  4. Costs and prospects for home based Long Term Care in Northern Italy: the Galca survey

    OpenAIRE

    Bettio, Francesca; Mazzotta, Fernanda; Solinas, Giovanni

    2007-01-01

    An important issue in the design of sustainable Long Term Care policies is the relative social cost of community or home based care versus institutional care. Here we undertake this cost comparison making use of the findings from the GALCA surveys on Long Term Care in Denmark, Ireland and Italy but confining attention to Italy. The survey for Italy was conducted in the municipality of Modena that may be considered broadly representative of Long Term Care conditions in the North of the country...

  5. Addressing Tobacco in Managed Care: Results of the 2002 Survey

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    Carol McPhillips-Tangum

    2004-10-01

    Full Text Available Introduction In the United States, tobacco use is the leading preventable cause of death and disease. The health and cost consequences of tobacco dependence have made treatment and prevention of tobacco use a key priority among multiple stakeholders, including health plans, insurers, providers, employers, and policymakers. In 2002, the third survey of tobacco control practices and policies in health plans was conducted by America’s Health Insurance Plans’ technical assistance office as part of the Addressing Tobacco in Managed Care (ATMC program. Methods The ATMC survey was conducted in the spring of 2002 via mail, e-mail, and fax. A 19-item survey instrument was developed and pilot-tested. Of the 19 items, 12 were the same as in previous years, four were modified to collect more detailed data on areas of key interest, and three were added to gain information about strategies to promote smoking cessation. The sample for the survey was drawn from the 687 plans listed in the national directory of member and nonmember health plans in America's Health Insurance Plans. Results Of the 246 plans in the sample, 152 plans (62% representing more than 43.5 million health maintenance organization members completed the survey. Results show that health plans are using evidence-based programs and clinical guidelines to address tobacco use. Compared to ATMC survey data collected in 1997 and 2000, the 2002 ATMC survey results indicate that more health plans are providing full coverage for first-line pharmacotherapies and telephone counseling for smoking cessation. Plans have also shown improvement in their ability to identify at least some members who smoke. Similarly, a greater percentage of plans are employing strategies to address smoking cessation during the postpartum period to prevent smoking relapse and during pediatric visits to reduce or eliminate children’s exposure to environmental tobacco smoke. Conclusion The results of the 2002 ATMC survey

  6. Status of simulation in health care education: an international survey

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    Qayumi K

    2014-11-01

    Full Text Available Karim Qayumi,1 George Pachev,2 Bin Zheng,3 Amitai Ziv,4 Valentyna Koval,1 Sadia Badiei,5 Adam Cheng6 1Center of Excellence for Simulation Education and Innovation, Department of Surgery, 2Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada; 3Surgical Simulation Research Laboratory, Department of Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada; 4Israel Center for Medical Simulation, Chaim Sheba Medical Center and Sackler Medical School, Tel Aviv University, Tel Aviv, Israel; 5Centre of Excellence for Simulation Education and Innovation, University of British Columbia, Vancouver, BC, Canada; 6KidSIM-ASPIRE Simulation Research Program, Alberta Children’s Hospital, University of Calgary, Calgary, AB, CanadaAbstract: Simulation is rapidly penetrating the terrain of health care education and has gained growing acceptance as an educational method and patient safety tool. Despite this, the state of simulation in health care education has not yet been evaluated on a global scale. In this project, we studied the global status of simulation in health care education by determining the degree of financial support, infrastructure, manpower, information technology capabilities, engagement of groups of learners, and research and scholarly activities, as well as the barriers, strengths, opportunities for growth, and other aspects of simulation in health care education. We utilized a two-stage process, including an online survey and a site visit that included interviews and debriefings. Forty-two simulation centers worldwide participated in this study, the results of which show that despite enormous interest and enthusiasm in the health care community, use of simulation in health care education is limited to specific areas and is not a budgeted item in many institutions. Absence of a sustainable business model, as well as sufficient financial support in terms of budget, infrastructure

  7. A Survey on Ambient Intelligence in Health Care.

    Science.gov (United States)

    Acampora, Giovanni; Cook, Diane J; Rashidi, Parisa; Vasilakos, Athanasios V

    2013-12-01

    Ambient Intelligence (AmI) is a new paradigm in information technology aimed at empowering people's capabilities by the means of digital environments that are sensitive, adaptive, and responsive to human needs, habits, gestures, and emotions. This futuristic vision of daily environment will enable innovative human-machine interactions characterized by pervasive, unobtrusive and anticipatory communications. Such innovative interaction paradigms make ambient intelligence technology a suitable candidate for developing various real life solutions, including in the health care domain. This survey will discuss the emergence of ambient intelligence (AmI) techniques in the health care domain, in order to provide the research community with the necessary background. We will examine the infrastructure and technology required for achieving the vision of ambient intelligence, such as smart environments and wearable medical devices. We will summarize of the state of the art artificial intelligence methodologies used for developing AmI system in the health care domain, including various learning techniques (for learning from user interaction), reasoning techniques (for reasoning about users' goals and intensions) and planning techniques (for planning activities and interactions). We will also discuss how AmI technology might support people affected by various physical or mental disabilities or chronic disease. Finally, we will point to some of the successful case studies in the area and we will look at the current and future challenges to draw upon the possible future research paths. PMID:24431472

  8. 78 FR 51276 - Proposed Information Collection (Access to Care Dialysis Pilot Survey and Interview); Activity...

    Science.gov (United States)

    2013-08-20

    ... Questionnaire, VA Form 10-10067. b. Access to Care Semi-Structured Interview Guide. OMB Control Number: 2900-NEW... AFFAIRS Proposed Information Collection (Access to Care Dialysis Pilot Survey and Interview); Activity... refer to ``OMB Control No. 2900-NEW (Access to Care Dialysis Pilot Survey and Interview)'' in...

  9. Improving Wait Times to Care for Individuals with Multimorbidities and Complex Conditions Using Value Stream Mapping

    Directory of Open Access Journals (Sweden)

    Tara Sampalli

    2015-07-01

    Full Text Available Background Recognizing the significant impact of wait times for care for individuals with complex chronic conditions, we applied a LEAN methodology, namely – an adaptation of Value Stream Mapping (VSM to meet the needs of people with multiple chronic conditions and to improve wait times without additional resources or funding. Methods Over an 18-month time period, staff applied a patient-centric approach that included LEAN methodology of VSM to improve wait times to care. Our framework of evaluation was grounded in the needs and perspectives of patients and individuals waiting to receive care. Patient centric views were obtained through surveys such as Patient Assessment of Chronic Illness Care (PACIC and process engineering based questions. In addition, LEAN methodology, VSM was added to identify non-value added processes contributing to wait times. Results The care team successfully reduced wait times to 2 months in 2014 with no wait times for care anticipated in 2015. Increased patient engagement and satisfaction are also outcomes of this innovative initiative. In addition, successful transformations and implementation have resulted in resource efficiencies without increase in costs. Patients have shown significant improvements in functional health following Integrated Chronic Care Service (ICCS intervention. The methodology will be applied to other chronic disease management areas in Capital Health and the province. Conclusion Wait times to care in the management of multimoribidities and other complex conditions can add a significant burden not only on the affected individuals but also on the healthcare system. In this study, a novel and modified LEAN methodology has been applied to embed the voice of the patient in care delivery processes and to reduce wait times to care in the management of complex chronic conditions.

  10. Oral care practices for patients in Intensive Care Units: A pilot survey

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    Alexandre Franco Miranda

    2016-01-01

    Full Text Available Objective: To assess the level of knowledge and difficulties concerning hospitalized patients regarding preventive oral health measures among professionals working in Intensive Care Units (ICUs. Study Population and Methods: A cross-sectional survey was conducted among 71 health professionals working in the ICU. A self-administered questionnaire was used to determine the methods used, frequency, and attitude toward oral care provided to patients in Brazilian ICUs. The variables were analyzed using descriptive statistics (percentages. A one-sample t-test between proportions was used to assess significant differences between percentages. t-statistics were considered statistically significant for P < 0.05. Bonferroni correction was applied to account for multiple testing. Results: Most participants were nursing professionals (80.3% working 12-h shifts in the ICU (70.4%; about 87.3% and 66.2% reported having knowledge about coated tongue and nosocomial pneumonia, respectively (P < 0.05. Most reported using spatulas, gauze, and toothbrushes (49.3% or only toothbrushes (28.2% with 0.12% chlorhexidine (49.3% to sanitize the oral cavity of ICU patients (P < 0.01. Most professionals felt that adequate time was available to provide oral care to ICU patients and that oral care was a priority for mechanically ventilated patients (80.3% and 83.1%, respectively, P < 0.05. However, most professionals (56.4% reported feeling that the oral cavity was difficult to clean (P < 0.05. Conclusion: The survey results suggest that additional education is necessary to increase awareness among ICU professionals of the association between dental plaque and systemic conditions of patients, to standardize oral care protocols, and to promote the oral health of patients in ICUs.

  11. Satisfaction survey on the critical care response team services in a teaching hospital

    OpenAIRE

    Saad Al Qahtani

    2011-01-01

    Saad Al Qahtani1,21Intensive Care Department, Critical Care Response Team, King Abdulaziz Medical City (KAMC), National Guard Health Affairs, 2King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, Kingdom of Saudi ArabiaIntroduction: Patient care and safety is the main goal and mission of any health care provider. We surveyed nurses in the wards and obtained their feedback about the quality of care delivered by the Critical Care Response Team (CCRT).Methods: Our...

  12. Survey of CAM interest, self-care, and satisfaction with health care for type 2 diabetes at group health cooperative

    Directory of Open Access Journals (Sweden)

    Bradley Ryan

    2011-12-01

    Full Text Available Abstract Background Very little research has explored the factors that influence interest in complementary and alternative medicine (CAM treatments. We surveyed persons with sub-optimally controlled type 2 diabetes to evaluate potential relationships between interest in complementary and alternative medicine (CAM treatments, current self-care practices, motivation to improve self-care practices and satisfaction with current health care for diabetes. Methods 321 patients from a large integrated healthcare system with type 2 diabetes, who were not using insulin and had hemoglobin A1c values between 7.5-9.5%, were telephoned between 2009-2010 and asked about their self-care behaviors, motivation to change, satisfaction with current health care and interest in trying naturopathic (ND care for their diabetes. Responses from patients most interested in trying ND care were compared with those from patients with less interest. Results 219 (68.5% patients completed the survey. Nearly half (48% stated they would be very likely to try ND care for their diabetes if covered by their insurance. Interest in trying ND care was not related to patient demographics, health history, clinical status, or self-care behaviors. Patients with greater interest in trying ND care rated their current healthcare as less effective for controlling their blood sugar (mean response 5.9 +/- 1.9 vs. 6.6 +/- 1.5, p = 0.003, and were more determined to succeed in self-care (p = 0.007. Current CAM use for diabetes was also greater in ND interested patients. Conclusions Patients with sub-optimally controlled type 2 diabetes expressed a high level of interest in trying ND care. Those patients with the greatest interest were less satisfied with their diabetes care, more motivated to engage in self-care, and more likely to use other CAM therapies for their diabetes.

  13. A survey of nurses' and podiatrists' attitudes, skills and knowledge of lower extremity wound care

    OpenAIRE

    McIntosh, Caroline; Ousey, Karen

    2008-01-01

    Published literature has identified deficits in the wound care knowledge of many healthcare professionals involved in tissue viability, which may suggest some patients are receiving suboptimal care. This article explores podiatrists’ and nurses’ attitudes, knowledge and skills regarding lower extremity wound care. Interactive electronic voting pads were used to survey a sample of nurses and podiatrists (n=102). The results were used to inform the delivery of wound care education at the Unvers...

  14. Internet and technology transfer in acute care hospitals in the United States: survey-2000.

    Science.gov (United States)

    Hatcher, M

    2001-12-01

    This paper provides the results of the survey-2000 measuring technology transfer and, specifically, Internet usage. The purpose of the survey was to measure the levels of Internet and Intranet existence and usage in acute care hospitals. The depth of the survey includes e-commerce for both business-to-business and customers. These results are compared with responses to the same questions in survey-1997. Changes in response are noted and discussed. This information will provide benchmarks for hospitals to plan their network technology position and to set goals. This is the third of three articles based upon the results of the survey-2000. Readers are referred to prior articles by the author, which discuss the survey design and provide a tutorial on technology transfer in acute care hospitals. (1) Thefirst article based upon the survey results discusses technology transfer, system design approaches, user involvement, and decision-making purposes. (2) PMID:11708395

  15. National survey of US primary care physicians’ perspectives about causes of obesity and solutions to improve care

    OpenAIRE

    Bleich, Sara N.; Bennett, Wendy L.; Gudzune, Kimberly A.; Cooper, Lisa A.

    2012-01-01

    Objective To describe physician perspectives on the causes of and solutions to obesity care and identify differences in these perspectives by number of years since completion of medical school. Design National cross-sectional online survey from 9 February to 1 March 2011. Setting USA. Participants 500 primary care physicians. Main Measures We evaluated physician perspectives on: (1) causes of obesity, (2) competence in treating obese patients, (3) perspectives on the health professional most ...

  16. A Survey of Managed Care Education at Optometry Schools.

    Science.gov (United States)

    Soroka, Mort; Reis, Lesley

    2003-01-01

    Studied the courses and topics offered at schools of optometry and the total hours devoted to managed care. Responses from the 17 schools of optometry reveal significant variations in curricular coverage of managed care, although a core set of materials was found to exist that could be the basis for more standard curriculum. (SLD)

  17. Screening for atrial fibrillation – a cross-sectional survey of healthcare professionals in primary care

    OpenAIRE

    Taggar, Jaspal; Coleman, Tim; Lewis, Sarah; Jones, Matthew

    2016-01-01

    Introduction: Screening for atrial fibrillation (AF) in primary care has been recommended; however, the views of healthcare professionals (HCPs) are not known. This study aimed to determine the opinions of HCP about the feasibility of implementing screening within a primary care setting. Methods: A cross-sectional mixed methods census survey of 418 HCPs from 59 inner-city practices (Nottingham, UK) was conducted between October-December 2014. Postal and web-surveys ascertained data ...

  18. Health care payments in the asia pacific: validation of five survey measures of economic burden

    OpenAIRE

    Reddy, Sheila R; Ross-Degnan, Dennis; Zaslavsky, Alan M.; Soumerai, Stephen B; Wagner, Anita K

    2013-01-01

    Introduction: Many low and middle-income countries rely on out-of-pocket payments to help finance health care. These payments can pose financial hardships for households; valid measurement of this type of economic burden is therefore critical. This study examines the validity of five survey measures of economic burden caused by health care payments. Methods: We analyzed 2002/03 World Health Survey household-level data from four Asia Pacific countries to assess the construct validity of five m...

  19. Health care payments in the asia pacific: validation of five survey measures of economic burden

    OpenAIRE

    Reddy, Sheila R; Ross-Degnan, Dennis; Zaslavsky, Alan M.; Soumerai, Stephen B; Wagner, Anita K

    2013-01-01

    Introduction Many low and middle-income countries rely on out-of-pocket payments to help finance health care. These payments can pose financial hardships for households; valid measurement of this type of economic burden is therefore critical. This study examines the validity of five survey measures of economic burden caused by health care payments. Methods We analyzed 2002/03 World Health Survey household-level data from four Asia Pacific countries to assess the construct validity of five mea...

  20. Using hospital surveys to enhance the quality of care.

    Science.gov (United States)

    Carey, R G

    1989-11-01

    Hospitals need the data that valid surveys can provide. However, no data are better than inaccurate or poorly interpreted data. Survey research appears to be deceptively simple. Many hospital managers are not sensitive to the pitfalls in writing a quality questionnaire and some who have their own personal computers believe that they can enter and tabulate the data. However, just as medical technology has advanced and become more complicated in recent years, survey research has also become more sophisticated during the past decade. The use of computers has assisted in the display of vast amounts of survey data, but interpretation is still the key to effective survey research. Many people can read the same table of data but come to different conclusions, depending on their point of view and their level of involvement with the issues being discussed. It is only human nature to interpret data to support what we believe to be the truth. Hospital managers should understand that interpretation of survey data is best done by neutral and skilled professionals who have worked closely with those who have authority to make costly decisions based on the results. A radiologist will tell you that reading a CT scan is an art as well as a science. So is quality survey research. PMID:10295772

  1. Deficiencies in Suicide Training in Primary Care Specialties: A Survey of Training Directors

    Science.gov (United States)

    Sudak, Donna; Roy, Alec; Sudak, Howard; Lipschitz, Alan; Maltsberger, John; Hendin, Herbert

    2007-01-01

    Objective: A high percentage of suicide victims have seen a primary care physician in the months before committing suicide. Thus, primary care physicians may play an important role in suicide prevention. Method: The authors mailed a survey to directors of training programs in family practice, internal medicine, and pediatrics, and 50.5% responded.…

  2. Development of a Fall Prevention Survey to Determine Educational Needs for Primary Care Providers

    Science.gov (United States)

    Kramer, B. Josea; Ganz, David A.; Vivrette, Rebecca L.; Harker, Judith O.; Josephson, Karen R.; Saliba, Debra

    2010-01-01

    Quality indicators are standardized measures of health care quality. We designed a survey to assess how knowledge, attitude, and organizational practices might affect healthcare provider behaviors in meeting quality indicators for fall prevention to plan curricula for a continuing educational intervention. The survey was pilot tested in the…

  3. Patient satisfaction with in-centre haemodialysis care: an international survey

    OpenAIRE

    Palmer, Suetonia C; De Berardis, Giorgia; Craig, Jonathan C; Tong, Allison; Tonelli, Marcello; Pellegrini, Fabio; Ruospo, Marinella; Hegbrant, Jörgen; Wollheim, Charlotta; Celia, Eduardo; Gelfman, Ruben; Ferrari, Juan Nin; Törok, Marietta; Murgo, Marco; Leal, Miguel

    2014-01-01

    Objectives To evaluate patient experiences of specific aspects of haemodialysis care across several countries. Design Cross-sectional survey using the Choices for Healthy Outcomes in Caring for End-Stage Renal Disease (CHOICE) questionnaire. Setting Haemodialysis clinics within a single provider in Europe and South America. Participants 2748 adults treated in haemodialysis. Primary and secondary outcomes The primary outcome was patient satisfaction with overall care. Secondary outcomes includ...

  4. Welcome back survey: exploring concerns impacting HIV care engagement and retention.

    Science.gov (United States)

    Gonzalez, Marisol; Precht, Allison; Fletcher, Jason; Catrambone, Jennifer; Bailey, L'Oreal; Espino, Susan Ryerson

    2016-09-01

    The current study describes the development of a short pre-clinic survey that helped multidiscipline providers to elicit patient perspective on barriers to HIV primary care. The survey was piloted with 318 patients returning to care after being lost to care for at least 12 months. Reasons for breaks in care were dependent on age, gender, and race. Concerns about confidentiality in care were more commonly reported by African-American, Latino, and younger patients, while concerns relating to acceptance of diagnosis and side effects were greater for women, African-American, and Latino participants. Further, Intimate Partner Violence (IPV) and transportation were greater concerns for women and younger patients in the sample. PMID:26916635

  5. The psychosocial oncology learning assessment: a province-wide survey of cancer care providers' learning needs.

    Science.gov (United States)

    Rennie, Heather; Mackenzie, Gina

    2010-06-01

    A psychosocial oncology learning needs assessment was developed and offered online to cancer care providers in a variety of settings across all health regions in British Columbia. The purpose was to better understand the psychosocial learning needs of cancer care providers and to use this knowledge to shape continuing education priorities. Respondents' preferred learning formats, access to technology and barriers to accessing psychosocial learning opportunities were also assessed. Cancer care providers including radiation therapists, social workers, dieticians, pharmacists, physicians and nurses in both community and agency settings were surveyed. Two hundred and sixty-seven people completed the survey. Key learning needs identified included cultural aspects of care, symptom management, treating the anxious patient, self-care for the professional, care of elderly patients, basic cancer-related medical issues surrounding care and ethics. Community respondents indicated more needs than agency respondents. On-site training was the most preferred learning format, and time constraints were the biggest barrier to accessing learning opportunities. Participants had access to technology. Next steps include conducting key informant and focus group interviews to determine if interest in a learning need is the same as a relevant knowledge and practice gap. This research suggests that cancer care providers are interested in learning more about the psychosocial issues related to cancer care. PMID:20361284

  6. Medicaid payment policies for nursing home care: A national survey

    OpenAIRE

    Buchanan, Robert J.; Madel, R. Peter; Persons, Dan

    1991-01-01

    This research gives a comprehensive overview of the nursing home payment methodologies used by each State Medicaid program. To present this comprehensive overview, 1988 data were collected by survey from 49 States and the District of Columbia. The literature was reviewed and integrated into the study to provide a theoretical framework to analyze the collected data. The data are organized and presented as follows: payment levels, payment methods, payment of capital-related costs, and incentive...

  7. Pediatric Primary Care Providers' Relationships with Mental Health Care Providers: Survey Results

    Science.gov (United States)

    Pidano, Anne E.; Honigfeld, Lisa; Bar-Halpern, Miri; Vivian, James E.

    2014-01-01

    Background: As many as 20 % of children have diagnosable mental health conditions and nearly all of them receive pediatric primary health care. However, most children with serious mental health concerns do not receive mental health services. This study tested hypotheses that pediatric primary care providers (PPCPs) in relationships with mental…

  8. Burn unit care of Stevens Johnson syndrome/toxic epidermal necrolysis: A survey.

    Science.gov (United States)

    Le, Hong-Gam; Saeed, Hajirah; Mantagos, Iason S; Mitchell, Caroline M; Goverman, Jeremy; Chodosh, James

    2016-06-01

    Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a systemic disease that can be associated with debilitating acute and chronic complications across multiple organ systems. As patients with acute SJS/TEN are often treated in a burn intensive care unit (BICU), we surveyed burn centers across the United States to determine their approach to the care of these patients. The goal of our study was to identify best practices and possible variations in the care of patients with acute SJS/TEN. We demonstrate that the method of diagnosis, use of systemic therapies, and involvement of subspecialists varied significantly between burn centers. Beyond supportive care provided to every patient, our data highlights a lack of standardization in the acute care of patients with SJS/TEN. A comprehensive guideline for the care of patients with acute SJS/TEN is indicated. PMID:26810444

  9. Examining the role of information exchange in residential aged care work practices-a survey of residential aged care facilities

    OpenAIRE

    Gaskin Sarah; Georgiou Andrew; Barton Donna; Westbrook Johanna

    2012-01-01

    Abstract Background The provision of residential aged care is underpinned by information, and is reliant upon systems that adequately capture and effectively utilise and communicate this information. The aim of this study was to explicate and quantify the volume and method by which information is collected, exchanged within facilities and with external providers, and retrieved from facility information systems and hospitals. Methods A survey of staff (n = 119), including managers, health info...

  10. Development of a survey instrument to measure patient experience of integrated care

    OpenAIRE

    Walker, Kara Odom; Stewart, Anita L; Grumbach, Kevin

    2016-01-01

    Background Healthcare systems are working to move towards more integrated, patient-centered care. This study describes the development and testing of a multidimensional self-report measure of patients’ experiences of integrated care. Methods Random-digit-dial telephone survey in 2012 of 317 adults aged 40 years or older in the San Francisco region who had used healthcare at least twice in the past 12 months. One-time cross-sectional survey; psychometric evaluation to confirm dimensions and cr...

  11. A Survey of Primary Care Offices: Triage of Poisoning Calls without a Poison Control Center

    OpenAIRE

    Travis Austin; Brooks, Daniel E.; Sharyn Welch; Frank LoVecchio

    2012-01-01

    Poison control centers hold great potential for saving health care resources particularly by preventing unnecessary medical utilization. We developed a four-question survey with three poisoning-related scenarios, based on common calls to our poison center, and one question regarding after-hours calls. We identified primary care provider offices in our poison center's region from an internet search. We contacted these offices via telephone and asked to speak to an office manager or someone res...

  12. Satisfaction survey on the critical care response team services in a teaching hospital

    Directory of Open Access Journals (Sweden)

    Saad Al Qahtani

    2011-03-01

    Full Text Available Saad Al Qahtani1,21Intensive Care Department, Critical Care Response Team, King Abdulaziz Medical City (KAMC, National Guard Health Affairs, 2King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Riyadh, Kingdom of Saudi ArabiaIntroduction: Patient care and safety is the main goal and mission of any health care provider. We surveyed nurses in the wards and obtained their feedback about the quality of care delivered by the Critical Care Response Team (CCRT.Methods: Our hospital has 900 beds. A self-administered survey was given onsite to all ward nurses. Survey items were identified, discussed, reviewed, piloted, and finalized over a 3-month period in a focus group discussion format during three CCRT core group meetings. Responses were anonymous and collected by the nurses onsite.Results: The total number of returned and analyzed surveys was 274 (98.6%. Ninety-seven percent agreed that CCRT staff arrived in a timely manner. Ninety-four percent reported that CCRT staff helped in managing sick patients and ~70% reported that it strengthened team dynamics. Only 50% of the nurses felt CCRT staff improved competence at the bedside. The overall satisfaction was 100%; none of the nurses were dissatisfied with the team.Conclusion: The CCRT helped manage sick patients in the wards. However, CRRT staff should remember to involve and communicate with the team initiator and the patient’s physician to optimize patient health care.Keywords: rapid response team, medical emergency team, critical care response team, satisfaction

  13. Practice patterns of physiotherapists in neonatal intensive care units: A national survey

    OpenAIRE

    Chokshi, Tejas; Alaparthi, Gopala Krishna; Krishnan, Shyam; Vaishali, K; Zulfeequer, C.P.

    2013-01-01

    Objective: To determine practice pattern of physiotherapists in the neonatal intensive care units (ICUs) in India with regards to cardiopulmonary and neuromuscular physiotherapy. Materials and Methods: A cross-sectional survey was conducted across India, in which 285 questionnaires were sent via e-mail to physiotherapists working in neonatal intensive care units. Results: A total of 139 completed questionnaires were returned with a response rate of 48.7%, with a majority of responses from Kar...

  14. A Pilot Survey of Clergy Regarding Mental Health Care for Children

    OpenAIRE

    Leigh Blalock; Dew, Rachel E.

    2012-01-01

    Collaborations between healthcare and faith-based organizations have emerged in the drive to improve access to care. Little research has examined clergy views on collaborations in the provision of mental healthcare, particularly to children. The current paper reports survey responses of 25 clergy from diverse religious traditions concerning mental health care in children. Subjects queried include clergy referral habits, specific knowledge of childhood conditions such as depression and anxiety...

  15. Indicators of Family Care for Development for Use in Multicountry Surveys

    OpenAIRE

    Kariger, Patricia; Frongillo, Edward A.; Engle, Patrice; Britto, Pia M. Rebello; Sywulka, Sara M.; Menon, Purnima

    2012-01-01

    Indicators of family care for development are essential for ascertaining whether families are providing their children with an environment that leads to positive developmental outcomes. This project aimed to develop indicators from a set of items, measuring family care practices and resources important for caregiving, for use in epidemiologic surveys in developing countries. A mixed method (quantitative and qualitative) design was used for item selection and evaluation. Qualitative and quanti...

  16. The ethics of animal research: a survey of pediatric health care workers

    OpenAIRE

    Ari R. Joffe; Bara, Meredith; Anton, Natalie; Nobis, Nathan

    2014-01-01

    Introduction Pediatric health care workers (HCW) often perform, promote, and advocate use of public funds for animal research (AR). We aim to determine whether HCW consider common arguments (and counterarguments) in support (or not) of AR convincing. Design After development and validation, an e-mail survey was sent to all pediatricians and pediatric intensive care unit nurses and respiratory therapists (RTs) affiliated with a Canadian University. We presented questions about demographics, su...

  17. Health care issues in Croatian elections 2005-2009: series of public opinion surveys

    OpenAIRE

    Radin, Dagmar; Džakula, Aleksandar; Benković, Vanesa

    2011-01-01

    Aim To compare the results of a series of public opinion surveys on experiences with the health care sector in Croatia conducted in the time of elections and to analyze whether political party affiliation had any influence on issues of priority ranking. Methods The surveys were conducted during 2005, 2007, and 2009. They were administered through a Computer Assisted Telephone Interviewing method to representative samples of Croatian population and were statistically weighted according to sex,...

  18. Swedish Hospital Survey on Patient Safety Culture - Psychometric properties and health care staff’s perception

    OpenAIRE

    2013-01-01

    This study examined the psychometric properties of the Swedish and the original version of the Hospital Survey on Patient Safety Culture within a Swedish hospital setting and described health care staff’s per- ceptions of patient safety culture. A web-survey was used to obtain data from registered nurses, enrolled nurses and physicians (N = 1023). Psychometric properties were tested using Confirmatory Factor Analysis and internal consistency using Cronbach’s alpha coefficient. Root mean squar...

  19. Informal Care and Inter-vivos Transfers: Results from the National Longitudinal Survey of Mature Women.

    Science.gov (United States)

    Norton, Edward C; Nicholas, Lauren H; Huang, Sean Sheng-Hsiu

    2013-05-01

    Informal care is the largest source of long-term care for elderly, surpassing home health care and nursing home care. By definition, informal care is unpaid. It remains a puzzle why so many adult children give freely of their time. Transfers of time to the older generation may be balanced by financial transfers going to the younger generation. This leads to the question of whether informal care and inter-vivos transfers are causally related. We analyze data from the 1999 and 2003 waves of National Longitudinal Survey of Mature Women. We examine whether the elderly parents give more inter-vivos monetary transfers to adult children who provide informal care, by examining both the extensive and intensive margins of financial transfers and of informal care. We find statistically significant results that a child who provides informal care is more likely to receive inter-vivos transfers than a sibling who does not. If a child does provide care, there is no statistically significant effect on the amount of the transfer. PMID:25285181

  20. A survey of health care benefits in the apparel industry.

    Science.gov (United States)

    Moore, W B

    1985-09-01

    Each day as Americans prepare to begin their days, many put on their clothing often without a thought as to how or where it was manufactured. The manufacture of clothing in the United States is a labor intensive industry pressed by competition in foreign countries where labor is abundant and less expensive; therefore, the manufacturers must look for every opportunity to reduce their costs. The survey presented here reviews the health benefit plans in the apparel industry and current initiatives for cost reduction. The results are interesting, for they give the hospital administrator vital information on the types of programs that might be in place in local manufacturers and the method of cost containment expected in this industry. PMID:10273751

  1. Seroepidemiological survey of health care workers in Maharashtra

    Directory of Open Access Journals (Sweden)

    S Taishete

    2016-01-01

    Full Text Available Context: HCWs all over the world carry occupational risk of getting infected with major blood borne infections through needle stick injuries (NSIs. As health care industry has been expanding, risk of nosocomial infections is increasing proportionately. Measures to prevent it and put in place a mechanism to control these injuries are needed urgently, especially in India where there is not only increase in domestic demand but impetus in health tourism. Aim: To determine HBs Ag, HBc IgM level and to assess anti-HBs level prevalence in HCWs, in a tertiary care hospital and to study the influence of factors like age and sex in the vaccinated HCWs and formulate mechanism to increase awareness to create a safe working environment in the hospitals. Settings and Design: 437 HCWs, working in Laboratories, Surgical, Medical or Dental departments in 11 Civil Hospitals and Sub-district Hospitals covering 8 circles of the State. Methods and Material: Qualitative and Quantitative estimation of HBs Ag and Anti-HBs by sandwich ELISA technique and qualitative HBc IgM level by antibody-capture, non-competitive test. Liver profile (SGPT, SGOT and Alkaline Phosphatase by IFCC method done. Statistical Analysis Used: Tabulation and Pie Circle Result: 193 of the total 229 vaccinated HCWs tested positive for core antibody, meaning that they were infected prior to HBs Ag vaccination, leaving a total of 36 ′truly′ vaccinated HCWs. 11 HBs Ag positive HCWs were tested for Liver Profile and all had ALAT, ASAT and ALP within normal range. Out of total number of 141 HCWs having 10 and below IU/L anti HBs, 5 HCWs were positive for HBS Ag, showing a positivity of 3.5%. Conclusion: Need of vaccination and for post-vaccination serological testing of all HCWs considering the high rates of non-responders and low responders (anti-HBs-34.2%. Importance of educating the HCWs of safety precautions while handling body fluids, and the management of ′ sharps ′ injuries.

  2. [Beyond the convention: a qualitative survey inside the Sannio primary care Centres].

    Science.gov (United States)

    Scala, Daniela; Foglia Manzillo, Rossella; Ranisio, Gianfranca; Crescenzo, Simone

    2012-01-01

    Beyond the convention:a qualitative survey inside the Sannio primary care Centres.Within primary care, multidisciplinary team working is essential to promote and maintain the health whilst improving service effectiveness. This study aims to explore the effects of the new organisation of the primary care on the professional and emotional level of the professionals working in the three primary care Centres in Sannio, Benevento, utilizing the focus group technique. Our findings show the professional and organizational effort of primary care professionals to change working methods and tools. Despite teamwork being an efficient and productive way of achieving goals and results, several barriers exist that hinder its potential from becoming fully exploited. PMID:22322622

  3. A survey of midwives' views on providing aspects of antenatal care in Estonia

    DEFF Research Database (Denmark)

    Lazarus, Jeffrey V; Rull, Kristiina; Wyn Huws, Dyfed; Rasch, Vibeke; Liljestrand, Jerker

    2008-01-01

    OBJECTIVE: to survey the views of midwives in Estonia about who they considered should have responsibility for carrying out certain aspects of antenatal care (ANC) in Estonia. DESIGN, SETTING AND STUDY POPULATION: in collaboration with key stakeholder organisations, the authors developed eight st...

  4. The relevance of comorbidities for heart failure treatment in primary care : A European survey

    NARCIS (Netherlands)

    Sturm, HB; Haaijer-Ruskamp, FM; Veeger, NJ; Balje-Volkers, CP; Swedberg, K; van Gilst, WH

    2006-01-01

    Aim: To assess the impact of comorbidities on chronic heart failure (CHF) therapy. Methods: The IMPROVEMENT-HF survey included 11,062 patients from 100 primary care practices in 14 European countries. The influence of patient characteristics on drug regimes was assessed with multinomial logistical r

  5. Continuity of Care in the Family Medicine Residency: Results of a national survey of program directors

    OpenAIRE

    Moore, Lisa; Busing, Nick

    1993-01-01

    Based on the results of a survey of family medicine residency program directors across the country, there is a need for a national consensus on the definition of continuity of care, and on structures for teaching it and methods of evaluating it.

  6. Palliative radiotherapy for patients with bone metastases: survey of primary care physicians

    International Nuclear Information System (INIS)

    Three hundred Canadian primary care physicians were surveyed to determine their perceived barriers to the accessibility of palliative bone radiotherapy and their perceptions regarding treatment efficacy. The response rate was 61%. Factors perceived to hinder accessibility were identified, and the physicians recognized they were not comfortable with their radiotherapy knowledge

  7. Venous leg ulcer patient priorities and quality of care: results of a survey

    DEFF Research Database (Denmark)

    Kjaer, Monica Linda; Mainz, Jan; Sorensen, Lars Tue;

    2004-01-01

    -sectional study to assess the quality of and assign priority to 28 aspects of medical technical, interpersonal, and organizational care. The response rate to the mailed questionnaire and follow-up telephone survey was 80%. Almost half (46%) of patients (median age 76 years, range 30 to 92) had an ulcer history of...

  8. Factors associated with herbal use among urban multiethnic primary care patients: a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Balkrishnan Rajesh

    2004-12-01

    Full Text Available Abstract Background The use of herbal supplements in the United States has become increasingly popular. The prevalence of herbal use among primary care patients varies in previous studies; the pattern of herbal use among urban racially/ethnically diverse primary care patients has not been widely studied. The primary objectives of this study were to describe the use of herbs by ethnically diverse primary care patients in a large metropolitan area and to examine factors associated with such use. The secondary objective was to investigate perceptions about and patterns of herbal use. Methods Data for a cross-sectional survey were collected at primary care practices affiliated with the Southern Primary-care Urban Research Network (SPUR-Net in Houston, Texas, from September 2002 to March 2003. To participate in the study, patients had to be at least 18 years of age and visiting one of the SPUR-Net clinics for routine, nonacute care. Survey questions were available in both English and Spanish. Results A total of 322 patients who had complete information on race/ethnicity were included in the analysis. Overall, 36% of the surveyed patients (n = 322 indicated use of herbs, with wide variability among ethnic groups: 50% of Hispanics, 50% of Asians, 41% of Whites, and 22% of African-Americans. Significant factors associated with an individual's herbal use were ethnicity other than African-American, having an immigrant family history, and reporting herbal use by other family members. About 40% of survey respondents believed that taking prescription medications and herbal medicines together was more effective than taking either alone. One-third of herbal users reported using herbs on a daily basis. More Whites (67% disclosed their herbal use to their health-care providers than did African-Americans (45%, Hispanics (31%, or Asians (31%. Conclusions Racial/ethnic differences in herbal use were apparent among this sample of urban multiethnic adult primary care

  9. Occupational health of home care aides: results of the safe home care survey

    OpenAIRE

    Quinn, Margaret M; Markkanen, Pia K; Galligan, Catherine J; Sama, Susan R; Kriebel, David; Gore, Rebecca J.; Brouillette, Natalie M; Okyere, Daniel; Sun, Chuan; Punnett, Laura; Laramie, Angela K; Davis, Letitia

    2015-01-01

    Objectives In countries with ageing populations, home care (HC) aides are among the fastest growing jobs. There are few quantitative studies of HC occupational safety and health (OSH) conditions. The objectives of this study were to: (1) assess quantitatively the OSH hazards and benefits for a wide range of HC working conditions, and (2) compare OSH experiences of HC aides who are employed via different medical and social services systems in Massachusetts, USA. Methods HC aides were recruited...

  10. Customer satisfaction survey with clinical laboratory and phlebotomy services at a tertiary care unit level.

    Science.gov (United States)

    Koh, Young Rae; Kim, Shine Young; Kim, In Suk; Chang, Chulhun L; Lee, Eun Yup; Son, Han Chul; Kim, Hyung Hoi

    2014-09-01

    We performed customer satisfaction surveys for physicians and nurses regarding clinical laboratory services, and for outpatients who used phlebotomy services at a tertiary care unit level to evaluate our clinical laboratory and phlebotomy services. Thus, we wish to share our experiences with the customer satisfaction survey for clinical laboratory and phlebotomy services. Board members of our laboratory designed a study procedure and study population, and developed two types of questionnaire. A satisfaction survey for clinical laboratory services was conducted with 370 physicians and 125 nurses by using an online or paper questionnaire. The satisfaction survey for phlebotomy services was performed with 347 outpatients who received phlebotomy services by using computer-aided interviews. Mean satisfaction scores of physicians and nurses was 58.1, while outpatients' satisfaction score was 70.5. We identified several dissatisfactions with our clinical laboratory and phlebotomy services. First, physicians and nurses were most dissatisfied with the specimen collection and delivery process. Second, physicians and nurses were dissatisfied with phlebotomy services. Third, molecular genetic and cytogenetic tests were found more expensive than other tests. This study is significant in that it describes the first reference survey that offers a survey procedure and questionnaire to assess customer satisfaction with clinical laboratory and phlebotomy services at a tertiary care unit level. PMID:25187892

  11. Usability of patient experience surveys in Australian primary health care: a scoping review.

    Science.gov (United States)

    Gardner, Karen; Parkinson, Anne; Banfield, Michelle; Sargent, Ginny M; Desborough, Jane; Hehir, Kanupriya Kalia

    2016-01-01

    Monitoring patient experience is essential for stimulating innovation in health care and improving quality and accountability. Internationally, standardised approaches are used to collect patient experience information, but in Australian primary health care (PHC), little is known about which patient experience surveys are used and which aspects of experience they measure. This prevents routine inclusion of patient experience data in quality improvement or system performance measurement. A scoping review was undertaken to identify relevant surveys. Data on survey availability, psychometric properties, target population, method and frequency of administration were extracted. Survey items were mapped against six dimensions of patient experience described internationally. Ninety-five surveys were identified; 34 were developed for use in Australia. Surveys vary in content, size, aspects of experience measured and methods of administration. The quality of data collected and the extent to which it is used in quality improvement is unclear. Collection of patient experience data in Australian PHC is not well developed or standardised and there are few publicly available instruments. There is a need to clearly identify the purposes for which data are to be used and to develop an integrated approach that articulates these collections with other quality and performance data. Some options are discussed. PMID:27469275

  12. Survey of Oxygen Delivery Practices in UK Paediatric Intensive Care Units

    Science.gov (United States)

    Peters, Mark J.

    2016-01-01

    Purpose. Administration of supplemental oxygen is common in paediatric intensive care. We explored the current practice of oxygen administration using a case vignette in paediatric intensive care units (PICU) in the united kingdom. Methods. We conducted an online survey of Paediatric Intensive Care Society members in the UK. The survey outlined a clinical scenario followed by questions on oxygenation targets for 5 common diagnoses seen in critically ill children. Results. Fifty-three paediatric intensive care unit members from 10 institutions completed the survey. In a child with moderate ventilatory requirements, 21 respondents (42%) did not follow arterial partial pressure of oxygen (PaO2) targets. In acute respiratory distress syndrome, cardiac arrest, and sepsis, there was a trend to aim for lower PaO2 as the fraction of inspired oxygen (FiO2) increased. Conversely, in traumatic brain injury and pulmonary hypertension, respondents aimed for normal PaO2 even as the FiO2 increased. Conclusions. In this sample of clinicians PaO2 targets were not commonly used. Clinicians target lower PaO2 as FiO2 increases in acute respiratory distress syndrome, cardiac arrest, and sepsis whilst targeting normal range irrespective of FiO2 in traumatic brain injury and pulmonary hypertension.

  13. Stress levels of critical care doctors in India: A national survey

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    Rahul Amte

    2015-01-01

    Full Text Available Background: Doctors working in critical care units are prone to higher stress due to various factors such as higher mortality and morbidity, demanding service conditions and need for higher knowledge and technical skill. Aim: The aim was to evaluate the stress level and the causative stressors in doctors working in critical care units in India. Materials and Methods: A two modality questionnaire-based cross-sectional survey was conducted. In manual mode, randomly selected delegates attending the annual congress of Indian Society of Critical Care Medicine filled the questionnaire. In the electronic mode, the questionnaires were E-mailed to critical care doctors. These questionnaires were based on General Health Questionnaire-12 (GHQ-12. Completely filled 242 responses were utilized for comparative and correlation analysis. Results: Prevalence of moderate to severe stress level was 40% with a mean score of 2 on GHQ-12 scale. Too much responsibility at times and managing VIP patients ranked as the top two stressors studied, while the difficult relationship with colleagues and sexual harassment were the least. Intensivists were spending longest hours in the Intensive Care Unit (ICU followed by pulmonologists and anesthetists. The mean number of ICU bed critical care doctors entrusted with was 13.2 ± 6.3. Substance abuse to relieve stress was reported as alcohol (21%, anxiolytic or antidepressants (18% and smoking (14%. Conclusion: Despite the higher workload, stress levels measured in our survey in Indian critical care doctors were lower compared to International data. Substantiation of this data through a wider study and broad-based measures to improve the quality of critical care units and quality of the lives of these doctors is the need of the hour.

  14. General practitioners' use and experiences of palliative care services: a survey in south east England

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    Higginson Irene J

    2008-11-01

    Full Text Available Abstract Background The role of the General Practitioner (GP is central to community palliative care. Good liaison between the different professionals involved in a patient's care is extremely important in palliative care patients. In cases where GPs have previously been dissatisfied with palliative services, this may be seen as a barrier to referral when caring for other patients. The aim of this survey is to investigate the use and previous experiences of GPs of two palliative care services, with particular emphasis on barriers to referral and to explore issues surrounding the GP's role in caring for palliative patients. Methods Design: Descriptive postal survey of use and experience of palliative care services with particular emphasis on barriers to referral. Setting: One Primary Care Trust (PCT, south London, England, population 298,500. Subjects: 180 GPs in the PCT, which is served by two hospice services (A&B. Results An overall questionnaire response rate of 77% (138 was obtained, with 69% (124 used in analysis. Over 90% of GPs were satisfied with the palliative care services over the preceding two years. Two areas of possible improvement emerged; communication and prescribing practices. GPs identified some patients that they had not referred, most commonly when patients or carers were reluctant to accept help, or when other support was deemed sufficient. Over half of the GPs felt there were areas where improvement could be made; with clarification of the rules and responsibilities of the multi disciplinary team being the most common. The majority of GPs were working, and want to work with, the specialist services as part of an extended team. However, a greater number of GPs want to hand over care to the specialist services than are currently doing so. Conclusion A large number of GPs were happy with the service provision of the palliative care services in this area. They suggested that 3 out of 4 terminally ill patients needed specialist

  15. A Pilot Survey of Clergy Regarding Mental Health Care for Children

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    Leigh Blalock

    2012-01-01

    Full Text Available Collaborations between healthcare and faith-based organizations have emerged in the drive to improve access to care. Little research has examined clergy views on collaborations in the provision of mental healthcare, particularly to children. The current paper reports survey responses of 25 clergy from diverse religious traditions concerning mental health care in children. Subjects queried include clergy referral habits, specific knowledge of childhood conditions such as depression and anxiety, past experiences with behavioral health workers, and resources available through their home institutions. Overall, surveyed clergy support collaborations to improve childhood mental health. However, they vary considerably in their confidence with recognizing mental illness in children and perceive significant barriers to collaborating with mental health providers.

  16. Psychometric properties of the Transitions from Foster Care Key Leader Survey.

    Science.gov (United States)

    Salazar, Amy M; Brown, Eric C; Monahan, Kathryn C; Catalano, Richard F

    2016-04-01

    This study summarizes the development and piloting of the Transitions from Foster Care Key Leader Survey (TFC-KLS), an instrument designed to measure change in systems serving young people transitioning from foster care to adulthood. The Jim Casey Youth Opportunity Initiative's logic model was used as a basis for instrument development. The instrument was piloted with 119 key leaders in six communities. Seven of eight latent scales performed well in psychometric testing. The relationships among the 24 measures of system change were explored. A CFA testing overall model fit was satisfactory following slight modifications. Finally, a test of inter-rater reliability between two raters did not find reliable reporting of service availability in a supplemental portion of the survey. The findings were generally positive and supported the validity and utility of the instrument for measuring system change, following some adaptations. Implications for the field are discussed. PMID:26771369

  17. Maternal Pregnancy Intention and Professional Antenatal Care Utilization in Bangladesh: A Nationwide Population-Based Survey

    Science.gov (United States)

    Rahman, Md. Mosfequr; Rahman, Md. Mizanur; Tareque, Md. Ismail; Ferdos, Jannatul; Jesmin, Syeda S.

    2016-01-01

    Objective To investigate the association between maternal pregnancy intention and professional antenatal and delivery care utilization. Methods Our data were derived from the 2011 nationally representative Bangladesh Demographic Health Survey. We included antenatal and delivery care utilization data of the most recent live births for women for the previous three years (n = 4672). We used multilevel logistic regression models to assess the relationship between pregnancy intention and use of professional antenatal and delivery care, with adjustment for potential confounding variables. Results Approximately 13% and 16% of children were reported by their mothers as unwanted and mistimed at the time of conception, respectively. Among the women, 55% received at least one professional antenatal care service; 21% received four or more professional antenatal services, while 32% were attended by professionals during deliveries. Mothers of children whose pregnancies had been unwanted had a greater risk for not seeking professional antenatal and professional delivery care than those whose pregnancies had been wanted [1≥ ANC from professionals: AOR: 0.66; 95% CI:0.51–0.93; 4≥ ANC from professionals: AOR:0.56; 95% CI:0.37–0.84; and delivery care from professionals: AOR: 0.70; 95% CI:0.50–0.97]. Women who were married after age 18, had secondary or higher level of education, and were from the wealthiest households were more likely to utilize antenatal and delivery care. Conclusion Unwanted pregnancy is significantly associated with lower utilization of professional antenatal and delivery care services in Bangladesh. Reducing unwanted births and promoting access to professional antenatal and delivery care are crucial for achieving the Sustainable Development Goals (SDGs) 3 in Bangladesh. PMID:27309727

  18. A Survey on the Status of Nutrition Care Process Implementation in Korean Hospitals

    OpenAIRE

    Kim, Eun Mi; Baek, Hee Joon

    2013-01-01

    The Nutrition Care Process (NCP), developed by the American Dietetic Association, is a significant issue to dietetic professionals in many countries and there are rising needs for NCP implementation in Korea. We surveyed clinical nutrition managers of Korean general hospitals regarding the perception of NCP, the status of NCP implementation, and the opinions on NCP. The questionnaire was collected from 35 hospitals. Most clinical nutrition managers perceived NCP, but NCP implementation in hos...

  19. German ambulatory care physicians' perspectives on clinical guidelines – a national survey

    OpenAIRE

    Böcken Jan; Dieterle Wilfried E; Schnee Melanie; Kempkens Daniela; Butzlaff Martin; Rieger Monika A

    2006-01-01

    Abstract Background There has been little systematic research about the extent to which German physicians accept or reject the concept and practice of a) clinical practice guidelines (CPG) and b) evidence based medicine (EBM) The aim of this study was to investigate German office-based physicians' perspective on CPGs and EBM and their application in medical practice. Methods Structured national telephone survey of ambulatory care physicians, four thematic blocks with 21 questions (5 point Lik...

  20. Perceived quality of health care services among people with osteoarthritis – results from a nationwide survey

    Directory of Open Access Journals (Sweden)

    Grønhaug G

    2015-09-01

    Full Text Available Gudmund Grønhaug,1 Jon Hagfors,2 Ingebjørg Borch,2 Nina Østerås,1 Kåre Birger Hagen11National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, 2Norwegian Rheumatism Association, Oslo, NorwayObjective: To assess the perceived quality of care received by people with osteoarthritis (OA in Norway and explore factors associated with the quality of care.Methods: A national survey in which members of the Norwegian Rheumatism Association with OA registered as their main diagnosis completed a questionnaire. The perceived quality of care was reported on a 17-item OsteoArthritis Quality Indicator questionnaire, covering both pharmacological and non-pharmacological aspects of OA care. In addition, the four-page questionnaire covered areas related to demographic characteristics, the location and impact of the OA, and utilization and satisfaction with health care services. The quality of care is calculated as pass rates, where the numerator represents the number of indicators passed and the denominator represents the number of eligible persons.Results: In total, 1,247 participants (response rate 57% completed the questionnaire. Mean age was 68 years (standard deviation 32 and 1,142 (92% were women. Respondents reported OA in hand only (12.4%, hip only (7.3%, knee only (10.4%, in two locations (42% or all three locations (27%. The overall OsteoArthritis Quality Indicator pass rate was 47% (95% confidence interval [CI] 46%–48%, and it was higher for pharmacological aspects (53% [51%–54%] than for non-pharmacological aspects of care (44% [43%–46%]. The pass rate for the individual quality indicators ranged from 8% for “referral for weight reduction” to 81% for “receiving advice about exercises”. Satisfaction with care was strongly associated with perceived quality. The pass rate for those who were “very satisfied” was 33% (25%–40% higher than those who were “very unsatisfied” with care.Conclusion: While the OA

  1. The difficulties of interprofessional teamwork in diabetes care: a questionnaire survey

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    Kishimoto M

    2014-08-01

    Full Text Available Miyako Kishimoto,1,2 Mitsuhiko Noda2,3 1Department of Diabetes, Endocrinology, and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan; 2Diabetes and Metabolism Information Center, Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan; 3Department of Diabetes Research, Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan Background: Diabetes is a multifactorial disease and its nature means that interprofessional teamwork is essential for its treatment. However, in general, interprofessional teamwork has certain problems that impede its function. To clarify these problems in relation to diabetes care, a questionnaire survey was conducted. Methods: The participants who were involved in diabetes-related educational seminars, and medical personnel who were engaged in diabetes care from the National Center for Global Health and Medicine, were asked to complete the questionnaire about perceptions of, and satisfaction with, interprofessional teamwork across multiple health care providers, who were actually involved in diabetes care. Results: From 456 people who were asked to take the questionnaire, 275 people answered. The percentages of the respondents according to profession who considered multidisciplinary teamwork sufficient were as follows: physicians, 20.5%; nurses, 12.7%; registered dietitians, 29.6%; pharmacists, 21.9%; physiotherapists, 18.2%; and clinical laboratory technicians 15.4%. Insufficient interprofessional communication and inconsistency in motivation levels among staff were frequently cited as causes of insufficient teamwork. All professions considered interprofessional meetings or conferences necessary and essential for teamwork. Conclusion: The survey revealed that interprofessional teamwork in diabetes care is currently insufficient. Continuous efforts to change each profession

  2. Attitudes towards implantable cardioverter-defibrillator therapy: a national survey in Danish health-care professionals

    DEFF Research Database (Denmark)

    Johansen, Jens B; Mortensen, Peter T; Videbæk, Regitze;

    2011-01-01

    Aims The aim of this study was to examine health-care professionals attitudes towards implantable cardioverter-defibrillator (ICD) therapy and issues discussed with patients. Methods and results Survey of 209 health-care professionals providing specialized treatment and care of ICD patients at the......-physicians. Physicians were less likely to believe that their personal attitude towards ICD treatment has no influence on how they deal professionally with patients (27.8 vs. 43.6%; P = 0.04). Physicians and non-physicians were equally positive towards ICD therapy as primary prophylaxis in ischaemic cardiomyopathy (87...... discussing ICD treatment with candidate patients. At the same time, physicians are more aware that their attitude towards ICD treatment may influence how they deal professionally with patients compared with non-physicians....

  3. Examining the role of information exchange in residential aged care work practices-a survey of residential aged care facilities

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    Gaskin Sarah

    2012-08-01

    Full Text Available Abstract Background The provision of residential aged care is underpinned by information, and is reliant upon systems that adequately capture and effectively utilise and communicate this information. The aim of this study was to explicate and quantify the volume and method by which information is collected, exchanged within facilities and with external providers, and retrieved from facility information systems and hospitals. Methods A survey of staff (n = 119, including managers, health informatics officers (HIOs, quality improvement staff, registered nurses (RNs, enrolled nurses (ENs/endorsed enrolled nurses (EENs and assistants in nursing (AINs was carried out in four residential aged care facilities in New South Wales and Victoria, Australia. Sites varied in size and displayed a range of information technology (IT capabilities. The survey investigated how and by whom information is collected, retrieved and exchanged, and the frequency and amount of time devoted to these tasks. Descriptive analysis was performed using SPSS, and open responses to questions were coded into key themes. Results Staff completed a median of six forms each, taking a median of 30 min per shift. 68.8% of staff reported transferring information from paper to a computer system, which took a median of 30 min per shift. Handover and face-to-face communication was the most frequently used form of information exchange within facilities. There was a large amount of faxing and telephone communication between facility staff and General Practitioners and community pharmacists, with staff reporting sending a median of 2 faxes to pharmacy and 1.5 faxes to General Practitioners, and initiating 2 telephone calls to pharmacies and 1.5 calls to General Practitioners per shift. Only 38.5% of respondents reported that they always had information available at the point-of-care and only 35.4% of respondents reported that they always had access to hospital stay information of residents

  4. [Acute head injuries in primary health care--internet survey conducted with general practitioners].

    Science.gov (United States)

    Luoto, Teemu M; Artsola, Minna; Helminen, Mika; Liimatainen, Suvi; Kosunen, Elise; Ohman, Juha

    2013-01-01

    Patients with head injury constitute a large population treated in primary health care. It is essential to recognize patients with traumatic brain injury among this notable population to determine the need for more specific evaluation. General practitioners (n=331) in Pirkanmaa hospital district in Finland received an email link to answer the survey. The response rate was 54.1% (n=179). Mean survey score was 20.5 points (max. 25). Only acquaintance with the national traumatic brain injury practice guidelines was associated with greater survey scores. The general practitioners' level of knowledge in managing head injuries was good. Deficiencies were found in the questions dealt with post-traumatic amnesia and the definition of traumatic brain injury. PMID:23786110

  5. Perceptions and utilization of primary health care services in Iraq: findings from a national household survey

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    Burnham Gilbert

    2011-12-01

    Full Text Available Abstract Background After many years of sanctions and conflict, Iraq is rebuilding its health system, with a strong emphasis on the traditional hospital-based services. A network exists of public sector hospitals and clinics, as well as private clinics and a few private hospitals. Little data are available about the approximately 1400 Primary Health Care clinics (PHCCs staffed with doctors. How do Iraqis utilize primary health care services? What are their preferences and perceptions of public primary health care clinics and private primary care services in general? How does household wealth affect choice of services? Methods A 1256 household national survey was conducted in the catchment areas of randomly selected PHCCs in Iraq. A cluster of 10 households, beginning with a randomly selected start household, were interviewed in the service areas of seven public sector PHCC facilities in each of 17 of Iraq's 18 governorates. A questionnaire was developed using key informants. Teams of interviewers, including both males and females, were recruited and provided a week of training which included field practice. Teams then gathered data from households in the service areas of randomly selected clinics. Results Iraqi participants are generally satisfied with the quality of primary care services available both in the public and private sector. Private clinics are generally the most popular source of primary care, however the PHCCs are utilized more by poorer households. In spite of free services available at PHCCs many households expressed difficulty in affording health care, especially in the purchase of medications. There is no evidence of informal payments to secure health services in the public sector. Conclusions There is widespread satisfaction reported with primary health care services, and levels did not differ appreciably between public and private sectors. The public sector PHCCs are preferentially used by poorer populations where they are

  6. Measuring the Mental Health-Care System Responsiveness: Results of an Outpatient Survey in Tehran.

    Science.gov (United States)

    Forouzan, Setareh; Padyab, Mojgan; Rafiey, Hassan; Ghazinour, Mehdi; Dejman, Masoumeh; San Sebastian, Miguel

    2015-01-01

    As explained by the World Health Organization (WHO) in 2000, the concept of health system responsiveness is one of the core goals of health systems. Since 2000, further efforts have been made to measure health system responsiveness and the factors affecting responsiveness, yet few studies have applied responsiveness concepts to the evaluation of mental health systems. The present study aims to measure responsiveness and its related domains in the mental health-care system of Tehran. Utilizing the same method used by the WHO for its responsiveness survey, responsiveness for outpatient mental health care was evaluated using a validated Farsi questionnaire. A sample of 500 public mental health service users in Tehran participated and subsequently completed the questionnaire. On average, 47% of participants reported experiencing poor responsiveness. Among responsiveness domains, confidentiality and dignity were the best performing factors while autonomy, access to care, and quality of basic amenities were the worst performing. Respondents who reported their social status as low were more likely to experience poor responsiveness overall. Attention and access to care were responsiveness dimensions that performed poorly but were considered to be highly important by study participants. In summary, the study suggests that measuring responsiveness could provide guidance for further development of mental health-care systems to become more patient orientated and provide patients with more respect. PMID:26858944

  7. The provision of diabetes care in nursing homes in Galway city and county: a survey of nursing homes

    LENUS (Irish Health Repository)

    Hurley, Lorna

    2014-03-01

    In addition to the increasing prevalence of diabetes, our population is growing older and living longer. This survey aimed to determine the care provided to residents with diabetes in Nursing Homes.\\r\

  8. Critical care resources in the Solomon Islands: a cross-sectional survey

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    Westcott Mia

    2012-03-01

    Full Text Available Abstract Background There are minimal data available on critical care case-mix, care processes and outcomes in lower and middle income countries (LMICs. The objectives of this paper were to gather data in the Solomon Islands in order to gain a better understanding of common presentations of critical illness, available hospital resources, and what resources would be helpful in improving the care of these patients in the future. Methods This study used a mixed methods approach, including a cross sectional survey of respondents' opinions regarding critical care needs, ethnographic information and qualitative data. Results The four most common conditions leading to critical illness in the Solomon Islands are malaria, diseases of the respiratory system including pneumonia and influenza, diabetes mellitus and tuberculosis. Complications of surgery and trauma less frequently result in critical illness. Respondents emphasised the need for basic critical care resources in LMICs, including equipment such as oximeters and oxygen concentrators; greater access to medications and blood products; laboratory services; staff education; and the need for at least one national critical care facility. Conclusions A large degree of critical illness in LMICs is likely due to inadequate resources for primary prevention and healthcare; however, for patients who fall through the net of prevention, there may be simple therapies and context-appropriate resources to mitigate the high burden of morbidity and mortality. Emphasis should be on the development and acquisition of simple and inexpensive tools rather than complicated equipment, to prevent critical care from unduly diverting resources away from other important parts of the health system.

  9. Technology transfer with system analysis, design, decision making, and impact (Survey-2000) in acute care hospitals in the United States.

    Science.gov (United States)

    Hatcher, M

    2001-10-01

    This paper provides the results of the Survey-2000 measuring technology transfer for management information systems in health care. The relationships with systems approaches, user involvement, usersatisfaction, and decision-making were measured and are presented. The survey also measured the levels Internet and Intranet presents in acute care hospitals, which will be discussed in future articles. The depth of the survey includes e-commerce for both business to business and customers. These results are compared, where appropriate, with results from survey 1997 and changes are discussed. This information will provide benchmarks for hospitals to plan their network technology position and to set goals. This is the first of three articles based upon the results of the Srvey-2000. Readers are referred to a prior article by the author that discusses the survey design and provides a tutorial on technology transfer in acute care hospitals. PMID:11508906

  10. Reliability of a patient survey assessing cost-related changes in health care use among high deductible health plan enrollees

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    Galbraith Alison A

    2011-05-01

    Full Text Available Abstract Background Recent increases in patient cost-sharing for health care have lent increasing importance to monitoring cost-related changes in health care use. Despite the widespread use of survey questions to measure changes in health care use and related behaviors, scant data exists on the reliability of such questions. Methods We administered a cross-sectional survey to a stratified random sample of families in a New England health plan's high deductible health plan (HDHP with ≥ $500 in annualized out-of-pocket expenditures. Enrollees were asked about their knowledge of their plan, information seeking, behavior change associated with having a deductible, experience of delay in care due in part to cost, and hypothetical delay in care due in part to cost. Initial respondents were mailed a follow-up survey within two weeks of each family returning the original survey. We computed several agreement statistics to measure the test-retest reliability for select questions. We also conducted continuity adjusted chi-square, and McNemar tests in both the original and follow-up samples to measure the degree to which our results could be reproduced. Analyses were stratified by self-reported income. Results The test-retest reliability was moderate for the majority of questions (0.41 - 0.60 and the level of test-retest reliability did not differ substantially across each of the broader domains of questions. The observed proportions of respondents with delayed or foregone pediatric, adult, or any family care were similar when comparing the original and follow-up surveys. In the original survey, respondents in the lower-income group were more likely to delay or forego pediatric care, adult care, or any family care. All of the tests comparing income groups in the follow-up survey produced the same result as in the original survey. Conclusions In this population of HDHP beneficiaries, we found that survey questions concerning plan knowledge, information

  11. The BRACELET Study: surveys of mortality in UK neonatal and paediatric intensive care trials

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    Platt Martin

    2010-05-01

    Full Text Available Abstract Background The subject of death and bereavement in the context of randomised controlled trials in neonatal or paediatric intensive care is under-researched. The objectives of this phase of the Bereavement and RAndomised ControlLEd Trials (BRACELET Study were to determine trial activity in UK neonatal and paediatric intensive care (2002-06; numbers of deaths before hospital discharge; and variation in mortality across intensive care units and trials and to determine whether bereavement support policies were available within trials. These are essential prerequisites to considering the implications of future policies and practice subsequent to bereavement following a child's enrolment in a trial. Methods The units survey involved neonatal units providing level 2 or 3 care, and paediatric units providing level II care or above; the trials survey involved trials where allocation was randomized and interventions were delivered to intensive care patients, or to parents but designed to affect patient outcomes. Results Information was available from 191/220 (87% neonatal units (149 level 2 or 3 care; and 28/32 (88% paediatric units. 90/177 (51% eligible responding units participated in one or more trial (76 neonatal, 14 paediatric and 54 neonatal units and 6 paediatric units witnessed at least one death. 50 trials were identified (36 neonatal, 14 paediatric. 3,137 babies were enrolled in neonatal trials, 210 children in paediatric trials. Deaths ranged 0-278 (median [IQR interquartile range] 2 [1, 14.5] per neonatal trial, 0-4 (median [IQR] 1 [0, 2.5] per paediatric trial. 534 (16% participants died post-enrolment: 522 (17% in neonatal trials, 12 (6% in paediatric trials. Trial participants ranged 1-236 (median [IQR] 21.5 [8, 39.8] per neonatal unit, 1-53 (median [IQR] 11.5 [2.3, 33.8] per paediatric unit. Deaths ranged 0-37 (median [IQR] 3.5 [0.3, 8.8] per neonatal unit, 0-7 (median [IQR] 0.5 [0, 1.8] per paediatric unit. Three trials had a

  12. 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

  13. Aggression and violence against health care workers in Germany - a cross sectional retrospective survey

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    Kuhnert Saskia

    2010-02-01

    Full Text Available Abstract Background Although international scientific research on health issues has been dealing with the problem of aggression and violence towards those employed in health care, research activities in Germany are still at an early stage. In view of this, the aim of this study was to examine the frequency and consequences of aggressive behaviour towards nurses and health care workers in different health sectors in Germany and to assess the need for preventive measures. Methods We conducted a cross-sectional retrospective survey. Nurses and health care workers from two nursing homes, a psychiatric clinic and a workshop for people with disabilities were interviewed using a standardised questionnaire. The sample covered 123 individuals (response rate 38.8%. The survey assessed the frequency, the type and the consequences of aggressive behaviour, and social support in connection with coping with aggression in the workplace. Odds ratios (OR and 95% confidence intervals (CI for putative risk factors which may influence the stress induced by aggression at the workplace were calculated using conditional logistic regression. Results During the previous twelve months 70.7% of the respondents experienced physical and 89.4% verbal aggression. Physical aggression more frequently occurred in nursing homes (83.9% of the employees and verbal aggression was more common in the psychiatric clinic (96.7% of the employees. The proportion of the individuals affected in the workshop for people with disabilities was lower (41.9% and 77.4% respectively. The incidents impaired the physical (55% and emotional well-being (77.2% of the employees. The frequency of incidents (weekly: OR 2.7; 95% CI 1.1-6.4 combined with the lack of social support (OR 2.8; 95% CI 1.2-6.6 increased the probability of higher stress due to aggression. Conclusions This study corroborates previous reports of frequent physical and verbal aggression towards care workers in the various areas of

  14. Variation in patient–provider communication by patient’s race and ethnicity, provider type, and continuity in and site of care: An analysis of data from the Connecticut Health Care Survey

    OpenAIRE

    Aseltine, Robert H; Sabina, Alyse; Barclay, Gillian; Graham, Garth

    2016-01-01

    Objectives: The purpose of this study is to examine the quality of patient-reported communication with their health care providers using data from a large, statewide survey of patients. We examine the relationship between patient’s race and ethnicity, type of health care provider, site of and continuity in care, and the quality of patient–provider communication. Methods: We analyze data from the Connecticut Health Care Survey, a representative telephone survey of 4608 Connecticut residents co...

  15. Stroke and Nursing Home care: a national survey of nursing homes.

    LENUS (Irish Health Repository)

    Cowman, Seamus

    2010-01-01

    BACKGROUND: Although stroke is recognised as a major factor in admission to nursing home care, data is lacking on the extent and nature of the disabilities and dependency in nursing homes arising from stroke. A national study conducted in nursing homes can quantify the number of residents with stroke in nursing homes, their disability and levels of dependency. METHODS: A cross-sectional survey research design was used. A total of 572 public and private nursing homes were identified nationally and a stratified random selection of 60 nursing homes with 3,239 residents was made. In half of the nursing homes (n = 30) efforts were made to interview all residents with stroke Survey instruments were used to collect data from residents with stroke and nursing home managers on demography, patient disability, and treatment. RESULTS: Across all nursing homes (n = 60), 18% (n = 570) of the residents had previously had a stroke. In homes (n = 30), where interviews with residents with stroke (n = 257), only 7% (n = 18) residents were capable of answering for themselves and were interviewed. Data on the remaining 93% (n = 239) residents were provided by the nursing home manager. Nurse Managers reported that 73% of residents with stroke had a high level of dependency. One in two residents with stroke was prescribed antidepressants or sedative medication. Only 21% of stroke residents were prescribed anticoagulants, 42% antiplatelets, and 36% cholesterol lowering medications. Stroke rehabilitation guidelines were lacking and 68% reported that there was no formal review process in place. CONCLUSIONS: This study provides seminal findings on stroke and nursing home services in Ireland. We now know that one in six nursing home residents in a national survey are residents with a stroke, and have a wide range of disabilities. There is currently little or no structured care (beyond generic care) for stroke survivors who reside in nursing homes in Ireland.

  16. Explaining variation in cancer survival between 11 jurisdictions in the International Cancer Benchmarking Partnership: a primary care vignette survey

    OpenAIRE

    Rose, Peter W; Rubin, Greg; Perera-Salazar, Rafael; Almberg, Sigrun Saur; Barisic, Andriana; Dawes, Martin; Grunfeld, Eva; Hart, Nigel; Neal, Richard D.; Pirotta, Marie; Sisler, Jeffrey; Konrad, Gerald; Toftegaard, Berit Skjødeberg; Thulesius, Hans; Vedsted, Peter

    2015-01-01

    OBJECTIVES: The International Cancer Benchmarking Partnership (ICBP) is a collaboration between 6 countries and 12 jurisdictions with similar primary care-led health services. This study investigates primary care physician (PCP) behaviour and systems that may contribute to the timeliness of investigating for cancer and subsequently, international survival differences.DESIGN: A validated survey administered to PCPs via the internet set out in two parts: direct questions on primary care structu...

  17. Use of Palliative Care Consultation for Patients with End-Stage Liver Disease: Survey of Liver Transplant Service Providers.

    OpenAIRE

    Beck, KR; Pantilat, SZ; O'Riordan, DL; Peters, MG

    2016-01-01

    Palliative care services (PCS) are recommended to enhance quality of care for hospitalized patients.We evaluated the attitudes of liver transplant (LT) providers and perceived barriers to PCS for their patients by conducting a web-based survey of intensive care unit nurses, postgraduate year 1 (PGY1) physician trainees, nurse practitioners, fellows, and attending physicians on the LT service at an academic medical center.The response rate was 44% (88/200). Providers agreed that LT and PCS are...

  18. Measuring the mental health care system responsiveness: results of an outpatient survey in Tehran

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    Setareh eForouzan

    2016-01-01

    Full Text Available AbstractAs explained by the World Health Organisation (WHO in 2000, the concept of health system responsiveness is one of the core goals of health systems. Since 2000, further efforts have been made to measure health system responsiveness and the factors affecting responsiveness, yet few studies have applied responsiveness concepts to the evaluation of mental health systems. The present study aims to measure responsiveness and its related domains in the mental health care system of Tehran. Utilising the same method used by the WHO for its responsiveness survey, responsiveness for outpatient mental health care was evaluated using a validated Farsi questionnaire. A sample of 500 public mental health service users in Tehran participated and subsequently completed the questionnaire. On average, 47% of participants reported experiencing poor responsiveness. Among responsiveness domains, confidentiality and dignity were the best performing factors while autonomy, access to care and quality of basic amenities were the worst performing. Respondents who reported their social status as low were more likely to experience poor responsiveness overall. Autonomy, quality of basic amenities and clear communication were responsiveness dimensions that performed poorly but were considered to be important by study participants. In summary, the study suggests that measuring responsiveness could provide guidance for further development of mental health care systems to become more patient orientated and provide patients with more respect.

  19. Socioeconomic inequalities in health care utilisation in Norway: the population-based HUNT3 survey

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    Vikum Eirik

    2012-08-01

    Full Text Available Abstract Background In this study we investigated the distribution of self-reported health care utilisation by education and household income in a county population in Norway, in a universal public health care system based on ideals of equal access for all according to need, and not according to wealth. Methods The study included 24,147 women and 20,608 men aged 20 years and above in the third Nord-Trøndelag Health Survey (HUNT 3 of 2006–2008. Income-related horizontal inequity was estimated through concentration indexes, and inequity by both education and income was estimated as risk ratios through conventional regression. Results We found no overall pro-rich or pro-educated socioeconomic gradient in needs-adjusted utilisation of general practitioner or inpatient care. However, we found overall pro-rich and pro-educated inequity in utilisation of both private medical specialists and hospital outpatient care. For these services there were large differences in levels of inequity between younger and older men and women. Conclusion In contrast with recent studies from Norway, we found pro-rich and pro-educated social inequalities in utilisation of hospital outpatient services and not only private medical specialists. Utilisation of general practitioner and inpatient services, which have low access threshold or are free of charge, we found to be equitable.

  20. Self-Care Practices for Common Colds by Primary Care Patients: Study Protocol of a European Multicenter Survey-The COCO Study.

    Science.gov (United States)

    Weltermann, Birgitta M; Gerasimovska-Kitanovska, Biljana; Thielmann, Anika; Chambe, Juliette; Lingner, Heidrun; Pirrotta, Enzo; Buczkowski, Krzysztof; Tekiner, Selda; Czachowski, Slawomir; Edirne, Tamer; Zielinski, Andrzej; Yikilkan, Hülya; Koskela, Tuomas; Petrazzuoli, Ferdinando; Hoffman, Robert D; Petek Šter, Marija; Guede Fernández, Clara; Uludağ, Ayşegül; Hoffmann, Kathryn; Mevsim, Vildan; Kreitmayer Pestic, Sanda

    2015-01-01

    Background. Self-care for common colds is frequent, yet little is known about the spectrum, regional differences, and potential risks of self-care practices in patients from various European regions. Methods/Design. We describe the study protocol for a cross-sectional survey in 27 primary care centers from 14 European countries. At all sites, 120 consecutive adult patients, who visit their general practitioner for any reason, filled in a self-administered 27-item questionnaire. This addresses patients' self-care practices for common colds. Separately, the subjective level of discomfort when having a common cold, knowing about the diseases' self-limited nature, and medical and sociodemographic data are requested. Additionally, physicians are surveyed on their use of and recommendations for self-care practices. We are interested in investigating which self-care practices for common colds are used, whether the number of self-care practices used is influenced by knowledge about the self-limited nature of the disease, and the subjective level of discomfort when having a cold and to identify potential adverse interactions with chronic physician-prescribed medications. Further factors that will be considered are, for example, demographic characteristics, chronic conditions, and sources of information for self-care practices. All descriptive and analytical statistics will be performed on the pooled dataset and stratified by country and site. Discussion. To our knowledge, COCO is the first European survey on the use of self-care practices for common colds. The study will provide new insight into patients' and general practitioners' self-care measures for common colds across Europe. PMID:26421048

  1. The Use of Emergency Medication Kits in Community Palliative Care: An Exploratory Survey of Views of Current Practice in Australian Home-Based Palliative Care Services.

    Science.gov (United States)

    Bullen, Tracey; Rosenberg, John P; Smith, Bradley; Maher, Kate

    2015-09-01

    Improving symptom management for palliative care patients has obvious benefits for patients and advantages for the clinicians, as workload demands and work-related stress can be reduced when the emergent symptoms of patients are managed in a timely manner. The use of emergency medication kits (EMKs) can provide such timely symptom relief. The purpose of this study was to conduct a survey of a local service to examine views on medication management before and after the implementation of an EMK and to conduct a nationwide prevalence survey examining the use of EMKs in Australia. Most respondents from community palliative care services indicated that EMKs were not being supplied to palliative care patients but believed such an intervention could improve patient care. PMID:24871345

  2. Self-care and adherence to medication: a survey in the hypertension outpatient clinic

    Directory of Open Access Journals (Sweden)

    Lip Gregory YH

    2008-02-01

    Full Text Available Abstract Background Self-care practices for patients with hypertension include adherence to medication, use of blood pressure self-monitoring and use of complementary and alternative therapies (CAM The prevalence of CAM use and blood pressure self-monitoring have not been described in a UK secondary care population of patients with hypertension and their impact on adherence to medication has not been described. Adherence to medication is important for blood pressure control, but poor adherence is common. The study aimed to determine the prevalence of self-care behaviours in patients attending a secondary care hypertension clinic. Methods Cross-sectional questionnaire survey. 196 patients attending a secondary care hypertension clinic in a teaching hospital serving a multiethnic population, Birmingham, UK. Main outcome measures: Prevalence of use of CAM, home monitors, adherence to anti-hypertensive medication. Results CAM use in previous 12 months was reported by 66 (43.1% respondents. CAM users did not differ statistically from non-CAM users by age, gender, marital status or education. Vitamins, prayer a dietary supplements were the most commonly used CAM. Nine (12.7% women reported using herbal CAM compared to one man (1.2%, (p = 0.006. Ten (6.7% respondents reported ever being asked by a doctor about CAM use. Perfect adherence to anti-hypertensive medication was reported by 26 (44.8% CAM-users and 46 (60.5% non-CAM users (p = 0.07. Being female and a CAM user was significantly associated with imperfect adherence to anti-hypertensive medication. Older and white British respondents were significantly more likely to report perfect adherence. Blood pressure monitors were used by 67 (43.8% respondents, which was not associated with gender, CAM use or adherence to medication. Conclusion Hypertensive patients use a variety of self-care methods, including CAM, home blood pressure monitors, and adherence to prescribed medication. This study found the

  3. Carcinoma of the cervix: patterns of care studies: review of 1978, 1983, and 1988-1989 surveys

    International Nuclear Information System (INIS)

    Purpose: A review of the Patterns of Care Studies Process Survey data on carcinoma of the cervix conducted on patients in 1978, 1983, and 1988-89 was carried out to identify changes or trends in the demographics, evaluation, and treatment that might have occurred over this time period. Methods and Materials: Patterns of Care Studies conducted surveys on patients treated by radiation therapy for cervical carcinoma in 1978, 1983, and 1988-89. These surveys have compiled demographic and treatment data on a total of 993 patients. There is outcome data for the 1978 and 1983 surveys, but not for the 1988-89 survey because follow-up has not been collected yet. The demographic and treatment delivery data on all three surveys has been reviewed and analyzed and is the subject of this study. Results: There was no difference in the age distribution at the time of diagnosis of the patients in these surveys. The percentage of black patients remained constant in the three surveys, 19%, 17%, and 21%, respectively. The percentage of white patients was 76%, 78%, and 67%, but that of nonwhite/nonblack patients was 3%, 4%, and 12% (p 60Co units decreased from 35 to 2% from the first to the third survey [6 to 0% for short source-surface distance (SSD) 60Co units]. Point dose calculations for the intracavitary therapy increased from 78% in the 1978 survey to 95% in the third survey. As determined by the total dose delivered to the paracentral points, more patients (75.1%) were treated according to the Patterns of Care recommended guidelines in the 1988-89 survey than in the 1983 survey (63.6%). Chemotherapy was given to 12% of the patients undergoing radiation therapy during the period of the third survey, but these data are not available for the first and second surveys. Conclusion: Review of the Carcinoma of the Cervix Patterns of Care studies discloses significant changes in the demographics, patient evaluation, and radiation therapy techniques during the period of the studies. The

  4. Financial access to health care in Karuzi, Burundi: a household-survey based performance evaluation

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    Van Herp Michel

    2009-10-01

    Full Text Available Abstract Background In 2003, Médecins Sans Frontières, the provincial government, and the provincial health authority began a community project to guarantee financial access to primary health care in Karuzi province, Burundi. The project used a community-based assessment to provide exemption cards for indigent households and a reduced flat fee for consultations for all other households. Methods An evaluation was carried out in 2005 to assess the impact of this project. Primary data collection was through a cross-sectional household survey of the catchment areas of 10 public health centres. A questionnaire was used to determine the accuracy of the community-identification method, households' access to health care, and costs of care. Household socioeconomic status was determined by reported expenditures and access to land. Results Financial access to care at the nearest health centre was ensured for 70% of the population. Of the remaining 30%, half experienced financial barriers to access and the other half chose alternative sites of care. The community-based assessment increased the number of people of the population who qualified for fee exemptions to 8.6% but many people who met the indigent criteria did not receive a card. Eighty-eight percent of the population lived under the poverty threshold. Referring to the last sickness episode, 87% of households reported having no money available and 25% risked further impoverishment because of healthcare costs even with the financial support system in place. Conclusion The flat fee policy was found to reduce cost barriers for some households but, given the generalized poverty in the area, the fee still posed a significant financial burden. This report showed the limits of a programme of fee exemption for indigent households and a flat fee for others in a context of widespread poverty.

  5. Undergraduate medical education in emergency medical care: A nationwide survey at German medical schools

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    Timmermann Arnd

    2009-05-01

    Full Text Available Abstract Background Since June 2002, revised regulations in Germany have required "Emergency Medical Care" as an interdisciplinary subject, and state that emergency treatment should be of increasing importance within the curriculum. A survey of the current status of undergraduate medical education in emergency medical care establishes the basis for further committee work. Methods Using a standardized questionnaire, all medical faculties in Germany were asked to answer questions concerning the structure of their curriculum, representation of disciplines, instructors' qualifications, teaching and assessment methods, as well as evaluation procedures. Results Data from 35 of the 38 medical schools in Germany were analysed. In 32 of 35 medical faculties, the local Department of Anaesthesiology is responsible for the teaching of emergency medical care; in two faculties, emergency medicine is taught mainly by the Department of Surgery and in another by Internal Medicine. Lectures, seminars and practical training units are scheduled in varying composition at 97% of the locations. Simulation technology is integrated at 60% (n = 21; problem-based learning at 29% (n = 10, e-learning at 3% (n = 1, and internship in ambulance service is mandatory at 11% (n = 4. In terms of assessment methods, multiple-choice exams (15 to 70 questions are favoured (89%, n = 31, partially supplemented by open questions (31%, n = 11. Some faculties also perform single practical tests (43%, n = 15, objective structured clinical examination (OSCE; 29%, n = 10 or oral examinations (17%, n = 6. Conclusion Emergency Medical Care in undergraduate medical education in Germany has a practical orientation, but is very inconsistently structured. The innovative options of simulation technology or state-of-the-art assessment methods are not consistently utilized. Therefore, an exchange of experiences and concepts between faculties and disciplines should be promoted to guarantee a standard

  6. Factors that determine catastrophic expenditure for tuberculosis care: a patient survey in China

    Institute of Scientific and Technical Information of China (English)

    Chengchao Zhou; Qian Long; Jiaying Chen; Li Xiang; Qiang Li; Shenglan Tang; Fei Huang

    2016-01-01

    Background:Tuberculosis (TB) often causes catastrophic economic effects on both the individual suffering the disease and their households.A number of studies have analyzed patient and household expenditure on TB care,but there does not appear to be any that have assessed the incidence,intensity and determinants of catastrophic health expenditure (CHE) relating to TB care in China.That will be the objective of this paper.Methods:The data used for this study were derived from the baseline survey of the China Government-Gates Foundation TB Phase Ⅱ program.Our analysis included 747 TB cases.Catastrophic health expenditure for TB care was estimated using two approaches,with households defined as experiencing CHE if their annual expenditure on TB care:(a) exceeded 10 % of total household income;and (b) exceeded 40 % of their non-food expenditure (capacity to pay).Chi-square tests were used to identify associated factors and logistic regression analysis to identify the determinants of CHE.Results:The incidence of CHE was 66.8 % using the household income measure and 54.7 % using non-food expenditure (capacity to pay).An inverse association was observed between CHE rates and household income level.Significant determinants of CHE were:age,household size,employment status,health insurance status,patient income as a percentage of total household income,hospitalization and status as a minimum living security household.Factors including gender,marital status and type of TB case had no significant associations with CHE.Conclusions:Catastrophic health expenditure incidence from TB care is high in China.An integrated policy expanding the free treatment package and ensuring universal coverage,especially the height of UHC for TB patients,is needed.Financial and social protection interventions are essential for identified at-risk groups.

  7. Equity of inpatient health care in rural Tanzania: a population- and facility-based survey

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    Ferry Grace A

    2012-02-01

    Full Text Available Abstract Objective To explore the equity of utilization of inpatient health care at rural Tanzanian health centers through the use of a short wealth questionnaire. Methods Patients admitted to four rural health centers in the Kigoma Region of Tanzania from May 2008 to May 2009 were surveyed about their illness, asset ownership and demographics. Principal component analysis was used to compare the wealth of the inpatients to the wealth of the region's general population, using data from a previous population-based survey. Results Among inpatients, 15.3% were characterized as the most poor, 19.6% were characterized as very poor, 16.5% were characterized as poor, 18.9% were characterized as less poor, and 29.7% were characterized as the least poor. The wealth distribution of all inpatients (p Conclusion The findings indicated that while current Tanzanian health financing policies may have improved access to health care for children under five, additional policies are needed to further close the equity gap, especially for obstetric inpatients.

  8. Findings from the 2011 EBRI/MGA Consumer Engagement in Health Care Survey.

    Science.gov (United States)

    Fronstin, Paul

    2011-12-01

    SEVENTH ANNUAL SURVEY: This Issue Brief presents findings from the 2011 EBRI/MGA Consumer Engagement in Health Care Survey. This study is based on an online survey of 4,703 privately insured adults ages 21-64 to provide nationally representative data regarding the growth of consumer-driven health plans (CDHPs) and high-deductible health plans (HDHPs), and the impact of these plans and consumer engagement more generally on the behavior and attitudes of adults with private health insurance coverage. Findings from this survey are compared with EBRI's findings from earlier surveys. ENROLLMENT CONTINUES TO GROW: The survey finds continued growth in consumer-driven health plans: In 2011, 7 percent of the population was enrolled in a CDHP, up from 5 percent in 2010. Enrollment in HDHPs increased from 14 percent in 2010 to 16 percent in 2011. The 7 percent of the population with a CDHP represents 8.4 million adults ages 21-64 with private insurance, while the 16 percent with a HDHP represents 19.3 million people. Among the 19.3 million individuals with an HDHP, 38 percent (or 7.3 million) reported that they were eligible for a health savings ccount (HSA) but did not have such an account. Overall, 15.8 million adults ages 21-64 with private insurance, representing 13.1 percent of that market, were either in a CDHP or were in an HDHP that was eligible for an HSA but had not opened the account. When their children are counted, about 21 million individuals with private insurance, representing about 12 percent of the market, were either in a CDHP or an HSA-eligible plan. MORE COST-CONSCIOUS BEHAVIOR: Individuals in CDHPs were more likely than those with traditional coverage to exhibit a number of cost-conscious behaviors. They were more likely to say that they had checked whether their plan would cover care; asked for a generic drug instead of a brand name; talked to their doctor about treatment options and costs; talked to their doctor about prescription drug options and costs

  9. A Survey of System Architecture Requirements for Health Care-Based Wireless Sensor Networks

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    Abraham O. Fapojuwo

    2011-05-01

    Full Text Available Wireless Sensor Networks (WSNs have emerged as a viable technology for a vast number of applications, including health care applications. To best support these health care applications, WSN technology can be adopted for the design of practical Health Care WSNs (HCWSNs that support the key system architecture requirements of reliable communication, node mobility support, multicast technology, energy efficiency, and the timely delivery of data. Work in the literature mostly focuses on the physical design of the HCWSNs (e.g., wearable sensors, in vivo embedded sensors, et cetera. However, work towards enhancing the communication layers (i.e., routing, medium access control, et cetera to improve HCWSN performance is largely lacking. In this paper, the information gleaned from an extensive literature survey is shared in an effort to fortify the knowledge base for the communication aspect of HCWSNs. We highlight the major currently existing prototype HCWSNs and also provide the details of their routing protocol characteristics. We also explore the current state of the art in medium access control (MAC protocols for WSNs, for the purpose of seeking an energy efficient solution that is robust to mobility and delivers data in a timely fashion. Furthermore, we review a number of reliable transport layer protocols, including a network coding based protocol from the literature, that are potentially suitable for delivering end-to-end reliability of data transmitted in HCWSNs. We identify the advantages and disadvantages of the reviewed MAC, routing, and transport layer protocols as they pertain to the design and implementation of a HCWSN. The findings from this literature survey will serve as a useful foundation for designing a reliable HCWSN and also contribute to the development and evaluation of protocols for improving the performance of future HCWSNs. Open issues that required further investigations are highlighted.

  10. Physiotherapy practice patterns in Intensive Care Units of Nepal: A multicenter survey

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    Sumana Baidya

    2016-01-01

    Full Text Available Context: As physiotherapy (PT is a young profession in Nepal, there is a dearth of insight into the common practices of physiotherapists in critical care. Aims: To identify the availability of PT services in Intensive Care Units (ICUs and articulate the common practices by physiotherapists in ICUs of Nepal. Settings and Design: All tertiary care hospitals across Nepal with ICU facility via an exploratory cross-sectional survey. Subjects and Methods: An existing questionnaire was distributed to all the physiotherapists currently working in ICUs of Nepal with 2 years of experience. The survey was sent via E-mail or given in person to 86 physiotherapists. Statistical Analysis Used: Descriptive and inferential statistics according to nature of data. Results: The response rate was 60% (n = 52. In the majority of hospitals (68%, PT service was provided only after a physician consultation, and few hospitals (13% had established hospital criteria for PT in ICUs. Private hospitals (57.1% were providing PT service in weekends compared to government hospitals (32.1% (P = 0.17. The likelihood of routine PT involvement varied significantly with the clinical scenarios (highest 71.2% status cerebrovascular accident, lowest 3.8% myocardial infarction, P < 0.001. The most preferred PT treatment was chest PT (53.8% and positioning (21.2% while least preferred was therapeutic exercise (3.8% irrespective of clinical scenarios. Conclusions: There is a lack of regular PT service during weekends in ICUs of Nepal. Most of the cases are treated by physiotherapists only after physician's referral. The preferred intervention seems to be limited only to chest PT and physiotherapists are not practicing therapeutic exercise and functional mobility training to a great extent.

  11. Assessing Quality of Life and Medical Care in Chronic Angina: An Internet Survey

    Science.gov (United States)

    2016-01-01

    Background Angina is a clinical syndrome whose recognition relies heavily on self-report, so its identification can be challenging. Most data come from cohorts identified by physicians and nurses at the point of care; however, current widespread access to the Internet makes identification of community cohorts feasible and offers a complementary picture of angina. Objective To describe a population self-identified as experiencing chronic angina by use of an Internet survey. Methods Using email and an Internet portal, we invited individuals with a diagnosis of angina and recent symptoms to complete an Internet survey on treatment and quality of life (QOL). In total, 1147 surveys were received. The main analysis was further limited to those reporting a definite coronary heart disease (CHD) history (N=646, 56% of overall). Results Overall, about 15% reported daily angina and 40% weekly angina. Those with more frequent angina were younger, more often depressed, and reported a shorter time since diagnosis. They also had substantially worse treatment satisfaction, physical function, and overall QOL. Fewer than 40% were on ≥ 2 anti-anginals, even with daily angina. The subjects without a history of definite CHD had unexpectedly low use of antianginal and evidence-based medicines, suggesting either a lack of specificity in the use of self-reported angina to identify patients with CHD or lack of access to care. Conclusions Use of inexpensive electronic tools can identify community-based angina cohorts for clinical research. Limitation to subjects with a definite history of CHD lends diagnostic face validity to the approach; however, other symptomatic individuals are also identified. PMID:27125492

  12. Patient experience of access to primary care: identification of predictors in a national patient survey

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    Kontopantelis Evangelos

    2010-08-01

    Full Text Available Abstract Background The 2007/8 GP Access Survey in England measured experience with five dimensions of access: getting through on the phone to a practice, getting an early appointment, getting an advance appointment, making an appointment with a particular doctor, and surgery opening hours. Our aim was to identify predictors of patient satisfaction and experience with access to English primary care. Methods 8,307 English general practices were included in the survey (of 8,403 identified. 4,922,080 patients were randomly selected and contacted by post and 1,999,523 usable questionnaires were returned, a response rate of 40.6%. We used multi-level logistic regressions to identify patient, practice and regional predictors of patient satisfaction and experience. Results After controlling for all other factors, younger people, and people of Asian ethnicity, working full time, or with long commuting times to work, reported the lowest levels of satisfaction and experience of access. For people in work, the ability to take time off work to visit the GP effectively eliminated the disadvantage in access. The ethnic mix of the local area had an impact on a patient's reported satisfaction and experience over and above the patient's own ethnic identity. However, area deprivation had only low associations with patient ratings. Responses from patients in small practices were more positive for all aspects of access with the exception of satisfaction with practice opening hours. Positive reports of access to care were associated with higher scores on the Quality and Outcomes Framework and with slightly lower rates of emergency admission. Respondents in London were the least satisfied and had the worst experiences on almost all dimensions of access. Conclusions This study identifies a number of patient groups with lower satisfaction, and poorer experience, of gaining access to primary care. The finding that access is better in small practices is important given

  13. Reopening of the survey, study and medical care of atomic bomb victims

    International Nuclear Information System (INIS)

    Research on atomic bomb casuality of the results by Japanese scientists were greatly restricted during the Occupation period. Conditions improved in 1951 when the San Francisco Peace Treaty was signed. After the conclusion of the Treaty, there were various movements in the fields of the survey, study and medical care of atomic bomb victims. The Science Council of Japan formed the Atomic Bomb Casuality Research Group, which was supported by scientific research funds from the Ministry of Education in 1952. The group had the hope of taking place of Atomic Bomb Casuality Commission (ABCC) which was established by USA. But the study of the group was supported by ABCC. The Hiroshima Atomic Bomb Casuality Council was formed in January 1953 with the cooperation of Hiroshima City and its assembly, medical association of the city, and other groups. In Nagasaki, this Council was formed in May this year. These movement led the constitution of the Atomic Bomb Aftereffects Research Council in the National Institute of Health on November 1953. Hiroshima and Nagasaki City, and their Assemblies started their appeals of medical care for atomic bomb victims from the end of 1951. The same appeals were made by the press and welfare group in 1953. In the period from the end of 1951 to 1953, the way for the Medical Care Law was paved by various groups. But the enactment of the law needed the social power of the nationalwide movement against A- and H-bomb. (author)

  14. The health care for diabetic persons in Italy: the QUADRI survey

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    Marina Maggini

    2008-09-01

    Full Text Available To obtain regional and national data on the quality of diabetes care within the Italian National Health Service, a national survey among persons with diabetes was conducted in 2004. A sample of 3,426 diabetic patients (age 18-64 years were interviewed using a standardized questionnaire. The population was middle-aged (median age 57 years, had a low educational level, and was followed primarily in public diabetes centres. A total of 54% reported having hypertension but 14% were not on treatment; for hypercholesterolemia, the corresponding figures were 44% and 26%. Of the 72% who were overweight or obese, 51% were trying to lose weight; 26% currently smoked. Only 66% of patients had undergone haemoglobin A1c testing in the past four months (among the 67% who had ever heard of test; 30% suffered from microvascular or macrovascular complications. Only 5% received all eight main tests recommended by the guidelines within the specified intervals. Our study demonstrates that diabetic patients receive less than optimal care, they are engaged in unhealthy behaviours and received inadequate treatment for comorbidities, and that the translation of guidelines into clinical practice was unsatisfactory. These data have been used to formulate national and regional policy regarding integrated case management to improve the quality of diabetes care.

  15. Mobilization of patients in neurological Intensive Care Units of India: A survey

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    Anup Bhat

    2016-01-01

    Full Text Available Context: The rehabilitation needs of the patients in neurological Intensive Care Units (ICUs vary from that of a medical ICU patient. Early mobilization is known to improve the various neurological outcomes in patients admitted to neurological ICUs, although little is known about the practice pattern among physiotherapists. The mobilization practice pattern may vary significantly than that of developed countries due to the reasons of differences in training of professionals, availability of equipment, and financial assistance by health insurance. Aim of the Study: To study the current mobilization practices by the physiotherapists in neurological ICUs of India. Subjects and Methods: A cross-sectional survey was conducted with a content validated questionnaire about the mobilization practices. Online questionnaire was distributed to physiotherapists working in neurological ICUs of India. Descriptive statistics were used. Results: Out of 185 e-mails sent, 82 physiotherapists completed the survey (survey response rate = 44%. Eighty participants (97.6% mentioned that the patients received some form of mobilization during the day. The majority of the physiotherapists (58.5%, “always” provided bed mobility exercises to their patients when it was found appropriate for the patients. Many physiotherapists (41.5% used tilt table “sometimes” to introduce orthostatism for their patients. Conclusion: Mobilization in various forms is being practiced in the neurological ICUs of India. However, fewer mobilization sessions are conducted on weekends and night hours in Indian Neurological ICUs.

  16. A Survey of the quality of nursing care in several health districts in South Africa.

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    Naidoo Joanne R

    2004-02-01

    Full Text Available Abstract Background South Africa is currently focusing strongly on human resource development. The purpose of this study was to describe and compare the quality of nursing service and care in three health districts in the KwaZulu Natal Province. To identify deficiencies which could be addressed by education and training, it might be useful to measure the quality of care given by nurses. Methods From March to August 2002 a survey was done in six hospitals and six clinics in three health districts of the KwaZulu-Natal province of South Africa. Five different aspects of care was evaluated; hand-over from one nursing shift to another, implementation of universal precautions, patient satisfaction, nursing records, management of chronic illnesses. All these aspects were evaluated using checklists based on record reviews or direct observation, except for patient satisfaction, which was evaluated by questionnaires. Results The average scores on the different aspects varied from 11% (for nursing records to 73% (for management of chronic diseases. Specific problems became evident. In one district three out of four hand-overs between shifts of nurses scored less than 50%. In all three districts the use of protective gear scored low (43%. While the average score for management of chronic illnesses were high at 73%, the blood pressures of only 23% was within the target range, and the blood sugar of only 38% of patients were controlled. Patient satisfaction averaged 72% across the three districts. Conclusion The quality of care measurements identified specific training needs, but other management strategies are probably also indicated.

  17. A Survey of the quality of nursing care in several health districts in South Africa.

    Science.gov (United States)

    Uys, Leana R; Naidoo, Joanne R

    2004-01-01

    Background South Africa is currently focusing strongly on human resource development. The purpose of this study was to describe and compare the quality of nursing service and care in three health districts in the KwaZulu Natal Province. To identify deficiencies which could be addressed by education and training, it might be useful to measure the quality of care given by nurses. Methods From March to August 2002 a survey was done in six hospitals and six clinics in three health districts of the KwaZulu-Natal province of South Africa. Five different aspects of care was evaluated; hand-over from one nursing shift to another, implementation of universal precautions, patient satisfaction, nursing records, management of chronic illnesses. All these aspects were evaluated using checklists based on record reviews or direct observation, except for patient satisfaction, which was evaluated by questionnaires. Results The average scores on the different aspects varied from 11% (for nursing records) to 73% (for management of chronic diseases). Specific problems became evident. In one district three out of four hand-overs between shifts of nurses scored less than 50%. In all three districts the use of protective gear scored low (43%). While the average score for management of chronic illnesses were high at 73%, the blood pressures of only 23% was within the target range, and the blood sugar of only 38% of patients were controlled. Patient satisfaction averaged 72% across the three districts. Conclusion The quality of care measurements identified specific training needs, but other management strategies are probably also indicated. PMID:15028123

  18. Gender Difference in Health-Care Expenditure: Evidence from India Human Development Survey

    Science.gov (United States)

    Saikia, Nandita; Moradhvaj; Bora, Jayanta Kumar

    2016-01-01

    Background While the gender disparity in health and mortality in various stages of life in India is well documented, there is limited evidence on female disadvantage in health-care expenditure (HCE). Aims Examine the gender difference in HCE in short-term and major morbidity in India, and understand the role of factors underlying the difference. Data and Methods Using two rounds of nationally representative panel data—the India Human Development Survey (IHDS) 2004–2005 and 2011–2012 (IHDS I & II)—we calculate morbidity prevalence rate and mean HCE by gender, and examine the adjusted effect of gender on major morbidity-related HCE by using a two-part regression model. Further, we performed Oaxaca-Blinder decomposition of the gender gap in HCE in major morbidity to understand the contribution of demographic and socio-economic factors. Results Health-care expenditure on females was systematically lower than on males across all demographic and socio-economic groups. Multivariate analysis confirms that female HCE is significantly lower than male HCE even after controlling demographic and socio-economic factors (β = -0.148, p = 0.000, CI:-0.206–0.091). For both short-term and major morbidity, a female disadvantage on HCE increased from IHDS I to IHDS II. For instance, the male–female gap in major morbidity related expenditure increased from INR 1298 to INR 4172. A decomposition analysis of gender gap in HCE demonstrates that about 48% of the gap is attributable to differences in demographic and socio-economic factors (endowment effect), whereas 50% of the gap is due to the differential effect of the determinants (coefficient effect). Interpretation Indians spend less on female health care than on male health care. Most of the gender gap in HCE is not due to differential distribution of factors affecting HCE. PMID:27391322

  19. Status of respiratory care profession in Saudi Arabia: A national survey

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    Ghazi Alotaibi

    2015-01-01

    Full Text Available Background: Respiratory care (RC is an allied health profession that involves assessing and treating patients who have pulmonary diseases. Research indicates that respiratory therapists′ (RT′s involvement in caring for patients with respiratory disorders improves important outcome measures. In Kingdome of Saudi Arabia (KSA, RC has been practiced by RTs for more than 30 years. Objective: We sought to investigate the status of the RC workforce in Saudi Arabia in terms of demographic distribution, number, education, and RC service coverage. Methods: We used a specially designed survey to collect data. A list of 411 working hospitals in KSA was obtained. All hospitals were contacted to inquire if RC is practiced by RTs. Data were collected from hospitals that employ RTs. Results: Only 88 hospitals, 21.4% of total hospitals in the country, have RTs. Out of the 244 Ministry of Health (MOH hospitals, only 31 hospitals (12.7% employ RTs. There are 1,477 active RTs in KSA. Twenty-five percent of them, or 371, are Saudis. The majority of the RT workforce (60% work for non-MOH government hospitals, and almost half the total RTs work in Riyadh province. About 60% of RTs work in critical care settings. RC coverage of critical care was 44.5% of ideal. The overall RT-to-ICU bed ratio was 1:11. The ratio was 1:9 for non-MOH government hospitals, and 1:20 for MOH hospitals. Conclusions: We report the first insightful data on RC workforce in KSA. These data should be used by educational institutions and health policy makers to plan better RC coverage in the country.

  20. Antihypertensive combination therapy in primary care offices: results of a cross-sectional survey in Switzerland

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    Roas S

    2014-12-01

    Full Text Available Susanne Roas,1 Felix Bernhart,2 Michael Schwarz,3 Walter Kaiser,4 Georg Noll5 1Department of Internal Medicine, University Hospital, Zurich, 2Private Practice, Biberist, 3Ambulatorium Wiesendamm, Basel, 4Healthworld (Schweiz AG, Steinhausen, 5HerzKlinik Hirslanden, Zurich, Switzerland Background: Most hypertensive patients need more than one substance to reach their target blood pressure (BP. Several clinical studies indicate the high efficacy of antihypertensive combinations, and recent guidelines recommend them in some situations even as initial therapies. In general practice they seem widespread, but only limited data are available on their effectiveness under the conditions of everyday life. The objectives of this survey among Swiss primary care physicians treating hypertensive patients were: to know the frequency of application of different treatment modalities (monotherapies, free individual combinations, single-pill combinations; to see whether there are relationships between prescribed treatment modalities and patient characteristics, especially age, treatment duration, and comorbidities; and to determine the response rate (percentage of patients reaching target BP of different treatment modalities under the conditions of daily practice. Methods: This cross-sectional, observational survey among 228 randomly chosen Swiss primary care physicians analyzed data for 3,888 consecutive hypertensive patients collected at one single consultation. Results: In this survey, 31.9% of patients received monotherapy, 41.2% two substances, 20.9% three substances, and 4.7% more than three substances. By combination mode, 34.9% took free individual combinations and 30.0% took fixed-dose single-pill combinations. Combinations were more frequently given to older patients with a long history of hypertension and/or comorbidities. In total, 67.8% of patients achieved their BP target according to their physician's judgment. When compared, single

  1. Patient characteristics and clinical management of patients with shoulder pain in U.S. primary care settings: Secondary data analysis of the National Ambulatory Medical Care Survey

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    Mansfield Richard J

    2005-02-01

    Full Text Available Abstract Background Although shoulder pain is a commonly encountered problem in primary care, there are few studies examining its presenting characteristics and clinical management in this setting. Methods We performed secondary data analysis of 692 office visits for shoulder pain collected through the National Ambulatory Medical Care Survey (Survey years 1993–2000. Information on demographic characteristics, history and place of injury, and clinical management (physician order of imaging, physiotherapy, and steroid intraarticular injection were examined. Results Shoulder pain was associated with an injury in one third (33.2% (230/692 of office visits in this population of US primary care physicians. Males, and younger adults (age ≤ 52 more often associated their shoulder pain with previous injury, but there were no racial differences in injury status. Injury-related shoulder pain was related to work in over one-fifth (21.3% (43/202 of visits. An x-ray was performed in 29.0% (164/566 of office visits, a finding that did not differ by gender, race, or by age status. Other imaging (CT scan, MRI, or ultrasound was infrequently performed (6.5%, 37/566. Physiotherapy was ordered in 23.9% (135/566 of visits for shoulder pain. Younger adults and patients with a history of injury more often had physiotherapy ordered, but there was no significant difference in the ordering of physiotherapy by gender or race. Examination of the use of intraarticular injection was not possible with this data set. Conclusion These data from the largest sample of patients with shoulder pain presenting to primary care settings offer insights into the presenting characteristics and clinical management of shoulder pain at the primary care level. The National Ambulatory Medical Care Survey is a useful resource for examining the clinical management of specific symptoms in U.S. primary care offices.

  2. Findings from the 2009 EBRI/MGA Consumer Engagement in Health Care Survey.

    Science.gov (United States)

    Fronstin, Paul

    2009-12-01

    FIFTH ANNUAL SURVEY: This Issue Brief presents findings from the 2009 EBRI/MGA Consumer Engagement in Health Care Survey, which provides nationally representative data regarding the growth of consumer-driven health plans (CDHPs) and high-deductible health plans (HDHPs), and the impact of these plans and consumer engagement more generally on the behavior and attitudes of adults with private health insurance coverage. Findings from this survey are compared with four earlier annual surveys. ENROLLMENT LOW BUT GROWING: In 2009, 4 percent of the population was enrolled in a CDHP, up from 3 percent in 2008. Enrollment in HDHPs increased from 11 percent in 2008 to 13 percent in 2009. The 4 percent of the population with a CDHP represents 5 million adults ages 21-64 with private insurance, while the 13 percent with a HDHP represents 16.2 million people. Among the 16.2 million individuals with an HDHP, 38 percent (or 6.2 million) reported that they were eligible for a health savings account (HSA) but did not have such an account. Overall, 11.2 million adults ages 21-64 with private insurance, representing 8.9 percent of that market, were either in a CDHP or were in an HDHP that was eligible for an HSA, but had not opened the account. MORE COST-CONSCIOUS BEHAVIOR: Individuals in CDHPs were more likely than those with traditional coverage to exhibit a number of cost-conscious behaviors. They were more likely to say that they had checked whether the plan would cover care; asked for a generic drug instead of a brand name; talked to their doctor about prescription drug options, other treatments, and costs; asked their doctor to recommend a less costly prescription drug; developed a budget to manage health care expenses; checked prices before getting care; and used an online cost-tracking tool. CDHP MORE ENGAGED IN WELLNESS PROGRAMS: CDHP enrollees were more likely than traditional plan enrollees to report that they had the opportunity to fill out a health risk assessment

  3. Forgetting to Remember or Remembering to Forget - A Study of the Recall Period Length in Health Care Survey Questions

    OpenAIRE

    Kjellsson, Gustav; Clarke, Philip; Gerdtham, Ulf-G

    2013-01-01

    Self-reported data on utilization of health care is a key input into a range of studies. However, the length of the recall period in self-reported health care questions varies between surveys and this variation may affect the results of the studies. While longer recall periods include more information, shorter recall periods generally imply smaller bias. This article examines the role of the recall period length for the quality of self-reported data by comparing registered hospitalization wit...

  4. Care during the third stage of labour: A postal survey of UK midwives and obstetricians

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    Tuffnell Derek

    2010-05-01

    Full Text Available Abstract Background There are two approaches to care during the third stage of labour: Active management includes three components: administration of a prophylactic uterotonic drug, cord clamping and controlled cord traction. For physiological care, intervention occurs only if there is clinical need. Evidence to guide care during the third stage is limited and there is variation in recommendations which may contribute to differences in practice. This paper describes current UK practice during the third stage of labour. Methods A postal survey of 2230 fellows and members of the Royal College of Obstetricians and Gynaecologists (RCOG and 2400 members of the Royal College of Midwives was undertaken. Respondents were asked about care during the third stage of labour, for vaginal and caesarean births and their views on the need for more evidence to guide care in the third stage. The data were analysed in Excel and presented as descriptive statistics. Results 1189 (53% fellows and members of the RCOG and 1702 (71% midwives responded, of whom 926 (78% and 1297 (76% respectively had conducted or supervised births in the last year. 93% (863/926 of obstetricians and 73% (942/1297 of midwives report 'always or usually' using active management. 66% (611/926 of obstetricians and 33% (430/1297 of midwives give the uterotonic drug with delivery of the anterior shoulder; this was intramuscular Syntometrine® for 79% (728/926 and 86% (1118/1293 respectively. For term births, 74% (682/926 of obstetricians and 41% (526/1297 of midwives clamp the cord within 20 seconds, as do 57% (523/926 and 55% (707/1297 for preterm births. Controlled cord traction was used by 94% of both obstetricians and midwives. For caesarean births, intravenous oxytocin was the uterotonic used by 90% (837/926 of obstetricians; 79% (726/926 clamp the cord within 20 seconds for term births as do 63% (576/926 for preterm births. Physiological management was used 'always or usually' by 2% (21

  5. A frailty instrument for primary care: findings from the Survey of Health, Ageing and Retirement in Europe (SHARE).

    LENUS (Irish Health Repository)

    Romero-Ortuno, Roman

    2010-01-01

    A frailty paradigm would be useful in primary care to identify older people at risk, but appropriate metrics at that level are lacking. We created and validated a simple instrument for frailty screening in Europeans aged ≥50. Our study is based on the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE, http:\\/\\/www.share-project.org), a large population-based survey conducted in 2004-2005 in twelve European countries.

  6. Noncardiac chest pain--an Asia-Pacific survey on the views of primary care physicians.

    Science.gov (United States)

    Cheung, Ting Kin; Lim, Paul Wah Yonn; Wong, Benjamin C Y

    2007-11-01

    Noncardiac chest pain (NCCP) is common and has a significant impact on health care. Primary care physicians (PCPs)' attitudes, clinical approach, preference of diagnostic tests, referral patterns, and comfort in managing patients with NCCP in the Asia-Pacific region are not known. Consequently, we performed this survey in the Asia-Pacific region. The self-completed questionnaire was sent to PCPs in the Asia-Pacific region. A 28-item questionnaire contained questions on demographic information, characteristics of practice, preferences of diagnostic tests, referral patterns, treatment plans, and opinion on Helicobacter pylori and NCCP. A total of 108 (74%) PCPs returned the questionnaire. A mean of 18% of the patients were diagnosed with NCCP by PCPs in the past 6 months. Ninety-four percent of PCPs had treated NCCP patients in the last 6 months. Only 38% of the PCPs were comfortable in diagnosing NCCP but 85.2% believed that they should manage NCCP patients. PCPs in Malaysia and Philippines were more likely to refer patients to subspecialists. Fifty-seven and four-tenths percent of PCPs believed that H. pylori infection plays a role in the development of NCCP. The study demonstrates clearly that the understanding, diagnostic strategies, and treatment strategies of NCCP in the Asia-Pacific region are suboptimal and thus highlights the importance of educational and training programs tailored for PCPs in NCCP. PMID:17436083

  7. Factors Associated with Participation, Active Refusals and Reasons for Not Taking Part in a Mortality Followback Survey Evaluating End-of-Life Care

    OpenAIRE

    Calanzani, Natalia; Irene J Higginson; Koffman, Jonathan; Gomes, Barbara

    2016-01-01

    BACKGROUND: Examination of factors independently associated with participation in mortality followback surveys is rare, even though these surveys are frequently used to evaluate end-of-life care. We aimed to identify factors associated with 1) participation versus non-participation and 2) provision of an active refusal versus a silent refusal; and systematically examine reasons for refusal in a population-based mortality followback survey.METHODS: Postal survey about the end-of-life care rece...

  8. The results of a national survey regarding nutritional care of obese burn patients.

    Science.gov (United States)

    Coen, Jennifer R; Carpenter, Annette M; Shupp, Jeffrey W; Matt, Sarah E; Shaw, Jesse D; Flanagan, Katherine E; Pavlovich, Anna R; Jeng, James C; Jordan, Marion H

    2011-01-01

    Little is known about the nutritional needs of obese burn patients. Given the impact of obesity on the morbidity and mortality of these patients, a uniform understanding of perceptions and practices is needed. To elucidate current practices of clinicians working with the obese burn population, the authors constructed a multidisciplinary survey designed to collect this information from practitioners in United States burn centers. An electronic approach was implemented to allow for ease of distribution and completion. A portable document format (pdf) letter was e-mailed to the members of the American Burn Association and then mailed separately to additional registered dietitians identified as working in burn centers. This letter contained a link to a 29-question survey on the SurveyMonkey.com server. Questions took the form of multiple choice and free text entry. Responses were received from physicians, mid-level practitioners, registered dietitians, and nurses. Seventy-five percent of respondents defined obesity as body mass index >30. The Harris-Benedict equation was identified as the most frequently used equation to calculate the caloric needs of burn patients (32%). Fifty-eight percent indicated that they alter their calculations for the obese patient by using adjusted body weight. Calculations for estimated protein needs varied among centers. The majority did not use hypocaloric formulas for obese patients (79%). Enteral nutrition was initiated within the first 24 hours for both obese and nonobese patients at most centers. Sixty-three percent suspend enteral nutrition during operative procedures for all patients. Oral feeding of obese patients was the most preferred route, with total parenteral nutrition being the least preferred. Longer length of stay, poor wound healing, poor graft take, and prolonged intubation were outcomes perceived to occur more in the obese burn population. In the absence of supporting research, clinicians are making adjustments to the

  9. Use of tobacco and alcohol by Swiss primary care physicians: a cross-sectional survey

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    Künzi Beat

    2007-01-01

    Full Text Available Abstract Background Health behaviours among doctors has been suggested to be an important marker of how harmful lifestyle behaviours are perceived. In several countries, decrease in smoking among physicians was spectacular, indicating that the hazard was well known. Historical data have shown that because of their higher socio-economical status physicians take up smoking earlier. When the dangers of smoking become better known, physicians began to give up smoking at a higher rate than the general population. For alcohol consumption, the situation is quite different: prevalence is still very high among physicians and the dangers are not so well perceived. To study the situation in Switzerland, data of a national survey were analysed to determine the prevalence of smoking and alcohol drinking among primary care physicians. Methods 2'756 randomly selected practitioners were surveyed to assess subjective mental and physical health and their determinants, including smoking and drinking behaviours. Physicians were categorised as never smokers, current smokers and former smokers, as well as non drinkers, drinkers (AUDIT-C Results 1'784 physicians (65% responded (men 84%, mean age 51 years. Twelve percent were current smokers and 22% former smokers. Sixty six percent were drinkers and 30% at risk drinkers. Only 4% were never smokers and non drinkers. Forty eight percent of current smokers were also at risk drinkers and 16% of at risk drinkers were also current smokers. Smoking and at risk drinking were more frequent among men, middle aged physicians and physicians living alone. When compared to a random sample of the Swiss population, primary care physicians were two to three times less likely to be active smokers (12% vs. 30%, but were more likely to be drinkers (96% vs. 78%, and twice more likely to be at risk drinkers (30% vs. 15%. Conclusion The prevalence of current smokers among Swiss primary care physicians was much lower than in the general

  10. Health equity in the New Zealand health care system: a national survey

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    Doughty Robert

    2011-10-01

    Full Text Available Abstract Introduction In all countries people experience different social circumstances that result in avoidable differences in health. In New Zealand, Māori, Pacific peoples, and those with lower socioeconomic status experience higher levels of chronic illness, which is the leading cause of mortality, morbidity and inequitable health outcomes. Whilst the health system can enable a fairer distribution of good health, limited national data is available to measure health equity. Therefore, we sought to find out whether health services in New Zealand were equitable by measuring the level of development of components of chronic care management systems across district health boards. Variation in provision by geography, condition or ethnicity can be interpreted as inequitable. Methods A national survey of district health boards (DHBs was undertaken on macro approaches to chronic condition management with detail on cardiovascular disease, chronic obstructive pulmonary disease, congestive heart failure, stroke and diabetes. Additional data from expert informant interviews on program reach and the cultural needs of Māori and Pacific peoples was sought. Survey data were analyzed on dimensions of health equity relevant to strategic planning and program delivery. Results are presented as descriptive statistics and free text. Interviews were transcribed and NVivo 8 software supported a general inductive approach to identify common themes. Results Survey responses were received from the majority of DHBs (15/21, some PHOs (21/84 and 31 expert informants. Measuring, monitoring and targeting equity is not systematically undertaken. The Health Equity Assessment Tool is used in strategic planning but not in decisions about implementing or monitoring disease programs. Variable implementation of evidence-based practices in disease management and multiple funding streams made program implementation difficult. Equity for Māori is embedded in policy, this is not so

  11. Carbapenemase-producing Enterobacteriaceae in Irish critical care units: results of a pilot prevalence survey, June 2011.

    LENUS (Irish Health Repository)

    Burns, K

    2012-11-10

    The epidemiology of carbapenemase-producing Enterobacteriaceae (CPE) in Ireland is changing, with an increase in the number of reported cases in late 2010 and early 2011. Reported cases were predominantly linked to critical care units. In June 2011, a four-week national pilot survey took place in 40 Irish critical care units (37 adult and three paediatric) to examine the prevalence of rectal carriage of CPE and inform national CPE screening guidelines. A total of 760 screening swabs were taken over the study period, and CPE were not detected in any of the participating critical care units.

  12. Geriatric care in Europe – the EUGMS Survey part I: Belgium, Czech Republic, Denmark, Germany, Ireland, Spain, Switzerland, United Kingdom

    DEFF Research Database (Denmark)

    Kolb, G; Andersen-Ranberg, Karen; Cruz-Jentoft, A;

    2011-01-01

    Quality of geriatric care depends on institutional resources e.g. hospitals, medical departments engaged in acute medicine, rehabilitation and long term care but especially in quality and quantity of well educated and trained specialists, i.e. “geriatricians”. This survey initiated by the Academic...... about the national training tenure circumstances as well as political and historical influences on the geriatric care situation. The need for an European consensus concerning training curriculum is clearly stated, but also the need for fostering geriatric medicine with look on the demographic background...

  13. Developing new models of shared primary and specialist HIV care in the UK: a survey of current practice.

    Science.gov (United States)

    Hutchinson, Jane; Sutcliffe, Loma J; Williams, Andy J; Estcourt, Claudia S

    2016-07-01

    HIV care in the UK is led by hospital-based specialists with limited general practitioner (GP) involvement. As GPs have expertise in some non-microbial HIV-associated co-morbidities (e.g. cardiovascular disease), and more people are disclosing their HIV status to their GPs, there could be benefits in sharing HIV care. We describe contemporary models of shared HIV care in relevant developed world settings to inform future shared HIV care in the UK. An interview survey of key informants was used to explore experiences and models of shared care, and identify promoting and inhibiting factors. We interviewed ten key informants from six shared care models. There were three broad categories of shared care, with varying degrees of GP involvement. Strong clinical leadership in primary care, good professional relationships and communication, and tailored GP training were facilitators. Barriers included stigma, confidentiality concerns, and low prevalence of HIV outside major conurbations. Contemporary shared HIV care models have emerged organically and seem to work when grounded in good collaboration between a small number of dedicated GPs and specialist units. We propose two models for further study which may only be feasible in high HIV caseload practices. User acceptability, clinical and cost effectiveness must be considered. PMID:26113516

  14. Study of nurses′ knowledge about palliative care: A quantitative cross-sectional survey

    OpenAIRE

    Venkatesan Prem; Harikesavan Karvannan; Kumar, Senthil P; Surulirajan Karthikbabu; Nafeez Syed; Vaishali Sisodia; Saroja Jaykumar

    2012-01-01

    Context: Studies have documented that nurses and other health care professionals are inadequately prepared to care for patients in palliative care. Several reasons have been identified including inadequacies in nursing education, absence of curriculum content related to pain management, and knowledge related to pain and palliative care. Aims: The objective of this paper was to assess the knowledge about palliative care amongst nursing professionals using the palliative care knowledge tes...

  15. Results of the 03-05 patterns of care study nationwide survey for small-cell lung cancer

    International Nuclear Information System (INIS)

    The Japanese Patterns of Care Study (PCS) conducted a third nationwide survey of care process for patients with limited-disease small cell lung cancer (PCS 03-05). The PCS investigated changes in the care process including continuous technical evolution in radiotherapy as compared with preceding surveys (PCS 95-97, PCS 99-01) and assessed their influence on early outcome. PCS 99-01 showed that evidence based practice pattern had well penetrated into clinical practice. PCS 03-05 demonstrated several changes in patterns of radiotherapy. Decrease in the use of twice-daily radiotherapy did not influence early outcome. Results support the general consideration that technical evolution in radiotherapy has essential role in the era of intensive chemoradiation for small cell lung cancer. (author)

  16. Findings from the 2012 EBRI/MGA Consumer Engagement in Health Care Survey.

    Science.gov (United States)

    Fronstin, Paul

    2012-12-01

    The 2012 EBRI/MGA Consumer Engagement in Health Care Survey finds continued slow growth in consumer-driven health plans: 10 percent of the population was enrolled in a CDHP, up from 7 percent in 2011. Enrollment in HDHPs remained at 16 percent. Overall, 18.6 million adults ages 21-64 with private insurance, representing 15.4 percent of that market, were either in a CDHP or were in an HDHP that was eligible for an HSA. When their children were counted, about 25 million individuals with private insurance, representing about 14.6 percent of the market, were either in a CDHP or an HSA-eligible plan. This study finds evidence that adults in a CDHP and those in an HDHP were more likely than those in a traditional plan to exhibit a number of cost-conscious behaviors. While CDHP enrollees, HDHP enrollees, and traditional-plan enrollees were about equally likely to report that they made use of quality information provided by their health plan, CDHP enrollees were more likely to use cost information and to try to find information about their doctors' costs and quality from sources other than the health plan. CDHP enrollees were more likely than traditional-plan enrollees to take advantage of various wellness programs, such as health-risk assessments, health-promotion programs, and biometric screenings. In addition, financial incentives mattered more to CDHP enrollees than to traditional-plan enrollees. It is clear that the underlying characteristics of the populations enrolled in these plans are different: Adults in a CDHP were significantly more likely to report being in excellent or very good health. Adults in a CDHP and those in a HDHP were significantly less likely to smoke than were adults in a traditional plan, and they were significantly more likely to exercise. CDHP and HDHP enrollees were also more likely than traditional-plan enrollees to be highly educated. As the CDHP and HDHP markets continue to expand and more enrollees are enrolled for longer periods of time

  17. Coordination of Breast Cancer Care Between Radiation Oncologists and Surgeons: A Survey Study

    Energy Technology Data Exchange (ETDEWEB)

    Jagsi, Reshma, E-mail: rjagsi@med.umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, MI (United States); Abrahamse, Paul [Department of Internal Medicine, University of Michigan, Ann Arbor, MI (United States); Morrow, Monica [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Hamilton, Ann S. [Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Los Angeles, CA (United States); Graff, John J. [Department of Radiation Oncology, Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ (United States); Katz, Steven J. [Department of Internal Medicine, Division of General Medicine and Department of Health Management and Policy, School of Public Health, University of Michigan Health System, Ann Arbor, MI (United States)

    2012-04-01

    Purpose: To assess whether radiation oncologists and surgeons differ in their attitudes regarding the local management of breast cancer, and to examine coordination of care between these specialists. Methods and Materials: We surveyed attending surgeons and radiation oncologists who treated a population-based sample of patients diagnosed with breast cancer in metropolitan Detroit and Los Angeles. We identified 419 surgeons, of whom 318 (76%) responded, and 160 radiation oncologists, of whom 117 (73%) responded. We assessed demographic, professional, and practice characteristics; challenges to coordinated care; and attitudes toward management in three scenarios. Results: 92.1% of surgeons and 94.8% of radiation oncologists indicated access to a multidisciplinary tumor board. Nevertheless, the most commonly identified challenge to radiation oncologists, cited by 27.9%, was failure of other providers to include them in the treatment decision process early enough. Nearly half the surgeons (49.7%) stated that few or almost none of the breast cancer patients they saw in the past 12 months had consulted with a radiation oncologist before undergoing definitive surgery. Surgeons and radiation oncologists differed in their recommendations in management scenarios. Radiation oncologists were more likely to favor radiation than were surgeons for a patient with 3/20 lymph nodes undergoing mastectomy (p = 0.03); surgeons were more likely to favor more widely clear margins after breast conservation than were radiation oncologists (p = 0.001). Conclusions: Despite the widespread availability of tumor boards, a substantial minority of radiation oncologists indicated other providers failed to include them in the breast cancer treatment decision-making process early enough. Earlier inclusion of radiation oncologists may influence patient decisions, and interventions to facilitate this should be considered.

  18. Screening mammography beliefs and recommendations: a web-based survey of primary care physicians

    Directory of Open Access Journals (Sweden)

    Yasmeen Shagufta

    2012-02-01

    Full Text Available Abstract Background The appropriateness and cost-effectiveness of screening mammography (SM for women younger than 50 and older than 74 years is debated in the clinical research community, among health care providers, and by the American public. This study explored primary care physicians' (PCPs perceptions of the influence of clinical practice guidelines for SM; the recommendations for SM in response to hypothetical case scenarios; and the factors associated with perceived SM effectiveness and recommendations in the US from June to December 2009 before the United States Preventive Services Task Force (USPSTF recently revised guidelines. Methods A nationally representative sample of 11,922 PCPs was surveyed using a web-based questionnaire. The response rate was 5.7% (684; (41% 271 family physicians (FP, (36% 232 general internal medicine physicians (IM, (23% 150 obstetrician-gynaecologists (OBG, and (0.2% 31 others. Cross-sectional analysis examined PCPs perceived effectiveness of SM, and recommendation for SM in response to hypothetical case scenarios. PCPs responses were measured using 4-5 point adjectival scales. Differences in perceived effectiveness and recommendations for SM were examined after adjusting for PCPs specialty, race/ethnicity, and the US region. Results Compared to IM and FP, OBG considered SM more effective in reducing breast cancer mortality among women aged 40-49 years (p = 0.003. Physicians consistently recommended mammography to women aged 50-69 years with no differences by specialty (p = 0.11. However, 94% of OBG "always recommended" SM to younger and 86% of older women compared to 81% and 67% for IM and 84% and 59% for FP respectively (p = p = Conclusions A majority of physicians, especially OBG, favour aggressive breast cancer screening for women from 40 through 79 years of age, including women with short life expectancy. Policy interventions should focus on educating providers to provide tailored recommendations for

  19. Coordination of Breast Cancer Care Between Radiation Oncologists and Surgeons: A Survey Study

    International Nuclear Information System (INIS)

    Purpose: To assess whether radiation oncologists and surgeons differ in their attitudes regarding the local management of breast cancer, and to examine coordination of care between these specialists. Methods and Materials: We surveyed attending surgeons and radiation oncologists who treated a population-based sample of patients diagnosed with breast cancer in metropolitan Detroit and Los Angeles. We identified 419 surgeons, of whom 318 (76%) responded, and 160 radiation oncologists, of whom 117 (73%) responded. We assessed demographic, professional, and practice characteristics; challenges to coordinated care; and attitudes toward management in three scenarios. Results: 92.1% of surgeons and 94.8% of radiation oncologists indicated access to a multidisciplinary tumor board. Nevertheless, the most commonly identified challenge to radiation oncologists, cited by 27.9%, was failure of other providers to include them in the treatment decision process early enough. Nearly half the surgeons (49.7%) stated that few or almost none of the breast cancer patients they saw in the past 12 months had consulted with a radiation oncologist before undergoing definitive surgery. Surgeons and radiation oncologists differed in their recommendations in management scenarios. Radiation oncologists were more likely to favor radiation than were surgeons for a patient with 3/20 lymph nodes undergoing mastectomy (p = 0.03); surgeons were more likely to favor more widely clear margins after breast conservation than were radiation oncologists (p = 0.001). Conclusions: Despite the widespread availability of tumor boards, a substantial minority of radiation oncologists indicated other providers failed to include them in the breast cancer treatment decision-making process early enough. Earlier inclusion of radiation oncologists may influence patient decisions, and interventions to facilitate this should be considered.

  20. Extensive Variability in Vasoactive Agent Therapy: A Nationwide Survey in Chinese Intensive Care Units

    Institute of Scientific and Technical Information of China (English)

    Xian-Bo Pei; Peng-Lin Ma; Jian-Guo Li; Zhao-Hui Du; Qing Zhou; Zhang-Hong Lu; Luo Yun

    2015-01-01

    Background:Inconsistencies in the use of the vasoactive agent therapy to treat shock are found in previous studies.A descriptive study was proposed to investigate current use of vasoactive agents for patients with shock in Chinese intensive care settings.Methods:A nationwide survey of physicians was conducted from August 17 to December 30,2012.Physicians were asked to complete a questionnaire which focused on the selection ofvasoactive agents,management in the use ofvasopressor/inotropic therapy,monitoring protocols when using these agents,and demographic characteristics.Results:The response rate was 65.1% with physicians returning 586 valid questionnaires.Norepinephrine was the first choice of a vasopressor used to treat septic shock by 70.8% of respondents;73.4% of respondents favored dopamine for hypovolemic shock;and 68.3% of respondents preferred dopamine for cardiogenic shock.Dobutamine was selected by 84.1%,64.5%,and 60.6% of respondents for septic,hypovolemic,and cardiogenic shock,respectively.Vasodilator agents were prescribed by physicians in the management of cardiogenic shock (67.1%) rather than for septic (32.3%) and hypovolemic shock (6.5%).A significant number of physicians working in teaching hospitals were using vasoactive agents in an appropriate manner when compared to physicians in nonteaching hospitals.Conclusions:Vasoactive agent use for treatment of shock is inconsistent according to self-report by Chinese intensive care physicians;however,the variation in use depends upon the form of shock being treated and the type of hospital;thus,corresponding educational programs about vasoactive agent use for shock management should be considered.

  1. German ambulatory care physicians' perspectives on clinical guidelines – a national survey

    Directory of Open Access Journals (Sweden)

    Böcken Jan

    2006-07-01

    Full Text Available Abstract Background There has been little systematic research about the extent to which German physicians accept or reject the concept and practice of a clinical practice guidelines (CPG and b evidence based medicine (EBM The aim of this study was to investigate German office-based physicians' perspective on CPGs and EBM and their application in medical practice. Methods Structured national telephone survey of ambulatory care physicians, four thematic blocks with 21 questions (5 point Likert scale. 511 office-based general practitioners and specialists. Main outcome measures were the application of Clinical Practice Guidelines in daily practice, preference for sources of guidelines and degree of knowledge and acceptance of EBM. In the data analysis Pearson's correlation coefficient was used for explorative analysis of correlations. The comparison of groups was performed by Student's t-test. Chi2 test was used to investigate distribution of two or more categorical variables. Results Of the total study population 55.3% of physicians reported already using guidelines in the treatment of patients. Physicians in group practices (GrP as well as general practitioners (GP agreed significantly more with the usefulness of guidelines as a basis for patient care than doctors in single practices (SP or specialists (S (Student's t-test mean GP 2.57, S 2.84, p Conclusion Despite a majority of physicians accepting and applying CPGs a large group remains that is critical and opposed to the utilization of CPGs in daily practice and to the concept of EBM in general. Doctors in single practice and specialists appear to be more critical than physicians in group practices and GPs. Future research is needed to evaluate the willingness to acquire necessary knowledge and skills for the promotion and routine application of CPGs.

  2. Home delivery and newborn care practices among urban women in western Nepal: a questionnaire survey

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    Giri Sabitri

    2006-08-01

    Full Text Available Abstract Background About 98% of newborn deaths occur in developing countries, where most newborns deaths occur at home. In Nepal, approximately, 90% of deliveries take place at home. Information about reasons for delivering at home and newborn care practices in urban areas of Nepal is lacking and such information will be useful for policy makers. Methods A cross-sectional survey was carried out in the immunisation clinics of Pokhara city, western Nepal during January and February, 2006. Two trained health workers administered a semi-structured questionnaire to the mothers who had delivered at home. Results A total of 240 mothers were interviewed. Planned home deliveries were 140 (58.3% and 100 (41.7% were unplanned. Only 6.2% of deliveries had a skilled birth attendant present and 38 (15.8% mothers gave birth alone. Only 46 (16.2% women had used a clean home delivery kit and only 92 (38.3% birth attendants had washed their hands. The umbilical cord was cut after expulsion of placenta in 154 (64.2% deliveries and cord was cut using a new/boiled blade in 217 (90.4% deliveries. Mustard oil was applied to the umbilical cord in 53 (22.1% deliveries. Birth place was heated throughout the delivery in 88 (64.2% deliveries. Only 100 (45.8% newborns were wrapped within 10 minutes and 233 (97.1% were wrapped within 30 minutes. Majority (93.8% of the newborns were given a bath soon after birth. Mustard oil massage of the newborns was a common practice (144, 60%. Sixteen (10.8% mothers did not feed colostrum to their babies. Prelacteal feeds were given to 37(15.2% newborns. Initiation rates of breast-feeding were 57.9% within one hour and 85.4% within 24 hours. Main reasons cited for delivering at home were 'preference' (25.7%, 'ease and convenience' (21.4% for planned deliveries while 'precipitate labor' (51%, 'lack of transportation' (18% and 'lack of escort' during labor (11% were cited for the unplanned ones. Conclusion High-risk home delivery and

  3. Policies for care during the third stage of labour: a survey of maternity units in Syria

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    Abdulsalam Asma

    2010-06-01

    Full Text Available Abstract Background Care for women during the third stage aims to reduce the risk of major haemorrhage, but is very variable. The current World Health Organisation (WHO recommendation is that care should include administration of a uterotonic (oxytocin, if it is available soon after birth of the baby, delayed cord clamping, and delivery of the placenta by controlled cord traction. Methods To ascertain care policies used during the third stage of labour in maternity units in Syria, we conducted a survey of 69 maternity units in obstetric and general public hospitals. A brief questionnaire was administered by face to face interview or telephone with senior obstetricians and midwives. Outcome measures were the use of prophylactic uterotonic drugs, timing of cord clamping, use of controlled cord traction, and treatment for postpartum haemorrhage. Obstetricians were asked about both vaginal and caesarean births, midwives only about vaginal births. Results Responses were obtained for 66 (96% hospitals: a midwife and an obstetrician were interviewed in 40; an obstetrician only in 20; a midwife only in 6. Responses were similar, although midwives were more likely to report that the umbilical cord was clamped after 1-3 minutes or after cessation of pulsation (2/40 obstetricians and 9/40 midwives. Responses have therefore been combined. One hospital reported never using a prophylactic uterotonic drug. The uterotonic was Syntometrine® (oxytocin and ergometrine in two thirds of hospitals; given after delivery of the placenta in 60 (91% for vaginal births, and in 47 (78% for caesarean births. Cord clamping was within 20 seconds at 42 hospitals 64% for vaginal births and 45 (75% for caesarean births. Controlled cord traction was never used in a quarter (17/66 of hospitals for vaginal births and a half (32/60 for caesarean births. 68% of respondents (45/66 thought there was a need for more randomised trials of interventions during the third stage of labour

  4. Equity in health care financing in Portugal: findings from the Household Budget Survey 2010/2011.

    Science.gov (United States)

    Quintal, Carlota; Lopes, José

    2016-07-01

    Equity in health care financing is recognised as a main goal in health policy. It implies that payments should be linked to capacity to pay and that households should be protected against catastrophic health expenditure (CHE). The risk of CHE is inversely related to the share of out-of-pocket payments (OOP) in total health expenditure. In Portugal, OOP represented 26% of total health expenditure in 2010 [one of the highest among Organisation for Economic Co-operation and Development (OECD) countries]. This study aims to identify the proportion of households with CHE in Portugal and the household factors associated with this outcome. Additionally, progressivity indices are calculated for OOP and private health insurance. Data were taken from the Portuguese Household Budget Survey 2010/2011. The prevalence of CHE is 2.1%, which is high for a developed country with a universal National Health Service. The main factor associated with CHE is the presence of at least one elderly person in households (when the risk quadruples). Payments are particularly regressive for medicines. Regarding the results by regions, the Kakwani index for total OOP is larger (negative) for the Centre and lower, not significant, for the Azores. Payments for voluntary health insurance are progressive. PMID:26573411

  5. A survey-based study of knowledge of Alzheimer’s disease among health care staff

    OpenAIRE

    Smyth Wendy; Fielding Elaine; Beattie Elizabeth; Gardner Anne; Moyle Wendy; Franklin Sara; Hines Sonia; MacAndrew Margaret

    2013-01-01

    Abstract Background Continued aging of the population is expected to be accompanied by substantial increases in the number of people with dementia and in the number of health care staff required to care for them. Adequate knowledge about dementia among health care staff is important to the quality of care delivered to this vulnerable population. The purpose of this study was to assess knowledge about dementia across a range of health care staff in a regional health service district. Methods K...

  6. A survey of primary and specialised health care provision to prisons in England and Wales.

    OpenAIRE

    Cornford, C S; Mason, J.; Buchanan, K.; Reeves, D; Kontopantelis, E; Sibbald, B; Thornton-Jones, H; Williamson, M; Baer, L

    2008-01-01

    Background Prison health care in England, including primary care, is now incorporated into the National Health Service; the impetus for the change is in part due to concern about standards of health care within prisons. The demographic characteristics and health status of patients within prisons are relatively well understood, as are the problems faced by health care professionals. Less is known about current health care provision. Aims To describe the organisation of primary heal...

  7. Ready for discharge? A Survey of Discharge Transition of Care Education and Evaluation in Emergency Medicine Residency Programs

    Directory of Open Access Journals (Sweden)

    Fiona E. Gallahue

    2015-11-01

    Full Text Available This study aimed to assess current education and practices of emergency medicine (EM residents as perceived by EM program directors to determine if there are deficits in resident discharge handoff training. This survey study was guided by the Kern model for medical curriculum development. A six-member Council of EM Residency Directors (CORD Transitions of Care task force of EM physicians performed these steps and constructed a survey. The survey was distributed to program residency directors via the CORD listserve and/or direct contact. There were 119 responses to the survey, which were collected using an online survey tool. Over 71% of the 167 American College of Graduate Medical Education (ACGME accredited EM residency programs were represented. Of those responding, 42.9% of programs reported formal training regarding discharges during initial orientation and 5.9% reported structured curriculum outside of orientation. A majority (73.9% of programs reported that EM residents were not routinely evaluated on their discharge proficiency. Despite the ACGME requirements requiring formal handoff curriculum and evaluation, many programs do not provide formal curriculum on the discharge transition of care or evaluate EM residents on their discharge proficiency.

  8. A pilot survey of the current scope of the practice of South African physiotherapists in the intensive care units

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    H. van Aswegen

    2005-02-01

    Full Text Available Objective: A pilot study was conducted to determine the currentscope of practice of South African physiotherapists working in intensive care units in the government and the private sectors. These findings were compared to the findings from a European survey with regard to the role of the physiotherapist in European intensive care units.Methodology: Ninety questionnaires were distributed nationwide to secondary and tertiary government hospitals as well as to private practitioners involved in cardiopulmonary physiotherapy. The private practitioners included in this survey were listed in the Private Practitioners Association Official Members Directory. Junior and senior physiotherapists working in the intensive care units of their respective hospitals participated in completing the questionnaire. Comparisons between government and private sector data and between the South African survey and the European survey were carried out using the 2test for non-parametric data. A p-value of less than 0.05 was considered to be statistically significant.Results: Fifty-four questionnaires were analyzed and represented 60% of questionnaires sent out. Respondents to the South African survey reported 28% percent of all ICUs had between 9 - 12 beds; 83% physiotherapists indicated the availability of an on-call service during the night and 96% physiotherapists had a weekend physiotherapy service. Ninety-two percent of physiotherapists working in the government sector supervised students compared to 44% of physiotherapists in the private sector. Between 9% and 27% of physiotherapists in government and private hospitalsactively participated in research in ICU. There were no statistically significant differences in the use of respiratory physiotherapy, mobilization and positioning between respondents to the European survey and those of the South African survey respectively.Conclusion: The response rate to this questionnaire was good. It was evident from this pilot

  9. Information needs of gay, lesbian, bisexual, and transgendered health care professionals: results of an Internet survey

    OpenAIRE

    Fikar, Charles R.; Keith, Latrina (NYAM)

    2004-01-01

    Objectives: To obtain basic facts and considered opinions from health care professionals and students (nonlibrarian and librarian) about the information needs of gay, lesbian, bisexual, and transgendered (GLBT) health care professionals and their interactions with medical librarians.

  10. Patient safety in primary care: A survey of general practitioners in the Netherlands

    NARCIS (Netherlands)

    Gaal, S.; Verstappen, W.H.J.M.; Wensing, M.J.P.

    2010-01-01

    BACKGROUND: Primary care encompasses many different clinical domains and patient groups, which means that patient safety in primary care may be equally broad. Previous research on safety in primary care has focused on medication safety and incident reporting. In this study, the views of general prac

  11. Diabetes Self-Management and Education of People Living with Diabetes: A Survey in Primary Health Care in Muscat Oman

    OpenAIRE

    Elliott, James A.; Nadia Noor Abdulhadi; Al-Maniri, Abdullah A; Al-Shafaee, Mohammed A; Rolf Wahlström

    2013-01-01

    Background: Although the prevalence of type 2 diabetes in Oman is high and rising, information on how people were self-managing their disease has been lacking. The objective of this study was therefore to assess diabetes self-management and education (DSME) among people living with type 2 diabetes in Oman. Methods: A questionnaire survey was conducted in public primary health care centres in Muscat. Diabetes self-management and education was assessed by asking how patients recognized and resp...

  12. Pharmaceuticals and Personal Care Products in Archived U.S. Biosolids from the 2001 EPA National Sewage Sludge Survey

    OpenAIRE

    McClellan, Kristin; Halden, Rolf U.

    2010-01-01

    In response to the U.S. National Academies’ call for a better assessment of chemical pollutants contained in the approximately 6.9 million dry tons of digested municipal sludge produced annually in the United States, the mean concentration of 72 pharmaceuticals and personal care products (PPCP) were determined in 110 biosolids samples collected by the U.S. Environmental Protection Agency (EPA) in its 2001 National Sewage Sludge Survey. Composite samples of archived biosolids, collected at 94 ...

  13. Survey of Third-Year Postgraduate Training Positions in Family Medicine: Adding more positions for adequate training in primary care

    OpenAIRE

    Busing, Nick

    1992-01-01

    In a survey of 16 program directors of residency training in family medicine, respondents were asked about numbers and types of third-year positions they offer. As Canadian educational programs move toward implementing or expanding 2-year prelicensure requirements, many directors are exploring the need to add even more positions for adequate training in primary care. Respondents offered suggestions on tailoring strategies in view of the educational, political, and economic climate.

  14. Quality and coordination of care for patients with multiple conditions: results from an international survey of patient experience.

    Science.gov (United States)

    Burgers, Jako S; Voerman, Gerlienke E; Grol, Richard; Faber, Marjan J; Schneider, Eric C

    2010-09-01

    Previous studies using clinical performance measures suggest that quality of care for patients with multiple chronic conditions is not worse than that for others. This article presents patient-reported experiences of health care among 8,973 of chronically ill adults from eight countries, using telephone survey data. We designed a ''morbidity score'' combining the number of conditions and reported health status. Respondents with high morbidity scores reported less favorable experience with coordination of care compared to those with low morbidity scores. They also reported lower ratings of overall quality of care. There were no differences in reported experience with the individual physicians. Comparing type of comorbidity, chronic lung, and mental health problems were associated with lower ratings than hypertension, heart disease, diabetes, arthritis, and cancer. The implications and limitations of this study are discussed in the context of health care reform. Pay-for-performance programs need to account for chronic conditions to avoid penalizing physicians who care for larger shares of such patients. PMID:20801976

  15. Prevalence Rates of Self-Care Behaviors and Related Factors in a Rural Hypertension Population: A Questionnaire Survey

    Directory of Open Access Journals (Sweden)

    Huanhuan Hu

    2013-01-01

    Full Text Available The objective of this study was to investigate the self-care behaviors among hypertensive patients in primary care. A cross-sectional survey, with 318 hypertensive patients, was conducted in a rural area in Beijing, China, in 2012. Participants were mainly recruited from a community health clinic and completed questionnaires assessing their self-care behaviors, including data on adherence to a prescribed medication regimen, low-salt diet intake, smoking habits, alcohol consumption, blood pressure monitoring, and physical exercise. The logistic regression model was used for the analysis of any association between self-care behaviors and age, gender, duration of hypertension, self-rated health, marital status, education level, diabetes status, or body mass index. Subjects that adhered to their medication schedule were more likely to have hypertension for a long duration (OR, 3.44; 95% CI 1.99–5.97. Older participants (OR, 1.80; 95% CI 1.08–2.99 were more likely to monitor their blood pressure. Subjects who did not partake in physical exercise were more likely to be men, although the difference between genders was not significant (OR, 0.60; 95% CI 0.36–1.01. Patients with shorter history of hypertension, younger and being males have lower self-care behaviors. Primary care providers and public health practitioner should pay more attention to patients recently diagnosed with hypertension as well as younger male patients.

  16. Delirium, sedation and analgesia in the intensive care unit: a multinational, two-part survey among intensivists.

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    Alawi Luetz

    Full Text Available Analgesia, sedation and delirium management are important parts of intensive care treatment as they are relevant for patients' clinical and functional long-term outcome. Previous surveys showed that despite this fact implementation rates are still low. The primary aim of the prospective, observational multicenter study was to investigate the implementation rate of delirium monitoring among intensivists. Secondly, current practice concerning analgesia and sedation monitoring as well as treatment strategies for patients with delirium were assesed. In addition, this study compares perceived and actual practice regarding delirium, sedation and analgesia management. Data were obtained with a two-part, anonymous survey, containing general data from intensive care units in a first part and data referring to individual patients in a second part. Questionnaires from 101 hospitals (part 1 and 868 patients (part 2 were included in data analysis. Fifty-six percent of the intensive care units reported to monitor for delirium in clinical routine. Fourty-four percent reported the use of a validated delirium score. In this respect, the survey suggests an increasing use of delirium assessment tools compared to previous surveys. Nevertheless, part two of the survey revealed that in actual practice 73% of included patients were not monitored with a validated score. Furthermore, we observed a trend towards moderate or deep sedation which is contradicting to guideline-recommendations. Every fifth patient was suffering from pain. The implementation rate of adequate pain-assessment tools for mechanically ventilated and sedated patients was low (30%. In conclusion, further efforts are necessary to implement guideline recommendations into clinical practice. The study was registered (ClinicalTrials.gov identifier: NCT01278524 and approved by the ethical committee.

  17. Poor thermal care practices among home births in Nepal: further analysis of Nepal Demographic and Health Survey 2011.

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    Vishnu Khanal

    Full Text Available INTRODUCTION: Hypothermia is a major factor associated with neonatal mortality in low and middle income countries. Thermal care protection of newborn through a series of measures taken at birth and during the initial days of life is recommended to reduce the hypothermia and associated neonatal mortality. This study aimed to identify the prevalence of and the factors associated with receiving 'optimum thermal care' among home born newborns of Nepal. METHODS: Data from the Nepal Demographic and Health Surveys (NDHS 2011 were used for this study. Women who reported a home birth for their most recent childbirth was included in the study. Factors associated with optimum thermal care were examined using Chi-square test followed by logistic regression. RESULTS: A total of 2464 newborns were included in the study. A total of 57.6 % were dried before the placenta was delivered; 60.3% were wrapped; 24.5% had not bathing during the first 24 hours, and 63.9% were breastfed within one hour of birth. Overall, only 248 (10.7%; 95% CI (8.8 %, 12.9% newborns received optimum thermal care. Newborns whose mothers had achieved higher education (OR 2.810; 95% CI (1.132, 6.976, attended four or more antenatal care visits (OR 2.563; 95% CI (1.309, 5.017, and those whose birth were attended by skilled attendants (OR 2.178; 95% CI (1.428, 3.323 were likely to receive optimum thermal care. CONCLUSION: The current study showed that only one in ten newborns in Nepal received optimum thermal care. Future newborn survival programs should focus on those mothers who are uneducated; who do not attend the recommended four or more attend antenatal care visits; and those who deliver without the assistance of skilled birth attendants to reduce the risk of neonatal hypothermia in Nepal.

  18. Attitudes and beliefs regarding spiritual care. A survey of cancer nurses.

    Science.gov (United States)

    Taylor, E J; Highfield, M; Amenta, M

    1994-12-01

    Why nurses neglect spiritual care issues remains unclear. Therefore, a questionnaire designed to assess oncology nurse clinicians' attitudes and beliefs about spiritual care was mailed to a stratified, random sample of 700 Oncology Nursing Society members within the United States. Data from the 181 respondents were analyzed using descriptive and multivariate statistics (for quantitative items) and content analysis (for essay questions). Analysis of data revealed both a positive regard for spiritual care within nursing, and relationships between beliefs and attitudes about spiritual care and self-reported spiritually, religiosity, ethnicity, work role, and education. Recommendations are for inclusion of theoretical and practical aspects of spiritual care in nursing education and for further investigation of nurses' attitudes and beliefs regarding spiritual care. PMID:7820826

  19. Explaining public satisfaction with health care systems: findings from a nationwide survey in China

    OpenAIRE

    Munro, Neil; Duckett, Jane

    2016-01-01

    Objective: To identify factors and covariates associated with health care system satisfaction in China. Context: Recent research suggests that socio-demographic characteristics, self-reported health, income and insurance, ideological beliefs, health care utilization, media use and perceptions of services may affect health care system satisfaction, but the relationships between these factors are poorly understood. New data from China offers the opportunity to test theories about the source...

  20. Towards integrated care in breastfeeding support: a cross-sectional survey of practitioners’ perspectives

    OpenAIRE

    Rosin, Stefanie Inge; Zakarija-Grković, Irena

    2016-01-01

    Background Integrated care is defined as concerted action of healthcare providers ensuring continuity of care within a patient-centered approach, thus contributing to healthcare efficiency and quality. Apart from the WHO/UNICEF Baby-Friendly Initiatives, integrated care has been poorly explored within the context of breastfeeding support. The aim of this study was to investigate the experience of breastfeeding support practitioners, identifying barriers and facilitators towards integrated car...

  1. The state of emergency obstetric care services in Nairobi informal settlements and environs: Results from a maternity health facility survey

    Directory of Open Access Journals (Sweden)

    Saliku Teresa

    2009-03-01

    Full Text Available Abstract Background Maternal mortality in Sub-Saharan Africa remains a challenge with estimates exceeding 1,000 maternal deaths per 100,000 live births in some countries. Successful prevention of maternal deaths hinges on adequate and quality emergency obstetric care. In addition to skilled personnel, there is need for a supportive environment in terms of essential drugs and supplies, equipment, and a referral system. Many household surveys report a reasonably high proportion of women delivering in health facilities. However, the quality and adequacy of facilities and personnel are often not assessed. The three delay model; 1 delay in making the decision to seek care; 2 delay in reaching an appropriate obstetric facility; and 3 delay in receiving appropriate care once at the facility guided this project. This paper examines aspects of the third delay by assessing quality of emergency obstetric care in terms of staffing, skills equipment and supplies. Methods We used data from a survey of 25 maternity health facilities within or near two slums in Nairobi that were mentioned by women in a household survey as places that they delivered. Ethical clearance was obtained from the Kenya Medical Research Institute. Permission was also sought from the Ministry of Health and the Medical Officer of Health. Data collection included interviews with the staff in-charge of maternity wards using structured questionnaires. We collected information on staffing levels, obstetric procedures performed, availability of equipment and supplies, referral system and health management information system. Results Out of the 25 health facilities, only two met the criteria for comprehensive emergency obstetric care (both located outside the two slums while the others provided less than basic emergency obstetric care. Lack of obstetric skills, equipment, and supplies hamper many facilities from providing lifesaving emergency obstetric procedures. Accurate estimation of burden

  2. The GP Patient Survey for use in primary care in the National Health Service in the UK – development and psychometric characteristics

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    Bower Peter

    2009-08-01

    Full Text Available Abstract Background The UK National GP Patient Survey is one of the largest ever survey programmes of patients registered to receive primary health care, inviting five million respondents to report their experience of NHS primary healthcare. The third such annual survey (2008/9 involved the development of a new survey instrument. We describe the process of that development, and the findings of an extensive pilot survey in UK primary healthcare. Methods The survey was developed following recognised guidelines and involved expert and stakeholder advice, cognitive testing of early versions of the survey instrument, and piloting of the questionnaire in a cross sectional pilot survey of 1,500 randomly selected individuals from the UK electoral register with two reminders to non-respondents. Results The questionnaire comprises 66 items addressing a range of aspects of UK primary healthcare. A response rate of 590/1500 (39.3% was obtained. Non response to individual items ranged from 0.8% to 15.3% (median 5.2%. Participants did not always follow internal branching instructions in the questionnaire although electronic controls allow for correction of this problem in analysis. There was marked skew in the distribution of responses to a number of items indicating an overall favourable impression of care. Principal components analysis of 23 items offering evaluation of various aspects of primary care identified three components (relating to doctor or nurse care, or addressing access to care accounting for 68.3% of the variance in the sample. Conclusion The GP Patient Survey has been carefully developed and pilot-tested. Survey findings, aggregated at practice level, will be used to inform the distribution of £65 million ($107 million of UK NHS resource in 2008/9 and this offers the opportunity for NHS service planners and providers to take account of users' experiences of health care in planning and delivering primary healthcare in the UK.

  3. P06.01. Survey of Business and Care Models of Integrative Medicine

    OpenAIRE

    MacElhern, Lauray; Carter, Susan

    2013-01-01

    Focus Areas: Sustainable Business Models In 2012, the business sub-committee of the clinical working group for the Consortium of Academic Health Centers for Integrative Medicine (CAHCIM) launched a pilot survey to collect information about the structure and business models of the member integrative centers. Although the survey provided useful insight into the business operations and financial resources needed to start up a center, the survey needed a better design and response rate. The 2013 ...

  4. Knowledge, attitude and practices on needle-stick and sharps injuries in tertiary care cardiac hospital: A survey

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    S Sharma

    2010-01-01

    Full Text Available Aims: One of the potential hazards for health care workers (HCWs is needle-stick and sharp injuries (NSSIs. The objective of the study was to assess the knowledge and attitude of health care workers about the NSSIs. Settings and Design: This was a cross-sectional survey conducted in the tertiary care cardiac center. The participants were health care workers including doctors, nurses, technicians, and housekeeping staff from the different areas of the hospital. Methods and Materials: This cross-sectional survey was conducted in the institute using a self-administered validated questionnaire. The participants consisted of a total of 190 HCWs namely doctors, nurses, technicians, and housekeeping staff. Statistical Analysis Used: Nil. Results: Results showed maximum participant were in the age group of 20-30 years. 94.7% were aware about standard precautions. 91.5% knew about the procedure for reporting of NSSIs. Only 50.2% HCWs gave correct answers regarding disease transmission through needle stick and sharp injury. The prevalence of NSSIs was highest among nurses (38.4%, and needle on the disposable syringe (76.9% was the most common source of NSSIs. Conclusions: The survey revealed few gaps in the knowledge amongst HCWs about NSSIs like risks associated with needle-stick injuries and use of preventive measures, disassembling of needles prior to disposal. These gaps can be addressed by extensive education. As nurses were the most affected victim for the NSSIs, more emphasis should be given towards them for reducing the NSSIs.

  5. General practitioner management of shoulder pain in comparison with rheumatologist expectation of care and best evidence: an Australian national survey.

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    Rachelle Buchbinder

    Full Text Available OBJECTIVES: To determine whether current care for common shoulder problems in Australian general practice is in keeping with rheumatologist expectations and the best available evidence. METHODS: We performed a mailed survey of a random sample of 3500 Australian GPs and an online survey of all 270 rheumatologists in Australia in June 2009. Each survey included four vignettes (first presentation of shoulder pain due to rotator cuff tendinopathy, acute rotator cuff tear in a 45 year-old labourer and early and later presentation of adhesive capsulitis. For each vignette, GPs were asked to indicate their management, rheumatologists were asked to indicate appropriate primary care, and we determined best available evidence from relevant Cochrane and other systematic reviews and published guidelines. RESULTS: Data were available for at least one vignette for 614/3500 (17.5% GPs and 64 (23.8% rheumatologists. For first presentation of rotator cuff tendinopathy, 69% and 82% of GPs and 50% and 56% rheumatologists would order a shoulder X-ray and ultrasound respectively (between group comparisons P = 0.004 and P<0001. Only 66% GPs and 60% rheumatologists would refer to an orthopaedic surgeon for the acute rotator cuff tear. For adhesive capsulitis, significantly more rheumatologists recommended treatments of known benefit (e.g. glucocorticoid injection (56% versus 14%, P<0.0001, short course of oral glucocorticoids (36% versus 6%, p<0.0001 and arthrographic distension of the glenohumeral joint (41% versus 19%, P<0.0001. CONCLUSIONS: There is a mismatch between the stated management of common shoulder problems encountered in primary care by GPs, rheumatologist expectations of GP care and the available evidence.

  6. Estimating leptospirosis incidence using hospital-based surveillance and a population-based health care utilization survey in Tanzania.

    Directory of Open Access Journals (Sweden)

    Holly M Biggs

    Full Text Available BACKGROUND: The incidence of leptospirosis, a neglected zoonotic disease, is uncertain in Tanzania and much of sub-Saharan Africa, resulting in scarce data on which to prioritize resources for public health interventions and disease control. In this study, we estimate the incidence of leptospirosis in two districts in the Kilimanjaro Region of Tanzania. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a population-based household health care utilization survey in two districts in the Kilimanjaro Region of Tanzania and identified leptospirosis cases at two hospital-based fever sentinel surveillance sites in the Kilimanjaro Region. We used multipliers derived from the health care utilization survey and case numbers from hospital-based surveillance to calculate the incidence of leptospirosis. A total of 810 households were enrolled in the health care utilization survey and multipliers were derived based on responses to questions about health care seeking in the event of febrile illness. Of patients enrolled in fever surveillance over a 1 year period and residing in the 2 districts, 42 (7.14% of 588 met the case definition for confirmed or probable leptospirosis. After applying multipliers to account for hospital selection, test sensitivity, and study enrollment, we estimated the overall incidence of leptospirosis ranges from 75-102 cases per 100,000 persons annually. CONCLUSIONS/SIGNIFICANCE: We calculated a high incidence of leptospirosis in two districts in the Kilimanjaro Region of Tanzania, where leptospirosis incidence was previously unknown. Multiplier methods, such as used in this study, may be a feasible method of improving availability of incidence estimates for neglected diseases, such as leptospirosis, in resource constrained settings.

  7. Colorectal cancer screening practices of primary care providers: results of a national survey in Malaysia.

    Science.gov (United States)

    Norwati, Daud; Harmy, Mohamed Yusoff; Norhayati, Mohd Noor; Amry, Abdul Rahim

    2014-01-01

    The incidence of colorectal cancer has been increasing in many Asian countries including Malaysia during the past few decades. A physician recommendation has been shown to be a major factor that motivates patients to undergo screening. The present study objectives were to describe the practice of colorectal cancer screening by primary care providers in Malaysia and to determine the barriers for not following recommendations. In this cross sectional study involving 132 primary care providers from 44 Primary Care clinics in West Malaysia, self-administered questionnaires which consisted of demographic data, qualification, background on the primary care clinic, practices on colorectal cancer screening and barriers to colorectal cancer screening were distributed. A total of 116 primary care providers responded making a response rate of 87.9%. About 21% recommended faecal occult blood test (FOBT) in more than 50% of their patients who were eligible. The most common barrier was "unavailability of the test". The two most common patient factors are "patient in a hurry" and "poor patient awareness". This study indicates that colorectal cancer preventive activities among primary care providers are still poor in Malaysia. This may be related to the low availability of the test in the primary care setting and poor awareness and understanding of the importance of colorectal cancer screening among patients. More awareness programmes are required for the public. In addition, primary care providers should be kept abreast with the latest recommendations and policy makers need to improve colorectal cancer screening services in health clinics. PMID:24761922

  8. Knowledge of Alzheimer's Disease among Norwegian Undergraduate Health and Social Care Students: A Survey Study

    Science.gov (United States)

    Kada, Sundaran

    2015-01-01

    With an aging general population and a concurrent increase in the prevalence of dementia, health and social care professional students are increasingly exposed to this group of patients during their clinical placements and after graduation. A sound dementia-related knowledge base among health and social care students is important in providing…

  9. The Nordic maintenance care program – case management of chiropractic patients with low back pain: A survey of Swedish chiropractors

    Directory of Open Access Journals (Sweden)

    Jørgensen Kristian

    2008-06-01

    Full Text Available Abstract Background Chiropractic treatment for low back pain (LBP can often be divided into two phases: Initial treatment of the problem to attempt to remove pain and bring it back into its pre-clinical or maximum improvement status, and "maintenance care", during which it is attempted to maintain this status. Although the use of chiropractic maintenance care has been described and discussed in the literature, there is no information as to its precise indications. The objective of this study is to investigate if there is agreement among Swedish chiropractors on the overall patient management for various types of LBP-scenarios, with a special emphasis on maintenance care. Method The design was a mailed questionnaire survey. Members of the Swedish Chiropractors' Association, who were participants in previous practice-based research, were sent a closed-end questionnaire consisting of nine case scenarios and six clinical management alternatives and the possibility to create one's own alternative, resulting in a "nine-by-seven" table. The research team defined its own pre hoc choice of "clinically logical" answers based on the team's clinical experience. The frequency of findings was compared to the suggestions of the research team. Results Replies were received from 59 (60% of the 99 persons who were invited to take part in the study. A pattern of self-reported clinical management strategies emerged, largely corresponding to the "clinically logical" answers suggested by the research team. In general, patients of concern would be referred out for a second opinion, cases with early recovery and without a history of previous low back pain would be quickly closed, and cases with quick recovery and a history of recurring events would be considered for maintenance care. However, also other management patterns were noted, in particular in the direction of maintenance care. Conclusion To a reasonable extent, Swedish chiropractors participating in this

  10. Quality of surgical care in hospitals providing internship training in Kenya: a cross sectional survey.

    Science.gov (United States)

    Mwinga, Stephen; Kulohoma, Colette; Mwaniki, Paul; Idowu, Rachel; Masasabi, John; English, Mike

    2015-01-01

    Objective To evaluate services in hospitals providing internship training to graduate doctors in Kenya. Methods A survey of 22 internship training hospitals was conducted. Availability of key resources spanning infrastructure, personnel, equipment and drugs was assessed by observation. Outcomes and process of care for pre-specified priority conditions (head injury, chest injury, fractures, burns and acute abdomen) were evaluated by auditing case records. Results Each hospital had at least one consultant surgeon. Scheduled surgical outpatient clinics, major ward rounds and elective (half day) theatre lists were provided once per week in 91%, 55% and 9%, respectively. In all other hospitals, these were conducted twice weekly. Basic drugs were not always available (e.g. gentamicin, morphine and pethidine in 50%, injectable antistaphylococcal penicillins in 5% hospitals). Fewer than half of hospitals had all resources needed to provide oxygen. One hundred and forty-five of 956 cases evaluated underwent operations under general or spinal anaesthesia. We found operation notes for 99% and anaesthetic records for 72%. Pre-operatively measured vital signs were recorded in 80% of cases, and evidence of consent to operation was found in 78%. Blood loss was documented in only one case and sponge and instrument counts in 7%. Conclusions Evaluation of surgical services would be improved by development and dissemination of clear standards of care. This survey suggests that internship hospitals may be poorly equipped and documented care suggests inadequacies in quality and training. Objectif Evaluer les services dans les hôpitaux offrant des stages de formation à des médecins diplômés au Kenya. Méthodes Enquête auprès de 22 hôpitaux offrant des stages de formation. La disponibilité des ressources clés incluant infrastructure, personnel, matériel et médicaments a été évaluée par observation. Les résultats et processus de soins pour des affections prioritaires pr

  11. The relatives' perspective on advanced cancer care in Denmark. A cross-sectional survey

    DEFF Research Database (Denmark)

    Johnsen, Anna T; Ross, Lone; Petersen, Morten A;

    2012-01-01

    In order to improve advanced cancer care, evaluations are necessary. An important element of such evaluations is the perspective of the patient's relatives who have the role of being caregivers as well as co-users of the health care system. The aims were to investigate the scale structure of the...... FAMCARE scale, to investigate satisfaction with advanced cancer care from the perspective of the relatives of a representative sample of advanced cancer patients, and to investigate whether some sub-groups of relatives were more dissatisfied than others....

  12. Continuity of care : is the personal doctor still important? : A survey of general practitioners and family physicians in England and Wales, the United States, and The Netherlands

    NARCIS (Netherlands)

    Stokes, T.; Tarrant, C.; Mainous, A.G.; Schers, H.J.; Freeman, G.; Baker, R.

    2005-01-01

    PURPOSE: We determined the reported value general practitioners/family physicians in 3 different health care systems place on the various types of continuity of care. METHODS: We conducted a postal questionnaire survey in England and Wales, the United States, and The Netherlands. The participants we

  13. Behavioural and psychological symptoms of dementia in primary care: a survey of general practitioners in Ireland

    OpenAIRE

    Buhagiar, Kurt; Afzal, Neelam; Cosgrave, Mary

    2011-01-01

    Background Management of neuropsychiatric symptoms is a challenging task in primary care. Aims To assess self-reported confidence and knowledge of general practitioners (GPs) regarding the identification and management of behavioural and psychological symptoms of dementia (BPSD).

  14. Revisiting the symptom iceberg in today's primary care: results from a UK population survey

    Directory of Open Access Journals (Sweden)

    Hannaford Philip C

    2011-04-01

    Full Text Available Abstract Background Recent changes in UK primary care have increased the range of services and healthcare professionals available for advice. Furthermore, the UK government has promoted greater use of both self-care and the wider primary care team for managing symptoms indicative of self-limiting illness. We do not know how the public has been responding to these strategies. The aim of this study was to describe the current use of different management strategies in the UK for a range of symptoms and identify the demographic, socio-economic and symptom characteristics associated with these different approaches. Methods An age and sex stratified random sample of 8,000 adults (aged 18-60, drawn from twenty general practices across the UK, were sent a postal questionnaire. The questionnaire collected detailed information on 25 physical and psychological symptoms ranging from those usually indicative of minor illness to those which could be indicative of serious conditions. Information on symptom characteristics, actions taken to manage the symptoms and demographic/socio-economic details were also collected. Results Just under half of all symptoms reported resulted in respondents doing nothing at all. Lay-care was used for 35% of symptoms and primary care health professionals were consulted for 12% of symptoms. OTC medicine use was the most common lay-care strategy (used for 25% of all symptom episodes. The GP was the most common health professional consulted (consulted for 8% of all symptom episodes while use of other primary care health professionals was very small (each consulted for less than 2% of symptom episodes. The actions taken for individual symptoms varied substantially although some broad patterns emerged. Symptom characteristics (in particular severity, duration and interference with daily life were more commonly associated with actions taken than demographic or socio-economic characteristics. Conclusion While the use of lay-care was

  15. Telephone survey of private patients' views on continuity of care and registration with general practice in Ireland.

    LENUS (Irish Health Repository)

    Carmody, Patricia

    2007-01-01

    BACKGROUND: The desire of patients for personal continuity of care with a General Practitioner (GP) has been well documented, but not within non-registered private patients in Ireland. This study set out to examine the attitudes and reported behaviours of private fee-paying patients towards continuity of GP care and universal registration for patients. METHODS: Cross-sectional telephone survey of 400 randomly chosen fee-paying patients living within County Dublin. There is no formal system of registration with a GP for these patients. Main outcomes were attendance of respondents at primary health care facilities and their attitudes towards continuity of care and registration with a GP. Data was analysed using descriptive statistics and using parametric and non-parametric tests of association. Pearson correlation was used to quantify the association between the described variables and attitudes towards continuity and registration with a GP. Variables showing significance at the 5% level were entered into multiple linear regression models. RESULTS: 97% of respondents had seen a GP in the previous 5 years. The mean number of visits to the GP for respondents was 2.3 per annum. 89% of respondents had a regular GP and the mean length of time with their GP was 15.6 years. 96% preferred their personal medical care to be provided within one general practice. 16% of respondents had consulted a GP outside of their own practice in the previous year. They were more likely to be female, commute a longer distance to work or have poorer health status. 81% considered it important to be officially registered with a GP practice of their choice. CONCLUSION: Both personal and longitudinal continuity of care with a GP are important to private patients. Respondents who chose to visit GPs other than their regular GP were not easily characterised in this study and individual circumstances may lead to this behaviour. There is strong support for a system of universal patient registration

  16. The role of advance directives in end-of-life decisions in Austria: survey of intensive care physicians

    Directory of Open Access Journals (Sweden)

    Schopper Andrea

    2010-10-01

    Full Text Available Abstract Background Currently, intensive care medicine strives to define a generally accepted way of dealing with end-of-life decisions, therapy limitation and therapy discontinuation. In 2006 a new advance directive legislation was enacted in Austria. Patients may now document their personal views regarding extension of treatment. The aim of this survey was to explore Austrian intensive care physicians' experiences with and their acceptance of the new advance directive legislation two years after enactment (2008. Methods Under the aegis of the OEGARI (Austrian Society of Anaesthesiology, Resuscitation and Intensive Care an anonymised questionnaire was sent to the medical directors of all intensive care units in Austria. The questions focused on the physicians' experiences regarding advance directives and their level of knowledge about the underlying legislation. Results There were 241 questionnaires sent and 139 were turned, which was a response rate of 58%. About one third of the responders reported having had no experience with advance directives and only 9 directors of intensive care units had dealt with more than 10 advance directives in the previous two years. Life-supporting measures, resuscitation, and mechanical ventilation were the predominantly refused therapies, wishes were mainly expressed concerning pain therapy. Conclusion A response rate of almost 60% proves the great interest of intensive care professionals in making patient-oriented end-of-life decisions. However, as long as patients do not make use of their right of co-determination, the enactment of the new law can be considered only a first important step forward.

  17. Barriers to sexual health care: a survey of Iranian-American physicians in California, USA

    OpenAIRE

    Rashidian, Mitra; Minichiello, Victor; Knutsen, Synnove F; Ghamsary, Mark

    2016-01-01

    Background Despite increasing numbers of Iranian-American physicians practicing in the United States, little is known about the barriers that may impact them as providers of sexual health care. This is an important topic as discussions of sexual topics are generally considered a taboo among Iranians. We aimed to identify barriers experienced by Iranian-American physicians that inhibit their willingness to engage in discussions of sexual health care with patients. Methods In 2013, a self-admin...

  18. A baseline survey on use of drugs at the primary health care level in Bangladesh.

    OpenAIRE

    Guyon, A. B.; Barman, A.; J. U. Ahmed; Ahmed, A U; Alam, M. S.(Physics Department, SUNY Albany, Albany, NY, USA)

    1994-01-01

    The drug use pattern and the quality of care were assessed in 80 public sector facilities throughout rural Bangladesh. A total of 40 thana health complexes and 40 union subcentres, the lowest level in primary health care facilities, were selected at random. A total of 2880 prescriptions, consultations, and drug-dispensing practices were studied, and the availability and use of essential drugs and of the essential drugs list were recorded. The average consulting time (54 seconds), the proporti...

  19. Patient safety skills in primary care: a national survey of GP educators

    OpenAIRE

    Ahmed, Maria; Arora, Sonal; McKay, John; Long, Susannah; Vincent, Charles; Kelly, Moya; Sevdalis, Nick; Bowie, Paul

    2014-01-01

    Background Clinicians have a vital role in promoting patient safety that goes beyond their technical competence. The qualities and attributes of the safe hospital doctor have been explored but similar work within primary care is lacking. Exploring the skills and attributes of a safe GP may help to inform the development of training programmes to promote patient safety within primary care. This study aimed to determine the views of General Practice Educational Supervisors (GPES) regarding the ...

  20. Towards Patient-Oriented Diabetes Care: Results from Two KORA Surveys in Southern Germany

    OpenAIRE

    Michaela Schunk; Renée Stark; Peter Reitmeir; Christa Meisinger; Rolf Holle

    2015-01-01

    Objective. This study aims to examine the relationship of diabetes care processes and patient outcomes with an expanded set of indicators regarding patient-oriented care delivery, such as treatment satisfaction, the quality of patient-physician relationship, and a wider range of patient outcomes such as self-management, health behaviour, disease-related burden, and health-related quality of life (HRQL). Methods. The study population consisted of 486 participants with type 2 diabetes in two po...

  1. Self-care and adherence to medication: a survey in the hypertension outpatient clinic

    OpenAIRE

    Lip Gregory YH; Beevers D Gareth; Greenfield Sheila M; Gohar Faekah; Jolly Kate

    2008-01-01

    Abstract Background Self-care practices for patients with hypertension include adherence to medication, use of blood pressure self-monitoring and use of complementary and alternative therapies (CAM) The prevalence of CAM use and blood pressure self-monitoring have not been described in a UK secondary care population of patients with hypertension and their impact on adherence to medication has not been described. Adherence to medication is important for blood pressure control, but poor adheren...

  2. Are Marketplace Plans Affordable? Consumer Perspectives from the Commonwealth Fund Affordable Care Act Tracking Survey, March-May 2015.

    Science.gov (United States)

    Collins, Sara R; Gunja, Munira; Rasmussen, Petra W; Doty, Michelle M; Beutel, Sophie

    2015-09-01

    Most employers who provide health insurance to employees subsidize their premiums and provide a comprehensive benefit package. Before the Affordable Care Act, people who lacked health insurance through a job and purchased it on their own paid the full cost of their plans, which often came with skimpy benefit packages and high deductibles. Findings from the Commonwealth Fund Affordable Care Act Tracking Survey, March--May 2015, indicate that the law's tax credits have made premium costs in health plans sold through the marketplaces roughly comparable to employer plans, at least for people with low and moderate incomes. At higher incomes, the phase-out of the subsidies means that adults in marketplace plans have higher premium costs than those in employer plans. Overall, larger shares of adults in marketplace plans reported deductibles of $1,000 or more, compared with those in employer plans, though these differences were narrower among low-and moderate-income adults. PMID:26445739

  3. Strategies for effective goals of care discussions and decision-making: perspectives from a multi-centre survey of Canadian hospital-based healthcare providers

    OpenAIRE

    Roze des Ordons, Amanda L; Sharma, Nishan; Heyland, Daren K; You, John J

    2015-01-01

    Background Communication gaps impact the quality of patient care. Previous research has focused on communication barriers rather than seeking solutions. Our aim was to identify strategies for effective communication and decision-making about goals of care for medical interventions in serious illness, from the perspectives of hospital-based healthcare providers. Methods A cross-sectional survey composed of closed- and open-ended questions about goals of care communication and decision-making w...

  4. Community nursing needs more silver surfers: a questionnaire survey of primary care nurses' use of information technology

    Directory of Open Access Journals (Sweden)

    de Lusignan Simon

    2004-10-01

    Full Text Available Abstract Background In the UK the health service is investing more than ever before in information technology (IT and primary care nurses will have to work with computers. Information about patients will be almost exclusively held in electronic patient records; and much of the information about best practice is most readily accessible via computer terminals. Objective To examine the influence of age and nursing profession on the level of computer use. Methods A questionnaire was developed to examine: access, training received, confidence and use of IT. The survey was carried out in a Sussex Primary Care Trust, in the UK. Results The questionnaire was sent to 109 nurses with a 64% response rate. Most primary care nurses (89% use their computer regularly at work: 100% of practice nurses daily, compared with 60% of district nurses and 59% of health visitors (p Conclusions Using computers in the surgery has become the norm for primary care nurses. However, nurses over 50, working out in the community, lack the confidence and skill of their younger and practice based colleagues.

  5. Medical physics aspects of cancer care in the Asia Pacific region: 2011 survey results

    OpenAIRE

    2012-01-01

    Background: Medical physicists are essential members of the radiation oncology team. Given the increasing complexity of radiotherapy delivery, it is important to ensure adequate training and staffing. The aim of the present study was to update a similar survey from 2008 and assess the situation of medical physicists in the large and diverse Asia Pacific region. Methods: Between March and July 2011, a survey on profession and practice of radiation oncology medical physicists (ROMPs) in the Asi...

  6. Risk-Based Immunization Policies and Tuberculosis Screening Practices for Animal Care and Research Workers in the United States: Survey Results and Recommendations

    OpenAIRE

    Weigler, Benjamin J; Cooper, Donna R; Hankenson, F Claire

    2012-01-01

    A national survey was conducted to assess immunization practices and tuberculosis screening methods for animal care and research workers in biomedical settings throughout the United States. Veterinarians (n = 953) were surveyed via a web-based mechanism; completed surveys (n = 308) were analyzed. Results showed that occupational health and safety programs were well-developed, enrolling veterinary, husbandry, and research staff at rates exceeding 90% and involving multiple modalities of health...

  7. Health care seeking behavior for diarrhea in children under 5 in rural Niger: results of a cross-sectional survey

    Directory of Open Access Journals (Sweden)

    Djibo Ali

    2011-05-01

    Full Text Available Abstract Background Diarrhea remains the second leading cause of death in children under 5 years of age in sub-Saharan Africa. Health care seeking behavior for diarrhea varies by context and has important implications for developing appropriate care strategies and estimating burden of disease. The objective of this study was to determine the proportion of children under five with diarrhea who consulted at a health structure in order to identify the appropriate health care levels to set up surveillance of severe diarrheal diseases. Methods A cluster survey was done on 35 clusters of 21 children under 5 years of age in each of four districts of the Maradi Region, Niger. Caretakers were asked about diarrhea of the child during the recall period and their health seeking behavior in case of diarrhea. A weighted cluster analysis was conducted to determine the prevalence of diarrhea, as well as the proportion of consultations and types of health structures consulted. Results In total, the period prevalence of diarrhea and severe diarrhea between April 24th and May 21st 2009 were 36.8% (95% CI: 33.7 - 40.0 and 3.4% (95% CI: 2.2-4.6, respectively. Of those reporting an episode of diarrhea during the recall period, 70.4% (95% CI: 66.6-74.1 reported seeking care at a health structure. The main health structures visited were health centers, followed by health posts both for simple or severe diarrhea. Less than 10% of the children were brought to the hospital. The proportion of consultations was not associated with the level of education of the caretaker, but increased with the number of children in the household. Conclusions The proportion of consultations for diarrhea cases in children under 5 years old was higher than those reported in previous surveys in Niger and elsewhere. Free health care for under 5 years old might have participated in this improvement. In this type of decentralized health systems, the WHO recommended hospital-based surveillance of

  8. Attitudes toward guidelines in Finnish primary care nursing: a questionnaire survey

    DEFF Research Database (Denmark)

    Seija, Alanen; Kaila, Minna; Välimäki, Marita;

    2009-01-01

    guidelines more positively and that guidelines were more easily available. Further, nurses who were familiar or very familiar with the guidelines had more positive attitudes toward them. Attitudes were also associated with self-reported guideline use. CONCLUSIONS: The evidence-based guidelines were accepted......BACKGROUND: Evidence-based clinical guidelines have attracted international interest as tools for improving the quality of health care. Attitudes toward these guidelines are of great importance because attitudes are proven to be important predictors of guideline use. Attitudes are also believed to...... be shaped by perceptions of others, which makes the role of organizational implementation interventions interesting. AIMS: This article describes primary care nurses' attitudes toward guidelines among Finnish primary care nurses and the associations between attitudes, implementation interventions...

  9. A national survey of health professionals and volunteers working in voluntary hospice services in the UK. I. Attitudes to current issues affecting hospices and palliative care.

    Science.gov (United States)

    Addington-Hall, Julia M; Karlsen, Saffron

    2005-01-01

    This paper reports results from a national survey in 1999 of voluntary hospice services in the UK. It focuses on volunteer and staff views of the purposes of hospice care, and on current debates within palliative care. Twenty-five hospice services, stratified by region, services provided (inpatient care, day care and/or home care) and number of beds were randomly sampled from amongst 175 voluntary hospices in the UK. Nineteen participated. Seventy per cent of a random sample of professional and voluntary staff within these hospices returned a postal questionnaire. Both volunteers and professionals considered care of the whole person, pain and symptom control, quality of life and dying peacefully to be important aspects of hospice care. Most doctors chose care of the whole person as the most important aspect, and they were more likely to choose this option than other staff. Hospice volunteers were less positive than hospice staff (particularly doctors and nurses) in their attitudes to extending hospice care to noncancer patients (where many volunteers held no strong view), to restricting care to patients with specialist palliative care needs, and less negative about euthanasia. These findings illustrate the importance of including hospice volunteers and the general public, as well as hospice staff, in debates about the future of hospice and palliative care in the UK. Further research is needed into lay and professional views of the role of hospices and palliative care services. PMID:15690867

  10. Inequity in maternal health care service utilization in Gujarat: analyses of district-level health survey data

    Directory of Open Access Journals (Sweden)

    Dileep V. Mavalankar

    2013-03-01

    Full Text Available Background: Two decades after the launch of the Safe Motherhood campaign, India still accounts for at least a quarter of maternal death globally. Gujarat is one of the most economically developed states of India, but progress in the social sector has not been commensurate with economic growth. The purpose of this study was to use district-level data to gain a better understanding of equity in access to maternal health care and to draw the attention of the policy planers to monitor equity in maternal care. Methods: Secondary data analyses were performed among 7,534 ever-married women who delivered since January 2004 in the District Level Household and Facility Survey (DLHS-3 carried out during 2007–2008 in Gujarat, India. Based on the conceptual framework designed by the Commission on the Social Determinants of Health, associations were assessed between three outcomes – Institutional delivery, antenatal care (ANC, and use of modern contraception – and selected intermediary and structural determinants of health using multiple logistic regression. Results: Inequities in maternal health care utilization persist in Gujarat. Structural determinants like caste group, wealth, and education were all significantly associated with access to the minimum three antenatal care visits, institutional deliveries, and use of any modern method of contraceptive. There is a significant relationship between being poor and access to less utilization of ANC services independent of caste category or residence. Discussion and conclusions: Poverty is the most important determinant of non-use of maternal health services in Gujarat. In addition, social position (i.e. caste has a strong independent effect on maternal health service use. More focused and targeted efforts towards these disadvantaged groups needs to be taken at policy level in order to achieve targets and goals laid out as per the MDGs. In particular, the Government of Gujarat should invest more in basic

  11. National Medical Care System May Impede Fostering of True Specialization of Radiation Oncologists: Study Based on Structure Survey in Japan

    International Nuclear Information System (INIS)

    Purpose: To evaluate the actual work environment of radiation oncologists (ROs) in Japan in terms of working pattern, patient load, and quality of cancer care based on the relative time spent on patient care. Methods and Materials: In 2008, the Japanese Society of Therapeutic Radiology and Oncology produced a questionnaire for a national structure survey of radiation oncology in 2007. Data for full-time ROs were crosschecked with data for part-time ROs by using their identification data. Data of 954 ROs were analyzed. The relative practice index for patients was calculated as the relative value of care time per patient on the basis of Japanese Blue Book guidelines (200 patients per RO). Results: The working patterns of RO varied widely among facility categories. ROs working mainly at university hospitals treated 189.2 patients per year on average, with those working in university hospitals and their affiliated facilities treating 249.1 and those working in university hospitals only treating 144.0 patients per year on average. The corresponding data were 256.6 for cancer centers and 176.6 for other facilities. Geographically, the mean annual number of patients per RO per quarter was significantly associated with population size, varying from 143.1 to 203.4 (p < 0.0001). There were also significant differences in the average practice index for patients by ROs working mainly in university hospitals between those in main and affiliated facilities (1.07 vs 0.71: p < 0.0001). Conclusions: ROs working in university hospitals and their affiliated facilities treated more patients than the other ROs. In terms of patient care time only, the quality of cancer care in affiliated facilities might be worse than that in university hospitals. Under the current national medical system, working patterns of ROs of academic facilities in Japan appear to be problematic for fostering true specialization of radiation oncologists.

  12. A survey of the domiciliary situation of urban and rural patients of a palliative care unit in south India

    Directory of Open Access Journals (Sweden)

    Ramu Kandasamy

    2008-01-01

    Full Text Available Aim: A demographic study was conducted to understand the social status of the urban and rural patients attending a palliative care unit in South India. Methods: Fifty rural and 50 urban patients attending the palliative care outpatient clinic of the Christian Medical College and Hospital, South India were prospectively surveyed using a structured interview and home visits. Parameters studied included age, gender, marital status, education, occupation, religion, caste, housing, economic status, diagnosis, distance to the nearest health resource personnel and hospitals. Results: Occupation, religion, caste, housing, electricity, toilet and accessibility to health care were found to be significantly different between urban and rural patients. Seventy percent of the patients were below 60 years of age. The majority were unskilled laborers or housewives. One-third had never been to school and only 3% had been educated beyond high school. Half the patients slept on the floor, 50% of the dwellings had only one or two rooms and did not have toilets or running water. Ninety-five percent had electricity. The economic status of the patients correlated significantly with age, occupation and facilities in the house such as number of rooms, availability of beds, toilets and water supply. Women and older patients were significantly less likely to have completed school education. Women were less likely to be the main decision-makers and more likely to be the main caregivers. Conclusion: Economic status was a strong predictor of the various facilities available to the patient. A significant proportion of this population lived in deprived circumstances. A knowledge and understanding of the social conditions of the palliative care patients helps provide better-tailored care.

  13. National survey of paediatric audiological services for diagnosis and intervention in the South African private health care sector

    Directory of Open Access Journals (Sweden)

    Miriam E. Meyer

    2014-06-01

    Full Text Available Objective: A national survey of early hearing detection and intervention services was undertaken to describe the current status of diagnostic and intervention services in the South African private health care sector.Methods: All private hospitals with obstetric units (n = 166 were surveyed telephonically. The data was integrated with data collected from self-administered questionnaires subsequently distributed nationally to private audiology practices providing hearing screening at the respective hospitals reporting hearing screening services (n = 87. Data was analysed descriptively to yield national percentages and frequency distributions.Results: Average reported age at diagnosis was 11 months. Most participants (74% indicated that less than 20% of infants fitted with hearing aids received amplification before the age of 6 months. Most (64% participants indicated that the average period between confirmed diagnosis and hearing aid fitting was 1 month, on par with international benchmarks. Only 16%–23% of participants included all diagnostic procedures recommended by the Health Professions Council of South Africa’s 2007 position statement for minimum diagnostic test batteries for infants and young children.Conclusions: Diagnosis of hearing loss, hearing aid fitting and audiological intervention is delayed significantly in the South African private health care sector. Improved services should include integrated systematic hospital-based screening as part of birthing packages with diagnostic referral to specialist paediatric audiologists for accurate assessment and management of patients in a timely manner.

  14. Understanding the standard of care in the treatment of type 2 diabetes in China: results from a national survey

    Institute of Scientific and Technical Information of China (English)

    Ji Linong; Julliana Newman; Lu Juming; Cai Xiaoling

    2014-01-01

    Background Given the pace with which standards of care have changed,timely assessment of their impact on routine clinical practice and patient outcomes is needed.In coordination with the Chinese Diabetes Society (CDS),we developed a quantitative survey to explore the implementation of standards of care for type 2 diabetes (T2D) in China.Methods A national online survey of physicians involved in the management of T2D in China was conducted over a 4-week period in 2012.Completed responses were obtained from 1 028 physicians.Participants responded to 52 questions designed to capture information relating to their demographic and clinical practice profiles.The questionnaire was divided into three sections:basic information,diagnosis practices and screening methods on main complications,and treatment and control practices.The questionnaire was developed in conjunction with the CDS.Results Overall,83% of surveyed physicians were at least "aware" of the CDS guidelines on standards of care for T2D.Level of awareness was directly related to hospital grade,specialty,geographic location,professional rank and participation in CDS training.The 2-hour oral glucose tolerance test was reported as the most ever-used approach across all three hospital grades and physician specialties,with a usage rate of 97%.Respondents selected their choice of primary treatment for newly diagnosed T2D patients.Just over half (52%) indicated the use of oral anti-diabetic drugs (OAD) monotherapy,in line with CDS recommendations.However,OAD use varied considerably between different regions and city tiers.Despite hemoglobin A1c being defined as the gold standard for glucose control,it was not universally measured,with more physicians indicating routine use of glucose before fasting and glucose non-fasting.Conclusion The standards-of-care analysis has provided important insights into the current management of T2D among physicians in China across different geographical regions,hospital grades

  15. A survey study to validate a four phases development model for integrated care in the Netherlands

    NARCIS (Netherlands)

    Minkman, Mirella M. N.; Vermeulen, Robbert P.; Ahaus, Kees T. B.; Huijsman, Robbert

    2013-01-01

    Background: The development of integrated care is a complex and long term process. Previous research shows that this development process can be characterised by four phases: the initiative and design phase; the experimental and execution phase; the expansion and monitoring phase and the consolidatio

  16. Teaching the Spiritual Dimension of Nursing Care: A Survey of U.S. Baccalaureate Nursing Programs.

    Science.gov (United States)

    Lemmer, Corinne

    2002-01-01

    Responses from 132 baccalaureate nursing programs indicated that the majority include spiritual dimensions in program philosophy and curriculum, but few had definitions of spirituality and nursing care. Content typically addressed patients' spiritual needs, dying, and holism. Respondents were uncertain about faculty preparation to teach about…

  17. Should euthanasia be legal? : An international survey of neonatal intensive care units staff

    NARCIS (Netherlands)

    Cuttini, M.; Casotto, V.; Kaminski, M.; Beaufort, I.D. de; Berbik, I.; Hansen, G.; Kollee, L.A.A.; Kucinskas, A.; Lenoir, S.; Levin, A.V.; Orzalesi, M.; Persson, J.; Rebagliato, M.; Reid, M.; Saracci, R.

    2004-01-01

    OBJECTIVE: To present the views of a representative sample of neonatal doctors and nurses in 10 European countries on the moral acceptability of active euthanasia and its legal regulation. DESIGN: A total of 142 neonatal intensive care units were recruited by census (in the Netherlands, Sweden, Hung

  18. Evaluation of the structure and provision of primary care in Slovakia: a survey-based project.

    NARCIS (Netherlands)

    Boerma, W.G.W.; Wiegers, T.A.; Baltag, V.

    2012-01-01

    Health reforms are part of the profound and comprehensive changes in essential societal functions and values occurring in many eastern European countries in economic and political transition. Primary care reform is not always evidence based and may be driven by political arguments or the interests o

  19. Access to Dental Care for Rural Children: A Survey of Nebraska General Dentists

    Science.gov (United States)

    McFarland, Kimberly K.; Salama, Fouad; Yaseen, Muhammad

    2011-01-01

    Background: Pediatric dentists are too few in number to care for all children. Therefore, the level of pediatric dental services provided by general dentists, especially in rural areas, is crucial to improving the dental health of children. Purpose: The objectives of the study were to establish a baseline in regard to the quantity of pediatric…

  20. Health care utilisation and characteristics of long-term breast cancer survivors: nationwide survey in Denmark

    DEFF Research Database (Denmark)

    Peuckmann, Vera; Ekholm, Ola; Sjøgren, Per;

    2009-01-01

    population reported health care utilisation (61% versus. 56%; age-standardised risk ratio (SRR): 1.10; 95% confidence interval (CI) 1.05-1.15), but significantly fewer BCS were disability pensioners (15% versus 19%; SRR: 0.77; 95% CI 0.64-0.93). 'Daily activities limited due to sequelae' were reported by 20...

  1. Surveying Community Nursing Support for Persons with an Intellectual Disability and Palliative Care Needs

    Science.gov (United States)

    Bailey, Maria; Doody, Owen; Lyons, Rosemary

    2016-01-01

    Palliative care services have developed over the years to support all persons with life-limiting conditions. Moreover, services for people with an intellectual disability have moved from the traditional institutional setting to supporting people with an intellectual disability to live in their own community and family home. The expansion of…

  2. Evaluation of structure and provision of primary care in Romania: a survey-based project.

    NARCIS (Netherlands)

    Boerma, W.G.W.; Wiegers, T.A.; Baltag, V.; Teunissen, E.; Farcasanu, D.

    2012-01-01

    In many countries in transition, health reforms are part of profound and comprehensive changes in essential societal functions and values. Reforms of (primary) care are not always based on evidence, and progress may be driven by political arguments or the interests of specific professional groups, r

  3. Extensive Variability in Vasoactive Agent Therapy: A Nationwide Survey in Chinese Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Xian-Bo Pei

    2015-01-01

    Conclusions: Vasoactive agent use for treatment of shock is inconsistent according to self-report by Chinese intensive care physicians; however, the variation in use depends upon the form of shock being treated and the type of hospital; thus, corresponding educational programs about vasoactive agent use for shock management should be considered.

  4. Prospective survey on neurosurgical intensive care for patients with severe head injury

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To prospectively compare the clinical outcome ofintensive care therapy (ICT) with that of conventional care therapy (CCT) in severe head injured patients.Methods: Patients with severe head injury were assigned randomly into Group ICT and Group CCT, 100 patients in each group. Patients in Group ICT accepted intensive care therapy in neurosurgical intensive care (NIC) unit for the first 2 weeks after admission, while patients in Group CCT accepted conventional care therapy in ordinary ward. The outcomes were evaluated 3 months after injury.Results: There was a significant increase in good recovery (54%) (χ2=4.43, P<0.05) and significant decrease of death (25%) (χ2=4.50, P<0.05) in Group ICT compared to 39% and 39% in Group CCT respectively. The differences were also confirmed statistically in the following aspects: the patients under 50 years with good recovery pronounced a number increase (χ2=7.54, P<0.01), while the mortality in the same range of age was decreased in Group ICT (χ2=5.28, P<0.05). The mortality was reduced significantly in patients with GCS for 6-8 on admission (χ2=8.47, P<0.01) and in patients with the level of brain stem injured bellow mesencephalon (χ2=4.15, P<0.05). ICT would improve the outcome in patients undergoing conservative therapy only (χ2=13.13, P<0.01).Conclusions: NIC plays an important role in assessing the neurological state, guiding management, evaluating curative effect and estimating the outcome.

  5. A mail survey of health care professionals: an analysis of the response

    OpenAIRE

    Hay, David A

    1996-01-01

    Mail questionnaires provide a cost effective alternative for the survey of geographically dispersed populations. However, mail questionnaires are also characterized by low response rates, particularly for medical and other professionals. As a result of the potential systematic differences between respondents and nonrespondents, the external validity of the results are jeopardized.

  6. Malaria related care-seeking-behaviour and expenditures in urban settings: A household survey in Ouagadougou, Burkina Faso.

    Science.gov (United States)

    Beogo, Idrissa; Huang, Nicole; Drabo, Maxime K; Yé, Yazoumé

    2016-08-01

    In Sub-Sahara Africa, malaria inflicts a high healthcare expenditure to individuals. However, little is known about healthcare expenditure to individual affected by malaria and determinants of healthcare seeking behaviour in urban settings where private sector is thriving. This study investigated the level and correlates of expenditure among individuals with self-reported malaria episode in Ouagadougou, Burkina Faso. A cross-sectional household survey conducted in August-November 2011 in Ouagadougou covered 8,243 individuals (1,600 households). Using Generalized Estimating Equations, the analysis included 1082 individuals from 715 households, who reported an episode of malaria. Of individuals surveyed, 38.3% sought care from public, 27.4% from private providers, and, 34.2% self-medicated. The median cost for malaria treatment was USD10.1 (4,850.0XOF) with significant different between public, private and self-medication (p<0.001). In public primary care health facilities, the median cost was USD8.4 (4,050.0XOF) for uncomplicated malaria and USD15.2 (7,333.5XOF) for severe malaria. In private-for-profit facilities run by a medical doctor, the median cost was USD30.3 (14,600.0XOF) for uncomplicated malaria and USD 43.0 (20,725.0XOF) for severe malaria. Regardless of the source of care, patients with insurance incurred significantly higher expenditure compared to those without insurance (p<0.001) and medicine accounted for the largest share of the expenditure. The type of provider, having insurance, and the severity of the malaria predict the amount of money spent. The high financial cost of malaria treatment regardless of the providers poses threat to the goal of universal access to malaria interventions, the unique way to achieve elimination goals. PMID:27154586

  7. Feasibility of a self-administered survey to identify primary care patients at risk of medication-related problems

    Directory of Open Access Journals (Sweden)

    Makowsky MJ

    2014-02-01

    Full Text Available Mark J Makowsky,1 Andrew J Cave,2 Scot H Simpson1 1Faculty of Pharmacy and Pharmaceutical Sciences, 2Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada Background and objectives: Pharmacists working in primary care clinics are well positioned to help optimize medication management of community-dwelling patients who are at high risk of experiencing medication-related problems. However, it is often difficult to identify these patients. Our objective was to test the feasibility of a self-administered patient survey, to facilitate identification of patients at high risk of medication-related problems in a family medicine clinic. Methods: We conducted a cross-sectional, paper-based survey at the University of Alberta Hospital Family Medicine Clinic in Edmonton, Alberta, which serves approximately 7,000 patients, with 25,000 consultations per year. Adult patients attending the clinic were invited to complete a ten-item questionnaire, adapted from previously validated surveys, while waiting to be seen by the physician. Outcomes of interest included: time to complete the questionnaire, staff feedback regarding impact on workflow, and the proportion of patients who reported three or more risk factors for medication-related problems. Results: The questionnaire took less than 5 minutes to complete, according to the patient's report on the last page of the questionnaire. The median age (and interquartile range of respondents was 57 (45–69 years; 59% were women; 47% reported being in very good or excellent health; 43 respondents of 100 had three or more risk factors, and met the definition for being at high risk of a medication-related problem. Conclusions: Distribution of a self-administered questionnaire did not disrupt patients, or the clinic workflow, and identified an important proportion of patients at high risk of medication-related problems. Keywords: screening tool, pharmacists, primary

  8. Is there a demand for physical activity interventions provided by the health care sector? Findings from a population survey

    Directory of Open Access Journals (Sweden)

    Walter Lars

    2010-01-01

    Full Text Available Abstract Background Health care providers in many countries have delivered interventions to improve physical activity levels among their patients. Thus far, less is known about the population's interest to increase their physical activity levels and their opinion about the health care provider's role in physical activity promotion. The aims of this paper were to investigate the self-reported physical activity levels of the population and intention to increase physical activity levels, self-perceived need for support, and opinions about the responsibilities of both individuals and health care providers to promote physical activity. Methods A regional public health survey was mailed to 13 440 adults (aged 18-84 years living in Östergötland County (Sweden in 2006. The survey was part of the regular effort by the regional Health Authorities. Results About 25% of the population was categorised as physically active, 38% as moderately active, 27% as somewhat active, and 11% as low active. More than one-third (37% had no intentions to increase their physical activity levels, 36% had thought about change, while 27% were determined to change. Lower intention to change was mainly associated with increased age and lower education levels. 28% answered that physical activity was the most important health-related behaviour to change "right now" and 15% of those answered that they wanted or needed support to make this change. Of respondents who might be assumed to be in greatest need of increased activity (i.e. respondents reporting poor general health, BMI>30, and inactivity more than one-quarter wanted support to make improvements to their health. About half of the respondents who wanted support to increase their physical activity levels listed health care providers as a primary source for support. Conclusions These findings suggest that there is considerable need for physical activity interventions in this population. Adults feel great responsibility for

  9. Community nursing needs more silver surfers: a questionnaire survey of primary care nurses' use of information technology.

    Science.gov (United States)

    Chan, Tom; Brew, Sarah; de Lusignan, Simon

    2004-10-01

    BACKGROUND: In the UK the health service is investing more than ever before in information technology (IT) and primary care nurses will have to work with computers. Information about patients will be almost exclusively held in electronic patient records; and much of the information about best practice is most readily accessible via computer terminals. OBJECTIVE: To examine the influence of age and nursing profession on the level of computer use. METHODS: A questionnaire was developed to examine: access, training received, confidence and use of IT. The survey was carried out in a Sussex Primary Care Trust, in the UK. RESULTS: The questionnaire was sent to 109 nurses with a 64% response rate. Most primary care nurses (89%) use their computer regularly at work: 100% of practice nurses daily, compared with 60% of district nurses and 59% of health visitors (p nurses had their own computer while many district nurses and health visitors had to share (p Nurses over 50 had received more training that their younger colleagues (p confidence and used computers less (p nurses were confident at in using computerised medical records, compared with 53% of district nurses and 44% of health visitors (p nurses. However, nurses over 50, working out in the community, lack the confidence and skill of their younger and practice based colleagues. PMID:15469616

  10. Clergy as collaborators in the delivery of mental health care: an exploratory survey from Benin City, Nigeria.

    Science.gov (United States)

    James, Bawo O; Igbinomwanhia, Nosa G; Omoaregba, Joyce O

    2014-08-01

    The paucity of skilled manpower in sub-Saharan Africa limits the delivery of effective interventions for the mentally ill. Individuals with mental disorders and their caregivers frequently consult clergy when mental symptoms cause distress. There is an urgent need for collaboration with nonprofessionals in order to improve mental health care delivery and close the widening treatment gap. Using a cross-sectional descriptive method, we explored clergy's (Christian and Muslim) aetiological attributions for common mental illness (schizophrenia and depression) from Benin City, Nigeria, as well as their willingness to collaborate with mainstream mental health services. We observed that a majority of clergy surveyed were able to correctly identify mental illnesses depicted in vignettes, embraced a multifactorial model of disease causation, and expressed willingness to collaborate with mental health care workers to deliver care. Clergy with a longer duration of formal education, prior mental health training, and Catholic/Protestant denomination expressed a greater willingness to collaborate. Educational interventions are urgently required to facilitate this partnership. PMID:24599283

  11. Survey of public perceptions of prion disease risks in Canada: what does the public care about?

    Science.gov (United States)

    Lemyre, L; Gibson, S; Markon, M P L; Lee, J E C; Brazeau, I; Carroll, A; Boutette, P; Krewski, D

    2009-01-01

    A national public survey on public perceptions of prion disease risk in Canada was conducted from October to December 2007. The survey aimed at documenting the public's perceptions of prion diseases, within the broader context of food safety, in establishing parameters of risk acceptability. It also documented the public's perceptions of prion diseases in delineating social values and ethics that can guide Canada's future policies on prion disease risk management. In addition, the survey served to establish baseline data against which to monitor the evolution of the public's views on and understanding of this important risk issue. In total, 1517 Canadians were randomly selected to be representative of the adult population by region, age, and gender, as per the 2001 Census. This study presents descriptive findings from the survey regarding perceived risk, perceived control, uncertainty, sources of information, trust and knowledge, and beliefs pertaining to bovine spongiform encephalopathy (BSE). The survey data reveal that Canadians do not perceive mad cow disease as a salient risk but consider it more of an economic, political, social, and foreign trade issue than a public health one. Canadians are somewhat prepared to pay a premium to have a safer food supply, but not to the same extent that they desire extra measures pertaining to BSE risk management. In the context of increasing accountability in risk management decisions about food safety and population health issues, it is important to understand the way Canadians perceive such matters and identify their information needs and the factors that influence the acceptability of risks and of risk management policies. PMID:19697248

  12. How useful are systematic reviews for informing palliative care practice? Survey of 25 Cochrane systematic reviews

    Directory of Open Access Journals (Sweden)

    Hadley Gina

    2008-08-01

    Full Text Available Abstract Background In contemporary medical research, randomised controlled trials are seen as the gold standard for establishing treatment effects where it is ethical and practical to conduct them. In palliative care such trials are often impractical, unethical, or extremely difficult, with multiple methodological problems. We review the utility of Cochrane reviews in informing palliative care practice. Methods Published reviews in palliative care registered with the Cochrane Pain, Palliative and Supportive Care Group as of December 2007 were obtained from the Cochrane Database of Systematic Reviews, issue 1, 2008. We reviewed the quality and quantity of primary studies available for each review, assessed the quality of the review process, and judged the strength of the evidence presented. There was no prior intention to perform any statistical analyses. Results 25 published systematic reviews were identified. Numbers of included trials ranged from none to 54. Within each review, included trials were heterogeneous with respect to patients, interventions, and outcomes, and the number of patients contributing to any single analysis was generally much lower than the total included in the review. A variety of tools were used to assess trial quality; seven reviews did not use this information to exclude low quality studies, weight analyses, or perform sensitivity analysis for effect of low quality. Authors indicated that there were frequently major problems with the primary studies, individually or in aggregate. Our judgment was that the reviewing process was generally good in these reviews, and that conclusions were limited by the number, size, quality and validity of the primary studies. We judged the evidence about 23 of the 25 interventions to be weak. Two reviews had stronger evidence, but with limitations due to methodological heterogeneity or definition of outcomes. No review provided strong evidence of no effect. Conclusion Cochrane reviews

  13. Knowledge of lymphoedema among primary health care teams: a questionnaire survey.

    OpenAIRE

    Logan, V; Barclay, S; Caan, W.; McCabe, J; Reid, M.

    1996-01-01

    Lymphoedema usually develops following surgery or radiotherapy for cancer, but can also occur in advanced malignant disease or be primary in origin. Lower limb lymphoedema may present particular difficulties in diagnosis, treatment and management. All types of lymphoedema can seriously impair quality of life for those affected. This study aimed to determine the level of knowledge among primary health care team members concerning the identification and management of patients at risk of develop...

  14. Chest physiotherapy techniques in neurological intensive care units of India: A survey

    OpenAIRE

    Anup Bhat; Kalyana Chakravarthy; Rao, Bhamini K.

    2014-01-01

    Context: Neurological intensive care units (ICUs) are a rapidly developing sub-specialty of neurosciences. Chest physiotherapy techniques are of great value in neurological ICUs in preventing, halting, or reversing the impairments caused due to neurological disorder and ICU stay. However, chest physiotherapy techniques should be modified to a greater extent in the neurological ICU as compared with general ICUs. Aim: The aim of this study is to obtain data on current chest physiotherapy practi...

  15. Measuring the Mental Health-Care System Responsiveness: Results of an Outpatient Survey in Tehran

    OpenAIRE

    Forouzan, Setareh; Padyab, Mojgan; Rafiey, Hassan; Ghazinour, Mehdi; Dejman, Masoumeh; San Sebastian, Miguel

    2016-01-01

    As explained by the World Health Organization (WHO) in 2000, the concept of health system responsiveness is one of the core goals of health systems. Since 2000, further efforts have been made to measure health system responsiveness and the factors affecting responsiveness, yet few studies have applied responsiveness concepts to the evaluation of mental health systems. The present study aims to measure responsiveness and its related domains in the mental health-care system of Tehran. Utilizing...

  16. Measuring the mental health care system responsiveness: results of an outpatient survey in Tehran

    OpenAIRE

    Setareh eForouzan; Mojgan ePadyab; Hassan eRafiey; Mehdi eGhazinour; Masoumeh eDejman; Miguel eSan Sebastian

    2016-01-01

    AbstractAs explained by the World Health Organisation (WHO) in 2000, the concept of health system responsiveness is one of the core goals of health systems. Since 2000, further efforts have been made to measure health system responsiveness and the factors affecting responsiveness, yet few studies have applied responsiveness concepts to the evaluation of mental health systems. The present study aims to measure responsiveness and its related domains in the mental health care system of Tehran. U...

  17. Financial access to health care in Karuzi, Burundi: a household-survey based performance evaluation

    OpenAIRE

    Van Herp Michel; Bachy Catherine; Reid Tony; Ponsar Frederique; Lambert-Evans Sophie; Philips Mit

    2009-01-01

    Abstract Background In 2003, Médecins Sans Frontières, the provincial government, and the provincial health authority began a community project to guarantee financial access to primary health care in Karuzi province, Burundi. The project used a community-based assessment to provide exemption cards for indigent households and a reduced flat fee for consultations for all other households. Methods An evaluation was carried out in 2005 to assess the impact of this project. Primary data collection...

  18. Non-medical financial burden in tuberculosis care: a cross-sectional survey in rural China

    OpenAIRE

    Li, Qiang; JIANG, WEIXI; Wang, Quanli; Shen, Yuan; Gao, Jingyuan; Sato, Kaori D.; Long, Qian; Lucas, Henry

    2016-01-01

    Background Treatment of tuberculosis (TB) in China is partially covered by national programs and health insurance schemes, though TB patients often face considerable medical expenditures. For some, especially those from poorer households, non-medical costs, such as transport, accommodation, and nutritional supplementation may be a substantial additional burden. In this article we aim to evaluate these non-medical costs induced by seeking TB care using data from a large scale cross-sectional s...

  19. Ubiquitous HealthCare in Wireless Body Area Networks - A Survey

    OpenAIRE

    Javaid, N.; Khan, N. A.; Shakir, M.; Khan, M.A.; Bouk, S. H.; Khan, Z. A.

    2013-01-01

    Advances in wireless communication, system on chip and low power sensor nodes allowed realization of Wireless Body Area Network (WBAN). WBAN comprised of tiny sensors, which collect information of patient's vital signs and provide a real time feedback. In addition, WBAN also supports many applications including Ubiquitous HealthCare (UHC), entertainment, gaming, military, etc. UHC is required by elderly people to facilitate them with instant monitoring anywhere they move around. In this paper...

  20. 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 ...

  1. Navigating maternity health care: a survey of the Canadian prairie newcomer experience

    OpenAIRE

    Mumtaz, Zubia; O’Brien, Beverley; Higginbottom, Gina

    2014-01-01

    Background Immigration to Canada has significantly increased in recent years, particularly in the Prairie Provinces. There is evidence that pregnant newcomer women often encounter challenges when attempting to navigate the health system. Our aim was to explore newcomer women’s experiences in Canada regarding pregnancy, delivery and postpartum care and to assess the degree to which Canada provides equitable access to pregnancy and delivery services. Methods Data were obtained from the Canadian...

  2. Antimicrobial Stewardship in Acute Care Centres: A Survey of 68 Hospitals in Quebec

    Directory of Open Access Journals (Sweden)

    Vincent Nault

    2008-01-01

    Full Text Available BACKGROUND: Antimicrobial stewardship programs (ASPs and quantitative monitoring of antimicrobial use are required to ensure that antimicrobials are used appropriately in the acute care setting, and have the potential to reduce costs and limit the spread of antimicrobial-resistant organisms and Clostridium difficile. Currently, it is not known what proportion of Quebec hospitals have an ASP and/or monitor antimicrobial use.

  3. Modifying health behavior to prevent cardiovascular diseases: a nationwide survey among German primary care physicians.

    Science.gov (United States)

    Schneider, Sven; Diehl, Katharina; Bock, Christina; Herr, Raphael M; Mayer, Manfred; Görig, Tatiana

    2014-04-01

    Cardiovascular diseases (CVD) are a major public health concern as they are the leading cause of death in developed countries. Primary care is considered to be the ideal setting for CVD prevention. Therefore, more than 4,000 German primary care physicians (PCPs) were asked about their attitudes towards and their activities regarding the prevention of CVD in the nationwide ÄSP-kardio Study. The focus of the study was on health behavior modification. Two thirds of the participating PCPs stated that they routinely provided brief inventions to assist patients in reducing both their tobacco (72%) and alcohol (61%) consumption, to encourage them to increase their levels of physical activity (72%), and to assist them in adjusting to a more healthy diet (66%), and in achieving a healthy body weight (69%). However, only between 23% (quitting smoking) and 49% (diet modification) of PCPs felt that they had been successful in helping patients modify their lifestyles. Insufficient reimbursement, cultural diversity and a lack of time were reported to be the most problematic barriers to successful intervention in the primary care setting. Despite these obstacles, the majority of German PCPs was engaged in prevention and health behavior intervention to reduce the incidence and progression of CVD. PMID:24739770

  4. Modifying Health Behavior to Prevent Cardiovascular Diseases: A Nationwide Survey among German Primary Care Physicians

    Directory of Open Access Journals (Sweden)

    Sven Schneider

    2014-04-01

    Full Text Available Cardiovascular diseases (CVD are a major public health concern as they are the leading cause of death in developed countries. Primary care is considered to be the ideal setting for CVD prevention. Therefore, more than 4,000 German primary care physicians (PCPs were asked about their attitudes towards and their activities regarding the prevention of CVD in the nationwide ÄSP-kardio Study. The focus of the study was on health behavior modification. Two thirds of the participating PCPs stated that they routinely provided brief inventions to assist patients in reducing both their tobacco (72% and alcohol (61% consumption, to encourage them to increase their levels of physical activity (72%, and to assist them in adjusting to a more healthy diet (66%, and in achieving a healthy body weight (69%. However, only between 23% (quitting smoking and 49% (diet modification of PCPs felt that they had been successful in helping patients modify their lifestyles. Insufficient reimbursement, cultural diversity and a lack of time were reported to be the most problematic barriers to successful intervention in the primary care setting. Despite these obstacles, the majority of German PCPs was engaged in prevention and health behavior intervention to reduce the incidence and progression of CVD.

  5. Quality of Diabetes Care: The Challenges of an Increasing Epidemic in Mexico. Results from Two National Health Surveys (2006 and 2012.

    Directory of Open Access Journals (Sweden)

    Sergio Flores-Hernández

    Full Text Available The quality of diabetes care remains suboptimal according to numerous studies assessing the achievement of quality indicators for diabetes care in various healthcare settings. We report about global and specific quality indicators for diabetes care and their association to glycemic control at the population level in two national health surveys in Mexico.We conducted a cross-sectional analysis of the 2006 and 2012 National Health Surveys in Mexico. We examined quality of care for 2,965 and 4,483 adults (≥ 20 years with diagnosed type 2 diabetes using fourteen simple and two composite indicators derived from self-reported information. In a subsample for both surveys, glycated hemoglobin (HbA1c was measured at the time of the interview. We obtained survey weight-adjusted estimators using multiple regression models (logistic and linear with combined data files, including survey year as covariate to assess change.Global quality of care in 2012 was 40.8%, with a relative improvement of 11.7% between 2006 and 2012. Detections of cardiovascular disease risk factors (dyslipidemia and hypertension were the indicators with the highest improvement, while non-pharmaceutical treatment and diabetic foot exams showed minor changes. We found a significant association between the quality of the process of diabetes care and glycemic control (OR 2.53, 95% CI 1.63-3.94. Age more than 65 years old, the type of health subsystem, gender (males, and high socio-economic status were also significantly associated to glycemic control.Quality diabetes care and glycemic control improved and are significantly associated. However, according to international standards, the current situation remains suboptimal. A more holistic approach is needed, with an emphasis on improving quality in outpatient care.

  6. Quality of Diabetes Care: The Challenges of an Increasing Epidemic in Mexico. Results from Two National Health Surveys (2006 and 2012)

    Science.gov (United States)

    Flores-Hernández, Sergio; Saturno-Hernández, Pedro J.; Reyes-Morales, Hortensia; Barrientos-Gutiérrez, Tonatiuh; Villalpando, Salvador; Hernández-Ávila, Mauricio

    2015-01-01

    Background The quality of diabetes care remains suboptimal according to numerous studies assessing the achievement of quality indicators for diabetes care in various healthcare settings. We report about global and specific quality indicators for diabetes care and their association to glycemic control at the population level in two national health surveys in Mexico. Methods We conducted a cross-sectional analysis of the 2006 and 2012 National Health Surveys in Mexico. We examined quality of care for 2,965 and 4,483 adults (≥ 20 years) with diagnosed type 2 diabetes using fourteen simple and two composite indicators derived from self-reported information. In a subsample for both surveys, glycated hemoglobin (HbA1c) was measured at the time of the interview. We obtained survey weight-adjusted estimators using multiple regression models (logistic and linear) with combined data files, including survey year as covariate to assess change. Results Global quality of care in 2012 was 40.8%, with a relative improvement of 11.7% between 2006 and 2012. Detections of cardiovascular disease risk factors (dyslipidemia and hypertension) were the indicators with the highest improvement, while non-pharmaceutical treatment and diabetic foot exams showed minor changes. We found a significant association between the quality of the process of diabetes care and glycemic control (OR 2.53, 95% CI 1.63-3.94). Age more than 65 years old, the type of health subsystem, gender (males), and high socio-economic status were also significantly associated to glycemic control. Conclusions Quality diabetes care and glycemic control improved and are significantly associated. However, according to international standards, the current situation remains suboptimal. A more holistic approach is needed, with an emphasis on improving quality in outpatient care. PMID:26230991

  7. A Survey of Psychological Support Provision for People with Inflammatory Arthritis in Secondary Care in England

    OpenAIRE

    Dures, Emma; Almeida, Celia; Caesley, Judy; Peterson, Alice; Ambler, Nicholas; Morris, Marianne; Pollock, Jon; Hewlett, Sarah

    2014-01-01

    Objectives The consequences of inflammatory arthritis can include depression, anxiety and low mood, reducing patients’ quality of life and increasing pressure on the healthcare system. Treatment guidelines recommend psychological support, but data are lacking on the provision available. Methods A postal survey concerning psychological support provision was sent to rheumatology units in 143 acute trusts across England. Nurses from 73 rheumatology units (51%) responded. Results Overall, 73% rat...

  8. Disparities in oral health and access to care: findings of national surveys.

    Science.gov (United States)

    Edelstein, Burton L

    2002-01-01

    In this background paper, sociodemographic variables, including age, race, family income, sex, parental education, and geographic location, have been used to characterize the dental status of US children and their access to dental services. Because tooth decay, or dental caries, remains the preeminent oral disease of childhood and national data is available on dental office visits, tooth decay has been used as the primary marker for children's oral health, and visits to the dentist is the marker for care. In general, children from low-income families experience the greatest amount of oral disease, the most extensive disease, and the most frequent use of dental services for pain relief. Yet these children have the fewest overall dental visits. Paradoxically, children in poverty-those living in households with annual gross incomes under $16 500 for a family of 4-or near poverty-those in family households with incomes between $16 500 and $33 000-also have the highest rates of dental insurance coverage, primarily through Medicaid and SCHIP. For those most affected, dental disease is consequential for their growth, function, behavior, and comfort. The twin disparities of poor oral health and lack of dental care are most evident among low-income preschool children, who are twice as likely to have cavities as are higher income children. Medicaid-eligible children who have cavities have twice the numbers of decayed teeth and twice the number of visits for pain relief but fewer total dental visits, compared to children coming from families with higher incomes. Fewer preventive visits for services such as sealants increase the burden of disease in low-income children. These disparities continue into adolescence and young adulthood, but to a lesser degree. Disparities in oral health status and access to dental care are also evident when comparing black, Hispanic, and Native American children to white children and when comparing children of parents with low educational

  9. Medical physics aspects of cancer care in the Asia Pacific region: 2014 survey results.

    Science.gov (United States)

    Kron, Tomas; Azhari, H A; Voon, E O; Cheung, K Y; Ravindran, P; Soejoko, D; Inamura, K; Han, Y; Ung, N M; TsedenIsh, Bolortuya; Win, U M; Srivastava, R; Marsh, S; Farrukh, S; Rodriguez, L; Kuo, Men; Baggarley, S; DilipKumara, A H; Lee, C C; Krisanachinda, A; Nguyen, X C; Ng, K H

    2015-09-01

    It was the aim of this work to assess and track the workload, working conditions and professional recognition of radiation oncology medical physicists (ROMPs) in the Asia Pacific region over time. In this third survey since 2008, a structured questionnaire was mailed in 2014 to 22 senior medical physicists representing 23 countries. As in previous surveys the questionnaire covered seven themes: 1 education, training and professional certification, 2 staffing, 3 typical tasks, 4 professional organisations, 5 resources, 6 research and teaching, and 7 job satisfaction. The response rate of 100% is a result of performing a survey through a network, which allows easy follow-up. The replies cover 4841 ROMPs in 23 countries. Compared to 2008, the number of medical physicists in many countries has doubled. However, the number of experienced ROMPs compared to the overall workforce is still small, especially in low and middle income countries. The increase in staff is matched by a similar increase in the number of treatment units over the years. Furthermore, the number of countries using complex techniques (IMRT, IGRT) or installing high end equipment (tomotherapy, robotic linear accelerators) is increasing. Overall, ROMPs still feel generally overworked and the professional recognition, while varying widely, appears to be improving only slightly. Radiation oncology medical physics practice has not changed significantly over the last 6 years in the Asia Pacific Region even if the number of physicists and the number and complexity of treatment techniques and technologies have increased dramatically. PMID:26346030

  10. Sociodemographic Correlates of Eye Care Provider Visits in the 2006–2009 Behavioral Risk Factor Surveillance Survey

    Directory of Open Access Journals (Sweden)

    Caban-Martinez Alberto J

    2012-05-01

    Full Text Available Abstract Background Research has suggested that adults 40 years old and over are not following eye care visit recommendations. In the United States, the proportion of older adults is expected to increase drastically in the coming years. This has important implications for population ocular disease burden, given the relationship between older age and the development of many ocular diseases and conditions. Understanding individual level determinants of vision health could support the development of tailored vision health campaigns and interventions among our growing older population. Thus, we assessed correlates of eye care visits among participants of the Behavior Risk Factor Surveillance System (BRFSS survey. We pooled and analyzed 2006–2009 BRFSS data from 16 States (N = 118,075. We assessed for the proportion of survey respondents 40 years of age and older reporting having visited an eye care provider within the past two years, two or more years ago, or never by socio-demographic characteristics. Results Nearly 80% of respondents reported an eye care visit within the previous two years. Using the ‘never visits’ as the referent category, the groups with greater odds of having an ocular visit within the past two years included those: greater than 70 years of age (OR = 6.8 [95% confidence interval = 3.7–12.6], with college degree (5.2[3.0–8.8], reporting an eye disease, (4.74[1.1–21.2], diagnosed with diabetes (3.5[1.7–7.5], of female gender (2.9[2.1–3.9], with general health insurance (2.7[1.8–3.9], with eye provider insurance coverage (2.1[1.5–3.0], with high blood pressure (1.5[1.1–2.2], and with moderate to extreme near vision difficulties (1.42[1.11–2.08]. Conclusion We found significant variation by socio-demographic characteristics and some variation in state-level estimates in this study. The present findings suggest that there remains compliance gaps of screening guidelines among select socio

  11. Where Do Female Sex Workers Seek HIV and Reproductive Health Care and What Motivates These Choices? A Survey in 4 Cities in India, Kenya, Mozambique and South Africa

    Science.gov (United States)

    Lafort, Yves; Greener, Ross; Roy, Anuradha; Greener, Letitia; Ombidi, Wilkister; Lessitala, Faustino; Haghparast-Bidgoli, Hassan; Beksinska, Mags; Gichangi, Peter; Reza-Paul, Sushena; Smit, Jenni A.; Chersich, Matthew; Delva, Wim

    2016-01-01

    Background A baseline cross-sectional survey among female sex workers (FSWs) was conducted in four cities within the context of an implementation research project aiming to improve FSWs’ access to HIV, and sexual and reproductive health (SRH) services. The survey measured where FSWs seek HIV/SRH care and what motivates their choice. Methods Using respondent-driven sampling (RDS), FWSs were recruited in Durban, South Africa (n = 400), Tete, Mozambique (n = 308), Mombasa, Kenya (n = 400) and Mysore, India (n = 458) and interviewed. RDS-adjusted proportions were estimated by non-parametric bootstrapping, and compared across cities using post-hoc pairwise comparison tests. Results Across cities, FSWs most commonly sought care for the majority of HIV/SRH services at public health facilities, most especially in Durban (ranging from 65% for condoms to 97% for HIV care). Services specifically targeting FSWs only had a high coverage in Mysore for STI care (89%) and HIV testing (79%). Private-for-profit clinics were important providers in Mombasa (ranging from 17% for STI care and HIV testing to 43% for HIV care), but not in the other cities. The most important reason for the choice of care provider in Durban and Mombasa was proximity, in Tete ‘where they always go’, and in Mysore cost of care. Where available, clinics specifically targeting FSWs were more often chosen because of shorter waiting times, perceived higher quality of care, more privacy and friendlier personnel. Conclusion The place where care is sought for HIV/SRH services differs substantially between cities. Targeted services have limited coverage in the African cities compared to Mysore. Convenience appears more important for choosing the place of care than aspects of quality of care. The best model to improve access, linking targeted interventions with general health services, will need to be tailored to the specific context of each city. PMID:27494412

  12. Psychometric Evaluation of the SF-36® Health Survey in Medicare Managed Care

    OpenAIRE

    Gandek, Barbara; Sinclair, Samuel J.; Kosinski, Mark; Ware, John E

    2004-01-01

    Data quality and scoring assumptions for the SF-36® Health Survey were evaluated among the elderly and disabled, using 1998 Cohort I baseline Medicare HOS data (n=177,714). Missing data rates were low, and scoring assumptions were met. Internal consistency reliability was 0.83 to 0.93 for the eight scales and 0.94 and 0.89, respectively, for the physical (PCS) and mental (MCS) component summary measures. Results declined with increased risk factors (e.g., older age, more chronic conditions), ...

  13. Drugs given by a syringe driver: a prospective multicentre survey of palliative care services in the UK.

    Science.gov (United States)

    Wilcock, Andrew; Jacob, Jayin K; Charlesworth, Sarah; Harris, Elayne; Gibbs, Margaret; Allsop, Helen

    2006-10-01

    The use of a syringe driver to administer drugs by continuous subcutaneous infusion is common practice in the UK. Over time, drug combinations used in a syringe driver are likely to change and the aim of this survey was to obtain a more recent snapshot of practice. On four separate days, at two-week intervals, a questionnaire was completed for every syringe driver in use by 15 palliative care services. Of 336 syringe drivers, the majority contained either two or three drugs, but one-fifth contained only one drug. The median (range) volume of the infusions was 15 (9.5-48) mL, and duration of infusion was generally 24 hours. Only one combination was reported as visually incompatible, and there were 13 site reactions (4% of total). Laboratory physical and chemical compatibility data are available for less than half of the most frequently used combinations. PMID:17060264

  14. Enhancing physical activity guidelines: a needs survey of adults with spinal cord injury and health care professionals.

    Science.gov (United States)

    Foulon, Brianne L; Lemay, Valérie; Ainsworth, Victoria; Martin Ginis, Kathleen A

    2012-10-01

    The purpose of this study was to determine preferences of people with spinal cord injury (SCI) and health care professionals (HCP) regarding the content and format of a SCI physical activity guide to support recently released SCI physical activity guidelines. Seventy-eight people with SCI and 80 HCP completed a survey questionnaire. Participants with SCI identified desired content items and their preferences for format. HCP rated the helpfulness of content items to prescribe physical activity. All content items were rated favorably by participants with SCI and useful by HCP. The risks and benefits of activity and inactivity, and strategies for becoming more active, were rated high by both samples. Photographs and separate information for those with paraplegia versus tetraplegia were strongly endorsed. These data were used to guide the development of an SCI physical activity guide to enhance the uptake of physical activity guidelines for people with SCI. The guide was publically released November 11, 2011. PMID:23027146

  15. [Dental care of patients with organ transplants or prosthetic joints--a survey of specialty hospitals].

    Science.gov (United States)

    Nusime, Anne; Heide, Clarissa V D; Hornecker, Else; Mausberg, Rainer F; Ziebolz, Dirk

    2011-01-01

    The aim of the investigation was to collect information from specialized hospitals regarding dental care before and after organ transplantation or replacement of prosthetic joints. 50 transplantation centres and 100 orthopaedic hospitals in Germany were chosen. A questionnaire was used to elucidate the following aspects: Is a dental examination carried out preoperatively? When the patient is discharged, is he or she recommended to have antibiotic prophylaxis before dental treatment? If so, which antibiotic is recommended? The response rate was 56% (n = 28) for transplantation centres. 89% arranged a dental examination before the transplantation. 83% of those questioned recommend antibiotic prophylaxis before dental treatment: Amoxicillin was mentioned most frequently (36%). The response rate of the orthopaedic hospitals was 31% (n = 31). 3% of those questioned arranged a dental examination before insertion of an endoprothesis. 55% recommend antibiotic prophylaxis when dental treatment is to be carried out following the insertion of the endoprosthesis. Cephalosporine was most frequently mentioned (33%). It was not possible to identify a uniform recommendation regarding dental care before and after organ transplantation or replacement of prosthetic joints either for patients with an organ transplant or those having a prosthetic joint. PMID:21656390

  16. Postanalytical external quality assessment of urine albumin in primary health care: An international survey

    DEFF Research Database (Denmark)

    Aakre, K.M.; Thue, G.; Subramaniam-Haavik, S.; Bukve, T.; Morris, H.; Muller, M.; Lovrencic, M.V.; Plum, I.; Kallion, K.; Aab, A.; Kutt, M.; Gillery, P.; Schneider, N.; Horvath, A.R.; Onody, R.; Oosterhuis, W.; Ricos, C.; Perich, C.; Nordin, G.; Sandberg, S.

    2008-01-01

    BACKGROUND: Microalbuminuria (MA) is recognized as an important risk factor for cardiovascular and renal complications in diabetes. We sought to evaluate how screening for MA is conducted and how urine albumin (UA) results are interpreted in primary care internationally. METHODS: General practiti......BACKGROUND: Microalbuminuria (MA) is recognized as an important risk factor for cardiovascular and renal complications in diabetes. We sought to evaluate how screening for MA is conducted and how urine albumin (UA) results are interpreted in primary care internationally. METHODS: General...... practitioners (GPs) received a case history-based questionnaire depicting a male type 2 diabetes patient in whom UA testing had not been performed. Questions were related to type of urine sample used for UA testing, need for a repeat test, whether UA testing was performed in the office laboratory, and what...... changes in UA results were considered clinically important [critical difference (CD)]. Participants received national benchmarking feedback reports. RESULTS: We included 2078 GPs from 9 European countries. Spot urine samples were used most commonly for first time office-based testing, whereas timed...

  17. There is no association between a measure of clinical care and the response rate of GPs to postal surveys: A methodological study

    OpenAIRE

    Muller, Sara; Wynne-Jones, Gwenllian; Daniel, Rebecca; Creavin, Samuel T.; Bishop, Annette; Mallen, Christian D

    2012-01-01

    Background: There has been much research into factors that can be modified to improve the response rates of general practitioners to surveys and to the demographic characteristics of those who do and do not respond. However, response is yet to be considered with respect to the quality of clinical care provided by GPs. In the UK, one measure of quality of care is the Quality and Outcomes Framework (QOF) score achieved by a general practice. Objective: This study considers the association of QO...

  18. [原著]Factors related to the transition from hospital to home care in terminal cancer patients in Okinawa -Questionnaire survey of hospital nurses assisting the patient's discharge-

    OpenAIRE

    Teruya, Noriko; Sunagawa, Yoko; Department of Adult Nursing, School of Health Sciences,Faculty of Medicine

    2012-01-01

    The purpose of this study was to examine the factors related to the realization of transition from hospital to home care in terminal cancer patients, and to clarify the problems that need to be solved in promoting home care in Okinawa. The subjects were 197 nurses who supported a terminal cancer patient's discharge in 17 hospitals with more than 200 beds that provided medical treatment for cancer patients. A questionnaire survey was conducted by mail. Among the 165 nurses who responded, 113 n...

  19. Perspectives of continuous renal replacement therapy in the intensive care unit: a paired survey study of patient, physician, and nurse views

    OpenAIRE

    Andrew S. Allegretti; Hundemer, Gregory; Chorghade, Rajeev; Cosgrove, Katherine; Bajwa, Ednan; Bhan, Ishir

    2015-01-01

    Background Recent studies suggest discrepancies between patients and providers around perceptions of hemodialysis prognosis. Such data are lacking for continuous renal replacement therapy (CRRT). We aim to assess patient and provider understanding of outcomes around CRRT. Methods From February 1 to August 31, 2013, a triad of (1) a patient on CRRT (or health care proxy [HCP]), (2) physician and (3) primary nurse from the intensive care unit (ICU) team were surveyed. Univariate chi-square and ...

  20. Income inequality and foregone medical care in Europe during The Great Recession: multilevel analyses of EU-SILC surveys 2008–2013

    OpenAIRE

    Elstad, Jon Ivar

    2016-01-01

    Background The association between income inequality and societal performance has been intensely debated in recent decades. This paper reports how unmet need for medical care has changed in Europe during The Great Recession, and investigates whether countries with smaller income differences have been more successful than inegalitarian countries in protecting access to medical care during an economic crisis. Methods Six waves of EU-SILC surveys (2008—2013) from 30 European countries were analy...

  1. Factors associated with underutilization of antenatal care services in Indonesia: results of Indonesia Demographic and Health Survey 2002/2003 and 2007

    OpenAIRE

    Titaley Christiana R; Dibley Michael J; Roberts Christine L

    2010-01-01

    Abstract Background Antenatal care aims to prevent maternal and perinatal mortality and morbidity. In Indonesia, at least four antenatal visits are recommended during pregnancy. However, this service has been underutilized. This study aimed to examine factors associated with underutilization of antenatal care services in Indonesia. Methods We used data from Indonesia Demographic and Health Survey (IDHS) 2002/2003 and 2007. Information of 26,591 singleton live-born infants of the mothers' most...

  2. Factors associated with underutilization of antenatal care services in Indonesia: results of Indonesia Demographic and Health Survey 2002/2003 and 2007

    OpenAIRE

    Titaley, Christiana R; Dibley, Michael J.; Roberts, Christine L.

    2010-01-01

    Background Antenatal care aims to prevent maternal and perinatal mortality and morbidity. In Indonesia, at least four antenatal visits are recommended during pregnancy. However, this service has been underutilized. This study aimed to examine factors associated with underutilization of antenatal care services in Indonesia. Methods We used data from Indonesia Demographic and Health Survey (IDHS) 2002/2003 and 2007. Information of 26,591 singleton live-born infants of the mothers' most recent b...

  3. Which aspects of non-clinical quality of care are most important? Results from WHO's general population surveys of "health systems responsiveness" in 41 countries.

    Science.gov (United States)

    Valentine, Nicole; Darby, Charles; Bonsel, Gouke J

    2008-05-01

    Quality of care research has reached some agreement on concepts like structure, process and outcome, and non-clinical versus clinical processes of care. These concepts are commonly explored through surveys measuring patient experiences, yet few surveys have focused on patient, or "user", priorities across different quality dimensions. Population surveys on priorities can contribute to, although not replace participation in, policy decision making. Using 105,806 survey interview records from the World Health Organization's (WHO's) general population surveys in 41 countries, this paper describes the relative importance of eight domains in the non-clinical quality of care concept WHO calls "health systems responsiveness". Responsiveness domains are divided into interpersonal domains (dignity, autonomy, communication and confidentiality) and structural domains (quality of basic amenities, choice, access to social support networks and prompt attention). This paper explores variations in domain importance by country-level variables (country of residence, human development, health system expenditure, and "geographic zones") and by subpopulations defined by sex, age, education, health status, and utilization. Most respondents selected prompt attention as the most important domain. Dignity was selected second, followed by communication. Access to social support networks was identified as the least important domain. In general, convergence in rankings was stronger across subpopulations within countries than across countries. Yet even across diverse countries, there was more convergence than divergence in views. These results provide a ranking of quality of care criteria for consideration during health reform processes further to the usual emphasis on clinical quality and supply-side efficiency. PMID:18313822

  4. Impact of health care worker policy awareness on hand hygiene and urinary catheter care in nursing homes: Results of a self-reported survey

    OpenAIRE

    Montoya, Ana; Chen, Shu; Galecki, Andrzej; McNamara, Sara; Lansing, Bonnie; Mody, Lona

    2013-01-01

    Utilizing a self-administered questionnaire in 440 health care workers (81% response rate), we evaluated the impact of health care workers policy awareness on hand hygiene and urinary catheter care in nursing homes. We show that health care workers aware of their nursing home policies are more likely to report wearing gloves and practicing hand hygiene as per evidence-based recommendations during urinary catheter care compared with those who are unaware of their facility policies.

  5. HIV testing and counselling in Colombia: evidence from a national health survey and recommendations for health-care services.

    Science.gov (United States)

    Arrivillaga, M; Hoyos, P A; Tovar, L M; Varela, M T; Correa, D; Zapata, H

    2012-11-01

    The purpose of this study was to assess the prevalence of, and the factors associated with HIV testing and pre- and post-test counselling (PPTC) in Colombia. Cross-sectional data from the National Health Survey carried out during 2007 were analysed. Data were gathered from records of 29,760 individuals between the ages of 18 and 69 from the main regions of the country. Only 19.7% of the sample had taken an HIV test. Men, people with no education, those not affiliated with the health-care system, residents of rural areas and those aged older than 65 were less likely to have been tested for HIV; 42% of those tested did not receive pre-test counselling and 56.9% received no report of the results. Considering the low prevalence of HIV testing among the Colombian population, it is necessary to design and apply guidelines for HIV screening in all health-care settings and to conduct targeted testing in high-risk sub-populations. A national norm of PPTC in those who undergo HIV testing should be examined. PMID:23155103

  6. Associations of Spontaneous Self-Affirmation with Health Care Experiences and Health Information Seeking in National Survey of US Adults

    Science.gov (United States)

    Taber, Jennifer M.; Howell, Jennifer L.; Emanuel, Amber S.; Klein, William M. P.; Ferrer, Rebecca A.; Harris, Peter R.

    2016-01-01

    Objective Self-affirming—such as by reflecting on one's strengths and values—reduces defensiveness to threatening information, reduces negative effects of stereotype threat, and promotes prosociality. These outcomes may promote physical health, highlighting a need to examine the role of self-affirmation in medical and health contexts. Design Data were collected as part of the nationally representative, cross-sectional, 2013 Health Information National Trends Survey. Items were completed by 2,731 respondents. Main Outcome Measures Respondents answered questions about spontaneous self-affirmation tendencies, perceptions of providers and health care, involvement in medical appointments, health information seeking, and engagement in medical research. Results Spontaneous self-affirmation was associated with more positive perceptions of communication with one's provider, better perceived quality of care, greater likelihood of asking questions in a medical appointment, greater information seeking for oneself, and multiple indices of surrogate information seeking (i.e., seeking information for others). Four of eight significant associations remained significant when controlling for optimism. The associations of self-affirmation with aspects of the patient-provider relationship were not modified by factors likely to be associated with stereotype threat (e.g., race or BMI). Conclusion Spontaneous self-affirmation was related to positive outcomes in health contexts. Experimental research is needed to further explore the causal nature of these associations. PMID:26315683

  7. Assessing governance theory and practice in health-care organizations: a survey of UK hospices.

    Science.gov (United States)

    Chambers, Naomi; Benson, Lawrence; Boyd, Alan; Girling, Jeff

    2012-05-01

    This paper sets out a theoretical framework for analyzing board governance, and describes an empirical study of corporate governance practices in a subset of non-profit organizations (hospices in the UK). It examines how practices in hospice governance compare with what is known about effective board working. We found that key strengths of hospice boards included a strong focus on the mission and the finances of the organizations, and common weaknesses included a lack of involvement in strategic matters and a lack of confidence, and some nervousness about challenging the organization on the quality of clinical care. Finally, the paper offers suggestions for theoretical development particularly in relation to board governance in non-profit organizations. It develops an engagement theory for boards which comprises a triadic proposition of high challenge, high support and strong grip. PMID:22673698

  8. Japanese Structure Survey of Radiation Oncology in 2007 Based on Institutional Stratification of Patterns of Care Study

    International Nuclear Information System (INIS)

    Purpose: To evaluate the ongoing structure of radiation oncology in Japan in terms of equipment, personnel, patient load, and geographic distribution to identify and improve any deficiencies. Methods and Materials: A questionnaire-based national structure survey was conducted from March to December 2008 by the Japanese Society of Therapeutic Radiology and Oncology (JASTRO). These data were analyzed in terms of the institutional stratification of the Patterns of Care Study. Results: The total numbers of new cancer patients and total cancer patients (new and repeat) treated with radiation in 2007 were estimated at 181,000 and 218,000, respectively. There were 807 linear accelerator, 15 telecobalt, 46 Gamma Knife, 45 60Co remote-controlled after-loading, and 123 192Ir remote-controlled after-loading systems in actual use. The linear accelerator systems used dual-energy function in 539 units (66.8%), three-dimensional conformal radiation therapy in 555 (68.8%), and intensity-modulated radiation therapy in 235 (29.1%). There were 477 JASTRO-certified radiation oncologists, 826.3 full-time equivalent (FTE) radiation oncologists, 68.4 FTE medical physicists, and 1,634 FTE radiation therapists. The number of interstitial radiotherapy (RT) administrations for prostate, stereotactic body radiotherapy, and intensity-modulated radiation therapy increased significantly. Patterns of Care Study stratification can clearly identify the maturity of structures based on their academic nature and caseload. Geographically, the more JASTRO-certified physicians there were in a given area, the more RT tended to be used for cancer patients. Conclusions: The Japanese structure has clearly improved during the past 17 years in terms of equipment and its use, although a shortage of personnel and variations in maturity disclosed by Patterns of Care Study stratification were still problematic in 2007.

  9. Japanese Structure Survey of Radiation Oncology in 2005 Based on Institutional Stratification of Patterns of Care Study

    International Nuclear Information System (INIS)

    Purpose: To evaluate the structure of radiation oncology in Japan in terms of equipment, personnel, patient load, and geographic distribution to identify and improve any deficiencies. Methods and Materials: A questionnaire-based national structure survey was conducted between March 2006 and February 2007 by the Japanese Society of Therapeutic Radiology and Oncology. These data were analyzed in terms of the institutional stratification of the Patterns of Care Study. Results: The total numbers of new cancer patients and total cancer patients (new and repeat) treated with radiotherapy in 2005 were estimated at approximately 162,000 and 198,000, respectively. In actual use were 765 linear accelerators, 11 telecobalt machines, 48 GammaKnife machines, 64 60Co remote-controlled after-loading systems, and 119 192Ir remote-controlled after-loading systems. The linear accelerator systems used dual-energy function in 498 systems (65%), three-dimensional conformal radiotherapy in 462 (60%), and intensity-modulated radiotherapy in 170 (22%). There were 426 Japanese Society of Therapeutic Radiology and Oncology-certified radiation oncologists, 774 full-time equivalent radiation oncologists, 117 medical physicists, and 1,635 radiation therapists. Geographically, a significant variation was found in the use of radiotherapy, from 0.9 to 2.1 patients/1,000 population. The annual patient load/FTE radiation oncologist was 247, exceeding the Blue Book guidelines level. Patterns of Care Study stratification can clearly discriminate the maturity of structures according to their academic nature and caseload. Conclusions: The Japanese structure has clearly improved during the past 15 years in terms of equipment and its use, although the shortage of manpower and variations in maturity disclosed by this Patterns of Care Study stratification remain problematic. These constitute the targets for nationwide improvement in quality assurance and quality control

  10. Psychometric evaluation of the SF-36 health survey in Medicare managed care.

    Science.gov (United States)

    Gandek, Barbara; Sinclair, Samuel J; Kosinski, Mark; Ware, John E

    2004-01-01

    Data quality and scoring assumptions for the SF-36 Health Survey were evaluated among the elderly and disabled, using 1998 Cohort I baseline Medicare HOS data (n=177,714). Missing data rates were low, and scoring assumptions were met. Internal consistency reliability was 0.83 to 0.93 for the eight scales and 0.94 and 0.89, respectively, for the physical (PCS) and mental (MCS) component summary measures. Results declined with increased risk factors (e.g., older age, more chronic conditions), but were well above accepted standards for all subgroups. These findings support using standard algorithms for scoring the SF-36 in the HOS and subgroup analyses of HOS data. PMID:15493441

  11. Psychometric Evaluation of the SF-36® Health Survey in Medicare Managed Care

    Science.gov (United States)

    Gandek, Barbara; Sinclair, Samuel J.; Kosinski, Mark; Ware, John E.

    2004-01-01

    Data quality and scoring assumptions for the SF-36® Health Survey were evaluated among the elderly and disabled, using 1998 Cohort I baseline Medicare HOS data (n=177,714). Missing data rates were low, and scoring assumptions were met. Internal consistency reliability was 0.83 to 0.93 for the eight scales and 0.94 and 0.89, respectively, for the physical (PCS) and mental (MCS) component summary measures. Results declined with increased risk factors (e.g., older age, more chronic conditions), but were well above accepted standards for all subgroups. These findings support using standard algorithms for scoring the SF-36® in the HOS and subgroup analyses of HOS data. PMID:15493441

  12. Diagnosis and treatment of Helicobacter pylori infection in children: a survey of WV primary care physicians.

    Science.gov (United States)

    Stevens, I W; Lawrence, Z; Elitsur, Y

    2001-01-01

    Helicobacter pylori infection has been implicated in the development of peptic ulcer disease in children. Although clinical protocols for the diagnosis and treatment of this infection in children are available, the implementation of those guidelines by primary physicians are insufficient. In this study, we surveyed the clinical practices of 409 primary physicians who practice in West Virginia and treat children with H. pylori infection. Results showed in contradiction with the recommendation, primary physicians are still using serology as the preferred diagnostic method for this disease. Most of the physicians treat this disease with a combination of two antibiotics and anti-acid medication (H2 blockers or PPI) for at least one week. We conclude that an increase in knowledge of those guidelines among primary physicians may improve physicians' compliance with H. pylori guidelines. PMID:11761653

  13. Acceptability of meningococcal serogroup B vaccine among parents and health care workers in Italy: a survey.

    Science.gov (United States)

    Mameli, Chiara; Faccini, Marino; Mazzali, Cristina; Picca, Marina; Colella, Giacomo; Duca, Pier Giorgio; Zuccotti, Gian Vincenzo

    2014-01-01

    A new meningococcal serogroup B vaccine (4 CMenB) has recently been licensed. This study assessed the acceptability of 4 CMenB vaccine among parents and healthcare workers (HCWs). From May to July 2013 in Milan, Italy, self-administered questionnaires were distributed to 2050 parents of infants presenting at immunization clinics for the mandatory hexavalent vaccination and submitted to 350 HCWs involved in immunization practices. 1842 parents (89.1%) responded to the survey; 64.4% of parents wanted their child to receive the 4 CMenB vaccine and 5.1% would not vaccinate their children. Multivariate analysis showed that recognition of the severity of meningitis [a life threatening vs a mild or unthreatening disease (Odds ratio (OR): 2.3; confidence interval (CI): 1.4-3.6], awareness of vaccination as a beneficial preventive measure (very beneficial vs not beneficial OR = 6.4; CI 3.0-13.7) and knowledge of the Meningococcal C vaccine (OR = 1.4; CI 1.1-1.8) were strongly associated to willingness to receive 4 CMenB vaccine. On the contrary, level of education was associated with refusal of immunization (university vs education level lower than middle school OR = 0.68; CI 0.47-0.97). Among the parents who were willing to immunize their children, 66.9% would agree with three injections to be administered during the same visit. A total of 291 HCWs (83.1%) agreed to participate in the survey; 73% considered 4 CMenB vaccine a priority in infants' immunization schedule; 26.8% of HCWs suggested the concomitant administration with routine infant immunization. Parental and HCWs acceptability of 4 CMenB vaccine was high. Increasing knowledge about meningitis and vaccine prevention might further increase the acceptability of this vaccine. PMID:25483638

  14. Chaperone use during intimate examinations in primary care: postal survey of family physicians

    Directory of Open Access Journals (Sweden)

    Upshur Ross EG

    2005-12-01

    Full Text Available Abstract Background Physicians have long been advised to have a third party present during certain parts of a physical examination; however, little is known about the frequency of chaperone use for those specific intimate examinations regularly performed in primary care. We aimed to determine the frequency of chaperone use among family physicians across a variety of intimate physical examinations for both male and female patients, and also to identify the factors associated with chaperone use. Methods Questionnaires were mailed to a randomly selected sample of 500 Ontario members of the College of Family Physicians of Canada. Participants were asked about their use of chaperones when performing a variety of intimate examinations, namely female pelvic, breast, and rectal exams and male genital and rectal exams. Results 276 of 500 were returned (56%, of which 257 were useable. Chaperones were more commonly used with female patients than with males (t = 9.09 [df = 249], p Conclusion Clinical practice concerning the use of chaperones during intimate exams continues to be discordant with the recommendations of medical associations and medico-legal societies. Chaperones are used by only a minority of Ontario family physicians. Chaperone use is higher for examinations of female patients than of male patients and is highest for female pelvic exams. The availability of a nurse in the clinic to act as a chaperone is associated with more frequent use of chaperones.

  15. Patterns of care in patients with cervical cancer 2012. Results of a survey among German radiotherapy departments and out-patient health care centers

    International Nuclear Information System (INIS)

    Platinum-based primary or adjuvant chemoradiation is the treatment of choice for patients with cervical cancer. However, despite national guidelines and international recommendations, many aspects in diagnosis, therapy, and follow-up of patients with cervical cancer are not based on valid data. To evaluate the current patterns of care for patients with cervical cancer in Germany, a questionnaire with 25 items was sent to 281 radiooncologic departments and out-patient health care centers. The response rate was 51 %. While 87 % of institutions treat 0-25 patients/year, 12 % treat between 26 and 50 and only 1 % treat more than 50 patients/year. In 2011, the stage distribution of 1,706 treated cervical cancers were IB1, IB2, IIA, IIB, IIIA/IIIB, and IV in 11, 12, 11, 22, 28, and 16 %, respectively. CT (90 %) and MRI (86 %) are mainly used as staging procedures in contrast to PET-CT with 14 %. Interestingly, 27 % of institutions advocate surgical staging prior to chemoradiation. In the majority of departments 3D-based (70 %) and intensity-modulated radiotherapy (76 %) are used for percutaneous radiation, less frequently volumetric arc techniques (26 %). Nearly all colleagues (99.3 %) apply conventional fractioning of 1.8-2 Gy for external-beam radiotherapy, in 19 % combined with a simultaneous integrated boost. Cisplatinum mono is used as a radiosensitizer with 40 mg/m2 weekly by 90 % of radiooncologists. For boost application in the primary treatment, HDR (high-dose rate) brachytherapy is the dominant technique (84 %). In patients after radical hysterectomy pT1B1/1B2, node negative and resection in sound margins adjuvant chemoradiation is applied due to the occurrence of 1-4 other risk factors in 16-97 %. There is a broad spectrum of recommended primary treatment strategies in stages IIB and IVA. Results of the survey underline the leading role but also differences in the use of chemoradiation in the treatment of cervical cancer patients in Germany. (orig.)

  16. Should euthanasia be legal? An international survey of neonatal intensive care units staff

    Science.gov (United States)

    Cuttini, M; Casotto, V; Kaminski, M; de Beaufort, I; Berbik, I; Hansen, G; Kollee, L; Kucinskas, A; Lenoir, S; Levin, A; Orzalesi, M; Persson, J; Rebagliato, M; Reid, M; Saracci, R

    2004-01-01

    Objective: To present the views of a representative sample of neonatal doctors and nurses in 10 European countries on the moral acceptability of active euthanasia and its legal regulation. Design: A total of 142 neonatal intensive care units were recruited by census (in the Netherlands, Sweden, Hungary, and the Baltic countries) or random sampling (in France, Germany, Italy, Spain, and the United Kingdom); 1391 doctors and 3410 nurses completed an anonymous questionnaire (response rates 89% and 86% respectively). Main outcome measure: The staff opinion that the law in their country should be changed to allow active euthanasia "more than now". Results: Active euthanasia appeared to be both acceptable and practiced in the Netherlands, France, and to a lesser extent Lithuania, and less acceptable in Sweden, Hungary, Italy, and Spain. More then half (53%) of the doctors in the Netherlands, but only a quarter (24%) in France felt that the law should be changed to allow active euthanasia "more than now". For 40% of French doctors, end of life issues should not be regulated by law. Being male, regular involvement in research, less than six years professional experience, and having ever participated in a decision of active euthanasia were positively associated with an opinion favouring relaxation of legal constraints. Having had children, religiousness, and believing in the absolute value of human life showed a negative association. Nurses were slightly more likely to consider active euthanasia acceptable in selected circumstances, and to feel that the law should be changed to allow it more than now. Conclusions: Opinions of health professionals vary widely between countries, and, even where neonatal euthanasia is already practiced, do not uniformly support its legalisation. PMID:14711848

  17. Do Children in Rural Areas Still Have Different Access to Health Care? Results from a Statewide Survey of Oregon's Food Stamp Population

    Science.gov (United States)

    Devoe, Jennifer E.; Krois, Lisa; Stenger, Rob

    2009-01-01

    Purpose: To determine if rural residence is independently associated with different access to health care services for children eligible for public health insurance. Methods: We conducted a mail-return survey of 10,175 families randomly selected from Oregon's food stamp population (46% rural and 54% urban). With a response rate of 31%, we used a…

  18. Impact and therapy of osteoarthritis: the Arthritis Care OA Nation 2012 survey.

    Science.gov (United States)

    Conaghan, Philip G; Porcheret, Mark; Kingsbury, Sarah R; Gammon, Anne; Soni, Ashok; Hurley, Michael; Rayman, Margaret P; Barlow, Julie; Hull, Richard G; Cumming, Jo; Llewelyn, Kate; Moscogiuri, Federico; Lyons, Jane; Birrell, Fraser

    2015-09-01

    Osteoarthritis (OA) is the fastest growing cause of disability worldwide. The aim of this study was to understand the impact of OA on individuals and to explore current treatment strategies. An online UK-wide survey of people with self-reported OA was conducted, composed of 52 questions exploring the impact of OA, diagnosis and treatment, the role of health professionals and self-management. Four thousand forty-three people were invited with 2,001 respondents (49 % response, 56 % women; mean age 65 years). Fifty-two percent reported that OA had a large impact on their lives. Fifteen percent of respondents had taken early retirement on average 7.8 years earlier than planned. In consultations with general practitioners, only half reported a discussion on pain; fewer reported discussing their fears (21 %) or management goals (15 %). Nearly half (48 %) reported not seeking medical help until pain was frequently unbearable. Oral analgesics (62 %), topical therapies (47 %), physiotherapy (38 %) and steroid injections (28 %) were commonly used. The majority (71 %) reported varying degrees of persistent pain despite taking all prescribed medication. Although 64 % knew that increasing exercise was important, only 36 % acted on this knowledge; 87 % who increased exercise found it beneficial. Over half had future concerns related to mobility (60 %), maintaining independence (52 %) and coping with everyday activities (51 %). OA had significant individual economic impact especially on employment. Current treatment strategies still leave most people in pain with significant fears for the future. There is considerable opportunity to improve the holistic nature of OA consultations especially in provision of information and promotion of self-management strategies. PMID:24889403

  19. Paediatric palliative home care in areas of Germany with low population density and long distances: a questionnaire survey with general paediatricians

    Directory of Open Access Journals (Sweden)

    Kremeike Kerstin

    2012-09-01

    Full Text Available Abstract Background In 2007, the patient’s right to specialised palliative home care became law in Germany. However, childhood palliative care in territorial states with low patient numbers and long distances requires adapted models to ensure an area-wide maintenance. Actually, general paediatricians are the basic care providers for children and adolescents. They also provide home care. The aim of this study was to improve the knowledge about general paediatrician’s involvement in and contribution to palliative care in children. Findings To evaluate the current status of palliative home care provided by general paediatricians and their cooperation with other paediatric palliative care providers, a questionnaire survey was disseminated to general paediatricians in Lower Saxony, a German federal state with nearly eight million inhabitants and a predominantly rural infrastructure. Data analysis was descriptive. One hundred forty one of 157 included general paediatricians completed the questionnaire (response rate: 89.8%. A total of 792 children and adolescents suffering from life-limiting conditions were cared for by these general paediatricians in 2008. Severe cerebral palsy was the most prevalent diagnosis. Eighty-nine per cent of the general paediatricians stated that they had professional experience with paediatric palliative care. Collaboration of general paediatricians and other palliative care providers was stated as not well developed. The support by a specialised team including 24-hour on-call duty and the intensification of educational programs were emphasised. Conclusions The current regional infrastructure of palliative home care in Lower Saxony can benefit from the establishment of a coordinated network of palliative home care providers.

  20. Radiotherapeutic management of osseous metastases: A survey of current patterns of care

    International Nuclear Information System (INIS)

    Purpose: Radiotherapy plays a major role in the management of painful osseous metastases. This survey was conducted to study the current approaches to this clinical problem in the radiotherapy community. Methods and Materials: A questionnaire was sent to 2500 members of the American Society for Therapeutic Radiology and Oncology. It consisted of 30 multiple-choice questions regarding four hypothetical clinical scenarios likely to be encountered in daily practice. Questions related to the technique of choice [local field (LF) vs. hemibody radiotherapy (HBI)], the use of systemic radionuclides (SR), fractionation schemes, dose, the integration of modalities, and the follow-up of these patients. The analysis is based on 817 (33%) responses received regarding 3268 cases. Results: Local field is the most common form of therapy. Overall, LF was used, alone or in combination with other forms of therapy, in 54% and 74% of patients, respectively. LF was used more frequently in patients with breast cancer than in patients with prostate cancer (79% vs. 45%; p = 0.0001). Long fractionation schemes were used by 90% of physicians in 96% of cases. Short fractionation schemes were used by 7% of physicians in 4% of cases. This tendency was more pronounced in private practice than in the university or government/multidisciplinary settings (p = 0.008) and in physicians starting their practice before 1982 (p = 0.05). The most common schedule was 30 Gy in 10 fractions, used by 77% of physicians in 64% of cases. HBI was used, alone or in combination with other forms of therapy, in 1% and 2% of patients, respectively. It was used more frequently in patients with prostate cancer than in patients with breast cancer (1.2% vs. 0.1%, respectively; p < 0.0001). SR were used alone or in combination with local-field irradiation in 21% and 40% of cases, respectively. SR were used more frequently in patients with prostate cancer than in those with breast cancer (28% vs. 0.2%, respectively; p < 0

  1. Radical External Beam Radiotherapy for Clinically Localized Prostate Cancer in Japan: Changing Trends in the Patterns of Care Process Survey

    International Nuclear Information System (INIS)

    Purpose: To delineate changing trends in radical external beam radiotherapy (EBRT) for prostate cancer in Japan. Methods and Materials: Data from 841 patients with clinically localized prostate cancer treated with EBRT in the Japanese Patterns of Care Study (PCS) from 1996 to 2005 were analyzed. Results: Significant increases in the proportions of patients with stage T1 to T2 disease and decrease in prostate-specific antigen values were observed. Also, there were significant increases in the percentages of patients treated with radiotherapy by their own choice. Median radiation doses were 65.0 Gy and 68.4 Gy from 1996 to 1998 and from 1999 to 2001, respectively, increasing to 70 Gy from 2003 to 2005. Moreover, conformal therapy was more frequently used from 2003 to 2005 (84.9%) than from 1996 to 1998 (49.1%) and from 1999 to 2001 (50.2%). On the other hand, the percentage of patients receiving hormone therapy from 2003 to 2005 (81.1%) was almost the same as that from 1996 to 1998 (86.3%) and from 1999 to 2001 (89.7%). Compared with the PCS in the United States, patient characteristics and patterns of treatments from 2003 to 2005 have become more similar to those in the United States than those from 1996 to 1998 and those from 1999 to 2001. Conclusions: This study indicates a trend toward increasing numbers of patients with early-stage disease and increasing proportions of patients treated with higher radiation doses with advanced equipment among Japanese prostate cancer patients treated with EBRT during 1996 to 2005 survey periods. Patterns of care for prostate cancer in Japan are becoming more similar to those in the United States.

  2. Use of antenatal services and delivery care among women in rural western Kenya: a community based survey

    Directory of Open Access Journals (Sweden)

    Rosen Daniel H

    2006-04-01

    Full Text Available Abstract Background Improving maternal health is one of the UN Millennium Development Goals. We assessed provision and use of antenatal services and delivery care among women in rural Kenya to determine whether women were receiving appropriate care. Methods Population-based cross-sectional survey among women who had recently delivered. Results Of 635 participants, 90% visited the antenatal clinic (ANC at least once during their last pregnancy (median number of visits 4. Most women (64% first visited the ANC in the third trimester; a perceived lack of quality in the ANC was associated with a late first ANC visit (Odds ratio [OR] 1.5, 95% confidence interval [CI] 1.0–2.4. Women who did not visit an ANC were more likely to have 90%, but provision of other services was low, e.g. malaria prevention (21%, iron (53% and folate (44% supplementation, syphilis testing (19.4% and health talks (14.4%. Eighty percent of women delivered outside a health facility; among these, traditional birth attendants assisted 42%, laypersons assisted 36%, while 22% received no assistance. Factors significantly associated with giving birth outside a health facility included: age ≥ 30 years, parity ≥ 5, low SES, 1 hour walking distance from the health facility. Women who delivered unassisted were more likely to be of parity ≥ 5 (AOR 5.7, 95% CI 2.8–11.6. Conclusion In this rural area, usage of the ANC was high, but this opportunity to deliver important health services was not fully utilized. Use of professional delivery services was low, and almost 1 out of 5 women delivered unassisted. There is an urgent need to improve this dangerous situation.

  3. Postoperative radiotherapy for uterine cervical cancer. Results of the 1995-1997 patterns of care process survey in Japan

    International Nuclear Information System (INIS)

    The objective of this study was to determine the average national practice of postoperative radiotherapy (RT) for uterine cervical cancer in Japan. The Japanese Patterns of Care Study (PCS) reviewed the process of care employed for 455 uterine cervical cancer patients who were treated with surgery followed by postoperative RT during 1995-1997. Cases with missing data were excluded from calculations of percentage and significance for each of the surveyed items. According to International Federation of Gynecology and Obstetrics (FIGO) stages, 198 patients (45%) were in stage I, 52 patients (12%) were in stage IIA, 146 patients (33%) were in stage IIB and 46 patients (10%) were in stage III/IVA. The most common surgical procedure among the patients was radical hysterectomy (73%). Three hundred and seventy patients (82%) were treated with external beam RT (ERT) alone, and 74 patients (17%) were treated with a combination of ERT and intracavitary RT (ICRT). A midline block was used for the pelvic field in 63 patients (14%). Only seven patients (2%) were treated with extended field ERT. Pelvic ERT was most often performed using anterior posterior-posterior anterior (AP-PA) opposed fields for 431 patients (97%). A majority of the patients (312 patients, 70%) were treated with a total dose of 45.0-50.4 Gy for ERT. Chemotherapy (CT) was administered to 178 patients (40%), neoadjuvant preoperative CT was administered to 80 patients (22%) and concurrent CT with postoperative RT was administered to 29 patients (8%). This PCS established the national practice average of postoperative RT for uterine cervical cancer. Follow-up studies need to be conducted to determine whether the observed differences in treatment processes affect outcomes. (author)

  4. Clinical Preventive Services for Patients at Risk for Cardiovascular Disease, National Ambulatory Medical Care Survey, 2005-2006

    Directory of Open Access Journals (Sweden)

    Paula W. Yoon, ScD, MPH

    2011-03-01

    Full Text Available IntroductionClinical preventive services can detect diseases early, when they are most treatable, but these services may not be provided as recommended. Assessing the provision of services to patients at risk for cardiovascular disease (CVD could help identify disparities and areas for improvement.MethodsWe used data on patient visits (n = 21,261 from the National Ambulatory Medical Care Survey, 2005-2006, and classified patients with hypertension, hyperlipidemia, obesity, or diabetes as being at risk for CVD. We assessed differences in the provision of preventive services offered to patients who were and who were not at risk for CVD. Further, for those at risk, we compared the demographic characteristics of those who had and who had not been offered services.ResultsPatients at risk for CVD received significantly more preventive services compared with those not at risk. For patients at risk for CVD, aspirin therapy was more likely to be recommended to those aged 65 years or older than those aged 45 to 64 years and to men than women. Cholesterol screening was more likely for men and was less likely for patients with Medicare/Medicaid or no insurance than for patients who were insured. Rates of counseling for diet and nutrition, weight reduction, and exercise were low overall, but younger patients received these services more than older patients did.ConclusionPatients at risk for CVD are not all receiving the same level of preventive care, suggesting the need to clarify clinical practice guidelines and provide clinicians with education and support for more effective lifestyle counseling.

  5. Healthcare professionals' intentions to use wiki-based reminders to promote best practices in trauma care: a survey protocol

    Directory of Open Access Journals (Sweden)

    Lapointe Jean

    2010-06-01

    Full Text Available Abstract Background Healthcare professionals are increasingly using wikis as collaborative tools to create, synthesize, share, and disseminate knowledge in healthcare. Because wikis depend on collaborators to keep content up-to-date, healthcare professionals who use wikis must adopt behaviors that foster this collaboration. This protocol describes the methods we will use to develop and test the metrological qualities of a questionnaire that will assess healthcare professionals' intentions and the determinants of those intentions to use wiki-based reminders that promote best practices in trauma care. Methods Using the Theory of Planned Behavior, we will conduct semi-structured interviews of healthcare professionals to identify salient beliefs that may affect their future use of wikis. These beliefs will inform our questionnaire on intended behavior. A test-retest of the survey will verify the questionnaire's stability over time. We will interview 50 healthcare professionals (25 physicians and 25 allied health professionals working in the emergency departments of three trauma centers in Quebec, Canada. We will analyze the content of the interviews and construct and pilot a questionnaire. We will then test the revised questionnaire with 30 healthcare professionals (15 physicians and 15 allied health professionals and retest it two weeks later. We will assess the internal consistency of the questionnaire constructs using Cronbach's alpha coefficients and determine their stability with the intra-class correlation (ICC. Discussion To our knowledge, this study will be the first to develop and test a theory-based survey that measures healthcare professionals' intentions to use a wiki-based intervention. This study will identify professionals' salient beliefs qualitatively and will quantify the psychometric capacities of the questionnaire based on those beliefs.

  6. Case management for patients with chronic systolic heart failure in primary care: The HICMan exploratory randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Kunz Cornelia U

    2010-05-01

    Full Text Available Abstract Background Chronic (systolic heart failure (CHF represents a clinical syndrome with high individual and societal burden of disease. Multifaceted interventions like case management are seen as promising ways of improving patient outcomes, but lack a robust evidence base, especially for primary care. The aim of the study was to explore the effectiveness of a new model of CHF case management conducted by doctors' assistants (DAs, equivalent to a nursing role and supported by general practitioners (GPs. Methods This patient-randomised controlled trial (phase II included 31 DAs and employing GPs from 29 small office-based practices in Germany. Patients with CHF received either case management (n = 99 consisting of telephone monitoring and home visits or usual care (n = 100 for 12 months. We obtained clinical data, health care utilisation data, and patient-reported data on generic and disease-specific quality of life (QoL, SF-36 and KCCQ, CHF self-care (EHFScBS and on quality of care (PACIC-5A. To compare between groups at follow-up, we performed analyses of covariance and logistic regression models. Results Baseline measurement showed high guideline adherence to evidence-based pharmacotherapy and good patient self-care: Patients received angiotensin converting enzyme inhibitors (or angiotensin-2 receptor antagonists in 93.8% and 95%, and betablockers in 72.2% and 84%, and received both in combination in 68% and 80% of cases respectively. EHFScBS scores (SD were 25.4 (8.4 and 25.0 (7.1. KCCQ overall summary scores (SD were 65.4 (22.6 and 64.7 (22.7. We found low hospital admission and mortality rates. EHFScBS scores (-3.6 [-5.7;-1.6] and PACIC and 5A scores (both 0.5, [0.3;0.7/0.8] improved in favour of CM but QoL scores showed no significant group differences (Physical/Mental SF-36 summary scores/KCCQ-os [95%CI]: -0.3 [-3.0;2.5]/-0.1 [-3.4;3.1]/1.7 [-3.0;6.4]. Conclusions In this sample, with little room for improvement regarding evidence

  7. The nexus of evidence, context, and patient preferences in primary care: postal survey of Canadian family physicians

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    Moineddin Rahim

    2003-09-01

    Full Text Available Abstract Background Evidence-based medicine is gaining prominence in primary care. This study sought to examine the relationships among family physicians' attitudes toward EBM, contextual factors, and clinical decision-making and to investigate the factors that contribute to 'contrary to evidence' clinical decisions. Methods A postal survey mailed to a random sample of Canadian family physicians, stratified by age, gender, and practice setting. The main outcome measures were respondents' attitudes toward evidence-based medicine and preferred treatment option in four simulated clinical scenarios with wording randomly varied. Results Canadian family physicians report positive attitudes toward EBM, believe that EBM improves patient care, and agree that research findings are useful in the day-to-day management of patients. The scenario study showed that physicians were strongly influenced by a patient demanding/requesting either a screening test (adjusted Odds Ratio [OR] 5.15, 95% confidence interval [CI] 2.9 to 9.2 for demand mammogram; adjusted OR 3.11, 95% CI 1.7 to 5.6 for request mammogram or a diagnostic test (adjusted OR 3.95, 95% CI 2.1 to 7.5 for demand lumbar spine x-ray; adjusted OR 2.08, 95% CI 1.1 to 4.1 for request x-ray. This relationship did not hold for the treatment scenario (prescribing antibiotics for acute bronchitis where hours of practice (adjusted OR 3.5, 95% CI 1.1 to 11.7 for 50+ hours practice; adjusted OR 1.79, 95% CI 1.0 to 3.2 for 20–49 hours practice and type of practice (adjusted OR 2.22, 95% CI 1.3 to 3.7 for solo practice were significant. 80% of respondents reported teaching breast self-examination with female physicians twice as likely as males (adjusted OR 2.11, 95% CI 1.2 to 3.8. Conclusions Canadian family physicians are favourably disposed to the precepts of evidence-based medicine; however, patient expectations and practice characteristics can influence physicians such that decisions are taken that are

  8. Pretreatment prostate-specific antigen values in patients with prostate cancer: 1989 patterns of care study process survey

    International Nuclear Information System (INIS)

    Purpose: A Patterns of Care Study (PCS) national survey was conducted to show the national averages for processes of radiation therapy care for prostate cancer patients in 1989. In the current study we report an analysis of pretreatment prostate-specific antigen (PSA) by stage, grade, and ethnic origin. Methods and Materials: Process data were collected from 672 patients treated in 1989 at 71 separate institutions. Four hundred and twenty-seven (64%) of these patients had a pretreatment PSA value recorded. Three hundred and forty-three of the 427 patients were treated with external beam irradiation alone and were selected for the current analysis. The 1992 AJCC staging system was used. Results: There was a significant increase in pretreatment PSA with increasing stage. The median values of PSA were 8.3 ngm/ml in the T1 group (n = 65), 11.2 ngm/ml in the T2 group (n = 178), and 20.9 ngm/ml in the T3 group (n = 90) (p < 0.001). Ten patients were not staged. There was a significant increase in pretreatment PSA with decreasing differentiation. The median pretreatment PSA was 9.7 ngm/ml in well-differentiated tumors (n = 109), 13.0 ngm/ml in moderately differentiated tumors (n = 163), and 22.0 ngm/ml in poorly differentiated tumors. (n = 61) (p < 0.001). Ten patients had no differentiation recorded. African Americans (24) showed a significant increase in pretreatment PSA compared to Caucasians (304). The respective medians were 23.2 ng/ml and 11.9 ng/ml (p = 0.04). They also show more poorly differentiated tumors (33% vs. 17%) and more T3 tumors (46% vs. 25%). Other minorities, although small in number (n = 9) were similar to African Americans. Conclusion: Pretreatment PSA levels were established for patients treated with external beam irradiation in 1989 in the United States. They increase with stage and decreasing differentiation. African Americans and other minorities show a doubling of median values compared to Caucasians' pretreatment PSA with an increase in stage

  9. A survey of intestinal helminths of well-cared-for dogs in Jamaica, and their potential public health significance.

    Science.gov (United States)

    Robinson, R D; Thompson, D L; Lindo, J F

    1989-03-01

    This study investigates the level of helminthic infestation in better-cared-for dogs in a middle-class community in suburban Kingston. A canine zoographic study was conducted, and fresh faecal deposits were collected and analysed for helminth life-cycle stages. The survey indicated that 73% (n = 93) of households in the study area owned one dog or more (mean = 1.4). Resident's attitudes towards canine management suggested that the dog population was, in general, restricted to the residential estate, and most owners claimed to have dewormed their dogs at least as young animals. Of 141 faecal specimens, 58% contained eggs or larvae of one or more of eight helminths: Uncinaria stenocephala (26%), Ancylostoma sp. (23%), Trichuris vulpis (9%), Toxocara canis (8%), Spirocerca lupi (6%), Strongyloides sp. (6%), Apophallus sp. (4%) and taeniids (1%). There was a high level of multiple infection in the host animals, with approximately one fifth of the infected samples containing three or more helminth types. Infection intensity was apparently low, but some dogs harboured heavy worm loads. PMID:2723384

  10. Inequalities in the care experiences of patients with cancer: analysis of data from the National Cancer Patient Experience Survey 2011–2012

    Science.gov (United States)

    Bone, Anna; Mc Grath-Lone, Louise; Day, Sophie; Ward, Helen

    2014-01-01

    Objectives To explore inequalities in the care experiences of care by patients clinical or trust-level factors for patients with cancer. Design Secondary analysis of data from the National Cancer Patient Experience Survey 2011–2012. Setting and participants Adult patients with a primary diagnosis of cancer who attended an acute or specialist National Health Service (NHS) trust in England. Outcome measure OR of a patient rating their overall care positively, adjusting for other patient, clinical and trust-level factors. Methods Using cross-sectional data from 71 793 patients with cancer who completed the National Cancer Patient Experience Survey 2011–2012, we examined associations between patient, clinical and trust-level factors and a summary measure of patient experience, namely overall rating of care. Multivariate logistic regression was used to investigate variation by sociodemographic characteristics adjusting for other patient, clinical and trust-level factors. Results Female, non-white and younger patients were less likely to rate their overall care as excellent or very good. Patients with long-standing conditions, particularly those with learning disabilities or mental health conditions, also reported poorer overall care. This variation persisted when other patient, clinical and trust-level factors were controlled for, indicating that there are real differences in experiences among patients with cancer by sociodemographic characteristics. Conclusions There is evidence of inequalities in the experiences of patients with cancer in the UK by sociodemographic characteristics such as gender, age, ethnicity and disability. Quality cancer care services must strive to meet the needs of a diverse patient population equally; this study identifies patient groups for whom it appears cancer care services are in greatest need of improvement. PMID:24531454

  11. The lack of paid sick leave as a barrier to cancer screening and medical care-seeking: results from the National Health Interview Survey

    Directory of Open Access Journals (Sweden)

    Peipins Lucy A

    2012-07-01

    Full Text Available Abstract Background Preventive health care services, such as cancer screening can be particularly vulnerable to a lack of paid leave from work since care is not being sought for illness or symptoms. We first describe the prevalence of paid sick leave by broad occupational categories and then examine the association between access to paid sick leave and cancer testing and medical care-seeking in the U.S. workforce. Methods Data from the 2008 National Health Interview survey were analyzed by using paid sick leave status and other health-related factors to describe the proportion of U.S. workers undergoing mammography, Pap testing, endoscopy, fecal occult blood test (FOBT, and medical-care seeking. Results More than 48 million individuals (38% in an estimated U.S. working population of 127 million did not have paid sick leave in 2008. The percentage of workers who underwent mammography, Pap test, endoscopy at recommended intervals, had seen a doctor during the previous 12 months or had at least one visit to a health care provider during the previous 12 months was significantly higher among those with paid sick leave compared with those without sick leave after controlling for sociodemographic and health-care-related factors. Conclusions Lack of paid sick leave appears to be a potential barrier to obtaining preventive medical care and is a societal benefit that is potentially amenable to change.

  12. Previous Adverse Infant Outcomes as Predictors of Preconception Care Use: An Analysis of the 2010 and 2012 Los Angeles Mommy and Baby (LAMB) Surveys.

    Science.gov (United States)

    Batra, Priya; Higgins, Chandra; Chao, Shin M

    2016-06-01

    Objectives This study aimed to understand the impact of a previous adverse infant outcome (AIO) on use of preconception care prior to a subsequent pregnancy. Methods Responses from the 2010 and 2012 Los Angeles Mommy and Baby Surveys were analyzed. Weighted multivariate logistic regression was employed to identify significant associations between having had a previous AIO (preterm delivery, low birth weight infant, stillbirth, or major birth defect) and receipt of preconception care prior to the most recent pregnancy. Select patient-level covariates were included: chronic disease, age, education level, race/ethnicity, country of birth, insurance status prior to pregnancy and pregnancy intent. Adjustment for missing responses was performed using multiple chained imputation. Results After controlling for covariates, having had a previous AIO was associated with an increased odds of having utilized preconception care in the most recent pregnancy (OR 1.237, p = 0.040). Per the final regression model, a woman reporting a previous AIO and an intended subsequent pregnancy had a 42.4 % likelihood of having used preconception care. Of these women, only 28.8 % reported doing so because of concern regarding a previous birth complication. Discussion Women reporting a previous AIO were more likely to have used preconception care in a subsequent pregnancy. The prevalence of preconception care utilization remained low overall. Pregnancy intent emerged as a strong secondary predictor; any concerted strategy to improve access to preconception care must include initiatives to help ensure that pregnancies are planned. PMID:26679708

  13. Global pathways to men's caregiving: mixed methods findings from the International Men and Gender Equality Survey and the Men Who Care study.

    Science.gov (United States)

    Kato-Wallace, Jane; Barker, Gary; Eads, Marci; Levtov, Ruti

    2014-01-01

    Promoting men's participation in unpaid care work is part of the Programme of Action for the International Conference on Population and Development. However, men's involvement in care work does not mirror the advances women have made in paid work outside the home. This mixed method study explores which men are more involved in caregiving, and what childhood and adulthood factors influence their level of involvement. Quantitative research presents findings from 1169 men across six countries with children aged 0-4, and a qualitative study presents findings from in-depth interviews with 83 men engaged in atypical caregiving practices. Survey research finds that being taught to care for children, witnessing one's father take care of one's siblings, respondents' present attitudes about gender equality and having outside help (or none, in some cases) were all also associated with men's higher level of involvement. Qualitative research reveals that men's experiences of violence, the normalisation of domestic work as children and life circumstances rather than greater-than-average beliefs in gender equality all propelled them into care work. Findings suggest that engaging more men into care work implies changes to policies and structural realities in the workplace coupled with changing gender attitudes. These insights inform policy and practice aimed at promoting greater involvement in care work by men. PMID:24938308

  14. Patient Experience Assessment is a Requisite for Quality Evaluation: A Discussion of the In-Center Hemodialysis Consumer Assessment of Health Care Providers and Systems (ICH CAHPS) Survey.

    Science.gov (United States)

    Cavanaugh, Kerri L

    2016-03-01

    Patient experience surveys provide a critical and unique perspective on the quality of patient-centered healthcare delivery. These surveys provide a mechanism to systematically express patients' voice on topics valued by patients to make decisions about choices in care. They also provide an assessment to healthcare organizations about their service that cannot be obtained from any other source. Regulatory agencies have mandated the assessment of patients' experience as part of healthcare value based purchasing programs and weighted the results to account for up to 30% of the total scoring. This is a testimony to the accepted importance of this metric as a fundamental assessment of quality. After more than a decade of rigorous research, there is a significant body of growing evidence supporting specifically the validity and use of the Consumer Assessment of Healthcare Providers and Systems (CAHPS) surveys, including a version specific to in-center hemodialysis (ICH CAHPS). This review will focus on the ICH CAHPS survey including a review of its development, content, administration, and also a discussion of common criticisms. Although it is suggested that the survey assesses activities and experiences that are not modifiable by the healthcare organization (or the dialysis facility in our case) emerging evidence suggests otherwise. Dialysis providers have an exclusive opportunity to lead the advancement of understanding the implications and serviceability of the evaluation of the patient experience in health care. PMID:26858008

  15. Care seeking, complementary therapy and herbal medicine use among people with type 2 diabetes and cardiovascular disease CAMELOT phase II: Surveying for diversity

    DEFF Research Database (Denmark)

    Manderson, Lenore; Oldenburg, Brian; Lin, Vivian;

    2012-01-01

    cardiovascular disease, which are among the most prevalent chronic conditions in Australia. Qualitative data collected in the first phase of the study informed the design of a self administered questionnaire, for people with cardiovascular disease or diabetes, to investigate care seeking, complementary therapy...... use and the relevance of social, locational, economic and cultural factors to health behaviour. Valid survey returns totalled 2915 (290 online and 2625 postal), providing a rich data set on health status, health care and costs, demographic and social information, and quality of life. In the 12 months...

  16. Diagnosis of post-traumatic sepsis according to "Sepsis guidelines": a cross-sectional survey of sepsis in a trauma intensive care unit

    OpenAIRE

    Tang, Hao; Liu, Dong; Zhang, Hua-Yu; Li, Yang; Ming-tao CHANG; ZHANG Xiu-zhu; Jiang, Dong-Po; ZHANG Lian-yang

    2016-01-01

    Objective  To investigate the prevalence and risk factors of post-traumatic sepsis, and to evaluate the rationality of the 1992, 2001 and 2012 international sepsis definitions in diagnosing post-traumatic sepsis in a trauma intensive care unit (ICU) in China. Methods  A one-day cross-sectional survey of trauma patients who met the inclusion criteria was conducted from 8:00 a.m., June 16, 2014 to 8:00 a.m., June 17, 2014 in the trauma ICU of Daping Hospital. The survey data included demographi...

  17. A Frailty Instrument for primary care: findings from the Survey of Health, Ageing and Retirement in Europe (SHARE

    Directory of Open Access Journals (Sweden)

    Romero-Ortuno Roman

    2010-08-01

    Full Text Available Abstract Background A frailty paradigm would be useful in primary care to identify older people at risk, but appropriate metrics at that level are lacking. We created and validated a simple instrument for frailty screening in Europeans aged ≥50. Our study is based on the first wave of the Survey of Health, Ageing and Retirement in Europe (SHARE, http://www.share-project.org, a large population-based survey conducted in 2004-2005 in twelve European countries. Methods Subjects: SHARE Wave 1 respondents (17,304 females and 13,811 males. Measures: five SHARE variables approximating Fried's frailty definition. Analyses (for each gender: 1 estimation of a discreet factor (DFactor model based on the frailty variables using LatentGOLD®. A single DFactor with three ordered levels or latent classes (i.e. non-frail, pre-frail and frail was modelled; 2 the latent classes were characterised against a biopsychosocial range of Wave 1 variables; 3 the prospective mortality risk (unadjusted and age-adjusted for each frailty class was established on those subjects with known mortality status at Wave 2 (2007-2008 (11,384 females and 9,163 males; 4 two web-based calculators were created for easy retrieval of a subject's frailty class given any five measurements. Results Females: the DFactor model included 15,578 cases (standard R2 = 0.61. All five frailty indicators discriminated well (p N = 10,420; 66.9%, pre-frail (N = 4,025; 25.8%, and frail (N = 1,133; 7.3%. Relative to the non-frail class, the age-adjusted Odds Ratio (with 95% Confidence Interval for mortality at Wave 2 was 2.1 (1.4 - 3.0 in the pre-frail and 4.8 (3.1 - 7.4 in the frail. Males: 12,783 cases (standard R2 = 0.61, all frailty indicators had p N = 10,517; 82.3%, pre-frail (N = 1,871; 14.6%, and frail (N = 395; 3.1%; age-adjusted OR (95% CI for mortality: 3.0 (2.3 - 4.0 in the pre-frail, 6.9 (4.7 - 10.2 in the frail. Conclusions The SHARE Frailty Instrument has sufficient construct and

  18. Caregiver recognition of childhood diarrhea, care seeking behaviors and home treatment practices in rural Burkina Faso: a cross-sectional survey.

    Directory of Open Access Journals (Sweden)

    Shelby E Wilson

    Full Text Available INTRODUCTION: To design effective national diarrhea control programs, including oral rehydration solution (ORS and therapeutic zinc supplementation, information is needed on local perceptions of illness, external care seeking behaviors, and home treatment practices. METHODS: A cross-sectional, community-based household survey was conducted in the Orodara Health District, Burkina Faso. Caregivers of 10,490 children <27 months were interviewed to assess child diarrhea prevalence and related care practices. Characteristics of households, caregivers, children, and reported illnesses were compared for those caregivers who did or did not recognize the presence of diarrhea, as defined according to clinical criteria (≥ 3 liquid or semi-liquid stools/day. Multiple logistic regression models were used to examine factors associated with illness recognition and treatment. RESULTS: Clinically defined diarrhea was present in 7.6% (95% CI: 7.1-8.1% of children during the 24 hours preceding the survey but recognized by only 55% of caregivers. Over half (55% of the caregivers of 1,067 children with a clinically defined diarrhea episode in the past 14 days sought care outside the home; 78% of those seeking care attended a public sector clinic. Care was sought and treatment provided more frequently for children with fever, vomiting, anorexia, longer illness duration, and those living closer to the health center; and care was sought more frequently for male children. 80% of children with recent diarrhea received some form of treatment; only 24% received ORS, whereas 14% received antibiotics. Zinc was not yet available in the study area. CONCLUSIONS: Caregivers frequently fail to recognize children's diarrhea, especially among younger infants and when illness signs are less severe. Treatment practices do not correspond with international recommendations in most cases, even when caregivers consult with formal health services. Child caregivers need additional

  19. Quality of integrated chronic care measured by patient survey: identification, selection and application of most appropriate instruments

    OpenAIRE

    Vrijhoef, Hubertus J.M.; Berbee, Rieneke; Wagner, Edward H.; Steuten, Lotte M.G.

    2009-01-01

    Objective  To identify the most appropriate generic instrument to measure experience and/or satisfaction of people receiving integrated chronic care. Background  Health care is becoming more user-centred and, as a result, the experience of users of care and evaluation of their experience and/or satisfaction is taken more seriously. It is unclear to what extent existing instruments are appropriate in measuring the experience and/or satisfaction of people using integrated chronic care. Methods ...

  20. The importance of job characteristics in determining medical care-seeking in the Dutch working population, a longitudinal survey study

    OpenAIRE

    Steenbeek Romy

    2012-01-01

    Abstract Background The working population is ageing, which will increase the number of workers with chronic health complaints, and, as a consequence, the number of workers seeking health care. It is very important to understand factors that influence medical care-seeking in order to control the costs. I will investigate which work characteristics independently attribute to later care-seeking in order to find possibilities to prevent unnecessary or inefficient care-seeking. Methods Data were ...

  1. Factors associated with unmet dental care needs in Canadian immigrants: an analysis of the longitudinal survey of immigrants to Canada

    OpenAIRE

    Calvasina, Paola; Muntaner, Carles; Quiñonez, Carlos

    2014-01-01

    Background Immigrants are often considered to have poorer oral health than native born-populations. One possible explanation for immigrants’ poor oral health is lack of access to dental care. There is very little information on Canadian immigrants’ access to dental care, and unmet dental care needs. This study examines predictors of unmet dental care needs among a sample of adult immigrants to Canada over a three-point-five-year post-migration period. Methods A secondary data analysis was con...

  2. Quality of integrated chronic care measured by patient survey: identification, selection and application of most appropriate instruments

    NARCIS (Netherlands)

    Vrijhoef, Hubertus J.M.; Berbee, Rieneke; Wagner, Edward H.; Steuten, Lotte M.G.

    2009-01-01

    Objective  To identify the most appropriate generic instrument to measure experience and/or satisfaction of people receiving integrated chronic care. Background  Health care is becoming more user-centred and, as a result, the experience of users of care and evaluation of their experience and/or sat

  3. Do homosexual persons use health care services more frequently than heterosexuals persons: findings from a Dutch population survey.

    NARCIS (Netherlands)

    Bakker, F.C.; Sandfort, T.G.M.; Vanwesenbeeck, I.; Lindert, H. van; Westert, G.P.

    2006-01-01

    Use of health care services has been suggested to be lower among homo- or bisexual persons than among heterosexual persons, due to a lack of trust in the health care system. However, population-based studies on differences in health care utilization according to sexual orientation are scarce. The pu

  4. 78 FR 15958 - Submission for OMB Review; 30-day Comment Request: Pediatric Palliative Care Campaign Pilot Survey

    Science.gov (United States)

    2013-03-13

    ... for public comment. The National Institute of Nursing Research (NINR), National Institutes of Health... developed a Pediatric Palliative Care Campaign to address the communications challenges faced by health care...) determine if the pilot campaign is effective, relevant, and useful to health care providers who...

  5. A survey of primary care physician practices in antibiotic prescribing for the treatment of uncomplicated male gonoccocal urethritis

    Directory of Open Access Journals (Sweden)

    Blanchon Thierry

    2011-05-01

    Full Text Available Abstract Background The development of resistance to antimicrobial therapy by Neisseria gonorrhoeae causes on-going problems for individual case management of gonorrhoea. Surveillance data about N. gonorrhoeae have indicated an increase in the incidence of gonorrhoea in France in 2006. As a consequence of the development of antibiotic resistance in N. gonorrhoeae, French guidelines excluded fluoroquinolones as a standard treatment for N. gonorrhoeae. Ceftriaxone became the recommended treatment, associated with azithromycin for Clamydia trachomatis infection. Our aim was to describe the practice patterns of general practitioners (GPs in managing the antibiotic treatment of patients with symptoms suggestive of uncomplicated male urethritis. Methods We developed a clinical vignette describing a man with typical gonococcal urethritis symptoms to elicit questions about antibiotic treatment. We mailed the electronic questionnaire to a random sample of 1000 French GPs belonging to the Sentinelles Network. Results By the end of the survey period, 350 vignettes were received, yielding a response rate of 35%. Sixty-six GPs (20.2% prescribed the recommended antibiotics for the simultaneous treatment of N. gonorrhoeae and C. trachomatis infections, while 132 GPs (40.4% prescribed only non-recommended antibiotics, including ciprofloxacin in 69 cases (21.1%. General practitioners with less than 10 years in practice showed better compliance to guidelines than those with more years in practice (p Conclusions The results suggest a mismatch between the guidelines and the antibiotic treatment of male uncomplicated urethritis by French GPs, mostly among the subgroup of physicians who have been in practice longer. Educational approaches based on practice feedback need to be developed to improve these deficits in the quality of care.

  6. A survey of the management of urinary tract infection in children in primary care and comparison with the NICE guidelines.

    LENUS (Irish Health Repository)

    Kennedy, Kieran M

    2010-01-01

    BACKGROUND: The aim of this study was to establish current practices amongst general practitioners in the West of Ireland with regard to the investigation, diagnosis and management of urinary tract infection (UTI) in children and to evaluate these practices against recently published guidelines from the National Institute for Health and Clinical Excellence (NICE). METHODS: A postal survey was performed using a questionnaire that included short clinical scenarios. All general practices in a single health region were sent a questionnaire, cover letter and SAE. Systematic postal and telephone contact was made with non-responders. The data was analysed using SPSS version 15. RESULTS: Sixty-nine general practitioners were included in the study and 50 (72%) responded to the questionnaire. All respondents agreed that it is important to consider diagnosis of UTI in all children with unexplained fever. Doctors accurately identified relevant risk factors for UTI in the majority (87%) of cases. In collecting urine samples from a one year old child, 80% of respondents recommended the use of a urine collection bag and the remaining 20% recommended collection of a clean catch sample. Respondents differed greatly in their practice with regard to detailed investigation and specialist referral after a first episode of UTI. Co-amoxiclav was the most frequently used antibiotic for the treatment of cystitis, with most doctors prescribing a five day course. CONCLUSIONS: In general, this study reveals a high level of clinical knowledge amongst doctors treating children with UTI in primary care in the catchment area of County Mayo. However, it also demonstrates wide variation in practice with regard to detailed investigation and specialist referral. The common practice of prescribing long courses of antibiotics when treating lower urinary tract infection is at variance with NICE\\'s recommendation of a three day course of antibiotics for cystitis in children over three months of age when

  7. Do Children in Rural Areas Still Have Different Access to Health Care? Results from a Statewide Survey of Oregon’s Food Stamp Population

    Science.gov (United States)

    DeVoe, Jennifer E.; Krois, Lisa; Stenger, Rob

    2016-01-01

    Purpose To determine if rural residence is independently associated with different access to health care services for children eligible for public health insurance. Methods We conducted a mail-return survey of 10,175 families randomly selected from Oregon’s food stamp population (46% rural and 54% urban). With a response rate of 31%, we used a raking ratio estimation process to weight results back to the overall food stamp population. We examined associations between rural residence and access to health care (adjusting for child’s age, child’s race/ethnicity, household income, parental employment, and parental and child’s insurance type). A second logistic regression model controlled for child’s special health care needs. Findings Compared with urban children (reference = 1.00), rural children were more likely to have unmet medical care needs (odds ratio [OR] 1.48, 95% confidence interval [CI] 1.07–2.04), problems getting dental care (OR 1.36, 95% CI 1.03–1.79), and at least one emergency department visit in the past year (OR 1.42, 95% CI 1.10–1.81). After adjusting for special health care needs (more prevalent among rural children), there was no rural-urban difference in unmet medical needs, but physician visits were more likely among rural children. There were no statistically significant differences in unmet prescription needs, delayed urgent care, or having a usual source of care. Conclusions These findings suggest that access disparities between rural and urban low-income children persist, even after adjusting for health insurance. Coupled with continued expansions in children’s health insurance coverage, targeted policy interventions are needed to ensure the availability of health care services for children in rural areas, especially those with special needs. PMID:19166555

  8. Prescription for antibiotics at drug shops and strategies to improve quality of care and patient safety: a cross-sectional survey in the private sector in Uganda

    OpenAIRE

    Mbonye, AK; Buregyeya, E.; Rutebemberwa, E.; Clarke, SE; Lal, S; Hansen, KS; Magnussen, P; LaRussa, P

    2016-01-01

    Objectives The main objective of this study was to assess practices of antibiotic prescription at registered drug shops with a focus on upper respiratory tract infections among children in order to provide data for policy discussions aimed at improving quality of care and patient safety in the private health sector in Uganda. Methods A survey was conducted within 57 parishes from August to October 2014 in Mukono District, Uganda. Data was captured on the following variables: drug shop charact...

  9. Challenges to the provision of diabetes care in first nations communities: results from a national survey of healthcare providers in Canada

    Directory of Open Access Journals (Sweden)

    Macaulay Ann C

    2011-10-01

    Full Text Available Abstract Background Aboriginal peoples globally, and First Nations peoples in Canada particularly, suffer from high rates of type 2 diabetes and related complications compared with the general population. Research into the unique barriers faced by healthcare providers working in on-reserve First Nations communities is essential for developing effective quality improvement strategies. Methods In Phase I of this two-phased study, semi-structured interviews and focus groups were held with 24 healthcare providers in the Sioux Lookout Zone in north-western Ontario. A follow-up survey was conducted in Phase II as part of a larger project, the Canadian First Nations Diabetes Clinical Management and Epidemiologic (CIRCLE study. The survey was completed with 244 healthcare providers in 19 First Nations communities in 7 Canadian provinces, representing three isolation levels (isolated, semi-isolated, non-isolated. Interviews, focus groups and survey questions all related to barriers to providing optimal diabetes care in First Nations communities. Results the key factors emerging from interviews and focus group discussions were at the patient, provider, and systemic level. Survey results indicated that, across three isolation levels, healthcare providers' perceived patient factors as having the largest impact on diabetes care. However, physicians and nurses were more likely to rank patient factors as having a large impact on care than community health representatives (CHRs and physicians were significantly less likely to rank patient-provider communication as having a large impact than CHRs. Conclusions Addressing patient factors was considered the highest impact strategy for improving diabetes care. While this may reflect "patient blaming," it also suggests that self-management strategies may be well-suited for this context. Program planning should focus on training programs for CHRs, who provide a unique link between patients and clinical services

  10. How High is America's Health Care Cost Burden? Findings from the Commonwealth Fund Health Care Affordability Tracking Survey, July-August 2015.

    Science.gov (United States)

    Collins, Sara R; Gunja, Munira; Doty, Michelle M; Buetel, Sophie

    2015-11-01

    One-quarter of privately insured working-age adults have high health care cost burdens relative to their incomes in 2015, according to the Commonwealth Fund Health Care Affordability Index, a comprehensive measure of consumer health care costs. This figure, which is based on a nationally representative sample of people with private insurance who are mainly covered by employer plans, is statistically unchanged from 2014. When looking specifically at adults with low incomes, more than half have high cost burdens. In addition, when privately insured adults were asked how they rated their affordability, greater shares reported their premiums and deductible costs were difficult or impossible to afford than the Index would suggest. Health plan deductibles and copayments had negative effects on many people's willingness to get needed health care or fill prescriptions. In addition, many consumers are confused about which services are free to them and which count toward their deductible. PMID:26634240

  11. Association between forgone care and household income among the elderly in five Western European countries – analyses based on survey data from the SHARE-study

    Directory of Open Access Journals (Sweden)

    Stirbu Irina

    2009-03-01

    Full Text Available Abstract Background Studies on the association between access to health care and household income have rarely included an assessment of 'forgone care', but this indicator could add to our understanding of the inverse care law. We hypothesize that reporting forgone care is more prevalent in low income groups. Methods The study is based on the 'Survey of Health, Ageing and Retirement in Europe (SHARE', focusing on the non-institutionalized population aged 50 years or older. Data are included from France, Germany, Greece, Italy and Sweden. The dependent variable is assessed by the following question: During the last twelve months, did you forgo any types of care because of the costs you would have to pay, or because this care was not available or not easily accessible? The main independent variable is household income, adjusted for household size and split into quintiles, calculating the quintile limits for each country separately. Information on age, sex, self assessed health and chronic disease is included as well. Logistic regression models were used for the multivariate analyses. Results The overall level of forgone care differs considerably between the five countries (e.g. about 10 percent in Greece and 6 percent in Sweden. Low income groups report forgone care more often than high income groups. This association can also be found in analyses restricted to the subsample of persons with chronic disease. Associations between forgone care and income are particularly strong in Germany and Greece. Taking the example of Germany, forgone care in the lowest income quintile is 1.98 times (95% CI: 1.08–3.63 as high as in the highest income quintile. Conclusion Forgone care should be reduced even if it is not justified by an 'objective' need for health care, as it could be an independent stressor in its own right, and as patient satisfaction is a strong predictor of compliance. These efforts should focus on population groups with particularly high

  12. Care arrangements for community-dwelling people with dementia in Germany as perceived by informal carers - a cross-sectional pilot survey in a provincial-rural setting.

    Science.gov (United States)

    von Kutzleben, Milena; Reuther, Sven; Dortmann, Olga; Holle, Bernhard

    2016-05-01

    The majority of people with dementia live at home, and informal carers assume the role of key care providers, often supported by formal services. The purpose of this pilot study was to assess home-based care arrangements, to illustrate utilisation of formal services over time and to identify factors associated with perceived stability of the care situation from the informal carer's perspective. A self-administered questionnaire (D-IVA 'Instrument for Assessing Home-Based Care Arrangements for People with Dementia') was developed and distributed in a provincial-rural setting in Germany as a cross-sectional survey. Data analysis used descriptive statistics, unbiased conditional inference trees and thematic analysis for open-ended questions. In total, 84 care arrangements were assessed. The majority of participants were direct relatives of the care-dependent person [mostly adult children (48.8%) or spouses (27.4%)]. Formal services were already sought in the first year after onset of memory problems. The most frequently used formal services were home care nursing services (53.0%), day care (49.4%) and respite care (29.6%), whereas 15.5% did not use any type of formal support. Companion home visit, home care nursing service and day care were used over the longest periods of time. The recruitment strategy used in this study may have recruited persons who were relatively more dependent on their informal carers. In this small sample, carers' perceived stability of the care situation was high, and this was associated with the country of origin and sex of the person with dementia (P = 0.004 and 0.023 respectively). Most care arrangements consisted of a mix of informal and formal services. However, informal carers assumed prime responsibility. The questionnaire D-IVA proved to be suitable. It remains a challenge to further examine factors associated with perceived stability and to explain the phenomenon in its whole complexity. Further research using the D-IVA should

  13. Use of a population-based survey to determine incidence of AIDS-defining opportunistic illnesses among HIV-positive persons receiving medical care in the United States

    Directory of Open Access Journals (Sweden)

    Sullivan Patrick S

    2007-09-01

    Full Text Available Abstract Background Diagnosis of an opportunistic illness (OI in a person with HIV infection is a sentinel event, indicating opportunities for improving diagnosis of HIV infection and secondary prevention efforts. In the past, rates of OIs in the United States have been calculated in observational cohorts, which may have limited representativeness. Methods We used data from a 1998 population-based survey of persons in care for HIV infection to demonstrate the utility of population-based survey data for the calculation of OI rates, with inference to populations in care for HIV infection in three geographic areas: King County Washington, selected health districts in Louisiana, and the state of Michigan. Results The overall OI rate was 13.8 per 100 persons with HIV infection in care during 1998 (95% CI, 10.2–17.3. In 1998, an estimated 11.3% of all persons with HIV in care in these areas had at least one OI diagnosis (CI, 8.8–13.9. The most commonly diagnosed OIs were Pneumocystis jiroveci pneumonia (PCP (annual incidence 2.4 per 100 persons, CI 1.0–3.8 and cytomegalovirus retinitis (annual incidence 2.4 per 100 persons, CI 1.0–3.7. OI diagnosis rates were higher in Michigan than in the other two geographic areas, and were different among patients who were white, black and of other races, but were not different by sex or history of injection drug use. Conclusion Data from population-based surveys – and, in the coming years, clinical outcomes surveillance systems in the United States – can be used to calculate OI rates with improved generalizability, and such rates should be used in the future as a meaningful indicator of clinical outcomes in persons with HIV infection in care.

  14. The association between types of regular primary care and hospitalization among people with and without multimorbidity: A household survey on 25,780 Chinese

    Science.gov (United States)

    Chung, Roger Y.; Mercer, Stewart W.; Yip, Benjamin H. K.; Chan, Stephanie W. C.; Lai, Francisco T. T.; Wang, Harry H. X.; Wong, Martin C. S.; Wong, Carmen K. M.; Sit, Regina W. S.; Yeoh, Eng-Kiong; Wong, Samuel Y. S.

    2016-01-01

    Using data collected from 25,780 Hong Kong citizens in a household survey, this study aimed to investigate the association between having regular source of primary care and hospitalization amongst people with and without multimorbidity (two or more chronic conditions). Potential interaction effects of regular primary care with multimorbidity were also examined. Results revealed a significant association between having regular source of primary care from General Practitioners and reduced hospitalization amongst respondents with multimorbidity (RR = 0.772; 95% CI = 0.667–0.894), adjusting for other potential confounding factors (i.e., socio-demographic factors and medical insurance and benefits). In contrast, having regular Specialist care was significantly associated with increased risk of hospitalization among both people with multimorbidity (RR = 1.619; 95% CI = 1.256–2.087) and without multimorbidity (RR = 1.981; 95% CI = 1.246–3.149), adjusting for potential confounders. A dose-response relationship between the number of chronic diseases and hospitalization was also observed, regardless of whether participants had regular source of primary care or not; relative risks and predicted probabilities for hospitalization were generally greater for those without regular source of primary care. Further studies are warranted to explore the role of healthcare system, informatics, organizational and practice-related factors on healthcare and functional outcomes. PMID:27435519

  15. Is patient satisfaction in primary care dependent on structural and organizational characteristics among providers? Findings based on data from the national patient survey in Sweden.

    Science.gov (United States)

    Glenngård, Anna H

    2013-07-01

    In parallel to market-like reforms in Swedish primary care, the gathering and compilation of comparative information about providers, for example through survey tools, has been improved. Such information is increasingly being used to guide individuals' choice of provider and payers' assessments of provider performance, often without critically reflecting about underlying factors affecting the results. The purpose of this study was to analyze variation in patient satisfaction, with respect to organizational and structural factors, including the mix of registered individuals, among primary care providers, based on information from a national patient survey in primary care and register data in three Swedish county councils. Systematic variation in patient satisfaction was found with respect to both organizational and structural factors, including characteristics of registered individuals. Smaller practices and practices where a high proportion of all visits were with a doctor were associated with higher patient satisfaction. Also practices where registered individuals had a low level of social deprivation and a high overall illness on average were associated with higher patient satisfaction. Factors that are of relevance for how well providers perform according to patient surveys are more or less possible to control for providers. This adds to the complexity for the use of such information by individuals and payers to assess provider performance. PMID:23040560

  16. Barriers to home care for terminally ill Turkish and Moroccan migrants, perceived by GPs and nurses: a survey

    Directory of Open Access Journals (Sweden)

    de Graaff Fuusje M

    2009-01-01

    Full Text Available Abstract Background Previous qualitative research proved that relatives of elderly terminally ill Turkish and Moroccan immigrants experience several barriers to the use of Dutch professional home care. The aim of this study was to explore how general practitioners and home care nurses perceive the home care for terminally ill Turkish and Moroccan migrants and their families in the Netherlands. Methods Questionnaires were sent to home care organizations and GPs working in areas where most of these migrants are living. 93 nurses and 78 GPs provided information about their experiences and opinions regarding home care for this group of patients. The data were analyzed by descriptive statistics. Results GPs refer relatively few patients from these migrant groups to home care. They often find it difficult to assess the needs of these patients and their families. In 40% of the GPs' cases in which terminally ill Turkish and Moroccan migrants were not referred to home care, the GP regretted this afterwards: the patients had not received sufficient qualified care, and their informal carers had often become overburdened. In addition, home care nurses often express dissatisfaction with the home care given to terminally ill Turkish or Moroccan patients, because of communication problems, the patients' lack of knowledge of the disease, or difficulties in making suitable appointments with the patient or with the family. Conclusion Nurses and GPs cite chiefly similar factors influencing access to and use of home care as family members did in a previous study. However, according to GPs and nurses, the main barrier to the use of home care concerns communication problems, while relatives cited the preference for family care as the main reason for abstaining from the use of home care.

  17. The importance of job characteristics in determining medical care-seeking in the Dutch working population, a longitudinal survey study

    Directory of Open Access Journals (Sweden)

    Steenbeek Romy

    2012-08-01

    Full Text Available Abstract Background The working population is ageing, which will increase the number of workers with chronic health complaints, and, as a consequence, the number of workers seeking health care. It is very important to understand factors that influence medical care-seeking in order to control the costs. I will investigate which work characteristics independently attribute to later care-seeking in order to find possibilities to prevent unnecessary or inefficient care-seeking. Methods Data were collected in a longitudinal two-wave study (n = 2305 workers. The outcome measures were visits (yes/no and frequency to a general practitioner (GP, a physical therapist, a medical specialist and/or a mental health professional. Multivariate regression analyses were carried out separately for men and women for workers with health complaints. Results In the Dutch working population, personal, health, and work characteristics, but not sickness absence, were associated with later care-seeking. Work characteristics independently attributed to medical care-seeking but only for men and only for the frequency of visits to the GP. Women experience more health complaints and seek health care more often than men. For women, experiencing a work handicap (health complaints that impede work performance was the only work characteristic associated with more care-seeking (GP. For men, work characteristics that led to less care-seeking were social support by colleagues (GP frequency, high levels of decision latitude (GP frequency and high levels of social support by the supervisor (medical specialist. Other work characteristics led to more care-seeking: high levels of engagement (GP, full time work (GP frequency and experiencing a work handicap (physical therapist. Conclusions We can conclude that personal and health characteristics are most important when explaining medical care-seeking in the Dutch working population. Work characteristics independently attributed to

  18. "When it's just me at home, it hits me that I'm completely alone": an online survey of adolescents in self-care.

    Science.gov (United States)

    Ruiz-Casares, Mónica

    2012-01-01

    The present study examined adolescents' experiences of loneliness and solitude in their responses to an online survey on self-care. Both quantitative (n = 272) and qualitative (n = 150) responses were coded for these feelings when home alone. Results indicate that adolescents experience the duality of aloneness, including both positive solitude and negative loneliness. Adolescents' responses range from embraced solitude and self-care to feelings of loneliness and rejection of time by themselves. Adolescents reporting loneliness were significantly less likely to enjoy being home alone during the day and at night (p < or = .001). Also, gender, age, and emotions such as fear, boredom, and separation anxiety are associated with loneliness among adolescents in self-care. Interventions to increase connectedness and combat loneliness during out-of-school hours are recommended. PMID:22303617

  19. Patterns of care in patients with cervical cancer 2012. Results of a survey among German radiotherapy departments and out-patient health care centers

    Energy Technology Data Exchange (ETDEWEB)

    Marnitz, S.; Rauer, A.; Budach, V. [Charite Universitaetsmedizin, Department of Radiooncology, Berlin (Germany); Koehler, C.; Schneider, A.; Mangler, M. [Charite Universitaetsmedizin, Department of Gynecology, Berlin (Germany); Tsunoda, A. [Barretos Cancer Centre, Department of Gynecologic Oncology, Barretos (Brazil)

    2014-01-15

    Platinum-based primary or adjuvant chemoradiation is the treatment of choice for patients with cervical cancer. However, despite national guidelines and international recommendations, many aspects in diagnosis, therapy, and follow-up of patients with cervical cancer are not based on valid data. To evaluate the current patterns of care for patients with cervical cancer in Germany, a questionnaire with 25 items was sent to 281 radiooncologic departments and out-patient health care centers. The response rate was 51 %. While 87 % of institutions treat 0-25 patients/year, 12 % treat between 26 and 50 and only 1 % treat more than 50 patients/year. In 2011, the stage distribution of 1,706 treated cervical cancers were IB1, IB2, IIA, IIB, IIIA/IIIB, and IV in 11, 12, 11, 22, 28, and 16 %, respectively. CT (90 %) and MRI (86 %) are mainly used as staging procedures in contrast to PET-CT with 14 %. Interestingly, 27 % of institutions advocate surgical staging prior to chemoradiation. In the majority of departments 3D-based (70 %) and intensity-modulated radiotherapy (76 %) are used for percutaneous radiation, less frequently volumetric arc techniques (26 %). Nearly all colleagues (99.3 %) apply conventional fractioning of 1.8-2 Gy for external-beam radiotherapy, in 19 % combined with a simultaneous integrated boost. Cisplatinum mono is used as a radiosensitizer with 40 mg/m{sup 2} weekly by 90 % of radiooncologists. For boost application in the primary treatment, HDR (high-dose rate) brachytherapy is the dominant technique (84 %). In patients after radical hysterectomy pT1B1/1B2, node negative and resection in sound margins adjuvant chemoradiation is applied due to the occurrence of 1-4 other risk factors in 16-97 %. There is a broad spectrum of recommended primary treatment strategies in stages IIB and IVA. Results of the survey underline the leading role but also differences in the use of chemoradiation in the treatment of cervical cancer patients in Germany. (orig

  20. Survey and analysis in eye care of ICU critical patients%ICU危重患者实施眼部护理状况的调查分析

    Institute of Scientific and Technical Information of China (English)

    龚晓琪; 刘红波; 黄淑萍; 张海燕; 魏华丽

    2010-01-01

    Objective To describe and explore the practice of eye care in ICU,in order to make a specified training plan and guideline on eye care,and to improve the skill in eye care of ICU nurses. Methods A survey was conducted in 92 ICU nurses from 2 general hospitals in Huizhou city with non-random sampling using a self- made questionnaire to investigate their eye care of patients. Results The nursing practice of eye care in ICU was urged to be improved,there was no standard on eye care. Conclusions The knowledge of ICU nurses needs to be enhanced,and guideline on eye care is urged to be worked out,so that practice of eye care would be improved.%目的 了解与探讨ICU护士对危重患者眼部护理实施情况,进而有针对性制订培训方案与眼部护理指南,以提高护士对危重患者眼部护理的技能水平.方法 采用自行设计问卷,应用非随机取样法对本市2所综合医院92名ICU护士进行问卷调查,了解其对ICU危重患者实施眼部护理状况.结果 ICU护士对危重患者眼部护理实施情况不容乐观,缺乏统一标准.结论 应加强ICU护士专业理论知识培训学习,制订眼部护理指南,从而全面提高对危重患者的眼部护理水平.

  1. The Patterns of Care Survey of radiation therapy in localized prostate cancer: Similarities between the practice nationally and in minority-rich areas

    International Nuclear Information System (INIS)

    Purpose: Over the last two decades, the chance for the cure of localized prostate cancer by radiation has been improved by the widespread use of PSA for early detection and by a number of technical advances in treatment delivery. This study was designed to determine whether the stage of presentation and the quality of radiation treatment delivered are comparable between Caucasian and minority patients nationally and within minority-rich areas. Methods and Materials: A random survey conducted for the Patterns of Care Study in Radiation Oncology of 80 facilities treating patients with radiation in the USA. Of these, 67 comprise the 'National Survey' and 13 a 'Minority-Rich' survey (>40% of treated patients are minorities). Nine hundred twenty-six men with localized prostate cancer were treated in 1994. Five hundred ninety-five were in the national and 331 in the minority-rich survey. The main outcome measures were the clinical features of Caucasian and minority men at presentation and technical characteristics of the treatment delivered to them. Results: African-American men presented with more advanced disease (higher-presenting PSA and T-stage) than Caucasians in both the national and the minority-rich surveys. Hispanics also presented with later disease and could be grouped with African-American men rather than Caucasians. Overall the stage and PSA at presentation was earlier than seen in the previous Patterns of Care Study survey of 1989. The quality of treatment delivered has improved since 1989, with no distinction seen between those facilities sampled nationally and those within minority-rich areas. Conclusion: African-American and Hispanic men with prostate cancer present for therapy at a later stage than Caucasian men, but when they do, the treatment received is of comparable quality

  2. Physicians’ attitudes towards office-based delivery of methadone maintenance therapy: results from a cross-sectional survey of Nova Scotia primary-care physicians

    Directory of Open Access Journals (Sweden)

    Dooley Jessica

    2012-06-01

    Full Text Available Abstract Background Approximately 90,000 Canadians use opioids each year, many of whom experience health and social problems that affect the individual user, families, communities and the health care system. For those who wish to reduce or stop their opioid use, methadone maintenance therapy (MMT is effective and supporting evidence is well-documented. However, access and availability to MMT is often inconsistent, with greater inequity outside of urban settings. Involving community based primary-care physicians in the delivery of MMT could serve to expand capacity and accessibility of MMT programs. Little is known, however, about the extent to which MMT, particularly office-based delivery, is acceptable to physicians. The aim of this study is to survey physicians about their attitudes towards MMT, particularly office-based delivery, and the perceived barriers and facilitators to MMT delivery. Methods In May 2008, facilitated by the College of Physicians and Surgeons of Nova Scotia, a cross-sectional, e-mail survey of 950 primary-care physicians practicing in Nova Scotia, Canada was administered via the OPINIO on-line survey software, to assess the acceptability of office-based MMT. Logistic regressions, adjusted for physician sociodemographic characteristics, were used to examine the association between physicians’ willingness to participate in office-based MMT, and a series of measures capturing physician attitudes and knowledge about treatment approaches, opioid use, and methadone, as well as perceived barriers to MMT. Results Overall, 19.8% of primary-care physicians responded to the survey, with 56% who indicated that they would be willing to be involved in MMT under current or similar circumstances; however, willingness was associated with numerous attitudinal and systemic factors. The barriers to involvement in MMT that were frequently cited included a lack of training or experience in MMT, lack of support services, and potential

  3. Health care seeking behavior for diarrhea in children under 5 in rural Niger: results of a cross-sectional survey.

    OpenAIRE

    Djibo Ali; Luquero Francisco J; Hustache Sarah; Page Anne-Laure; Manzo Mahamane; Grais Rebecca F

    2011-01-01

    Abstract Background Diarrhea remains the second leading cause of death in children under 5 years of age in sub-Saharan Africa. Health care seeking behavior for diarrhea varies by context and has important implications for developing appropriate care strategies and estimating burden of disease. The objective of this study was to determine the proportion of children under five with diarrhea who consulted at a health structure in order to identify the appropriate health care levels to set up sur...

  4. The use of paediatric artemisinin combinations in sub-Saharan Africa: a snapshot questionnaire survey of health care personnel

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    Agnandji Selidji T

    2011-12-01

    Full Text Available Abstract Background Paediatric drug formulations for artemisinin combination therapy (P-ACT have been developed over the past few years and have been shown to improve the therapeutic management of young children with uncomplicated falciparum malaria. This process was however not equally paralleled by a timely adoption of P-ACT in national and international treatment recommendations. National malaria programmes in sub-Saharan Africa have not yet widely embraced this new therapeutic tool. To which extent P-ACT is used in the field in sub-Saharan Africa is not known to date. Methods This snapshot questionnaire survey aimed to provide an overview on the current routine practices for the availability and use of P-ACT as anti-malarial treatment for young children in sub-Saharan Africa. Health care personnel in seven countries in West-, Central, and East-Africa were invited to answer a structured questionnaire assessing use and availability of P-ACT. Results A total of 71 respondents including doctors, nurses and pharmacy personnel responsible for the anti-malarial treatment of young children were interviewed. P-ACT was used by 83% (95% confidence interval: 73-90%; n = 59 as first-line treatment for young children. Use of 15 different P-ACT products was reported among which only two have received WHO prequalification status and approval by a stringent registration authority. Use of a specific P-ACT product was not linked to consumer prices or availability of supporting clinical trial data, but may depend more on the marketing capacity of the manufacturer. Major differences in frequency and dosing of anti-malarial regimens with identical anti-malarial compounds and the marketing of loose combinations were recorded. Conclusion Paediatric ACT is widely used for the treatment of uncomplicated malaria in young children. However, the majority of P-ACT formulations in use do not meet highest international quality standards evoking concerns for patients

  5. Awareness of the Food and Drug Administration's Bad Ad Program and Education Regarding Pharmaceutical Advertising: A National Survey of Prescribers in Ambulatory Care Settings.

    Science.gov (United States)

    O'Donoghue, Amie C; Boudewyns, Vanessa; Aikin, Kathryn J; Geisen, Emily; Betts, Kevin R; Southwell, Brian G

    2015-01-01

    The U.S. Food and Drug Administration's Bad Ad program educates health care professionals about false or misleading advertising and marketing and provides a pathway to report suspect materials. To assess familiarity with this program and the extent of training about pharmaceutical marketing, a sample of 2,008 health care professionals, weighted to be nationally representative, responded to an online survey. Approximately equal numbers of primary care physicians, specialists, physician assistants, and nurse practitioners answered questions concerning Bad Ad program awareness and its usefulness, as well as their likelihood of reporting false or misleading advertising, confidence in identifying such advertising, and training about pharmaceutical marketing. Results showed that fewer than a quarter reported any awareness of the Bad Ad program. Nonetheless, a substantial percentage (43%) thought it seemed useful and 50% reported being at least somewhat likely to report false or misleading advertising in the future. Nurse practitioners and physician assistants expressed more openness to the program and reported receiving more training about pharmaceutical marketing. Bad Ad program awareness is low, but opportunity exists to solicit assistance from health care professionals and to help health care professionals recognize false and misleading advertising. Nurse practitioners and physician assistants are perhaps the most likely contributors to the program. PMID:26176326

  6. What are patient factors associated with the quality of diabetes care?: results from the Korean National Health and Nutrition Examination Survey

    Directory of Open Access Journals (Sweden)

    Ko Ki

    2012-08-01

    Full Text Available Abstract Background Recently there has been a growing interest in healthcare quality control in Korea. We examined the association between patient factors and quality indicators of diabetic care among Korean adults with diabetes. Methods We obtained a sample of 335 adults aged 20 or older diagnosed with diabetes from the 2005 Korean National Health and Nutrition Examination Survey. Patient factors were divided into two categories: socioeconomic position and health-related factors. Quality indicators for diabetes care were defined as receiving preventive care services for diabetes complications (e.g., fundus examination, microalbuminuria examination, diabetes education and diabetes-related clinical outcomes (e.g., HbA1c, blood pressure, LDL-cholesterol. We performed multiple logistic regression analyses for each quality indicator. Results We found that people with lower education levels or shorter duration of diabetes illness were less likely to receive preventive care services for diabetes complications. Women or people with longer duration of diabetes were less likely to reach the glycemic target. Obese diabetic patients were less likely to accomplish adequate control of blood pressure and LDL-cholesterol. Conclusions Several factors of patients with diabetes, such as education level, duration of illness, gender, and obesity grade are associated with the quality of diabetes care. These findings can help inform policy makers about subpopulations at risk in developing a public health strategy in the future.

  7. Factors associated with underutilization of antenatal care services in Indonesia: results of Indonesia Demographic and Health Survey 2002/2003 and 2007

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    Titaley Christiana R

    2010-08-01

    Full Text Available Abstract Background Antenatal care aims to prevent maternal and perinatal mortality and morbidity. In Indonesia, at least four antenatal visits are recommended during pregnancy. However, this service has been underutilized. This study aimed to examine factors associated with underutilization of antenatal care services in Indonesia. Methods We used data from Indonesia Demographic and Health Survey (IDHS 2002/2003 and 2007. Information of 26,591 singleton live-born infants of the mothers' most recent birth within five years preceding each survey was examined. Twenty-three potential risk factors were identified and categorized into four main groups, external environment, predisposing, enabling, and need factors. Logistic regression models were used to examine the association between all potential risk factors and underutilization of antenatal services. The Population Attributable Risk (PAR was calculated for selected significant factors associated with the outcome. Results Factors strongly associated with underutilization of antenatal care services were infants from rural areas and from outer Java-Bali region, infants from low household wealth index and with low maternal education level, and high birth rank infants with short birth interval of less than two years. Other associated factors identified included mothers reporting distance to health facilities as a major problem, mothers less exposed to mass media, and mothers reporting no obstetric complications during pregnancy. The PAR showed that 55% of the total risks for underutilization of antenatal care services were attributable to the combined low household wealth index and low maternal education level. Conclusions Strategies to increase the accessibility and availability of health care services are important particularly for communities in rural areas. Financial support that enables mothers from poor households to use health services will be beneficial. Health promotion programs targeting

  8. Models of inter professional working for older people living at home: a survey and review of the local strategies of english health and social care statutory organisations

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    Goodman Claire

    2011-12-01

    Full Text Available Abstract Background Most services provided by health and social care organisations for older people living at home rely on interprofessional working (IPW. Although there is research investigating what supports and inhibits how professionals work together, less is known about how different service models deliver care to older people and how effectiveness is measured. The aim of this study was to describe how IPW for older people living at home is delivered, enacted and evaluated in England. Method An online survey of health and social care managers across England directly involved in providing services to older people, and a review of local strategies for older people services produced by primary care organisations and local government adult services organisations in England. Results The online survey achieved a 31% response rate and search strategies identified 50 local strategies that addressed IPW for older people living at home across health and social care organisations. IPW definitions varied, but there was an internal consistency of language informed by budgeting and organisation specific definitions of IPW. Community Services for Older People, Intermediate Care and Re-enablement (rehabilitation Teams were the services most frequently identified as involving IPW. Other IPW services identified were problem or disease specific and reflected issues highlighted in local strategies. There was limited agreement about what interventions or strategies supported the process of IPW. Older people and their carers were not reported to be involved in the evaluation of the services they received and it was unclear how organisations and managers judged the effectiveness of IPW, particularly for services that had an open-ended commitment to the care of older people. Conclusion Health and social care organisations and their managers recognise the value and importance of IPW. There is a theoretical literature on what supports IPW and what it can achieve

  9. Improving year-end transfers of care in academic ambulatory clinics: a survey of pediatric resident physician perceptions

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    Carlos F. Lerner

    2012-05-01

    Full Text Available Background: In resident primary care continuity clinics, at the end of each academic year, continuity of care is disrupted when patients cared for by the graduating class are redistributed to other residents. Yet, despite the recent focus on the transfers of care between resident physicians in inpatient settings, there has been minimal attention given to patient care transfers in academic ambulatory clinics. We sought to elicit the views of pediatric residents regarding year-end patient handoffs in a pediatric resident continuity clinic.Methods: Residents assigned to a continuity clinic of a large pediatric residency program completed a questionnaire regarding year-end transfers of care.Results: Thirty-one questionnaires were completed out of a total 45 eligible residents (69% response. Eighty seven percent of residents strongly or somewhat agreed that it would be useful to receive a written sign-out for patients with complex medical or social issues, but only 35% felt it would be useful for patients with no significant issues. Residents more frequently reported having access to adequate information regarding their new patients’ medical summary (53% and care plan (47% than patients’ functional abilities (30%, social history (17%, or use of community resources (17%. When rating the importance of receiving adequate sign-out in each those domains, residents gave most importance to the medical summary (87% of residents indicating very or somewhat important and plan of care (84%. Residents gave less importance to receiving sign-out regarding their patients’ functional abilities (71% social history (58%, and community resources (58%. Residents indicated that lack of access to adequate patient information resulted in additional work (80%, delays or omissions in needed care (56%, and disruptions in continuity of care (58%.Conclusions: In a single-site study, residents perceive that they lack adequate information during year-end patient transfers

  10. Survey on radiotherpy protocols for the rectal cancers among the Korean radiation oncologists in 2002 for the development of the patterns of care study of radiation therapy

    International Nuclear Information System (INIS)

    To conduct a nationwide survey on the principles in radiotherapy for rectal cancer, and develop the framework of a database of Korean Patterns of Care Study. A consensus committee was established to develop a tool for measuring the patterns in radiotherapy protocols for rectal cancer. The panel was composed of radiation oncologists from 18 hospitals in Seoul Metropolitan area. The committee developed a survey format to analyze radiation oncologist's treatment principles for rectal cancer. The survey items developed for measuring the treatment principles were composed of 1) 8 eligibility criteria, 2) 20 items for staging work-ups and prognostic factors, 3) 7 items for principles of combined surgery and chemotherapy, 4) 9 patient set-ups, 5) 19 determining radiation fields, 6) 5 radiotherapy treatment plans, 7) 4 physical/laboratory examination to monitor a patient's condition during treatment, and 8) 10 follow-up evaluations. These items were sent to radiation oncologists in charge of gastrointestinal malignancies in all hospitals (48 hospitals) in Korea to which 30 replies were received (63%). Most of the survey items were replied to without no major differences between the repliers, but with the following items only 50% of repliers were in agreement : 1) indications of preoperative radiation, 2) use of endorectal ultrasound, CT scan, and bone scan for staging work-ups, 3) principles of combining chemotherapy with radiotherapy, 4) use of contrast material for small bowel delineation during simulation, 5) determination of field margins, and 6) use of CEA and colonoscopy for follow-up evaluations. The items where considerable disagreement was shown among the radiation oncologists seemed to make no serious difference in the treatment outcome, but a practical and reasonable consensus should be reached by the committee, with logical processes of agreement. These items can be used for a basic database for the Patterns of Care Study, which will survey the practical

  11. New Zealand Medical Students Have Positive Attitudes and Moderate Confidence in Providing Nutrition Care: A Cross-Sectional Survey

    Directory of Open Access Journals (Sweden)

    Jennifer Crowley

    2015-01-01

    Full Text Available Throughout the world, medical students and doctors report inadequate nutrition education and subsequently lack of knowledge, attitude, and skills to include nutrition in patient care. This study described New Zealand’s students’ attitudes to and self-perceived skills in providing nutrition care in practice as well as perceived quantity and quality of nutrition education received in training. 183 medical students from New Zealand’s largest medical school (response rate 52% completed a 65-item questionnaire, partially validated, using 5-point Likert scales. Students believed incorporating nutrition care into practice is important, yet they were less confident patients improve nutrition behaviours after receiving this care. Students were confident in skills related to nutrition in health and disease but less confident in skills related to general food knowledge. Greater quantity and quality of nutrition education received was associated with greater self-perceived skills in providing nutrition care to patients but not with attitudes towards incorporating nutrition care into practice. This cohort of New Zealand medical students places similarly high importance on nutrition care as students and doctors from other countries. Further investigations beyond graduation are required to inform whether additional nutrition education is warranted for these doctors.

  12. Emerging organisational models of primary healthcare and unmet needs for care: insights from a population-based survey in Quebec province

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    Levesque Jean-Frédéric

    2012-07-01

    Full Text Available Abstract Background Reform of primary healthcare (PHC organisations is underway in Canada. The capacity of various types of PHC organizations to respond to populations’ needs remains to be assessed. The main objective of this study was to evaluate the association of PHC affiliation with unmet needs for care. Methods Population-based survey of 9205 randomly selected adults in two regions of Quebec, Canada. Outcomes Self-reported unmet needs for care and identification of the usual source of PHC. Results Among eligible adults, 18 % reported unmet needs for care in the last six months. Reasons reported for unmet needs were: waiting times (59 % of cases; unavailability of usual doctor (42 %; impossibility to obtain an appointment (36 %; doctors not accepting new patients (31 %. Regression models showed that unmet needs were decreasing with age and was lower among males, the least educated, and unemployed or retired. Controlling for other factors, unmet needs were higher among the poor and those with worse health status. Having a family doctor was associated with fewer unmet needs. People reporting a usual source of care in the last two-years were more likely to report unmet need for care. There were no differences in unmet needs for care across types of PHC organisations when controlling for affiliation with a family physician. Conclusion Reform models of primary healthcare consistent with the medical home concept did not differ from other types of organisations in our study. Further research looking at primary healthcare reform models at other levels of implementation should be done.

  13. Knowledge, Attitudes and Beliefs about Chronic Noncancer Pain in Primary Care: a Canadian Survey of Physicians and Pharmacists

    OpenAIRE

    Lyne Lalonde; Vincent Leroux-Lapointe; Manon Choinière; Elisabeth Martin; David Lussier; Djamal Berbiche; Diane Lamarre; Robert Thiffault; Ghaya Jouini; Sylvie Perreault

    2014-01-01

    BACKGROUND: Primary care providers’ knowledge, attitudes and beliefs (KAB) regarding chronic noncancer pain (CNCP) are a barrier to optimal management. OBJECTIVES: To evaluate and identify the determinants of the KAB of primary care physicians and pharmacists, and to document clinician preferences regarding the content and format of a continuing education program (CEP). METHOD: Physicians and pharmacists of 486 CNCP patients participated. Physicians completed the original version of the KnowP...

  14. Assessing predictors of delayed antenatal care visits in Rwanda: a secondary analysis of Rwanda demographic and health survey 2010

    OpenAIRE

    Manzi, Anatole; Munyaneza, Fabien; Mujawase, Francisca; Banamwana, Leonidas; Sayinzoga, Felix; Thomson, Dana R; Ntaganira, Joseph; Hedt-Gauthier, Bethany L

    2014-01-01

    Background Early initiation of antenatal care (ANC) can reduce common maternal complications and maternal and perinatal mortality. Though Rwanda demonstrated a remarkable decline in maternal mortality and 98% of Rwandan women receive antenatal care from a skilled provider, only 38% of women have an ANC visit in their first three months of pregnancy. This study assessed factors associated with delayed ANC in Rwanda. Methods This is a cross-sectional study using data collected during the 2010 R...

  15. Assessing predictors of delayed antenatal care visits in Rwanda: a secondary analysis of Rwanda demographic and health survey 2010

    OpenAIRE

    Manzi, Anatole; Munyaneza, Fabien; Mujawase, Francisca; Banamwana, Leonidas; Sayinzoga, Felix; Thomson, Dana R; Ntaganira, Joseph; Hedt-Gauthier, Bethany L

    2014-01-01

    Background: Early initiation of antenatal care (ANC) can reduce common maternal complications and maternal and perinatal mortality. Though Rwanda demonstrated a remarkable decline in maternal mortality and 98% of Rwandan women receive antenatal care from a skilled provider, only 38% of women have an ANC visit in their first three months of pregnancy. This study assessed factors associated with delayed ANC in Rwanda. Methods: This is a cross-sectional study using data collected during the 2010...

  16. The Relative Impacts of Design Effects and Multiple Imputation on Variance Estimates: A Case Study with the 2008 National Ambulatory Medical Care Survey

    Directory of Open Access Journals (Sweden)

    Lewis Taylor

    2014-03-01

    Full Text Available The National Ambulatory Medical Care Survey collects data on office-based physician care from a nationally representative, multistage sampling scheme where the ultimate unit of analysis is a patient-doctor encounter. Patient race, a commonly analyzed demographic, has been subject to a steadily increasing item nonresponse rate. In 1999, race was missing for 17 percent of cases; by 2008, that figure had risen to 33 percent. Over this entire period, single imputation has been the compensation method employed. Recent research at the National Center for Health Statistics evaluated multiply imputing race to better represent the missing-data uncertainty. Given item nonresponse rates of 30 percent or greater, we were surprised to find many estimates’ ratios of multiple-imputation to single-imputation estimated standard errors close to 1. A likely explanation is that the design effects attributable to the complex sample design largely outweigh any increase in variance attributable to missing-data uncertainty.

  17. 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

  18. Paediatric intensive care admissions for respiratory syncytial virus bronchiolitis in France: results of a retrospective survey and evaluation of the validity of a medical information system programme.

    Science.gov (United States)

    Soilly, A-L; Ferdynus, C; Desplanches, O; Grimaldi, M; Gouyon, J B

    2012-04-01

    The purpose of this study was to describe the characteristics of patients with bronchiolitis admitted to a paediatric intensive care unit (PICU), and to evaluate a national registry of hospitalizations (Programme de Médicalisation des Systèmes d'Information; PMSI) as a potential source of epidemiological data. Of the 49 French PICUs invited to take part in a retrospective survey of children aged PMSI data was good only for mechanical ventilation (0·63) and the death rate (0·86). PMID:21733254

  19. Burden of menstrual symptoms in Japanese women – an analysis of medical care-seeking behavior from a survey-based study

    Directory of Open Access Journals (Sweden)

    Tanaka E

    2013-12-01

    Full Text Available Erika Tanaka,1 Mikio Momoeda,2 Yutaka Osuga,3 Bruno Rossi,4 Ken Nomoto,5 Masakane Hayakawa,5 Kinya Kokubo,6 Edward CY Wang1 1Health Economics and Outcomes Research, Bayer Yakuhin Ltd, Tokyo, Japan; 2Department of Integrated Women's Health, St Luke's International Hospital, Tokyo, Japan; 3Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan; 4Market Access, Bayer Yakuhin Ltd, Osaka, Japan; 5Medical Affairs Women's Health and Dermatology, Bayer Yakuhin Ltd, Osaka, Japan; 6Consumer Goods/Service and Healthcare Industry Consulting Department, Nomura Research Institute, Tokyo, Japan Background: Menstrual symptoms are associated with various health problems in women of reproductive age, and this may impact their quality of life. Despite this, Japanese women are likely to hesitate seeking a specialist's medical help for their menstrual symptoms. Purpose: To study subject parameters including symptom severity, gynecological disorders, and treatments in medical care-seeking women (outpatient and women opting for self-care (nonvisit, to identify reasons why Japanese women do not see a gynecologist, and to document the benefit of gynecologist visits by assessing the impact on women's daily lives. Methods: Two online surveys were conducted among women aged 15–49 years. Sampling was structured to approximate the age and geographic distribution in Japan. Results of the first survey and part of the second survey on the overall current burden of menstrual symptoms are reported in a separate publication. Further outcomes from the second survey reported in this paper included data from the outpatient (n=274 and nonvisit (n=500 groups on symptom severity, gynecological disorders, medical treatment use, reasons for not seeking medical care, and the improvement of daily life. Results: The outpatient group tended to have greater symptom severity compared to the nonvisit group. Uterine fibroids, dysmenorrhea

  20. Hospital-acquired infection rate in a tertiary care teaching hospital in China: a cross-sectional survey involving 2434 inpatients

    OpenAIRE

    Xiu-Bin Tao; Li-Hua Qian; Yan Li; Qun Wu; Jing-Jing Ruan; Dong-Zhen Cai; Hui Peng

    2014-01-01

    A single-day hospital-acquired infections (HAIs) point prevalence study was conducted in a tertiary care hospital in China. The overall prevalence rate of HAIs was 3.53% (95% confidence interval 2.80–4.26%) among 2434 inpatients surveyed. Respiratory system infection was the most common type of HAI (49.43%), followed by surgical site infection (22.99%). The pathogen detection results for 50 patients showed Pseudomonas aeruginosa to account for 24.00% of isolates, followed by Klebsiella pneumo...

  1. Hospital-acquired infection rate in a tertiary care teaching hospital in China: a cross-sectional survey involving 2434 inpatients

    Directory of Open Access Journals (Sweden)

    Xiu-Bin Tao

    2014-10-01

    Full Text Available A single-day hospital-acquired infections (HAIs point prevalence study was conducted in a tertiary care hospital in China. The overall prevalence rate of HAIs was 3.53% (95% confidence interval 2.80–4.26% among 2434 inpatients surveyed. Respiratory system infection was the most common type of HAI (49.43%, followed by surgical site infection (22.99%. The pathogen detection results for 50 patients showed Pseudomonas aeruginosa to account for 24.00% of isolates, followed by Klebsiella pneumoniae (14.00% and Escherichia coli (14.00%.

  2. Readiness of hospital-based internists to embrace and discuss high-value care with patients and family members: a single-centre cross-sectional survey study

    Science.gov (United States)

    Brandt Vegas, Daniel; Levinson, Wendy; Norman, Geoff; Monteiro, Sandra; You, John J.

    2015-01-01

    Background: Choosing Wisely Canada is a campaign that fosters conversations between physicians and patients about high-value health care. However, little is known about physicians' readiness to have these conversations. Our objective was to determine how ready practising internists were to embrace and openly address high-value care during conversations with patients or their families. Methods: Practising internists in hospitals affiliated with McMaster University, Hamilton, Ontario, were invited to complete an electronic survey with 3 clinical scenarios: each had 3 low-value interventions that had been requested by the patient or family member. For each request, participants chose 1 of 3 statements reflecting how they would respond: a low-value statement agreeing to provide the intervention, an implicit high-value statement declining to provide the intervention without mentioning value or an explicit high-value statement declining to provide the intervention with mention of value. Results: Forty-four of 62 eligible physicians (71.0% response rate) participated in the survey. High-value statements were selected in 91% of cases. The implicit high-value statement was chosen more often than the explicit high-value statement (65.7% v. 25.5% of all responses, respectively; χ2 range 4.46-56.23, p < 0.05). Interpretation: Physicians favoured high-value care but frequently chose not to explicitly address value in their statements. Physicians seemed ready to embrace high-value health care practice, although they were not ready to openly discuss it with patients and their families. PMID:26770961

  3. Factors Associated with Participation, Active Refusals and Reasons for Not Taking Part in a Mortality Followback Survey Evaluating End-of-Life Care.

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    Natalia Calanzani

    Full Text Available Examination of factors independently associated with participation in mortality followback surveys is rare, even though these surveys are frequently used to evaluate end-of-life care. We aimed to identify factors associated with 1 participation versus non-participation and 2 provision of an active refusal versus a silent refusal; and systematically examine reasons for refusal in a population-based mortality followback survey.Postal survey about the end-of-life care received by 1516 people who died from cancer (aged ≥18, identified through death registrations in London, England (response rate 39.3%. The informant of death (a relative in 95.3% of cases was contacted 4-10 months after the patient died. We used multivariate logistic regression to identify factors associated with participation/active refusals and content analysis to examine refusal reasons provided by 205 nonparticipants.The odds of partaking were higher for patients aged 90+ (AOR 3.48, 95%CI: 1.52-8.00, ref: 20-49yrs and female informants (AOR 1.70, 95%CI: 1.33-2.16. Odds were lower for hospital deaths (AOR 0.62, 95%CI: 0.46-0.84, ref: home and proxies other than spouses/partners (AORs 0.28 to 0.57. Proxies of patients born overseas were less likely to provide an active refusal (AOR 0.49; 95% CI: 0.32-0.77. Refusal reasons were often multidimensional, most commonly study-related (36.0%, proxy-related and grief-related (25.1% each. One limitation of this analysis is the large number of nonparticipants who did not provide reasons for refusal (715/920.Our survey better reached proxies of older patients while those dying in hospitals were underrepresented. Proxy characteristics played a role, with higher participation from women and spouses/partners. More information is needed about the care received by underrepresented groups. Study design improvements may guide future questionnaire development and help develop strategies to increase response rates.

  4. Using patients’ experiences to identify priorities for quality improvement in breast cancer care: patient narratives, surveys or both?

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    Tsianakas Vicki

    2012-08-01

    Full Text Available Abstract Background Patients’ experiences have become central to assessing the performance of healthcare systems worldwide and are increasingly being used to inform quality improvement processes. This paper explores the relative value of surveys and detailed patient narratives in identifying priorities for improving breast cancer services as part of a quality improvement process. Methods One dataset was collected using a narrative interview approach, (n = 13 and the other using a postal survey (n = 82. Datasets were analyzed separately and then compared to determine whether similar priorities for improving patient experiences were identified. Results There were both similarities and differences in the improvement priorities arising from each approach. Day surgery was specifically identified as a priority in the narrative dataset but included in the survey recommendations only as part of a broader priority around improving inpatient experience. Both datasets identified appointment systems, patients spending enough time with staff, information about treatment and side effects and more information at the end of treatment as priorities. The specific priorities identified by the narrative interviews commonly related to ‘relational’ aspects of patient experience. Those identified by the survey typically related to more ‘functional’ aspects and were not always sufficiently detailed to identify specific improvement actions. Conclusions Our analysis suggests that whilst local survey data may act as a screening tool to identify potential problems within the breast cancer service, they do not always provide sufficient detail of what to do to improve that service. These findings may have wider applicability in other services. We recommend using an initial preliminary survey, with better use of survey open comments, followed by an in-depth qualitative analysis to help deliver improvements to relational and functional aspects of patient

  5. Indonesian infertility patients’ health seeking behaviour and patterns of access to biomedical infertility care: an interviewer administered survey conducted in three clinics

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    Bennett Linda Rae

    2012-09-01

    Full Text Available Abstract Background Indonesia has high levels of biological need for infertility treatment, great sociological and psychological demand for children, and yet existing infertility services are underutilized. Access to adequate comprehensive reproductive health services, including infertility care, is a basic reproductive right regardless of the economic circumstances in which individuals are born into. Thus, identifying and implementing strategies to improve access to assisted reproductive technology (ART in Indonesia is imperative. The principle objectives of this article are to improve our understanding of infertility patients’ patterns of health seeking behaviour and their patterns of access to infertility treatment in Indonesia, in order to highlight the possibilities for improving access. Methods An interviewer-administered survey was conducted with 212 female infertility patients recruited through three Indonesian infertility clinics between July and September 2011. Participants were self-selected and data was subject to descriptive statistical analysis. Results Patients identified a number of barriers to access, including: low confidence in infertility treatment and high rates of switching between providers due to perceived treatment failure; the number and location of clinics; the lack of a well established referral system; the cost of treatment; and patients also experienced fear of receiving a diagnosis of sterility, of vaginal examinations and of embarrassment. Women’s age of marriage and the timing of their initial presentation to gynaecologists were not found to be barriers to timely access to infertility care. Conclusions The findings based on the responses of 212 female infertility patients indicated four key areas of opportunity for improving access to infertility care. Firstly, greater patient education about the nature and progression of infertility care was required among this group of women. Secondly, increased resources

  6. How and by whom care is delivered influences anti-inflammatory use in asthma : Results of a national population survey

    NARCIS (Netherlands)

    Adams, RJ; Weiss, ST; Fuhlbrigge, A

    2003-01-01

    Background: Studies examining the influence of provider behavior and patterns of care delivery on the use of antiinflammatory asthma therapy have been limited to selected populations or have been unable to assess the appropriateness of therapy for individuals. We have previously reported the influen

  7. Who Is Providing and Who Is Getting Asthma Patient Education: An Analysis of 2001 National Ambulatory Medical Care Survey Data

    Science.gov (United States)

    Shah, Shaival S.; Lutfiyya, May Nawal; McCullough, Joel Emery; Henley, Eric; Zeitz, Howard Jerome; Lipsky, Martin S.

    2008-01-01

    Patient education in asthma management is important; however, there is little known about the characteristics of patients receiving asthma education or how often primary care physicians provide it. The objective of the study was to identify the characteristics of patients receiving asthma education. It was a cross-sectional study using 2001…

  8. Measuring coverage in MNCH: a validation study linking population survey derived coverage to maternal, newborn, and child health care records in rural China.

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    Li Liu

    Full Text Available BACKGROUND: Accurate data on coverage of key maternal, newborn, and child health (MNCH interventions are crucial for monitoring progress toward the Millennium Development Goals 4 and 5. Coverage estimates are primarily obtained from routine population surveys through self-reporting, the validity of which is not well understood. We aimed to examine the validity of the coverage of selected MNCH interventions in Gongcheng County, China. METHOD AND FINDINGS: We conducted a validation study by comparing women's self-reported coverage of MNCH interventions relating to antenatal and postnatal care, mode of delivery, and child vaccinations in a community survey with their paper- and electronic-based health care records, treating the health care records as the reference standard. Of 936 women recruited, 914 (97.6% completed the survey. Results show that self-reported coverage of these interventions had moderate to high sensitivity (0.57 [95% confidence interval (CI: 0.50-0.63] to 0.99 [95% CI: 0.98-1.00] and low to high specificity (0 to 0.83 [95% CI: 0.80-0.86]. Despite varying overall validity, with the area under the receiver operating characteristic curve (AUC ranging between 0.49 [95% CI: 0.39-0.57] and 0.90 [95% CI: 0.88-0.92], bias in the coverage estimates at the population level was small to moderate, with the test to actual positive (TAP ratio ranging between 0.8 and 1.5 for 24 of the 28 indicators examined. Our ability to accurately estimate validity was affected by several caveats associated with the reference standard. Caution should be exercised when generalizing the results to other settings. CONCLUSIONS: The overall validity of self-reported coverage was moderate across selected MNCH indicators. However, at the population level, self-reported coverage appears to have small to moderate degree of bias. Accuracy of the coverage was particularly high for indicators with high recorded coverage or low recorded coverage but high specificity. The

  9. Primary care practice-based care management for chronically ill patients (PraCMan: study protocol for a cluster randomized controlled trial [ISRCTN56104508

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    Baldauf Annika

    2011-06-01

    Full Text Available Abstract Background Care management programmes are an effective approach to care for high risk patients with complex care needs resulting from multiple co-occurring medical and non-medical conditions. These patients are likely to be hospitalized for a potentially "avoidable" cause. Nurse-led care management programmes for high risk elderly patients showed promising results. Care management programmes based on health care assistants (HCAs targeting adult patients with a high risk of hospitalisation may be an innovative approach to deliver cost-efficient intensified care to patients most in need. Methods/Design PraCMan is a cluster randomized controlled trial with primary care practices as unit of randomisation. The study evaluates a complex primary care practice-based care management of patients at high risk for future hospitalizations. Eligible patients either suffer from type 2 diabetes mellitus, chronic obstructive pulmonary disease, chronic heart failure or any combination. Patients with a high likelihood of hospitalization within the following 12 months (based on insurance data will be included in the trial. During 12 months of intervention patients of the care management group receive comprehensive assessment of medical and non-medical needs and resources as well as regular structured monitoring of symptoms. Assessment and monitoring will be performed by trained HCAs from the participating practices. Additionally, patients will receive written information, symptom diaries, action plans and a medication plan to improve self-management capabilities. This intervention is addition to usual care. Patients from the control group receive usual care. Primary outcome is the number of all-cause hospitalizations at 12 months follow-up, assessed by insurance claims data. Secondary outcomes are health-related quality of life (SF12, EQ5D, quality of chronic illness care (PACIC, health care utilisation and costs, medication adherence (MARS, depression

  10. Patient refusal for regional anesthesia in elderly orthopedic population: A cross-sectional survey at a tertiary care hospital

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    Asma Abdus Salam

    2016-01-01

    Conclusion: This survey showed that the main reasons among elderly female population were the fear of remaining awake and backache. However, overall it was the surgeon′s choice which made patients refuse RA, and the anesthesiologists were the main source of information.

  11. PrEP Awareness and Attitudes in a National Survey of Primary Care Clinicians in the United States, 2009–2015

    Science.gov (United States)

    Stryker, Jo Ellen; Rose, Charles E.

    2016-01-01

    Objectives As trials were assessing the safety and efficacy of daily oral antiretroviral preexposure prophylaxis (PrEP) for the prevention of HIV infection, there was a clear need to understand the evolution of knowledge of, and attitudes toward, PrEP among primary care clinicians. Methods Physicians and nurse practitioners were surveyed in 2009 (n = 1500), 2010 (n = 1504), 2012 (n = 1503), 2013 (n = 1507), 2014 (n = 1508) and 2015 (n = 1501) to assess their awareness of PrEP, willingness to prescribe PrEP, and whether they support use of public funds to pay for PrEP. Pharmacists (n = 251) were surveyed about PrEP in 2012 only. Descriptive statistics were computed for physician demographics and PrEP-related questions. Prevalence ratios for willingness to prescribe PrEP were computed using Poisson regression analysis. Results Awareness of PrEP was low among clinicians (2009: 24%, 2010: 29%) but increased after trials reported effectiveness (2012: 49%, 2013: 51%, 2014: 61%, 2015: 66%). Following a description of PrEP with an estimated effectiveness of 75%, across 6 of the study years 91% of clinicians indicated a willingness to prescribe PrEP to at least one group at high risk of HIV acquisition. A smaller majority of clinicians indicated support for public funding of PrEP in 2009: 59%, 2010: 53%, and 2013: 63%. Conclusions In surveys conducted before and after the release of PrEP trial results, primary care clinicians were largely unaware of PrEP. They indicated high levels of willingness to prescribe it for patients at high risk of HIV acquisition and expressed interest in education about how to deliver this new clinical HIV prevention method. It will be important to continue monitoring clinician knowledge, attitudes, and practices as the use of PrEP increases in the US. PMID:27258374

  12. PrEP Awareness and Attitudes in a National Survey of Primary Care Clinicians in the United States, 2009-2015.

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    Dawn K Smith

    Full Text Available As trials were assessing the safety and efficacy of daily oral antiretroviral preexposure prophylaxis (PrEP for the prevention of HIV infection, there was a clear need to understand the evolution of knowledge of, and attitudes toward, PrEP among primary care clinicians.Physicians and nurse practitioners were surveyed in 2009 (n = 1500, 2010 (n = 1504, 2012 (n = 1503, 2013 (n = 1507, 2014 (n = 1508 and 2015 (n = 1501 to assess their awareness of PrEP, willingness to prescribe PrEP, and whether they support use of public funds to pay for PrEP. Pharmacists (n = 251 were surveyed about PrEP in 2012 only. Descriptive statistics were computed for physician demographics and PrEP-related questions. Prevalence ratios for willingness to prescribe PrEP were computed using Poisson regression analysis.Awareness of PrEP was low among clinicians (2009: 24%, 2010: 29% but increased after trials reported effectiveness (2012: 49%, 2013: 51%, 2014: 61%, 2015: 66%. Following a description of PrEP with an estimated effectiveness of 75%, across 6 of the study years 91% of clinicians indicated a willingness to prescribe PrEP to at least one group at high risk of HIV acquisition. A smaller majority of clinicians indicated support for public funding of PrEP in 2009: 59%, 2010: 53%, and 2013: 63%.In surveys conducted before and after the release of PrEP trial results, primary care clinicians were largely unaware of PrEP. They indicated high levels of willingness to prescribe it for patients at high risk of HIV acquisition and expressed interest in education about how to deliver this new clinical HIV prevention method. It will be important to continue monitoring clinician knowledge, attitudes, and practices as the use of PrEP increases in the US.

  13. Effects of residence and race on burden of travel for care: cross sectional analysis of the 2001 US National Household Travel Survey

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    Wang Jong-Yi

    2007-03-01

    Full Text Available Abstract Background Travel burden is a key element in conceptualizing geographic access to health care. Prior research has shown that both rural and minority populations bear disproportionate travel burdens. However, many studies are limited to specific types of patient or specific locales. The purpose of our study was to quantify geographic and race-based differences in distance traveled and time spent in travel for medical/dental care using representative national data. Methods Data were drawn from 2001 National Household Travel Survey (NHTS, a nationally representative, cross-sectional household survey conducted by the US Department of Transportation. Participants recorded all travel on a designated day; the overall response rate was 41%. Analyses were restricted to households reporting at least one trip for medical and/or dental care; 3,914 trips made by 2,432 households. Dependent variables in the analysis were road miles traveled, minutes spent traveling, and high travel burden, defined as more than 30 miles or 30 minutes per trip. Independent variables of interest were rural residence and race. Characteristics of the individual, the trip, and the community were controlled in multivariate analyses. Results The average trip for care in the US in 2001 entailed 10.2 road miles (16.4 kilometers and 22.0 minutes of travel. Rural residents traveled further than urban residents in unadjusted analysis (17.5 versus 8.3 miles; 28.2 versus 13.4 km. Rural trips took 31.4% longer than urban trips (27.2 versus 20.7 minutes. Distance traveled did not vary by race. African Americans spent more time in travel than whites (29.1 versus 20.6 minutes; other minorities did not differ. In adjusted analyses, rural residence (odds ratio, OR, 2.67, 95% confidence interval, CI 1.39 5.1.5 was associated with a trip of 30 road miles or more; rural residence (OR, 1.80, CI 1.09 2.99 and African American race/ethnicity (OR 3.04. 95% CI 2.0 4.62 were associated with a

  14. Is Satisfaction with the Acute-Care Experience Higher amongst Consumers Treated in the Private Sector? A Survey of Public and Private Sector Arthroplasty Recipients

    Science.gov (United States)

    Naylor, Justine M.; Descallar, Joseph; Grootemaat, Mechteld; Badge, Helen; Harris, Ian A.; Simpson, Grahame; Jenkin, Deanne

    2016-01-01

    Background Consumer satisfaction with the acute-care experience could reasonably be expected to be higher amongst those treated in the private sector compared to those treated in the public sector given the former relies on high-level satisfaction of its consumers and their subsequent recommendations to thrive. The primary aims of this study were to determine, in a knee or hip arthroplasty cohort, if surgery in the private sector predicts greater overall satisfaction with the acute-care experience and greater likelihood to recommend the same hospital. A secondary aim was to determine whether satisfaction across a range of service domains is also higher in the private sector. Methods A telephone survey was conducted 35 days post-surgery. The hospital cohort comprised eight public and seven private high-volume arthroplasty providers. Consumers rated overall satisfaction with care out of 100 and likeliness to recommend their hospital on a 5-point Likert scale. Additional Likert-style questions were asked covering specific service domains. Generalized estimating equation models were used to analyse overall satisfaction (dichotomised as ≥ 90 or response for each individual domain were compared using non-parametric tests. Results 457 survey respondents (n = 210 private) were included. Less patient-reported joint impairment pre-surgery [OR 1.03 (95% CI 1.01–1.05)] and absence of an acute complication (OR 2.13 95% CI 1.41–3.23) significantly predicted higher overall satisfaction. Hip arthroplasty [OR 1.84 (1.1–2.96)] and an absence of an acute complication [OR 2.31 (1.28–4.17] significantly predicted greater likelihood for recommending the hospital. The only care domains where the private out-performed the public sector were hospitality (46.7 vs 35.6%, p <0.01) and frequency of surgeon visitation (76.4 vs 65.8%, p = 0.03). Conclusions Arthroplasty consumers treated in the private sector are not more satisfied with their acute-care experience nor are they more

  15. The management of lactose intolerance among primary care physicians and its correlation with management by gastroenterologists: the SEPD-SEMG national survey

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    Federico Argüelles-Arias

    2015-09-01

    Full Text Available Introduction and aims: The understanding of lactose intolerance (LI is limited in some professional settings. Sociedad Española de Patología Digestiva (SEPD and Sociedad Española de Medicina General (SEMG have developed a survey in order to: a Analyze primary care physicians (PCPs knowledge and clinical management; and b to compare results with those of a previous survey of Spanish gastroenterologists (GEs. Material and methods: An online questionnaire was sent to SEMG members with 27 items on various issues: Demographics, occupational characteristics, outlook on LI, diagnostic tests, treatment, and follow-up. Results were compared to those from a survey of GEs. Results: A total of 456 PCPs responded, versus 477 GEs. PCPs had an older mean age and longer professional experience. Level of understanding of LI was similar, albeit a higher proportion of PCPs lacked epidemiological awareness (p 0.001, and LI symptoms as overlapping those of irritable bowel syndrome (93.5 vs. 88.2%; p = 0.005, although symptoms perceived as suspicious of LI were similar in both groups. Dietary recommendations were recognized as the primary therapeutic approach. Conclusion: This study reveals the outlook of PCPs on LI, and allows comparison with that of GEs, as a basis for the development of strategies aimed at improving LI understanding, approach and management in our setting.

  16. Quality of emergency medical care in Gondar University Referral Hospital, Northwest Ethiopia: a survey of patients’ perspectives

    Science.gov (United States)

    2014-01-01

    Background Ethiopia has fairly good coverage but very low utilization of health care services. Emergency medical care services require fast, correct and curious services to clients as they present with acute problems. In Ethiopia and Gondar in particular, the quality of emergency medical care has not been studied. The main aim of this study was to assess the disease profile and patients’ satisfaction in Gondar University Referral Hospital (GURH). Methods A facility based cross-sectional study was conducted among patients visiting GURH for emergency care. Ethical clearance was obtained from the Institutional Review Board of University of Gondar. Patients were selected by systematic random sampling, using patient flow list in the day and night emergency services. Data were collected using a standard Press Ganey questionnaire by BSc health science graduates. Data were entered in to Epi Info 3.5.3 software and exported to SPSS version 20.0 for windows for analysis. Results A total of 963 patients (response rate = 96.8%) were studied. The mean (+ s.d.) age of patients was 28.4 (+17.9) years. The overall satisfaction using the mean score indicates that 498 (51.7%) 95%CI: (48.4% - 54.9%) were satisfied with the service, the providers and the facility suitability whereas 465(48.3%) 95%CI: (45.1%- 51.6%) were not satisfied. Seven hundred and six (73.3%) 95%CI: 70.4%-76.1%, patients reported that they have been discriminated or treated badly during the service provision in the hospital. OPD site visited (p < 0.0001), visiting days of the week (P < 0.049), medical condition on arrival (P < 0.0001), degree of confidence in the hospital (AOR = 1.9, 95%CI: 1.1, 3.1), reported discrimination/bad treatment of patients with service (AOR = 0.4, 95%CI: 0.2, 0.7), were significantly associated determinants of patient satisfaction. Conclusions Non-communicable disease emergencies like injuries and cardiovascular diseases are common. There is a low level of

  17. Understanding the concept of resilience in relation to looked after children: A Delphi survey of perceptions from education, social care and foster care.

    Science.gov (United States)

    South, Rebecca; Jones, Fergal W; Creith, Elaine; Simonds, Laura M

    2016-04-01

    There has been a surge of interest regarding the application of resilience theory in childcare practice and how resilience can be promoted among vulnerable children, in particular, looked after children. However, little is known about how people working with looked after children understand the concept of resilience. This study aimed to explore how social workers, teachers and foster carers, working with looked after children, understand resilience and whether there is consensus as to what constitutes resilience. The study also sought to explore whether there are differences in how resilience is constructed across these groups. In total, 106 participants took part in a Delphi survey (34 teachers, 36 foster carers, 36 social workers). There was moderate consensus that resilience related to survival, coping and a sense of self-worth. Resilience was not considered a panacea but a concept that also had limitations. Participants understood resilience in ways that were both similar and different to existing conceptualisations within the literature. However, there were many aspects of resilience for which there was no consensus or significant difference of opinion between the participant groups. The need for further training and research is discussed, in order to support attempts to promote resilience among looked after children. PMID:25814650

  18. Variations in GP–patient communication by ethnicity, age, and gender: evidence from a national primary care patient survey

    OpenAIRE

    Burt, Jenni; Lloyd, Cathy; Campbell, John; Roland, Martin; Abel, Gary

    2016-01-01

    Background: Doctor–patient communication is a key driver of overall satisfaction with primary care. Patients from minority ethnic backgrounds consistently report more negative experiences of doctor–patient communication. However, it is currently unknown whether these ethnic differences are concentrated in one gender or in particular age groups. Aim: To determine how reported GP–patient communication varies between patients from different ethnic groups, stratified by age and gender. De...

  19. Challenges and barriers to health care and overall health in older residents of Alaska: evidence from a national survey

    OpenAIRE

    Julia D. Foutz; Cohen, Steven A; Cook, Sarah K.

    2016-01-01

    Background: From 1970 to 2010, the Alaskan population increased from 302,583 to 698,473. During that time, the growth rate of Alaskan seniors (65+) was 4 times higher than their national counterparts. Ageing in Alaska requires confronting unique environmental, sociodemographic and infrastructural challenges, including an extreme climate, geographical isolation and less developed health care infrastructure compared to the continental US. Objective: The objective of this analysis is to compare ...

  20. A questionnaire based survey to evaluate the usage pattern of carbapenems for sepsis management in intensive care unit

    OpenAIRE

    Vikram Kumar Shetty; Vishwaprakash M. K.; Somashekara S. C.

    2016-01-01

    Background: Sepsis remains one of the most common critical illnesses for patients to be admitted to an intensive care unit (ICU) and has very high associated morbidity and mortality ranging from 18 to 50%. It is a well-known fact that early goal directed therapy with broad spectrum antibiotics, IV fluids and other supportive therapies improve outcome. The current study was done to know the importance of carbapenems in the management of sepsis focusing on perceived use and the clinical outcome...

  1. Challenges and barriers to health care and overall health in older residents of Alaska: evidence from a national survey

    OpenAIRE

    Foutz, Julia D.; Cohen, Steven A.; Sarah K. Cook

    2016-01-01

    Background. From 1970 to 2010, the Alaskan population increased from 302,583 to 698,473. During that time, the growth rate of Alaskan seniors (65+) was 4 times higher than their national counterparts. Ageing in Alaska requires confronting unique environmental, sociodemographic and infrastructural challenges, including an extreme climate, geographical isolation and less developed health care infrastructure compared to the continental US.Objective. The objective of this analysis is to compare t...

  2. Survey nurse,s view about factors affects medication errors in different care units of Imam Hossein hospital in Shahroud

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    Mahbobeh Poorheydari

    2007-01-01

    Full Text Available Introduction: Medicine administeration is an important part of treatment and nursing care process and medication errors is a serious threat in health and patient safety and also in nursing profession. This study carried out to investigate the nurse,s view about factors affects medication errors in different care units of Imam Hossein hospital in Shahroud. Methods: This study is a descriptive analytic and cross-sectional study that has been done on 40 nurses who they work in different care units of Imam Hossein hospital in Shahrood. Subjects were selected in unrandomized sampling and their points of view about factors affect medication errors were measured by using a designed questionnaire. Data was analyzed by using descriptive and analytic statitic methods in SPSS software. Results: Upon to results, the majority of subjects mentioned that factors such as: Fatigue arised from overtime work (66.7%, deficiency number of nurses comparison number of patient (59%, psychological stress of nurse (48.7%, illegible physician order in patients file (42.5% and lack of enough time (42.1% are the most important factors that caused medication errors. Also, the majority of subjects mentioned that factors such as: Type of drug arrangement in drug shelf (47.4%, incorrect work devision in unit (46.2%, drug room environment (light, area, … (46.2% and type of prescription (intravascular, intramuscular,… (36.1% are the least important factors that caused medication errors. Subjects explained that factors such as: Morning shift (48.7% and drug protocol (38.9% were not effective in causing medication errors. There weren,t significant correlation between medication errors factors and demographic variables. Conclusion: Considering the results, for medication errors prevention in different care units, effective management and improvement motivation, knowledge potential and clinical skills in nurses about implementation of medication is recommended.

  3. Pattern and predictors of maternal care-seeking practices for severe neonatal jaundice in Nigeria: a multi-centre survey

    OpenAIRE

    Ezeaka, Chinyere V; Ugwu, Rosemary O; Mukhtar-Yola, Mariya; Ekure, Ekanem N; Olusanya, Bolajoko O

    2014-01-01

    Background Nigeria is frequently associated with disproportionately high rates of severe neonatal jaundice (NNJ) underpinned by widespread Glucose-6-phosphate dehydrogenase (G6PD) deficiency. Timely and appropriate treatment of NNJ is crucial for preventing the associated morbidity and neuro-developmental sequelae. Since mothers are likely to be the first mostly to observe the onset of severe illness in their newborns, we set out to identify the pattern and predictors of maternal care-seeking...

  4. Scientific publications in critical care medicine journals from East Asia: A 10-year survey of the literature

    OpenAIRE

    Cao, Zhenyu; Ou, Chongyang; Teng, Hongfei; Liu, Xiguang; Tang, Hongxin

    2016-01-01

    Objective: The quantity and quality of publications in critical care medicine from East Asia haven’t been reported. This study aimed to investigate the contribution of publications from East Asia. Methods: Articles from China, Japan and South Korea in 2005 to 2014 were retrieved from Web of Science and Pubmed. The number of publications, impact factor, citation, and article types were analyzed. Results: There were 3076 publications from East Asia (1720 from China, 913 from Japan, and 443 from...

  5. Factors associated with high job satisfaction among care workers in Swiss nursing homes – a cross sectional survey study

    OpenAIRE

    Schwendimann, René; Dhaini, Suzanne; Ausserhofer, Dietmar; Engberg, Sandra; Zúñiga, Franziska

    2016-01-01

    Background While the relationship between nurses’ job satisfaction and their work in hospital environments is well known, it remains unclear, which factors are most influential in the nursing home setting. The purpose of this study was to describe job satisfaction among care workers in Swiss nursing homes and to examine its associations with work environment factors, work stressors, and health issues. Methods This cross-sectional study used data from a representative national sample of 162 Sw...

  6. 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...

  7. The Mental Health Care Gap among Children and Adolescents: Data from an Epidemiological Survey from Four Brazilian Regions

    OpenAIRE

    Cristiane S Paula; Isabel A. S. Bordin; Jair de Jesus Mari; Luciane Velasque; Rohde, Luis A.; Evandro S F Coutinho

    2014-01-01

    INTRODUCTION: Worldwide, a minority of disordered children/adolescents receives mental health assistance. In order to improve service access, it is important to investigate factors that influence the process leading to receiving care. Data on frequency and barriers for mental health service use (MHSU) among Brazilian children/adolescents are extremely scarce and are needed to guide public policy. OBJECTIVES: To establish the frequency of MHSU among 6-to-16-year-old with psychiatric disorders ...

  8. Survey of U.S. zoo and aquarium animal care staff attitudes regarding humane euthanasia for population management.

    Science.gov (United States)

    Powell, David M; Ardaiolo, Matthew

    2016-05-01

    The humane euthanasia of animals for population management, or culling, has been suggested as one possible tool for managing animal populations for sustainability, and recent, highly publicized euthanasia of zoo animals in Copenhagen has stimulated global conversation about population management in zoos. We conducted a nationwide survey of U.S. zoo and aquarium personnel, including keepers, managers, and leaders of AZA animal programs, to assess their overall attitudes regarding population management euthanasia. The surveyed populations were generally very aware of the concept of population management euthanasia. Managers and animal program leaders were more supportive of euthanasia than keepers. We found that regardless of role, men were more supportive of euthanasia than women. Those personnel who were aware of instances of population management euthanasia at their institutions before were more supportive of it than those who were not. Support for culling varied with the kind of animal being considered for it, with three general taxon acceptability groupings emerging. Education, tenure in the profession, taxonomic expertise, and whether or not the responder took the survey before or after the Copenhagen events were not strong predictors of attitudes. Overall, the surveyed populations were approximately evenly split in terms of being in favor of euthanasia, not supporting euthanasia, or being unsure. Most responders indicated that they would be more likely to accept culling if more information was provided on its rationale. These results will form the basis for further discussions on the role of humane euthanasia for population management. Zoo Biol. 35:187-200, 2016. © 2016 Wiley Periodicals, Inc. PMID:26934585

  9. Web-Based Textual Analysis of Free-Text Patient Experience Comments From a Survey in Primary Care

    OpenAIRE

    Maramba, Inocencio Daniel; Davey, Antoinette; Elliott, Marc N; Roberts, Martin; Roland, Martin; Brown, Finlay; Burt, Jenni; Boiko, Olga; Campbell, John

    2015-01-01

    Background Open-ended questions eliciting free-text comments have been widely adopted in surveys of patient experience. Analysis of free text comments can provide deeper or new insight, identify areas for action, and initiate further investigation. Also, they may be a promising way to progress from documentation of patient experience to achieving quality improvement. The usual methods of analyzing free-text comments are known to be time and resource intensive. To efficiently deal with a large...

  10. How psychosocial factors affect well-being of practice assistants at work in general medical care? – a questionnaire survey

    OpenAIRE

    Götz, Katja; Berger, Sarah; Gavartina, Amina; Zaroti, Stavria; Szecsenyi, Joachim

    2015-01-01

    Background: Well-being at work is an important aspect of a workforce strategy. The aim of the study was to explore and evaluate psychosocial factors and health and work-related outcomes of practices assistants depending on their employment status in general medical practices. Methods: This observational study was based on a questionnaire survey to evaluate psychosocial aspects at work in general medical practices. A standardized questionnaire was used, the Copenhagen Psychosocial Questionna...

  11. Chronic disease prevalence and care among the elderly in urban and rural Beijing, China - a 10/66 Dementia Research Group cross-sectional survey

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    Sousa Renata

    2009-10-01

    Full Text Available Abstract Background Demographic ageing is occurring at an unprecedented rate in China. Chronic diseases and their disabling consequences will become much more common. Public policy has a strong urban bias, and older people living in rural areas may be especially vulnerable due to limited access to good quality healthcare, and low pension coverage. We aim to compare the sociodemographic and health characteristics, health service utilization, needs for care and informal care arrangements of representative samples of older people in two Beijing communities, urban Xicheng and rural Daxing. Methods A one-phase cross-sectional survey of all those aged 65 years and over was conducted in urban and rural catchment areas in Beijing, China. Assessments included questionnaires, a clinical interview, physical examination, and an informant interview. Prevalence of chronic diseases, self-reported impairments and risk behaviours was calculated adjusting for household clustering. Poisson working models were used to estimate the independent effect of rural versus urban residence, and to explore the predictors of health services utilization. Results We interviewed 1002 participants in rural Daxing, and 1160 in urban Xicheng. Those in Daxing were more likely to be younger, widowed, less educated, not receiving a pension, and reliant on family transfers. Chronic diseases were more common in Xicheng, when based on self-report rather than clinical assessment. Risk exposures were more common in Daxing. Rural older people were much less likely to access health services, controlling for age and health. Community health services were ineffective, particularly in Daxing, where fewer than 3% of those with hypertension were adequately controlled. In Daxing, care was provided by family, who had often given up work to do so. In Xicheng, 45% of those needing care were supported by paid caregivers. Caregiver strain was higher in Xicheng. Dementia was strongly associated with

  12. The relationship between maternal education and mortality among women giving birth in health care institutions: Analysis of the cross sectional WHO Global Survey on Maternal and Perinatal Health

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    Gülmezoglu A Metin

    2011-07-01

    Full Text Available Abstract Background Approximately one-third of a million women die each year from pregnancy-related conditions. Three-quarters of these deaths are considered avoidable. Millennium Development Goal five calls for a reduction in maternal mortality and the establishment of universal access to high quality reproductive health care. There is evidence of a relationship between lower levels of maternal education and higher maternal mortality. This study examines the relationship between maternal education and maternal mortality among women giving birth in health care institutions and investigates the association of maternal age, marital status, parity, institutional capacity and state-level investment in health care with these relationships. Methods Cross-sectional information was collected on 287,035 inpatients giving birth in 373 health care institutions in 24 countries in Africa, Asia and Latin America, between 2004-2005 (in Africa and Latin America and 2007-2008 (in Asia as part of the WHO Global Survey on Maternal and Perinatal Health. Analyses investigated associations between indicators measured at the individual, institutional and country level and maternal mortality during the intrapartum period: from admission to, until discharge from, the institution where women gave birth. There were 363 maternal deaths. Results In the adjusted models, women with no education had 2.7 times and those with between one and six years of education had twice the risk of maternal mortality of women with more than 12 years of education. Institutional capacity was not associated with maternal mortality in the adjusted model. Those not married or cohabiting had almost twice the risk of death of those who were. There was a significantly higher risk of death among those aged over 35 (compared with those aged between 20 and 25 years, those with higher numbers of previous births and lower levels of state investment in health care. There were also additional effects

  13. The Nordic maintenance care program: what are the indications for maintenance care in patients with low back pain? A survey of the members of the Danish Chiropractors' Association

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    Hansen Signe F

    2010-09-01

    Full Text Available Abstract Background Maintenance care (MC is relatively commonly used among chiropractors. However, factual information is needed on its indications for use. Objectives This study had two objectives: 1 to describe which role patients' past history and treatment outcome play in chiropractors' decision to use MC in patients with low back pain, 2 to investigate if the chiropractors' clinical/educational background has an effect on the frequency of using MC and their indications for use of MC. Method An anonymous questionnaire was sent to all 413 chiropractors practising in Denmark. Its main part consisted of 3 sets of 4 questions relating to one basic case of low back pain. For each case, the chiropractors were asked if they would use MC as they self-defined the term (no/perhaps/yes. There were questions also on gender, age, educational and clinical background, and on the number of MC patients seen by these chiropractors. Their decision to recommend MC was reported. Associations between the demographic variables and 1 the frequency of MC-use and 2 their indications for use of MC were tested through multivariate analysis. Results The response rate was 72%. Non-indications for MC were: 1 a good outcome combined with no previous events, or 2 a past history of LBP and gradual worsening with treatment. Indications for MC were a good outcome combined with a previous history of low back pain between once a month and once a year. The mean proportion of MC patients per week were 22% (SD 19, ranging from 0% to 100%. The use of MC was highest among experienced chiropractors, those who were educated in North America, and clinic owners. However, in Denmark most chiropractors graduated before 1999, are educated abroad, whereas most chiropractors thereafter are educated in Denmark. Therefore, we cannot conclude whether this difference relates to education or years of experience. There were no associations detected between demographic variables and the indications

  14. Inequity in maternal health care service utilization in Gujarat: analyses of district-level health survey data

    OpenAIRE

    Saxena, Deepak; Vangani, Ruchi; Mavalankar, Dileep V.; Thomsen, Sarah

    2013-01-01

    Background: Two decades after the launch of the Safe Motherhood campaign, India still accounts for at least a quarter of maternal death globally. Gujarat is one of the most economically developed states of India, but progress in the social sector has not been commensurate with economic growth. The purpose of this study was to use district-level data to gain a better understanding of equity in access to maternal health care and to draw the attention of the policy planers to monitor equity in m...

  15. Developing a survey instrument to assess the readiness of primary care data, genetic and disease registries to conduct linked research: TRANSFoRm International Research Readiness (TIRRE survey instrument

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    Emily Leppenwell

    2013-05-01

    Full Text Available Background Clinical data are collected for routine care in family practice; there are also a growing number of genetic and cancer registry data repositories. The Translational Research and Patient Safety in Europe (TRANSFoRm project seeks to facilitate research using linked data from more than one source. We performed a requirements analysis which identified a wide range of data and business process requirements that need to be met before linking primary care and either genetic or disease registry data.Objectives To develop a survey to assess the readiness of data repositories to participate in linked research – the Transform International Research Readiness (TIRRE survey.Method We develop the questionnaire based on our requirement analysis; with questions at micro-, meso- and macro levels of granularity, study-specific questions about diabetes and gastro-oesophageal reflux disease (GORD, and research track record. The scope of the data required was extensive. We piloted this instrument, conducting ten preliminary telephone interviews to evaluate the response to the questionnaire.Results Using feedback gained from these interviews we revised the questionnaire; clarifying questions that were difficult to answer and utilising skip logic to create different series of questions for the various types of data repository. We simplified the questionnaire replacing free-text responses with yes/no or picking list options, wherever possible. We placed the final questionnaire online and encouraged its use (www.clininf.eu/jointirre/info.html.Conclusion Limited field testing suggests that TIRRE is capable of collecting comprehensive and relevant data about the suitability and readiness of data repositories to participate in linked data research.

  16. A primary care physician perspective survey on the limited use of handwriting and pen computing in the electronic medical record

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    Gary Arvary

    2002-09-01

    The use of handwriting in the EMR was broadly supported by this group of PCPs in private practice. Likewise, wireless pen computers were the overwhelming choice of computer for use during a consultation. In this group, older and lower volume physicians were less likely to desire a computer for use during a consultation. User acceptance of the EMR may be related to how closely it resembles the processes that are being automated. More surveys are required to determine the needs and expectations of physicians. The data also support other research studies that demonstrate the preference for handwriting and wireless computers, and the need for a limited, standardised and controlled vocabulary.

  17. The influence of patients' immigration background and residence permit status on treatment decisions in health care. Results of a factorial survey among general practitioners in Switzerland.

    Science.gov (United States)

    Drewniak, Daniel; Krones, Tanja; Sauer, Carsten; Wild, Verina

    2016-07-01

    This study examines the influence of patients' immigration background and residence permit status on physicians' willingness to treat patients in due time. A factorial survey was conducted among 352 general practitioners with a background in internal medicine in a German-speaking region in Switzerland. Participants expressed their self-rating (SR) as well as the expected colleague-rating (CR) to provide immediate treatment to 12 fictive vignette patients. The effects of the vignette variables were analysed using random-effects models. The results show that SR as well as CR was not only influenced by the medical condition or the physicians' time pressure, but also by social factors such as the ethnicity and migration history, the residence permit status, and the economic condition of the patients. Our findings can be useful for the development of adequate, practically relevant teaching and training materials with the ultimate aim to reduce unjustified discrimination or social rationing in health care. PMID:27258017

  18. Japanese patterns of care study of postoperative radiotherapy for uterine cervical cancer. The assessment of treatment process of the 1995-2005 surveys

    International Nuclear Information System (INIS)

    The purpose of the study is to evaluate Japanese national practice patterns for patients undergoing postoperative radiotherapy for uterine cervical cancer. The Japan Patterns of Care Study (JPCS) collected the data of patients who were treated postoperative radiation therapy between 1995-1997 (JPCS 95-97), 1999-2001 (JPCS 99-01) and 2003-2005 (JPCS 03-05). Over 80% of patients were treated with external beam RT (ERT). ERT dose ranged from 45 to 50.4 Gy for over 70% of patients. The utilization rates of CT-simulation, multi-leaf collimator and over 10 MV photon energy were increased among three JPCS surveys. Positive lymph nodes, capillary lymphatic space tumor involvement and deep stromal invasion was the main reasons of adaptation of the postoperative radiotherapy. Compared with the previous 2 PCS studies, the patient who received concurrent chemoradiation was increased in JPCS 03-05 (6, 9% to 25%). (author)

  19. Covering young adults under the Affordable Care Act: the importance of outreach and Medicaid expansion: findings from the Commonwealth Fund Health Insurance Tracking Survey of Young Adults, 2013.

    Science.gov (United States)

    Collins, Sara R; Rasmussen, Petra W; Garber, Tracy; Doty, Michelle M

    2013-08-01

    There is concern that many young adults (ages 19--29) will remain without health insurance in 2014 despite the Affordable Care Act's reforms, including subsidized private coverage offered in new state marketplaces and expanded Medicaid eligibility. How things turn out will likely depend on outreach efforts and states' decisions on expanding Medicaid. Commonwealth Fund Health Insurance Tracking Survey data from 2011 and 2013 show increasing awareness among young adults of the 2010 requirement that health plans cover children under age 26. Of the estimated 15 million young adults enrolled in a parent's plan in the prior 12 months, 7.8 million would not likely have been eligible to enroll prior to the law. Still, only 27 percent of 19-to-29-year-olds are aware of the marketplaces. Meanwhile, most uninsured young adults living below poverty will not have access to subsidized public or private insurance in states opting out of the Medicaid expansion. PMID:24044138

  20. The prevalence of prescribing antibiotics by primary health care physicians in Turkey: A multi-centered survey

    International Nuclear Information System (INIS)

    Objective: Antibiotics are widely used in the treatment of infections and for empirical treatment purposes. Despite this common consumption of antibiotics, it is difficult to state that antibiotics are chosen and used consciously. This study was planned to determine the prevalence of prescribing antibiotics in Turkey. Methodology: This cross-sectional study was conducted in November 2003. The study was carried out in a total of 46 primary care health centers of the following cities; Central Anatolian, Western Anatolian, Eastern Anatolian regions. Results: Two hundred sixty seven physicians participated in the study, 38.9% (104) of which were women and 61.1% (163) were men. The proportion of antibiotic prescription was by 22,6%, and the most frequently chosen antibiotics were 15.6% (3301) Amoxycilline + Clavulanic acid (Amox/Clav), 15.1% (3184) Ampicilline + Sulbactam 12.84% (2711), respectively. When prescriptions with antibiotics were evaluated according to diagnosis, the most frequent diagnoses were found to be as follows: 53.3% (11430) Acute Upper Respiratory Infections, 16.4% (3516) Urinary Tract Infections. Conclusions: The findings of the study suggest that primary health care physicians most often prescribe for acute respiratory tract infections, and prescribe Amoxycilline + Clavunic the most. It may be argued that more extensive studies are needed in this field. (author)

  1. Increased risk of tuberculosis in health care workers: a retrospective survey at a teaching hospital in Istanbul, Turkey

    Directory of Open Access Journals (Sweden)

    Tabak Levent

    2002-07-01

    Full Text Available Abstract Background Tuberculosis (TB is an established occupational disease affecting health care workers (HCWs. Determining the risk of TB among HCWs is important to enable authorites to take preventative measures in health care facilities and protect HCWs. This study was designed to assess the incidence of TB in a teaching hospital in Istanbul, Turkey. This study is retrospective study of health records of HCWs in our hospital from 1991 to 2000. Results The mean workforce of the hospital was 3359 + 33.2 between 1991 and 2000. There were 31 cases (15 male meeting the diagnostic criteria for TB, comprising eight doctors, one nurse and 22 other health professionals. Mean incidence of TB was 96 per 100,000 for all HCWs (relative risk: 2.71, 79 per 100,000 for doctors (relative risk: 2.2, 14 per 100,000 for nurses and 121 per 100,000 (relative risk: 3.4 for other professionals. The mean incidence of TB in Turkey between 1991 and 2000 was 35.4 per 100,000. Incidence of TB was similar in the Departments of Chest Diseases and Clinical Medicine but there were no TB cases in the Basic Science and Managerial Departments. Conclusion HCWs in Turkey who work in clinics have an increased risk for TB. Post-graduate education and prevention programs reduce the risk of TB. Control programs to prevent nosocomial transmission of TB should be established in hospitals to reduce risk for HCWs.

  2. MUSCULOSKELETAL MORBIDITIES IN CLASS 4 WOMEN EMPLOYEES OF A TERTIARY CARE HOSPITAL: A CROSS-SECTIONAL SURVEY

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    Verma Chhaya

    2015-06-01

    Full Text Available Background: A job is a piece of work done as a part of the routine of one’s occupation for an agreed price. Every occupation is associated with one or more ill effects on the health of the worker. Musculoskeletal morbidity is the commonest cause for occupational health problems & accounts for large number of workers’ compensation days & disabilities. Aim: To conduct a survey on prevalence of musculoskeletal pain & dysfunction in class 4 female hospital employees Materials & Methodology: Settings & Design: Interview based randomized cross sectional survey. 80 female class 4 employees working at the Lokmanya Tilak municipal medical college & general hospital (LTMMC & LTMGH participated in the study. Based on work pattern, a semi-structured questionnaire was prepared and validated. An informed consent was obtained before the interview. The data thus collected over a period of 3 months was analyzed to determine the prevalence & intensity of musculoskeletal dysfunction, pain & its influence on daily activity. Data was spread in Microsoft Excel 2010 & statistically analyzed using percentages. Results & Conclusion: This study shows that considerable musculoskeletal pain & dysfunction was observed among the women sweepers & aayabai. The back & the knee appear to be affected more than rest of the joints mainly attributed to the combined effect of occupational & psychological stress.

  3. Willingness to pay for health care services in common cold, retinal detachment, and myocardiac infarction: an internet survey in Japan

    Directory of Open Access Journals (Sweden)

    Imamura Tomoaki

    2006-02-01

    Full Text Available Abstract Background The application of Willingness To Pay (WTP measurement with Contingent Valuation Method (CVM to medical services is gradually increasing. Knowing what influences WTP is an important matter because validity of CVM in medical services remains controversial. The objective of this survey is to measure WTP for the treatment of typical acute illnesses and to analyze the factors affecting WTP. Methods A questionnaire survey was conducted over the Internet, in which 795 men and women between 40 and 59 years old responded to questions about WTP for medical expenses in three hypothetical scenarios: common cold (CC, retinal detachment (RD and myocardiac infarction (MI. Results Mean WTP was $29.9 for CC, $2,233 for RD, and $8,976 for MI. WTP for RD and MI was lower in the low-income group. While WTP for CC did not vary with income, WTP was higher in groups whose current subjective fitness levels were low. Conclusion Although WTP measurements are criticized frequently for their validity and reliability, they are still useful for determining the economic value of medical services. Based on the results of this study, it is deemed necessary to enhance safety nets for low-income earners in regards to serious illnesses that incur high medical expenses. Further, it is recommended that the rate of co-payments be set relatively high with respect to mild illnesses for which alternative services are available.

  4. Assessing early access to care and child survival during a health system strengthening intervention in Mali: a repeated cross sectional survey.

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    Ari D Johnson

    Full Text Available BACKGROUND: In 2012, 6.6 million children under age five died worldwide, most from diseases with known means of prevention and treatment. A delivery gap persists between well-validated methods for child survival and equitable, timely access to those methods. We measured early child health care access, morbidity, and mortality over the course of a health system strengthening model intervention in Yirimadjo, Mali. The intervention included Community Health Worker active case finding, user fee removal, infrastructure development, community mobilization, and prevention programming. METHODS AND FINDINGS: We conducted four household surveys using a cluster-based, population-weighted sampling methodology at baseline and at 12, 24, and 36 months. We defined our outcomes as the percentage of children initiating an effective antimalarial within 24 hours of symptom onset, the percentage of children reported to be febrile within the previous two weeks, and the under-five child mortality rate. We compared prevalence of febrile illness and treatment using chi-square statistics, and estimated and compared under-five mortality rates using Cox proportional hazard regression. There was a statistically significant difference in under-five mortality between the 2008 and 2011 surveys; in 2011, the hazard of under-five mortality in the intervention area was one tenth that of baseline (HR 0.10, p<0.0001. After three years of the intervention, the prevalence of febrile illness among children under five was significantly lower, from 38.2% at baseline to 23.3% in 2011 (PR = 0.61, p = 0.0009. The percentage of children starting an effective antimalarial within 24 hours of symptom onset was nearly twice that reported at baseline (PR = 1.89, p = 0.0195. CONCLUSIONS: Community-based health systems strengthening may facilitate early access to prevention and care and may provide a means for improving child survival.

  5. The effect of educational attainment levels on use of non-traditional health information resources: Findings from the Canadian survey of experiences with primary health care

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    Sean Hardiman

    2015-12-01

    Full Text Available Canadian provincial governments have made significant investments in nurse advice telephone lines and Internet resources as non-traditional options to reduce emergency department visits and improve access to health care for the population. However, little is known about the characteristics of users of these services, and who chooses to use them first, before accessing other sources of health advice. Additionally, individuals with lower levels of education tend to be late adopters of technology and have inconsistent utilization of health services. The purpose of the study is to examine the effect of educational attainment levels on the use of non-traditional health information sources first, before other more conventional sources of health information. The study utilized Canadian Survey of Experiences with Primary Health Care (CSE-PHC, 2007-2008 survey data. Logistic regression models were constructed to examine the relationship between use of non-traditional health information sources first, and educational attainment, adjusted for confounders. Relative to someone with less than secondary education, individuals with secondary education (OR = 4.30, 95% CI: 2.44 – 7.59, and individuals with post-secondary education (OR 4.91, 95% CI: 2.78 – 8.67, had significantly greater odds of using non-traditional health information sources first. These findings suggest that educational attainment has a significant effect on the use of non-traditional health information sources first. Future providers of non-traditional health information sources, especially in the design of future eHealth tools and consideration of eHealth literacy, should consider these results in development and implementation of their communications strategies to maximize the reach of their services.

  6. Socioeconomic inequalities in the use of outpatient services in Brazil according to health care need: evidence from the World Health Survey

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    Souza-Júnior Paulo RB

    2010-07-01

    Full Text Available Abstract Background The Brazilian health system is founded on the principle of equity, meaning provision of equal care for equal needs. However, little is known about the impact of health policies in narrowing socioeconomic health inequalities. Using data from the Brazilian World Health Survey, this paper addresses socioeconomic inequalities in the use of outpatient services according to intensity of need. Methods A three-stage cluster sampling was used to select 5000 adults (18 years and over. The non-response rate was 24.7% and calibration of the natural expansion factors was necessary to obtain the demographic structure of the Brazilian population. Utilization was established by use of outpatient services in the 12 months prior to the interview. Socioeconomic inequalities were analyzed by logistic regression models using years of schooling and private health insurance as independent variables, and controlling by age and sex. Effects of the socioeconomic variables on health services utilization were further analyzed according to self-rated health (good, fair and poor, considered as an indicator of intensity of health care need. Results Among the 5000 respondents, 63.4% used an outpatient service in the year preceding the survey. The association of health services utilization and self-rated health was significant (p Conclusions The analysis showed that the social gradient in outpatient services utilization decreases as the need is more intense. Among individuals with good self-rated health, possible explanations for the inequality are the lower use of preventive services and unequal supply of health services among the socially disadvantaged groups, or excessive use of health services by the wealthy. On the other hand, our results indicate an adequate performance of the Brazilian health system in narrowing socioeconomic inequalities in health in the most serious situations of need.

  7. Inspiratory muscle training is used in some intensive care units, but many training methods have uncertain efficacy: a survey of French physiotherapists

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    Tristan Bonnevie

    2015-10-01

    Full Text Available Questions: How common is inspiratory muscle training by physiotherapists in the intensive care unit (ICU? Which patients receive the training? What methods are used to administer the training? Is maximal inspiratory pressure used to evaluate the need for the training and the patient's outcome after training? Design: Cross-sectional survey of all ICUs in France. Participants: Two hundred and sixty-five senior physiotherapists. Results: The response rate was 99% among eligible units. Therapist experience in ICU was significantly associated with the use of inspiratory muscle training (p = 0.02. Therapists mainly used inspiratory muscle training either systematically or specifically in patients who failed to wean from mechanical ventilation. The training was used significantly more in non-sedated patients (p < 0.0001. The most commonly nominated technique that respondents claimed to use to apply the training was controlled diaphragmatic breathing (83% of respondents, whereas 13% used evidence-based methods. Among those who applied some form of inspiratory muscle training, 16% assessed maximal inspiratory pressure. Six respondents (2%, 95% CI 1 to 5 used both an evidence-based method to administer inspiratory muscle training and the recommended technique for assessment of inspiratory muscle strength. Conclusion: Most physiotherapists in French ICUs who apply inspiratory muscle training use methods of uncertain efficacy without assessment of maximal inspiratory pressure. Further efforts need to be made in France to disseminate information regarding evidence-based assessment and techniques for inspiratory muscle training in the ICU. The alignment of inspiratory muscle training practice with evidence could be investigated in other regions. [Bonnevie T, Villiot-Danger J-C, Gravier F-E, Dupuis J, Prieur G, Médrinal C (2015 Inspiratory muscle training is used in some intensive care units, but many training methods have uncertain efficacy: a survey of

  8. Current practices of mobilization, analgesia, relaxants and sedation in Indian ICUs: A survey conducted by the Indian Society of Critical Care Medicine

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    Rajesh Chawla

    2014-01-01

    Full Text Available Background and Aim: Use of sedation, analgesia and neuromuscular blocking agents is widely practiced in Intensive Care Units (ICUs. Our aim is to study the current practice patterns related to mobilization, analgesia, relaxants and sedation (MARS to help in standardizing best practices in these areas in the ICU. Materials and Methods: A web-based nationwide survey involving physicians of the Indian Society of Critical Care Medicine (ISCCM and the Indian Society of Anesthesiologists (ISA was carried out. A questionnaire included questions on demographics, assessment scales for delirium, sedation and pain, as also the pharmacological agents and the practice methods. Results: Most ICUs function in a semi-closed model. Midazolam (94.99% and Fentanyl (47.04% were the most common sedative and analgesic agents used, respectively. Vecuronium was the preferred neuromuscular agent. Monitoring of sedation, analgesia and delirium in the ICU. Ramsay′s Sedation Scale (56.1% and Visual Analogue Scale (48.07% were the preferred sedation and pain scales, respectively. CAM (Confusion Assessment Method-ICU was the most preferred method of delirium assessment. Haloperidol was the most commonly used agent for delirium. Majority of the respondents were aware of the benefit of early mobilization, but lack of support staff and safety concerns were the main obstacles to its implementation. Conclusion: The results of the survey suggest that compliance with existing guidelines is low. Benzodiazepines still remain the predominant ICU sedative. The recommended practice of giving analgesia before sedation is almost non-existent. Delirium remains an underrecognized entity. Monitoring of sedation levels, analgesia and delirium is low and validated and recommended scales for the same are rarely used. Although awareness of the benefits of early mobilization are high, the implementation is low.

  9. Surveying Humaness

    DEFF Research Database (Denmark)

    Markussen, Randi; Gad, Christopher

    procedures. Subjectivity is rather regulated and constituted in this practice. The relevant question becomes in what particular ways subjectivity and humanness are performed here? We want to look into this question exploring the agency of surveys, their effects and the politics involved in such a scientific......Christopher Gad. Ph.d. Dept. of Information and Media Studies Randi Markussen. Associate Professor, Dept. of Information and Media Studies. rmark@imv.au.dk   Abstract:   Surveying humanness -politics of care improvement   For various reasons we both were subjected to a specific survey procedure...... carried out in a Danish county in order to improve treatment of people who have suffered from long-term illnesses. The surveys concern not only feed back on how people experience their present and past interaction with the social services and health care system; they also ask people to indicate the state...

  10. Antenatal iron/folic acid supplements, but not postnatal care, prevents neonatal deaths in Indonesia: analysis of Indonesia Demographic and Health Surveys 2002/2003–2007 (a retrospective cohort study)

    OpenAIRE

    Titaley, Christiana Rialine; Dibley, Michael John

    2012-01-01

    Objective This study aimed to assess the contribution of postnatal services to the risk of neonatal mortality, and the relative contributions of antenatal iron/folic acid supplements and postnatal care in preventing neonatal mortality in Indonesia. Design Retrospective cohort study. Setting and participants Data used in this study were the 2002–2007 Indonesia Demographic and Health Surveys, nationally representative surveys. The pooled data provided survival information of 26 591 most recent ...

  11. A survey of alkylphenols, bisphenols, and triclosan in personal care products from China and the United States.

    Science.gov (United States)

    Liao, Chunyang; Kannan, Kurunthachalam

    2014-07-01

    Exposure of humans to environmental phenolic compounds such as bisphenol A (BPA) and alkylphenols is a matter of concern, due to these compounds' ubiquitous occurrence and estrogenic potencies. Little is known about the levels of environmental phenolics in personal care products (PCPs). In this study, nonylphenol, two octylphenols, eight bisphenols (BPA and its analogs), and triclosan (TCS) were determined by liquid chromatography-tandem mass spectrometry (LC-MS/MS) in PCP samples (n = 231) collected from China and the United States (U.S.). The concentrations of 4-n-nonylphenol (4-NP), 4-n-octylphenol (4-OP), 4-tert-octylphenol (4-t-OP), and TCS were in the ranges of geometric mean (GM): 21.5], 85 %) of the dermal exposure doses of the target phenolics. PMID:24639116

  12. A survey of phthalates and parabens in personal care products from the United States and its implications for human exposure.

    Science.gov (United States)

    Guo, Ying; Kannan, Kurunthachalam

    2013-12-17

    Despite the widespread usage of phthalates and parabens in personal care products (PCPs), little is known about concentrations and profiles as well as human exposure to these compounds through the use of PCPs. In this study, nine phthalates and six parabens were determined in 170 PCPs (41 rinse-off and 109 leave-on), including 20 baby care products collected from Albany, New York. Phthalates were less frequently found in rinse-off PCPs but were more frequently found in perfumes (detection frequency of 100% for diethyl phthalate [DEP], 67% for dibutyl phthalate [DBP]), skin toners (90% for DEP), and nail polishes (90% for DBP). Parabens were found in ∼40% of rinse-off products and ∼60% of leave-on products. The highest concentrations of DEP, DBP, methyl- (MeP), ethyl- (EtP), propyl- (PrP), and butyl parabens (BuP) were on the order of 1000 μg per gram of the product. On the basis of amount and frequency of use of PCPs and the measured median concentrations of target analytes, the total dermal intake doses (sum of all phthalates or parabens) were calculated to be 0.37 and 31.0 μg/kg-bw/day for phthalates and parabens, respectively, for adult females. The calculated dermal intake of phthalates from PCPs was lower for infants and toddlers than for adult females. In contrast, dermal intake of parabens from PCPs by infants and toddlers was higher than that for adult females. The calculated maximum daily exposure dose of MeP, EtP, and PrP from PCPs ranged between 58.6 and 766 μg/kg-bw/day for infants and toddlers, which was 3 times higher than that calculated for adult females. PCPs are an important source of human exposure to parabens; the contribution of PCPs to phthalate exposure is low, except for DEP. PMID:24261694

  13. Should β-lactam antibiotics be administered by continuous infusion in critically ill patients? A survey of Australia and New Zealand intensive care unit doctors and pharmacists.

    Science.gov (United States)

    Cotta, Menino O; Dulhunty, Joel M; Roberts, Jason A; Myburgh, John; Lipman, Jeffrey

    2016-06-01

    Although there is a biological precedent for administration of β-lactam antibiotics by continuous or extended infusion, there is no definitive evidence of a survival benefit compared with intermittent administration. The aim of this study was to explore clinician uncertainty with regard to the administration of β-lactam antibiotics by continuous infusion. Doctors and pharmacists in Australian and New Zealand intensive care units (ICUs) were surveyed to investigate current β-lactam antibiotic administration practices as well as the degree of uncertainty regarding the benefit of continuous infusion of two commonly used broad-spectrum β-lactams, namely meropenem and piperacillin/tazobactam (TZP). There were 111 respondents to the survey. Intermittent infusion was reported as standard practice for meropenem (73.9%) and TZP (82.0%). A greater proportion of pharmacists compared with doctors believed continuous infusion to be more effective than intermittent administration (85.4% vs. 34.3%, respectively; P <0.001). Both groups reported uncertainty as to whether administration by continuous infusion resulted in better patient outcomes (65.9% and 74.6%, respectively; P = 0.85). Overall, 91.0% of respondents were prepared to enrol eligible patients into a definitive randomised controlled trial on β-lactam antibiotic administration. In conclusion, there is equipoise among clinicians working in Australian and New Zealand ICUs as to whether administration by continuous infusion offers a survival benefit in critically ill patients. PMID:27179814

  14. Using group-based latent class transition models to analyze chronic disability data from the National Long-Term Care Survey 1984-2004.

    Science.gov (United States)

    White, Toby A; Erosheva, Elena A

    2013-09-10

    Latent class transition models track how individuals move among latent classes through time, traditionally assuming a complete set of observations for each individual. In this paper, we develop group-based latent class transition models that allow for staggered entry and exit, common in surveys with rolling enrollment designs. Such models are conceptually similar to, but structurally distinct from, pattern mixture models of the missing data literature. We employ group-based latent class transition modeling to conduct an in-depth data analysis of recent trends in chronic disability among the U.S. elderly population. Using activities of daily living data from the National Long-Term Care Survey (NLTCS), 1982-2004, we estimate model parameters using the expectation-maximization algorithm, implemented in SAS PROC IML. Our findings indicate that declines in chronic disability prevalence, observed in the 1980s and 1990s, did not continue in the early 2000s as previous NLTCS cross-sectional analyses have indicated. PMID:23553714

  15. A cross-sectional study of early identification of postpartum depression: Implications for primary care providers from The Ontario Mother & Infant Survey

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    Sword Wendy

    2002-04-01

    Full Text Available Abstract Background This survey's objective was to provide planning information by examining utilization patterns, health outcomes and costs associated with existing practices in the management of postpartum women and their infants. In particular, this paper looks at a subgroup of women who score ≥ 12 on the Edinburgh Postnatal Depression Survey (EPDS. Methods The design is cross-sectional with follow-up at four weeks after postpartum hospital discharge. Five Ontario hospitals, chosen for their varied size, practice characteristics, and geographic location, provided the setting for the study. The subjects were 875 women who had uncomplicated vaginal deliveries of live singleton infants. The main outcome measures were the EPDS, the Duke UNC Functional Social Support Questionnaire and the Health and Social Services Utilization Questionnaire. Results EPDS scores of ≥ 12 were found in 4.3 to 15.2% of otherwise healthy women. None of these women were being treated for postpartum depression. Best predictors of an EPDS score of ≥ 12 were lack: of confident support, lack of affective support, household income of Conclusions Primary care physicians, midwives, and public health nurses need to screen for depression at every opportunity early in the postpartum period. A mother's expression of undue concern about her own or her baby's health may be predictive of postpartum depression. Flexible, mother-focused support from community providers may decrease the prevalence of postpartum depression.

  16. Variation in Hepatitis C services may lead to inequity of heath-care provision: a survey of the organisation and delivery of services in the United Kingdom

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    Bennett-Lloyd Bethan

    2006-01-01

    Full Text Available Abstract Background Chronic hepatitis C infection (CHC is a major healthcare problem. Effective anti-viral therapy is available. To maximise population effectiveness, co-ordinated services for detection and management of patients with CHC are required. There is a need to determine patterns of healthcare delivery to plan improvements. A study was conducted to determine workload, configuration and care processes of current UK services available to manage patients with CHC. Methods A cross-sectional questionnaire survey of consultant members of British Association for the Study of the Liver (n = 53, Infectious Disease consultants (n = 43, and a 1 in 5 sample of Genito-Urinary Medicine (n = 48 and gastroenterologists (n = 200. Results Response rate was 70%. 40% of respondents provided a comprehensive service (included treatment and follow-up: speciality of clinical leads identified as Hepatology (37%; Gastroenterology (47%; and Infectious Disease (16%. The estimated number of patients managed by respondents was about 23,000 with an upward trend over the previous 3 years. There was variation between comprehensive service providers, including unit size, eligibility criteria for treatment, and drug regimes. Key barriers to quality of care identified were staffing capacity, funding of treatment and patient non-attendance. Most English strategic health authorities had at least one comprehensive service provider. Conclusion There was significant variation in all aspects of the patient pathway which may contribute to inequity of health care provision. Services need to be expanded to form geographical clinical networks, and properly resourced to ensure greater uptake and more equitable delivery of services if the future burden of chronic liver disease is to be reduced.

  17. Comparison of the epidemiologic features and patterns of initial care for prostate cancer between public and private institutions: a survey by the Brazilian Society of Urology

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    Aguinaldo Cesar Nardi

    2012-04-01

    Full Text Available OBJECTIVE: To describe the epidemiological features and patterns of initial care for prostate cancer at public and private institutions in the State of Sao Paulo, Brazil. MATERIALS AND METHODS: A total of 1,082 physicians affiliated to the Sao Paulo Section of the Brazilian Society of Urology were invited to participate in this cross-sectional, web-based survey. Between September 2004 and September 2005, participating urologists entered data on demographic, clinical and pathological characteristics of patients diagnosed with prostate cancer in their practice. Data on patients attended at public institutions were analyzed and compared with those patients attended at private practice. RESULTS: One hundred and ten society members contributed with data from 1915 patients, 1026 (53.6% of whom from public institutions. When compared with patients attended at private institutions, those attended at public institutions were older and more likely to be black, had higher serum prostate specific antigen (PSA levels, had a higher probability of being diagnosed with metastatic disease, but were less likely to undergo prostatectomy (all P < 0.001. In multivariate analysis, age, biopsy Gleason score, and being attended at a public institution were independently associated with metastatic disease upon diagnosis. The significant predictors of nonsurgical treatment were age, black race, and higher serum levels of PSA. CONCLUSIONS: A statewide registry provides valuable information regarding patient demographics, clinical features, and patterns of care. The results of this study suggest that significant disparities exist for patients with prostate cancer attended at different health-care systems. The relative contribution of biological versus socioeconomic features remains uncertain.

  18. The Role of Chiropractic Care in the Treatment of Dizziness or Balance Disorders: Analysis of National Health Interview Survey Data.

    Science.gov (United States)

    Ndetan, Harrison; Hawk, Cheryl; Sekhon, Vishaldeep Ka; Chiusano, Miguel

    2016-04-01

    The purpose of this study was to explore the role of chiropractic in the treatment of dizziness or balance disorders through an analysis of data from the 2008 National Health Interview Survey. Odds ratios and 95% confidence intervals (CIs) were used to assess the likelihood that respondents with dizziness or balance problems perceived that they were helped by specified practitioners. Eleven percent of respondents reported having had a balance or dizziness problem; more than 35% were aged 65 years and older. The odds ratio for perceiving being helped by a chiropractor was 4.36 (95% CI, 1.17-16.31) for respondents aged 65 years or older; 9.5 (95% CI, 7.92-11.40) for respondents reporting head or neck trauma; and 13.78 (95% CI, 5.59-33.99) for those reporting neurological or muscular conditions as the cause of their balance or dizziness. PMID:26362851

  19. Awareness about medical research among resident doctors in a tertiary care hospital: A cross-sectional survey

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    Dattatray B Pawar

    2012-01-01

    Full Text Available Context: Every medical practitioner should strive to contribute to the generation of evidence by conducting research. For carrying out research, adequate knowledge, practical skills, and development of the right attitude are crucial. A literature review shows that data regarding knowledge, attitude, and practices toward medical research, among resident doctors in India, is lacking. Aims: This study was conducted to assess research-related knowledge, attitude, and practices among resident doctors. Settings and Design: A cross-sectional survey was conducted using a pretested, structured, and pre-validated questionnaire. Materials and Methods: With approval of the Institutional Ethics Committee and a verbal consent, a cross-sectional survey among 100 resident doctors pursuing their second and third years in the MD and MS courses was conducted using a structured and pre-validated questionnaire. Statistical Analysis: Descriptive statistics were used to analyze the results. Results: The concept of research hypothesis was known to 58% of the residents. Ninety-eight percent of the residents were aware of the procedure to obtain informed consent. Seventy-six percent agreed that research training should be mandatory. Although 88% of the residents were interested in conducting research in future, 50% had participated in research other than a dissertation project, 28% had made scientific presentations, and only 4% had publications. Lack of time (74%, lack of research curriculum (42%, and inadequate facilities (38% were stated as major obstacles for pursuing research. Conclusions: Although resident doctors demonstrated a fairly good knowledge and positive attitude toward research, it did not translate into practice for most of them. There is a need to improve the existing medical education system to foster research culture among resident doctors

  20. The mental health care gap among children and adolescents: data from an epidemiological survey from four Brazilian regions.

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    Cristiane S Paula

    Full Text Available INTRODUCTION: Worldwide, a minority of disordered children/adolescents receives mental health assistance. In order to improve service access, it is important to investigate factors that influence the process leading to receiving care. Data on frequency and barriers for mental health service use (MHSU among Brazilian children/adolescents are extremely scarce and are needed to guide public policy. OBJECTIVES: To establish the frequency of MHSU among 6-to-16-year-old with psychiatric disorders from four Brazilian regions; and to identify structural/psychosocial/demographic barriers associated with child/adolescent MHSU. METHODS: Multicenter cross-sectional-study involving four towns from four out of five Brazilian regions. In each town, a representative sample of elementary public school students was randomly selected (sample: 1,721. Child/adolescent MHSU was defined as being seen by a psychologist/psychiatrist/neurologist in the previous 12 months. Standardized instruments measured: (1 children/adolescent characteristics [(1.1 Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS-PL-psychiatric disorders; (1.2 Ten Questions Screen-neurodevelopment problems; (1.3 two subtests of WISC-III-estimated IQ; (1.4 Academic Performance Test-school performance], (2 factors related to mothers/main caregivers (Self-Reporting Questionnaire-anxiety/depression, (3 family (Brazilian Research-Companies-Association's Questionnaire-SES. RESULTS: Only 19.8% of children/adolescents with psychiatric disorder have used mental health services in the previous 12 months. Multiple logistic regression modeling identified five factors associated with lower rates of MHSU (female gender, adequate school performance, mother/main caregiver living with a partner, lower SES, residing in deprived Brazilian regions regardless of the presence of any psychiatric disorders/neurodevelopmental problems. CONCLUSIONS: Only a small proportion of children

  1. Health care for immigrant women in Italy: are we really ready? A survey on knowledge about female genital mutilation

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    Emanuele Caroppo

    2014-03-01

    Full Text Available BACKGROUND: Because of immigration, female genital mutilation (FGM is an issue of increasing concern in western countries. Nevertheless operators without a specific training may ignore the health condition of women subjected to this practice and fail to provide them adequate assistance. The purpose of the study was to estimate the current knowledge about FGM among social and health care assistants working with asylum seeker. MATERIAL AND METHODS: From October to December 2012, a questionnaire was used to interview 41 operators working in CARA (Shelter for Refugees and Asylum Seekers in central and southern Italy. RESULTS: Only 7.3% of respondents states to know well FGM, while 4.9% do not know it at all. 70.7% declare to have never met or assisted a woman with FGM, nevertheless all respondents work with asylum seeker from countries where FGM are performed. CONCLUSIONS: Migration fluxes to Italy over the past decade created a healthcare challenge: women with FGM have specific medical and psychological problems that doctors, nurses and social assistants without specific training are not usually able to manage.

  2. Patient refusal for regional anesthesia in elderly orthopedic population: A cross-sectional survey at a tertiary care hospital

    Science.gov (United States)

    Salam, Asma Abdus; Afshan, Gauhar

    2016-01-01

    Background and Aims: Improvements in pain management techniques in the last decade have had a major impact on the practice of orthopedic surgeries, for example, total hip arthroplasty and total knee arthroplasty. Although there are a number of treatment options for postoperative pain, a gold standard has not been established. In our institution, both general anesthesia and regional anesthesia (RA), are being offered to the elderly orthopedic population but RA is not frequently accepted by elderly population. The objective of this study was to determine the frequency of various reasons for refusal of RA in elderly patients undergoing orthopedic surgeries. Material and Methods: A prospective study conducted over a period of 1 year, had 549 patients with ages above 60 years who underwent different types of elective orthopedic procedures 182 patients who refused RA were interviewed according to a structured questionnaire designed to assess the reasons of refusal. Results: Most common reason for the refusal of RA was surgeon's choice (38.5%), whereas 20.3% of the patients were unaware about the RA. There was a significant association between female gender and refusing RA due to backache (17.2%) and fear of being awake during the operation (24.1%) respectively. Conclusion: This survey showed that the main reasons among elderly female population were the fear of remaining awake and backache. However, overall it was the surgeon's choice which made patients refuse RA, and the anesthesiologists were the main source of information. PMID:27006550

  3. Implementing and managing self-management skills training within primary care organisations: a national survey of the expert patients programme within its pilot phase

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    Rogers Anne

    2006-02-01

    Full Text Available Abstract A key element of the United Kingdom (UK health policy reform in relation to chronic disease management is the introduction of a national programme seeking to promote self-care from within the National Health Service (NHS. The mainstay of the Expert Patients Programme (EPP is a six-week training course that provides the opportunity for anyone with a long-term condition to develop new skills to manage their condition better on a day-to-day basis. The course forms part of the NHS self-care support programme, is administered by Primary Care Trusts (PCTs and delivered by people who have personal experience of living with a long-term condition. The NHS' official Expert Patients Programme website presently states that, "Pilot EPP courses began at 26 NHS PCT sites across England in May 2002, and by May 2004 approximately 300 PCTs had either actively implemented pilot courses or had committed to joining. The majority of PCTs are now coming to the end of the pilot phase, with many implementing plans to make EPP sustainable for the long-term." The NHS website heralds the pilot "a success." A national, postal survey of PCT EPP Leads was undertaken in order to examine both the evolvement of EPP during its pilot stage and future plans for the programme. A questionnaire was sent out to the 299 PCTs known to have committed to the EPP pilot, and an excellent 100% response rate was obtained over a 3-month period (April-July 2005. One marker of success of the Expert Patients Programme implementation is the actual running of courses by the Primary Care Trusts. This paper explores the extent to which the implementation of the pilot can indeed be viewed as a "success," primarily in terms of the number of courses run, and considers the extent to which PCTs have carried out all that they were committed to do. Findings suggest that the more time an EPP Lead dedicates to the Programme, the more likely it is that EPP has run successfully in the past, and the more

  4. Noninvasive Mechanical Ventilation Knowledge Level of the Nurses: A Questionnaire Survey in a Tertiary Care Training and Research Hospital

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    Merve Tarhan

    2015-12-01

    Full Text Available Objective: The correct use of necessary equipment is the key for a successful noninvasive mechanical ventilation (NIMV practice. Trained health care personnel are important part of the practice. The current study was conducted to that end, with the aim of determining the level of knowledge about NIMV of nurses working in a training and research hospital as descriptive. Methods: The study was conducted with 147 nurses who are working at Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital in İstanbul. Questionnaire form of 36 questions prepared by investigators was used to collect data. For the analysis of the results, numerical, percentages, Mann-Whitney U and Kruskal Wallis tests were used.’ Results: 40.8% nurses had received training about NIMV. By contrast, 24.5% stated that they had learned NIMV practices on their own. The lowest rate (26.5% of correct answered question was “disadvantages of oronasal mask”. The most answered statement as true was “Face masks should be established to the patient’s face with no gaps for prevention of leaks and the mask should be worn not to pressure on nasal bridge” (78.9%. Female and postgraduate nurses‘ total scores obtained from NIMV questions were higher than others and were statistically significant (p<0.05. Conclusion: The effective NIMV practices requires trained personnel. Nurses who have active role in NIMV practices should receive basic training in this topic. How will be started treatment, indications, who will be responsible for follow-up and points to take into consideration are mentioned clearly in the training program. This training programme should include processing of clinical experience as well as theoretical information.

  5. Paediatricians’ perspectives on global health priorities for newborn care in a developing country: a national survey from Nigeria

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    Olusanya Bolajoko O

    2012-07-01

    Full Text Available Abstract Background An understanding of the perception of paediatricians as key stakeholders in child healthcare delivery and the degree of congruence with current investment priorities is crucial in accelerating progress towards the attainment of global targets for child survival and overall health in developing countries. This study therefore elicited the views of paediatricians on current global priorities for newborn health in Nigeria as possible guide for policy makers. Methods Paediatric consultants and residents in the country were surveyed nationally between February and March 2011 using a questionnaire requiring the ranking of nine prominent and other neonatal conditions based separately on hospital admissions, mortality, morbidity and disability as well as based on all health indices in order of importance or disease burden. Responses were analysed with Friedman test and differences between subgroups of respondents with Mann-Whitney U test. Results Valid responses were received from 152 (65.8% of 231 eligible physicians. Preterm birth/low birthweight ranked highest by all measures except for birth asphyxia which ranked highest for disability. Neonatal jaundice ranked next to sepsis by all measures except for disability and above tetanus except mortality. Preterm birth/low birthweight, birth asphyxia, sepsis, jaundice and meningitis ranked highest by composite measures while jaundice had comparable rating with sepsis. Birth trauma was most frequently cited under other unspecified conditions. There were no significant differences in ranking between consultants and residents except for birth asphyxia in relation to hospital admissions and morbidity as well as sepsis and tetanus in relation to mortality. Conclusions Current global priorities for neonatal survival in Nigeria largely accord with paediatricians’ views except for neonatal jaundice which is commonly subsumed under “other“ or "miscellaneous" neonatal conditions. While the

  6. YRS Survey

    OpenAIRE

    Van Cauter, Sofie; Bersou, Maxime

    2016-01-01

    Residents have many questions concerning their training, education, and future, especially in a professional atmosphere that is considered difficult due to increasing financial and political restrictions in the health care system. To objectify this matter, the young radiologist section (YRS) created an online survey.

  7. Nontraumatic dental condition-related visits to emergency departments on weekdays, weekends and night hours: findings from the National Hospital Ambulatory Medical Care Survey

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    Okunseri C

    2013-09-01

    Full Text Available Christopher Okunseri,1 Elaye Okunseri,1 Melissa Christine Fischer,1 Saba Noori Sadeghi,1 Qun Xiang,2 Aniko Szabo21Department of Clinical Services, School of Dentistry, Marquette University, Milwaukee, WI, USA; 2Division of Biostatistics, Institute of Health and Society, Medical College of Wisconsin, Milwaukee, WI, USAObjective: To determine whether the rates of nontraumatic dental condition (NTDC-related emergency department (ED visits are higher during the typical working hours of dental offices and lower during night hours, as well as the associated factors.Methods: We analyzed data from the National Hospital Ambulatory Medical Care Survey for 1997 through 2007 using multivariate binary and polytomous logistic regression adjusted for survey design to determine the effect of predictors on specified outcome variables.Results: Overall, 4,726 observations representing 16.4 million NTDC-related ED visits were identified. Significant differences in rates of NTDC-related ED visits were observed with 40%–50% higher rates during non-working hours and 20% higher rates on weekends than the overall average rate of 170 visits per hour. Compared with 19–33 year olds, subjects <18 years old had significantly higher relative rates of NTDC-related ED visits during nonworking hours [relative rate ratio (RRR = 1.6 to 1.8], whereas those aged 73 and older had lower relative rates during nonworking hours (RRR = 0.4; overall P = 0.0005. Compared with those having private insurance, Medicaid and self-pay patients had significantly lower relative rates of NTDC visits during nonworking and night hours (RRR = 0.6 to 0.7, overall P < 0.0003. Patients with a dental reason for visit were overrepresented during the night hours (RRR = 1.3; overall P = 0.04.Conclusion: NTDC-related visits to ED occurred at a higher rate during non-working hours and on weekends and were significantly associated with age, patient-stated reason for visit and payer type.Keywords: dental

  8. French district nurses' opinions towards euthanasia, involvement in end‐of‐life care and nurse–patient relationship: a national phone survey

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    Bendiane, M‐K; Galinier, A; Favre, R; Ribiere, C; Lapiana, J‐M; Obadia, Y; Peretti‐Watel, P

    2007-01-01

    Objectives To assess French district nurses' opinions towards euthanasia and to study factors associated with these opinions, with emphasis on attitudes towards terminal patients. Design and setting An anonymous telephone survey carried out in 2005 among a national random sample of French district nurses. Participants District nurses currently delivering home care who have at least 1 year of professional experience. Of 803 district nurses contacted, 602 agreed to participate (response rate 75%). Main outcome measures Opinion towards the legalisation of euthanasia (on a five‐point Likert scale from “strongly agree” to “strongly disagree”), attitudes towards terminal patients (discussing end‐of‐life issues with them, considering they should be told their prognosis, valuing the role of advance directives and surrogates). Results Overall, 65% of the 602 nurses favoured legalising euthanasia. Regarding associated factors, this proportion was higher among those who discuss end‐of‐life issues with terminal patients (70%), who consider competent patients should always be told their prognosis (81%) and who value the role of advance directives and surrogates in end‐of‐life decision‐making for incompetent patients (68% and 77% respectively). Women and older nurses were less likely to favour legalising euthanasia, as were those who believed in a god who masters their destiny. Conclusions French nurses are more in favour of legalising euthanasia than French physicians; these two populations contrast greatly in the factors associated with this support. Further research is needed to investigate how and to what extent such attitudes may affect nursing practice and emotional well‐being in the specific context of end‐of‐life home care. PMID:18055901

  9. Survey on nursing of breast cancer patients treated with radiotherapy following to breast-conserving surgery. Actual states and problems for nursing care by certified nurses in breast cancer nursing

    International Nuclear Information System (INIS)

    The purpose of the present study is to elucidate the actual states and problems of nursing care provided by certified nurses in breast cancer patients treated with radiotherapy following to breast-conserving surgery. The survey was conducted by a postal anonymous questionnaire. Participants were drawn from the list of certified nurses on the website of Japanese Nursing Association. The questionnaires consisted of multiple choice questions regarding the contents of care performed before, during and after radiotherapy, and free questionnaire on the related problems. The rate of valid replies was 41.2% (40 out of 97 subjects). Before radiotherapy, the accomplishing rate exceeded 70% in about half of all nursing cares. The accomplishing rates were 30 to 50% in about 90% of all cares and 40 to 60% in all cares during and after radiotherapy, respectively. Problems were classified into three categories high-quality practice of radiotherapy nursing, establishment of continuing care system and improvement of cooperation. It is recommended to achieve high quality radiotherapy nursing by certified nurses, the establishment of continuing care system and the improvement of cooperation in order to improve nursing care during and after radiotherapy. (author)

  10. Coverage and development of specialist palliative care services across the World Health Organization European region (2005-2012): results from a European association for palliative care task force survey of 53 countries

    OpenAIRE

    Centeno, Carlos; Lynch, Thomas; Garralda, Eduardo; Carrasco, José Miguel; Guillen-Grima, Francisco; Clark, David

    2016-01-01

    Background: The evolution of the provision of palliative care specialised services is important for planning and evaluation. Aim: To examine the development between 2005 and 2012 of three specialised palliative care services across the World Health Organization European Region – home care teams, hospital support teams and inpatient palliative care services. Design and setting: Data were extracted and analysed from two editions of the European Association for Palliative Care Atlas of Pal...

  11. Who seeks primary care for musculoskeletal disorders (MSDs with physicians prescribing homeopathic and other complementary medicine? Results from the EPI3-LASER survey in France

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    Magnier Anne-Marie

    2011-01-01

    Full Text Available Abstract Background There is a paucity of information describing patients with musculoskeletal disorders (MSDs using complementary and alternative medicines (CAMs and almost none distinguishing homeopathy from other CAMs. The objective of this study was to describe and compare patients with MSDs who consulted primary care physicians, either certified homeopaths (Ho or regular prescribers of CAMs in a mixed practice (Mx, to those consulting physicians who strictly practice conventional medicine (CM, with regard to the severity of their MSD expressed as chronicity, co-morbidity and quality of life (QOL. Methods The EPI3-LASER study was a nationwide observational survey of a representative sample of general practitioners and their patients in France. The sampling strategy ensured a sufficient number of GPs in each of the three groups to allow comparison of their patients. Patients completed a questionnaire on socio-demographics, lifestyle and QOL using the Short Form 12 (SF-12 questionnaire. Chronicity of MSDs was defined as more than twelve weeks duration of the current episode. Diagnoses and co-morbidities were recorded by the physician. Results A total of 825 GPs included 1,692 MSD patients (predominantly back pain and osteoarthritis were included, 21.6% in the CM group, 32.4% Ho and 45.9% Mx. Patients in the Ho group had more often a chronic MSD (62.1% than the CM (48.6% or Mx (50.3% groups, a result that was statistically significant after controlling for patients' characteristics (Odds ratio = 1.43; 95% confidence interval (CI: 1.07 - 1.89. Patients seen by homeopaths or mixed practice physicians who were not the regular treating physician, had more often a chronic MSD than those seen in conventional medicine (Odds ratios were1.75; 95% CI: 1.22 - 2.50 and 1.48; 95% CI: 1.06 - 2.12, respectively. Otherwise patients in the three groups did not differ for co-morbidities and QOL. Conclusion MSD patients consulting primary care physicians who

  12. Brand Name and Generic Proton Pump Inhibitor Prescriptions in the United States: Insights from the National Ambulatory Medical Care Survey (2006–2010

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    Andrew J. Gawron

    2015-01-01

    Full Text Available Introduction. Proton pump inhibitors (PPI are one of the most commonly prescribed medication classes with similar efficacy between brand name and generic PPI formulations. Aims. We determined demographic, clinical, and practice characteristics associated with brand name PPI prescriptions at ambulatory care visits in the United States. Methods. Observational cross sectional analysis using the National Ambulatory Medical Care Survey (NAMCS of all adult (≥18 yrs of age ambulatory care visits from 2006 to 2010. PPI prescriptions were identified by using the drug entry code as brand name only or generic available formulations. Descriptive statistics were reported in terms of unweighted patient visits and proportions of encounters with brand name PPI prescriptions. Global chi-square tests were used to compare visits with brand name PPI prescriptions versus generic PPI prescriptions for each measure. Poisson regression was used to determine the incidence rate ratio (IRR for generic versus brand PPI prescribing. Results. A PPI was prescribed at 269.7 million adult ambulatory visits, based on 9,677 unweighted visits, of which 53% were brand name only prescriptions. In 2006, 76.0% of all PPI prescriptions had a brand name only formulation compared to 31.6% of PPI prescriptions in 2010. Visits by patients aged 25–44 years had the greatest proportion of brand name PPI formulations (57.9%. Academic medical centers and physician-owned practices had the greatest proportion of visits with brand name PPI prescriptions (58.9% and 55.6% of visits with a PPI prescription, resp.. There were no significant differences in terms of median income, patient insurance type, or metropolitan status when comparing the proportion of visits with brand name versus generic PPI prescriptions. Poisson regression results showed that practice ownership type was most strongly associated with the likelihood of receiving a brand name PPI over the entire study period. Compared to

  13. Potential barriers and facilitators for implementation of an integrated care pathway for hearing-impaired persons: an exploratory survey among patients and professionals

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    Verschuure Hans

    2007-04-01

    Full Text Available Abstract Background Because of the increasing costs and anticipated shortage of Ear Nose and Throat (ENT specialists in the care for hearing-impaired persons, an integrated care pathway that includes direct hearing aid provision was developed. While this direct pathway is still under investigation, in a survey we examined expectations and potential barriers and facilitators towards this direct pathway, of patients and professionals involved in the pathway. Methods Two study populations were assessed: members of the health professions involved in the care pathway for hearing-impaired persons (general practitioners (GPs, hearing aid dispensers, ENT-specialists and clinical audiologists and persons with hearing complaints. We developed a comprehensive semi-structured questionnaire for the professionals, regarding expectations, barriers, facilitators and conditions for implementation. We developed two questionnaires for persons with hearing complaints, both regarding evaluations and preferences, and administered them after they had experienced two key elements of the direct pathway: the triage and the hearing aid fitting. Results On average GPs and hearing aid dispensers had positive expectations towards the direct pathway, while ENT-specialists and clinical audiologists had negative expectations. Professionals stated both barriers and facilitators towards the direct pathway. Most professionals either supported implementation of the direct pathway, provided that a number of conditions were satisfied, or did not support implementation, unless roughly the same conditions were satisfied. Professionals generally agreed on which conditions need to be satisfied. Persons with hearing complaints evaluated the present referral pathway and the new direct pathway equally. Many, especially older, participants stated however that they would still visit the GP and ENT-specialist, even when this would not be necessary for reimbursement of the hearing aid, and

  14. Psychometric evaluation of the German Version of the Supportive Care Needs Survey for Partners and Caregivers (SCNS-P&C-G) of cancer patients.

    Science.gov (United States)

    Sklenarova, H; Haun, M W; Krümpelmann, A; Friederich, H-C; Huber, J; Thomas, M; Winkler, E C; Girgis, A; Dinkel, A; Herzog, W; Hartmann, M

    2015-11-01

    This study aimed for psychometric validation of the German version of the Supportive Care Needs Survey for Partners and Caregivers (SCNS-P&C-G). In- and outpatients with lung, urological and gastrointestinal cancer at Heidelberg University Hospital in Germany and in each case one relevant caregiver were asked to complete a set of questionnaires assessing their unmet needs together with distress, depression, anxiety and caregiver strain. In addition, medical data of the patients were collected. Fully completed questionnaires were received from 188 pairs of patients and their caregivers. Using exploratory factor analysis, four domains of unmet needs were identified with an appropriate variance explanation (58.7%) and acceptable (>0.70) internal consistencies (α = 0.95 to 0.76) for each domain. Convergent validity was found with respect to significant positive correlations (>0.40) of the SCNS-P&C-G domains with caregivers' anxiety, depression and strain. Although poorer health status of the patient indicated more unmet caregiver needs, this finding was not consistent for all need domains. Overall, associations were only moderate to weak pointing out the necessity of a separate screening for caregivers' needs. The findings of this study support that the SCNS-P&C-G is an appropriate research instrument to assess caregivers' needs on different domains throughout the disease trajectory. PMID:25939448

  15. Need, enabling, predisposing, and behavioral determinants of access to preventative care in Argentina: analysis of the national survey of risk factors.

    Directory of Open Access Journals (Sweden)

    Eiman Jahangir

    Full Text Available INTRODUCTION: Health care utilization is an important step to disease management, providing opportunities for prevention and treatment. Anderson's Health Behavior Model has defined utilization by need, predisposing, and enabling determinants. We hypothesize that need, predisposing, and enabling, highlighting behavioral factors are associated with utilization in Argentina. METHODS: We performed a logistic regression analysis of the 2005 and 2009 Argentinean Survey of Risk Factors, a cohort of 41,392 and 34,732 individuals, to explore the association between need, enabling, predisposing, and behavioral factors to blood pressure measurement in the last year. RESULTS: In the 2005 cohort, blood pressure measurement was associated with perception of health, insurance coverage, basic needs met, and income. Additionally, female sex, civil state, household type, older age groups, education, and alcohol use were associated with utilization. The 2009 cohort showed similar associations with only minor differences between the models. CONCLUSIONS: We explored the association between utilization of clinical preventive services with need, enabling, predisposing, and behavioral factors. While predisposing and need determinants are associated with utilization, enabling factors such as insurance coverage provides an area for public intervention. These are important findings where policies should be focused to improve utilization of preventive services in Argentina.

  16. Practice related factors that may impact on postpartum care for mothers and infants in Australian general practice: a cross-sectional survey

    OpenAIRE

    Brodribb, Wendy E; Mitchell, Benjamin L; van Driel, Mieke L

    2016-01-01

    Background While there is a significant focus on the health and well-being of women during pregnancy, labour and birth, much less emphasis is placed on the care of postpartum women and their infants in primary care following the birth. Some studies have investigated the role of GPs in postpartum care, and others examined facilitators and barriers to mothers accessing care. However there is little information available to investigate the effect of practice related factors on access to care of ...

  17. Teasing Apart the Child Care Conundrum: A Factorial Survey Analysis of Perceptions of Child Care Quality, Fair Market Price and Willingness to Pay by Low-Income, African American Parents

    Science.gov (United States)

    Shlay, Anne B.; Tran, Henry; Weinraub, Marsha; Harmon, Michelle

    2005-01-01

    Child care quality plays a crucial role in children's social and cognitive development. While child care quality is a critical issue for all children, it matters more for low-income children. Policy makers have increased the emphasis on allowing parents, not government, to make decisions about the type of care they want for their children. Yet…

  18. Ad Hoc Influenza Vaccination During Years of Significant Antigenic Drift in a Tropical City With 2 Seasonal Peaks: A Cross-Sectional Survey Among Health Care Practitioners.

    Science.gov (United States)

    Wong, Martin C S; Nelson, E Anthony S; Leung, Czarina; Lee, Nelson; Chan, Martin C W; Choi, Kin Wing; Rainer, Timothy H; Cheng, Frankie W T; Wong, Samuel Y S; Lai, Christopher K C; Lam, Bosco; Cheung, Tak Hong; Leung, Ting Fan; Chan, Paul K S

    2016-05-01

    We evaluated the acceptability of an additional ad hoc influenza vaccination among the health care professionals following seasons with significant antigenic drift.Self-administered, anonymous surveys were performed by hard copy questionnaires in public hospitals, and by an on-line platform available to all healthcare professionals, from April 1st to May 31st, 2015. A total of 1290 healthcare professionals completed the questionnaires, including doctors, nurses, and allied health professionals working in both the public and private systems.Only 31.8% of participating respondents expressed an intention to receive the additional vaccine, despite that the majority of them agreed or strongly agreed that it would bring benefit to the community (88.9%), save lives (86.7%), reduce medical expenses (76.3%), satisfy public expectation (82.8%), and increase awareness of vaccination (86.1%). However, a significant proportion expressed concern that the vaccine could disturb the normal immunization schedule (45.5%); felt uncertain what to do in the next vaccination round (66.0%); perceived that the summer peak might not occur (48.2%); and believed that the summer peak might not be of the same virus (83.5%). Furthermore, 27.8% of all respondents expected that the additional vaccination could weaken the efficacy of previous vaccinations; 51.3% was concerned about side effects; and 61.3% estimated that there would be a low uptake rate. If the supply of vaccine was limited, higher priority groups were considered to include the elderly aged ≥65 years with chronic medical conditions (89.2%), the elderly living in residential care homes (87.4%), and long-stay residents of institutions for the disabled (80.7%). The strongest factors associated with accepting the additional vaccine included immunization with influenza vaccines in the past 3 years, higher perceived risk of contracting influenza, and higher perceived severity of the disease impact.The acceptability to an additional ad

  19. Diagnosis of post-traumatic sepsis according to "Sepsis guidelines": a cross-sectional survey of sepsis in a trauma intensive care unit

    Directory of Open Access Journals (Sweden)

    Hao TANG

    2016-04-01

    Full Text Available Objective  To investigate the prevalence and risk factors of post-traumatic sepsis, and to evaluate the rationality of the 1992, 2001 and 2012 international sepsis definitions in diagnosing post-traumatic sepsis in a trauma intensive care unit (ICU in China. Methods  A one-day cross-sectional survey of trauma patients who met the inclusion criteria was conducted from 8:00 a.m., June 16, 2014 to 8:00 a.m., June 17, 2014 in the trauma ICU of Daping Hospital. The survey data included demographic information, clinical characteristics, pertinent scores (APACHE Ⅱ, SOFA, GCS, ISS and injury mechanism. According to the definition of sepsis as depicted in the 1992, 2001, and 2012 "International Guideline of Sepsis", the patients were divided into A, B and C groups. The infection site, infection pathogens, and key medical treatment were recorded, the infection identified, and the 28day mortality recorded. A positive pathogen culture of respiratory and urinary tracts, blood, cerebrospinal fluid, and wound secretion was adopted as the diagnostic "gold standard" for septic infection. The diagnostic sensitivity and specificity of the three versions of the guidelines were statistically analyzed and the diagnostic feasibility of each definition was assessed. Results  A total of 30 trauma patients were enrolled, twenty-three patients met the 1992 sepsis criteria, 22 met the 2001 criteria, and 20 met the 2012 criteria. The prevalence rates were 76.7%, 73.3%, and 66.7%, respectively, and there was no significant statistical difference. Four patients died within 28 days, which was in line with the diagnostic criteria of the three versions of the sepsis criteria. The 28-day mortality in the three sepsis guidelines groups was 17.4%, 18.2%, and 25.0%, respectively, indicating no statistical difference. By adopting culture-positive pathogens as the "gold standard" of septic infection, the diagnostic sensitivity and specificity of the group A was 77.8% and 25

  20. Access to Care and Use of the Internet to Search for Health Information: Results From the US National Health Interview Survey

    OpenAIRE

    Amante, Daniel J.; Hogan, Timothy P.; Pagoto, Sherry; English, Thomas M.; Lapane, Kate L.

    2015-01-01

    Background The insurance mandate of the Affordable Care Act has increased the number of people with health coverage in the United States. There is speculation that this increase in the number of insured could make accessing health care services more difficult. Those who are unable to access care in a timely manner may use the Internet to search for information needed to answer their health questions. Objective The aim was to determine whether difficulty accessing health care services for reas...

  1. Barriers and Incentives to Orphan Care in a Time of AIDS and Economic Crisis: A Cross-Sectional Survey of Caregivers in Rural Zimbabwe

    Science.gov (United States)

    Howard, Brian H.; Phillips, Carl V.; Matinhure, Nelia; Goodman, Karen J.; McCurdy, Sheryl A; Johnson, Cary A.

    2007-01-01

    Background: Africa is in an orphan-care crisis. In Zimbabwe, where one-fourth of adults are HIV-positive and one-fifth of children are orphans, AIDS and economic decline are straining society's ability to care for orphans within their extended families. Lack of stable care is putting thousands of children at heightened risk of malnourishment,…

  2. What parents of children who have received emergency care think about deferring consent in randomised trials of emergency treatments: postal survey.

    Directory of Open Access Journals (Sweden)

    Carrol Gamble

    Full Text Available OBJECTIVE: To investigate parents' views about deferred consent to inform management of trial disclosure after a child's death. METHODS: A postal questionnaire survey was sent to members of the Meningitis Research Foundation UK charity, whose child had suffered from bacterial meningitis or meningococcal septicaemia within the previous 5 years. Main outcome measures were acceptability of deferred consent; timing of requesting consent; and the management of disclosure of the trial after a child's death. RESULTS: 220 families were sent questionnaires of whom 63 (29% were bereaved. 68 families responded (31%, of whom 19 (28% were bereaved. The majority (67% was willing for their child to be involved in the trial without the trial being explained to them beforehand; 70% wanted to be informed about the trial as soon as their child's condition had stabilised. In the event of a child's death before the trial could be discussed the majority of bereaved parents (66% 12/18 anticipated wanting to be told about the trial at some time. This compared with 37% (18/49 of non-bereaved families (p = 0.06. Parents' free text responses indicated that the word 'trial' held strongly negative connotations. A few parents regarded gaps in the evidence base about emergency treatments as indicating staff lacked expertise to care for a critically ill child. Bereaved parents' free text responses indicated the importance of individualised management of disclosure about a trial following a child's death. DISCUSSION: Deferred consent is acceptable to the majority of respondents. Parents whose children had recovered differed in their views compared to bereaved parents. Most bereaved parents would want to be informed about the trial in the aftermath of a child's death, although a minority strongly opposed such disclosure. Distinction should be drawn between the views of bereaved and non-bereaved parents when considering the acceptability of different consent processes.

  3. Consent and widespread access to personal health information for the delivery of care: a large scale telephone survey of consumers' attitudes using vignettes in New Zealand

    Science.gov (United States)

    Whiddett, Dick; Hunter, Inga; McDonald, Barry; Norris, Tony; Waldon, John

    2016-01-01

    Objectives In light of recent health policy, to examine factors which influence the public's willingness to consent to share their health information in a national electronic health record (EHR). Design Data were collected in a national telephone survey in 2008. Respondents were presented with vignettes that described situations in which their health information was shared and asked if they would consent to such sharing. The subset, consisting of the 18 vignettes that covered proving care, was reanalysed in depth using new statistical methods in 2016. Setting Adult population of New Zealand accessible by telephone landline. Participants 4209 adults aged 18+ years in the full data set, 2438 of which are included in the selected subset. Main outcome measures For each of 18 vignettes, we measured the percentage of respondents who would consent for their information to be shared for 2 groups; for those who did not consider that their records contained sensitive information, and for those who did or refused to say. Results Rates of consent ranged from 89% (95% CI 87% to 92%) for sharing of information with hospital doctors and nurses to 51% (47% to 55%) for government agencies. Mixed-effects logistic regression was used to identify factors which had significant impact on consent. The role of the recipient and the level of detail influenced respondents' willingness to consent (p<0.0001 for both factors). Of the individual characteristics, the biggest impact was that respondents whose records contain sensitive information (or who refused to answer) were less willing to consent (p<0.0001). Conclusions A proportion of the population are reluctant to share their health information beyond doctors, nurses and paramedics, particularly when records contain sensitive information. These findings may have adverse implications for healthcare strategies based on widespread sharing of information. Further research is needed to understand and overcome peoples' ambivalence towards

  4. HOSPITAL VARIATION IN MISSED NURSING CARE

    OpenAIRE

    Kalisch, Beatrice J.; Tschannen, Dana; Lee, Hyunhwa; Friese, Christopher R.

    2011-01-01

    Quality of nursing care across hospitals is variable, and this variation can result in poor patient outcomes. One aspect of quality nursing care is the amount of necessary care omitted. This paper reports on the extent and type of nursing care missed and the reasons for missed care. The MISSCARE Survey was administered to nursing staff (n = 4086) who provide direct patient care in ten acute care hospitals. Missed nursing care patterns, as well as reasons for missing care (labor resources, mat...

  5. Fiscal 1998 survey report. Welfare equipment (Development of human friendly care support intelligent equipment / Development of home welfare equipment system); 1998 nendo chosa hokokusho. Fukushi kiki (human friendly kaigo shien chino kiki kaihatsu / zaitaku fukushi kiki system kaihatsu)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-03-01

    Since disabled persons increase with a progress of an aging society, while a care power decreases with a decrease in birth rate, development and practical use of the welfare equipment contributing to self-support of aged and handicapped persons, reduction of doctors' or therapists' burdens, and as a result, reduction of medical care costs are desirable. Among them, R and D and practical use are expected of the advanced welfare equipment and system based on human engineering technology contributing to improvement of lives of aged and handicapped persons, and support of nurses and cares of disabled persons. In fiscal 1998, on both human friendly care support intelligent equipment and home welfare equipment system, this project clarified essential technical issues based on the future view, selected some themes to be newly developed in the future, and surveyed and evaluated the details of their R and D concretely. For the former, 'heart disease diagnosis and treatment total support system,' and for the latter, 'body function rehabilitation support system' were surveyed. (NEDO)

  6. Women at risk: why increasing numbers of women are failing to get the health care they need and how the Affordable Care Act will help. Findings from the Commonwealth Fund Biennial Health Insurance Survey of 2010.

    Science.gov (United States)

    Robertson, Ruth; Collins, Sara R

    2011-05-01

    Women have greater health care needs than men, and generally play larger roles in the health care of family members. Rising health care costs combined with sluggish income growth has contributed to losses in health insurance among women and rising rates of problems gaining necessary health care and paying medical bills. Women who seek coverage in the individual insurance market face additional hurdles--few plans offer maternity coverage and, in most states, insurance carriers charge higher premium rates to young women than men of the same age. The Affordable Care Act is bringing change for women through required free coverage of preventive care services, small business tax credits, new affordable coverage options, and insurance market reforms, including bans on gender rating. When the law is fully implemented in 2014, nearly all the 27 million working-age women who went without health insurance in 2010 will gain affordable and comprehensive benefits. PMID:21638798

  7. Correlates of unequal access to preventive care in China: a multilevel analysis of national data from the 2011 China Health and Nutrition Survey

    OpenAIRE

    Huang, Chi; Liu, Chao-Jie; Pan, Xiong-Fei; Liu, Xiang; Li, Ning-Xiu

    2016-01-01

    Background Preventive care has an essential role in reducing income-related health inequalities. Despite a general consensus of the need of shifting focus from disease treatment to wellness and prevention, little is known about inequalities in access to preventive care in China. Our study aimed to explore the inequalities in preventive care usage and factors that were associated with such inequalities among Chinese adults. Methods Multilevel logistic regression analyses were performed using n...

  8. A prospective survey of critical care procedures performed by physicians in helicopter emergency medical service: is clinical exposure enough to stay proficient?

    OpenAIRE

    Sollid, Stephen J M; Bredmose, Per P; Nakstad, Anders R; Sandberg, Mårten

    2015-01-01

    Background Physicians in prehospital care must be proficient in critical care procedures. Procedure proficiency requires a combination of training, experience and continuous clinical exposure. Most physicians in helicopter emergency medical service (HEMS) in Norway are well-trained and experienced anaesthesiologists, but we know little about their exposure to critical care procedures in the prehospital arena. This knowledge is required to plan clinical training and in-hospital practice to mai...

  9. Willingness to Favor Aggressive Care and Live with Disability Following Severe Traumatic Brain Injury: A Survey of Healthy Young Adults in Hawai‘i

    OpenAIRE

    Nakagawa, Kazuma; Obana, Kyle K

    2014-01-01

    Traumatic brain injury (TBI) is a major public health problem that significantly impacts young adults. Since severe TBI patients lack decision-making capacity, the providers and patient surrogates are often faced with the challenging task of deciding whether to continue with aggressive life-prolonging care or to transition to comfort-focused care with an expected outcome of natural death. The assumption is often made that aggressive care is appropriate for young patients who suffer severe TBI...

  10. Identifying the important factors associated with teaching sex education to people with intellectual disability: A cross-sectional survey among paid care staff †

    OpenAIRE

    Schaafsma, Dilana; Kok, Gerjo; Stoffelen, Joke M. T.; Van Doorn, Paulien; Curfs, Leopold M. G.

    2014-01-01

    Background Sex education programs have been developed with paid care staff as sex educators. However, no information is available about whether these programs are being delivered. Method The aim of this study was to investigate whether paid care staff working in an organisation specialised in the care of people with mild to moderate intellectual disability teach sex education or not. An online questionnaire was therefore constructed to assess the important factors associated with teaching sex...

  11. Self-reported health care utilization: measurement issues, data validity and implications for design of health surveys and economic evaluations An empirical investigation among patients with diabetes mellitus

    OpenAIRE

    Chernyak, Nadezda

    2012-01-01

    Objectives: 1. To develop, test and refine a questionnaire collecting data on health care utilization in patients with diabetes. 2. To develop methods for a validation study quantifying the accuracy of self-reported health care utilization data. Methods: The questionnaire on health care utilization was developed and tested by a combination of behavior coding and cognitive interviews in 43 patients with diabetes mellitus types 1 and 2 in Germany. Theoretical considerations and empirical eviden...

  12. 1998-1999 Patterns of Care Study process survey of national practice patterns using breast-conserving surgery and radiotherapy in the management of Stage I-II breast cancer

    International Nuclear Information System (INIS)

    Purpose: The Patterns of Care Study survey process evaluation has been an effective means of assessing the evaluation and treatment practices used by radiation oncologists in the United States for Stage I-II breast cancer. The current 1998-1999 report updates the previous 1989 and 1993-1994 analyses and reflects the recent changes in surgery and systemic therapy observed nationally in the management of early-stage disease. Methods and Materials: A weighted sample size of 71,877 patient records of women treated with breast-conserving surgery and radiotherapy (RT) was obtained from a stratified two-stage sampling of 353 patient records. These cases were centrally reviewed from academic and private radiation oncology practices across the United States. The data collected included patient characteristics, clinical and pathologic factors, and surgical and RT details. The results were compared with those of previous Patterns of Care Study survey reports. Results: Of the patients in the current survey, 97% had undergone mammography before biopsy. A review of the primary tumor pathologic findings indicated improved quantification of an intraductal component from 7.0% in 1993-1994 to 20.4% in 1998-1999 (p = 0.01). The tumor characteristics were better defined, with estrogen and progesterone receptor measurement performed in 91.4% and 91.3% in the 1998-1999 survey vs. 83.7% and 80.3% in the 1989 survey, respectively (p = 0.03 and p = 0.002, respectively). Axillary dissection was performed in 82.2% in the present survey compared with 93.6% in the 1993-1994 survey (p = 0.0004); sentinel node biopsy was performed in 20.1% of the present cases. The use of CT for planning was increased in the current survey, with 22.9% cases CT planned vs. 9% in 1993-1994 (p = 0.10). In the present survey, 100% had received whole breast RT. When a supraclavicular field was added, the dose was prescribed to a specified depth in 67.5% of cases, most commonly 3 cm. When an axillary field was added

  13. European survey of contact lens wearers and eye care professionals on satisfaction with a new water gradient daily disposable contact lens

    Directory of Open Access Journals (Sweden)

    Pérez-Gómez I

    2014-03-01

    Full Text Available Inma Pérez-Gómez,1 Tim Giles2 1Alcon Management SA, Geneva, Switzerland; 2Alcon Laboratories, Inc., Fort Worth, TX, USA Background: Delefilcon A daily disposable water gradient contact lenses (CLs; DAILIES TOTAL1® have radically different properties at the lens surface when compared with the core, resulting in high oxygen transmissibility with a lubricious surface. Purpose: To assess the real-world success of delefilcon A daily disposable CLs using a European survey, and to determine whether a successful experience changes eye care professionals' (ECPs CL preference or anticipated recommendation patterns. Methods: Current soft CL wearers, aged ≥18 years, were eligible for participation. Baseline demographics and 2-week data were obtained by ECPs after fitting ≥5 to ≤10 participants with delefilcon A CLs. Results: Twenty-four ECPs from 16 European countries assessed the use of delefilcon A CLs in 280 participants. Nearly two-thirds (62.9%; number [n]=176 of the participants reported dryness and/or discomfort with their habitual CLs. There was a 78.9% reduction in the proportion of participants with end-of-day dryness after 2 weeks of using delefilcon A CLs (P<0.0001. More participants agreed that they could wear their CLs comfortably all day long with delefilcon A CLs (93.2%; n=261 versus habitual CLs (58.2%; n=163; P<0.0001. There was a strong preference for delefilcon A CLs when compared with habitual lenses worn, with 81.8% of participants agreeing with the statement "I prefer these lenses to my previous contact lenses." Delefilcon A CLs were also highly rated by ECPs following their experience with fitting the lens. All (100% ECPs agreed or strongly agreed that the perceived comfort with delefilcon A CLs is better than that with other daily disposable lenses and that they would recommend these lenses to colleagues. Conclusion: The results indicate that delefilcon A daily disposable water gradient CLs may offer wearers greater comfort

  14. Health care use and costs for children with attention-deficit/hyperactivity disorder - National estimates front the Medical Expenditure Panel Survey

    NARCIS (Netherlands)

    Chan, E; Zhan, CL; Homer, CJ

    2002-01-01

    Context: Although attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent chronic condition of childhood, little is known about patterns of health care use and associated expenditures. Objective: To compare health care use and costs among children with ADHD, children with asthma, and t

  15. The relationship between organizational culture of nursing staff and quality of care for residents with dementia: questionnaire surveys and systematic observations in nursing homes.

    NARCIS (Netherlands)

    Beek, A.P.A. van; Gerritsen, D.L.

    2010-01-01

    BACKGROUND: Since the 1990s, several studies have shown that organizational culture is an important characteristic in long-term care. However, at the moment little is known about organizational culture and its relationship with quality of care. OBJECTIVES: In this study, the relationship between org

  16. National Nursing Home Survey

    Science.gov (United States)

    The National Nursing Home Survey provides includes characteristics such as size of nursing home facilities, ownership, Medicare/Medicaid certification, occupancy rate, number of days of care provided, and expenses.

  17. Bereavement Care Provision in Europe

    DEFF Research Database (Denmark)

    Guldin, Mai-Britt; Murphy, Irene; Keegan, Orla;

    2015-01-01

    The Bereavement Care Taskforce of the EAPC has conducted a survey on bereavement care service provision in Europe. Mai-Britt Guldin, Irene Murphy, Orla Keegan, Barbara Monroe, Maria Antonia Lacasta Reverte and Inger Benkel report on the results. One of the key findings is that not all palliative ...... care services seem to prioritise bereavement care as an integral part of their offer.......The Bereavement Care Taskforce of the EAPC has conducted a survey on bereavement care service provision in Europe. Mai-Britt Guldin, Irene Murphy, Orla Keegan, Barbara Monroe, Maria Antonia Lacasta Reverte and Inger Benkel report on the results. One of the key findings is that not all palliative...

  18. Psychiatric Residents' Needs for Education about Informed Consent, Principles of Ethics and Professionalism, and Caring for Vulnerable Populations: Results of a Multisite Survey

    Science.gov (United States)

    Jain, Shaili; Lapid, Maria I.; Dunn, Laura B.; Roberts, Laura Weiss

    2011-01-01

    Objective: The authors examined psychiatric residents' perceived needs for education in informed consent, principles of ethics and professionalism, and treating vulnerable populations. Method: A written survey was distributed to psychiatric residents (N = 249) at seven U.S. residency programs in 2005. The survey contained 149 questions in 10…

  19. A newly introduced comprehensive consultation fee in the national health insurance system in Japan. A promotive effect of multidisciplinary medical care in the field of radiation oncology. Results from a questionnaire survey

    International Nuclear Information System (INIS)

    The consultation fee for outpatient radiotherapy was newly introduced in the national health insurance system in Japan in April 2012. We conducted a survey on the use of this consultation fee and its effect on clinical practices. The health insurance committee of the Japanese Society of Therapeutic Radiology and Oncology conducted a questionnaire survey. The questionnaire form was mailed to 160 councilors of the Society, the target questionees. A total of 94 answers (58% of the target questionees) sent back were used for analyses. The analyses revealed that 75% of the hospitals charged most of the patients who receive radiotherapy in an outpatient setting a consultation fee. The introduction of the consultation fee led to some changes in radiation oncology clinics, as evidenced by the response of 'more careful observations by medical staff' in 37% of questionees and a 12% increase in the number of full-time radiation oncology nurses. It was also shown that the vast majority (92%) of radiation oncologists expected a positive influence of the consultation fee on radiation oncology clinics in Japan. Our questionnaire survey revealed the present status of the use of a newly introduced consultation fee for outpatient radiotherapy, and the results suggested its possible effect on promoting a multidisciplinary medical care system in radiation oncology departments in Japan. (author)

  20. "Good idea but not feasible" – the views of decision makers and stakeholders towards strategies for better palliative care in Germany: a representative survey

    Directory of Open Access Journals (Sweden)

    Schneider Nils

    2009-07-01

    Full Text Available Abstract Background Statements on potential measures to improve palliative care in Germany predominantly reflect the points of view of experts from specialized palliative care organizations. By contrast, relatively little is known about the views of representatives of organizations and institutions that do not explicitly specialize in palliative care, but are involved to a relevant extent in the decision-making and policy-making processes. Therefore, for the first time in Germany, we carried out a representative study of the attitudes of a broad range of different stakeholders acting at the national or state level of the health care system. Methods 442 organizations and institutions were included and grouped as follows: patient organizations, nursing organizations, medical associations, specialized palliative care organizations, political institutions, health insurance funds and others. Using a standardized questionnaire, the participants were asked to rate their agreement with the World Health Organization's definition of palliative care (five-point scale: 1 = completely agree, 5 = completely disagree and to evaluate 18 pre-selected improvement measures with regard to their general meaningfulness and the feasibility of their introduction into the German health care system (two-point scale: 1 = good, 2 = poor. Results The response rate was 67%. Overall, the acceptance of the aims of palliative care in the WHO definition was strong. However, the level of agreement among health insurance funds' representatives was significantly less than that among representatives of the palliative care organizations. All the improvement measures selected for evaluation were rated significantly higher in respect of their meaningfulness than of their feasibility in Germany. In detail, the meaningfulness of 16 measures was evaluated positively (70–100% participants chose the answer "good"; for six of these measures feasibility was evaluated negatively (0–30

  1. Developing a survey instrument to assess the readiness of primary care data, genetic and disease registries to conduct linked research: TRANSFoRm International Research Readiness (TIRRE) survey instrument

    OpenAIRE

    Emily Leppenwell; Simon de Lusignan; Marilia Tristan Vicente; Georgios Michalakidis; Paul Krause; Steve Thompson; Mark McGilchrist; Terry Desombre; Adel Taweel; Brendan Delaney

    2013-01-01

    Background Clinical data are collected for routine care in family practice; there are also a growing number of genetic and cancer registry data repositories. The Translational Research and Patient Safety in Europe (TRANSFoRm) project seeks to facilitate research using linked data from more than one source. We performed a requirements analysis which identified a wide range of data and business process requirements that need to be met before linking primary care and either genetic or disease re...

  2. Child Care Centres.

    Science.gov (United States)

    Australian Dept. of Labour and National Service, Melbourne. Women's Bureau.

    Based on a survey of legislation relating to full-day care for preschool children of working mothers and a study of records, this report: (1) covers the number of registered child care centers in Australia and the number of children being served, (2) sets the conditions applying to registration of centers, (3) indicates the extent and levels of…

  3. Child Care at CERN

    CERN Document Server

    CERN, Child Care Initiative

    2008-01-01

    This is a document summarizing a survey of child care needs of CERN staff and users which was performed in February 2008 by the CERN Child Care Initiative. The document presents the analysis of this data. Conclusions on the minimal facilities size are derived and possible funding source at the European Union are discussed.

  4. Does Care Matter?

    DEFF Research Database (Denmark)

    Loft, Lisbeth Trille Gylling; Hogan, Dennis P.

    2014-01-01

    The aim of this study is to introduce the concept of care capital and provide an example of its application in the context of child care and maternal employment using the currently most suitable American data. We define care capital as the nexus of available, accessible, and experienced resources...... for care. The American setting is an ideal context to investigate the linkages between child care capital and maternal employment as the patterns of child care use tend to be more diverse compared to other national context. In the presented application of care capital, we examine mothers’ entry to paid...... employment during the first 36 weeks following a birth, and its association with experienced non-parental child care use before labor force entry. Using data from the Early Childhood Longitudinal Survey – Birth Cohort (N = 10,400 mothers), results from discrete-time hazard models show that use of non...

  5. Lesbian health care needs.

    OpenAIRE

    Moran, N

    1996-01-01

    OBJECTIVE: To define the special health care needs of Canadian lesbians. DESIGN: A questionnaire containing 61 yes-or-no and multiple-choice questions sought information on six areas: demographics; health care use; habits, diet, and exercise; preventive care; mental health; and physical health. SETTING: The organizational meeting of a lesbian softball league in Toronto. PARTICIPANTS: Of 360 women eligible for the meeting, 205 attended and 195 completed the survey. Questionnaires used for anal...

  6. Evaluation of the organization and provision of primary care in Kazakhstan: a survey-based project in the regions of Almaty and Zhambyl.

    OpenAIRE

    Boerma, W; Wiegers, T. A.; Kringos, D.S.; Baltag, V.; Zhylkaidarova, A.

    2011-01-01

    Although the strengthening of primary care services is a health reform priority in many countries of the WHO European Region, the background for such reform varies. In western Europe, primary care is emphasized to help address rising costs and changing demand that result from demographic and epidemiological trends. In the central and eastern part of the Region, however, countries that were once part of or closely allied with the Soviet Union are struggling to improve the performance of their ...

  7. Living Will Interest and Preferred End-of-life Care and Death Locations among Japanese Adults 50 and over: A Population-based Survey

    OpenAIRE

    Nishie, Hiroyuki; Mizobuchi, Satoshi; Suzuki, Etsuji; Sato, Kenji; TODA, YUICHIRO; Matsuoka, Junji; Morimatsu, Hiroshi

    2014-01-01

    The main purpose of this study was to determine the relationships between Japanese individualsʼ interest in living wills and their preferred end-of-life care and death locations. Questionnaires were mailed to 1,000 individuals aged ァ50 to measure these 2 factors. We examined the associations between the respondentsʼ characteristics and their preferred care and death locations by using multinomial logistic regression models. The response rate was 74%. Home was the most frequently preferred pla...

  8. Development and psychometric evaluation of the Decisional Engagement Scale (DES-10): A patient-reported psychosocial survey for quality cancer care.

    Science.gov (United States)

    Hoerger, Michael; Chapman, Benjamin P; Mohile, Supriya G; Duberstein, Paul R

    2016-09-01

    In light of recent health care reforms, we have provided an illustrative example of new opportunities available for psychologists to develop patient-reported measures related to health care quality. Patient engagement in health care decision making has been increasingly acknowledged as a vital component of quality cancer care. We developed the 10-item Decisional Engagement Scale (DES-10), a patient-reported measure of engagement in decision making in cancer care that assesses patients' awareness of their diagnosis, sense of empowerment and involvement, and level of information seeking and planning. The National Institutes of Health's ResearchMatch recruitment tool was used to facilitate Internet-mediated data collection from 376 patients with cancer. DES-10 scores demonstrated good internal consistency reliability (α = .80), and the hypothesized unidimensional factor structure fit the data well. The reliability and factor structure were supported across subgroups based on demographic, socioeconomic, and health characteristics. Higher DES-10 scores were associated with better health-related quality of life (r = .31). In concurrent validity analyses controlling for age, socioeconomic status, and health-related quality of life, higher DES-10 scores were associated with higher scores on quality-of-care indices, including greater awareness of one's treatments, greater preferences for shared decision making, and clearer preferences about end-of-life care. A mini-measure, the DES-3, also performed well psychometrically. In conclusion, DES-10 and DES-3 scores showed evidence of reliability and validity, and these brief patient-reported measures can be used by researchers, clinicians, nonprofits, hospitals, insurers, and policymakers interested in evaluating and improving the quality of cancer care. (PsycINFO Database Record PMID:27537003

  9. Health care utilization and outpatient, out-of-pocket costs for active convulsive epilepsy in rural northeastern South Africa: a cross-sectional Survey

    OpenAIRE

    Wagner, Ryan G.; Bertram, Melanie Y; Gómez-Olivé, F. Xavier; Tollman, Stephen M; Lindholm, Lars; Charles R. Newton; Hofman, Karen J.

    2016-01-01

    Background Epilepsy is a common neurological disorder, with over 80 % of cases found in low- and middle-income countries (LMICs). Studies from high-income countries find a significant economic burden associated with epilepsy, yet few studies from LMICs, where out-of-pocket costs for general healthcare can be substantial, have assessed out-of-pocket costs and health care utilization for outpatient epilepsy care. Methods Within an established health and socio-demographic surveillance system in ...

  10. Pharmacotherapy for bipolar disorder and concordance with treatment guidelines: survey of a general population sample referred to a tertiary care service

    OpenAIRE

    Paterniti, Sabrina; Bisserbe, Jean-Claude

    2013-01-01

    Background Many new approaches have been adopted for the treatment of bipolar disorder (BD) in the past few years, which strived to produce more positive outcomes. To enhance the quality of care, several guideline recommendations have been developed. For study purposes, we monitored the prescription of psychotropic drugs administered to bipolar patients who had been referred to tertiary care services, and assessed the degree to which treatment met specific guidelines. Methods Between December...

  11. Marvellous to mediocre: findings of national survey of UK practice and provision of care in pregnancies after stillbirth or neonatal death

    OpenAIRE

    Mills, T A; Ricklesford, C.; Heazell, A. E. P.; Cooke, A.; Lavender, T

    2016-01-01

    Background Pregnancy after stillbirth or neonatal death is an emotionally challenging life-event for women and adequate emotional support during pregnancy should be considered an essential component of quality maternity care. There is a lack of evidence surrounding the role of UK maternity services in meeting womens’ emotional and psychological needs in subsequent pregnancies. This study aimed to gain an overview of current UK practice and womens’ experiences of care in pregnancy after the de...

  12. Prevalence and severity of gingivitis in school students aged 6–11 years in Tafelah Governorate, South Jordan: results of the survey executed by National Woman’s Health Care Center

    OpenAIRE

    Rodan, Rania; Khlaifat, Feryal; Smadi, Leena; Azab, Reem; Abdalmohdi, Asma

    2015-01-01

    Background A cross-sectional census was conducted on 994 public school students aged 6-11 years living in 3 different parts of Tafeleh Governorate—South of Jordan, to determine the prevalence, and severity of gingivitis and to evaluate the oral hygiene habits among them as a part a survey executed by National Woman’s Health Care Center. All students were examined for gingival index (GI) and plaque index (PI), information about oral hygiene habits was recorded. Results Only 29.8 % had healthy ...

  13. Training primary care physicians to offer their patients faecal occult blood testing and colonoscopy for colorectal cancer screening on an equal basis: a pilot intervention with before–after and parallel group surveys

    Science.gov (United States)

    Cornuz, Jacques; Gachoud, David; Bulliard, Jean-Luc; Nichita, Cristina; Dorta, Gian; Ducros, Cyril; Auer, Reto

    2016-01-01

    Objectives Primary care physicians (PCPs) should prescribe faecal immunochemical testing (FIT) or colonoscopy for colorectal cancer screening based on their patient's values and preferences. However, there are wide variations between PCPs in the screening method prescribed. The objective was to assess the impact of an educational intervention on PCPs’ intent to offer FIT or colonoscopy on an equal basis. Design Survey before and after training seminars, with a parallel comparison through a mailed survey to PCPs not attending the training seminars. Setting All PCPs in the canton of Vaud, Switzerland. Participants Of 592 eligible PCPs, 133 (22%) attended a seminar and 106 (80%) filled both surveys. 109 (24%) PCPs who did not attend the seminars returned the mailed survey. Intervention A 2 h-long interactive seminar targeting PCP knowledge, skills and attitudes regarding offering a choice of colorectal cancer (CRC) screening options. Outcome measures The primary outcome was PCP intention of having their patients screened with FIT and colonoscopy in equal proportions (between 40% and 60% each). Secondary outcomes were the perceived role of PCPs in screening decisions (from paternalistic to informed decision-making) and correct answer to a clinical vignette. Results Before the seminars, 8% of PCPs reported that they had equal proportions of their patients screened for CRC by FIT and colonoscopy; after the seminar, 33% foresaw having their patients screened in equal proportions (pcolonoscopy in equal proportions. PMID:27178977

  14. Watson's theory of transpersonal caring: factors impacting nurses professional caring.

    Science.gov (United States)

    Vandenhouten, Christine; Kubsch, Sylvia; Peterson, Margaret; Murdock, Jennifer; Lehrer, Leslie

    2012-01-01

    This study's purpose was to identify factors impacting nurses' perceived professional caring. The sample of 242 nurses completed a researcher-developed survey based on Watson's theory of transpersonal caring. Results showed that experienced, hospital-based nurses and those demonstrating greater familiarity with Watson's theory had higher caring scores. Implications for education, practice, and research are suggested. PMID:23075749

  15. SURVEY OF ESTABLISHING INSTITUTIONAL SYSTEM FOR CARE, EDUCATION AND REHABILITATION OF DISABLED PEOPLE IN THE REPUBLIC OF MACEDONIA IN THE PERIOD 1946-1996

    Directory of Open Access Journals (Sweden)

    Ljupcho AJDINSKI

    2004-12-01

    Full Text Available The period from the middle of the XIX to the middle of the XX century (1947, i.e., till passing the Statute of the World Health Organization, is a period in which not only the concept and the relationship was created and built up but also the institutionalized system for care, education and rehabilitation of disabled people in the world. During this one-century-period, institutional forms of social care, special education, professional training of disabled people were created.Unfortunately, our country did not have such a historical background. The society was not ready yet to accept the new ideas and to implement in practice the contemporary concepts in regard to the social care of the population that had been for ages on the margins of life.

  16. 42 CFR 488.310 - Extended survey.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Extended survey. 488.310 Section 488.310 Public...) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES Survey and Certification of Long-Term Care Facilities § 488.310 Extended survey. (a) Purpose of survey. The purpose of an...

  17. Infant Care Self-Efficacy.

    Science.gov (United States)

    Froman, Robin D.

    The Infant Care Survey (ICS) was developed to measure new mothers' confidence in their knowledge and skills regarding the care of babies under one year of age. One potential use of this test would be the identification of groups at high risk for health problems or for avoiding medical care. Self-efficacy was an important construct in the…

  18. Young Adults Seeking Medical Care: Do Race and Ethnicity Matter?

    Science.gov (United States)

    ... Reports from the National Medical Care Utilization and Expenditure Survey Clearinghouse on Health Indexes Statistical Notes for Health Planners ... Adults Seeking Medical Care: Do Race and Ethnicity ...

  19. Indonesian infertility patients’ health seeking behaviour and patterns of access to biomedical infertility care: an interviewer administered survey conducted in three clinics

    OpenAIRE

    Bennett Linda Rae; Wiweko Budi; Hinting Aucky; Adnyana IB Putra; Pangestu Mulyoto

    2012-01-01

    Abstract Background Indonesia has high levels of biological need for infertility treatment, great sociological and psychological demand for children, and yet existing infertility services are underutilized. Access to adequate comprehensive reproductive health services, including infertility care, is a basic reproductive right regardless of the economic circumstances in which individuals are born into. Thus, identifying and implementing strategies to improve access to assisted reproductive tec...

  20. Differences in Readiness between Rural Hospitals and Primary Care Providers for Telemedicine Adoption and Implementation: Findings from a Statewide Telemedicine Survey

    Science.gov (United States)

    Martin, Amy Brock; Probst, Janice C.; Shah, Kyle; Chen, Zhimin; Garr, David

    2012-01-01

    Purpose: Published advantages of and challenges with telemedicine led us to examine the scope of telemedicine adoption, implementation readiness, and barriers in a southern state where adoption has been historically low. We hypothesized that rural hospitals and primary care providers (RPCPs) differ on adoption, readiness, and implementation…

  1. Avoiding free care at all costs: a survey of uninsured patients choosing not to seek emergency services at an urban county hospital.

    Science.gov (United States)

    Weiner, Saul J; Vangeest, Jonathan B; Abrams, Richard I; Moswin, Arthur; Warnecke, Richard

    2006-03-01

    The purpose of this case study was to understand why many uninsured patients opt not to make use of a free public hospital when it is available, instead seeking emergency department care at sites where they will be billed for the services they receive. One hundred fifty seven uninsured patients were interviewed over an 8-week period at three emergency departments that bill for services near a county hospital that provides free care. Data was gathered on income, health status, and credit history. Subjects were also asked if they had previously sought care at the county hospital and, if they had, how satisfied they were with the quality of care and with the wait time. Seventy two percent of the subjects reported household incomes of income, problems with debt, and reported health status did not. Access involves more than geographic proximity and affordability. Excessive wait times can deter even patients who are poor, in ill health and in debt from making use of services that are intended for their benefit. PMID:16736373

  2. A Survey on Knowledge of Nursing Staff About Terminal Care%护理人员掌握临终关怀知识情况的调查

    Institute of Scientific and Technical Information of China (English)

    宋春燕; 余丽君

    2001-01-01

    为了解护理人员对临终关怀知识的掌握程度,对北京市一所综合医院和一所肿瘤专科医院的120名护理人员进行有关临终关怀知识的问卷调查。结果显示:61.7%护理人员的临终关怀知识处于一般水平,优秀率仅2.5%,以临终、临终关怀基本知识缺乏最严重。两所医院不同护龄、学历的护理人员掌握临终关怀知识程度无统计学意义。提示:临床护理人员普遍缺乏临终关怀知识。%To know the grasp of terminal care knowledge, 120 nursing staff were asked to filled up the questionnaire about the knowledge. They were come from both a general hospital and a tumor hospital of Beijing City. Results showed that 61.7% of nursing staff had some ordinary knowledge about terminal care. Only 2.5% of nursing staff knew terminal care well. Most of nursing staff was lack of the basic knowledge about the terminal care. And there was no significant difference between nursing staff from the general hospital and from the tumor hospital. It also showed that there were no differences among nursing staff with different records of formal schooling, different years of nursing experience, and how many terminal patients they had nursed. Suggested that nursing staff be commonly lack of terminal care knowledge.

  3. [Skin cancer in primary care: frequency, need to further education and subjective diagnostic certainty. A cross sectional survey among general practitioners in Canton of Zurich

    NARCIS (Netherlands)

    Badertscher, N.; Senn, O.; Rossi, P.O.; Wensing, M.; Rosemann, T.; Tandjung, R.

    2013-01-01

    BACKGROUND: Incidence of malignant skin lesions is rising in Switzerland. We wanted to assess the frequency of patients with suspicious skin lesions in daily practice. Furthermore, we asked for diagnostic certainty and the need of further education in skin cancer. METHODS: Survey with 1212 GPs in th

  4. Training May Affect Primary Care Staff Access to the Biomedical Electronic Evidence Base. A review of: Doney, Liz, Helen Barlow, and Joe West. “Use of Libraries and Electronic Information Resources by Primary Care Staff: Outcomes from a Survey.” Health Information and Libraries Journal 22.3 (September 2005: 182-188.

    Directory of Open Access Journals (Sweden)

    Marcy L. Brown

    2006-03-01

    Full Text Available Objective – To assess use of existing local libraries, the Internet, and biomedical databases by primary care staff prior to implementation of the Primary Care Knowledge Management Projects. Additionally, to assess the need to train primary care staff to use the Internet and biomedical databases. Design – Cross‐sectional postal questionnaire survey. Setting – Nottingham and Rotherham, two cities in the Trent region of the UK. Subjects – Questionnaires were analyzed from 243 general practitioners, practice nurses, and practice managers in four Nottingham primary care trusts as well as practices in the Rotherham Health Authority area. Methods – Questionnaires and cover letters were sent between May 2001 and February 2002. To encourage response, a postage‐paid envelope was enclosed. A total of 709 questionnaires were sent in Nottingham, and 169 were returned for a response rate of 24%. In Rotherham, 179 questionnaires were sent and 61 returned, for a 34% response rate. Thirteen responses from a May 2001 pilot in Rotherham were also included in the data analysis. Survey questions included a variety of formats, including tick boxes and open‐ended questions. Data was entered into an Access database and analysis was performed using Stata software. Main results – Reported use of libraries was low overall, with only 30% of respondents claiming to have used library facilities. However, there was significant variation among professional groups. Practice nurses (PNs had significantly higher usage of libraries than general practitioners (GPs and practice managers (P Conclusion – Based on the results of this admittedly small study, additional training is needed – and desired – by primary care staff in both Nottingham and Rotherham. Developing and offering training in Internet searching and evaluation as well as use of the biomedical databases is one important way in which libraries can build partnerships with primary care practitioners

  5. Is the Internet a useful and relevant source for health and health care information retrieval for German cardiothoracic patients? First results from a prospective survey among 255 Patients at a German cardiothoracic surgical clinic

    Directory of Open Access Journals (Sweden)

    Diez Claudius

    2006-10-01

    Full Text Available Abstract Background It is not clear how prevalent Internet use among cardiopathic patients in Germany is and what impact it has on the health care utilisation. We measured the extent of Internet use among cardiopathic patients and examined the effects that Internet use has on users' knowledge about their cardiac disease, health care matters and their use of the health care system. Methods We conducted a prospective survey among 255 cardiopathic patients at a German university hospital. Results Forty seven respondents (18 % used the internet and 8,8 % (n = 23 went online more than 20 hours per month. The most frequent reason for not using the internet was disinterest (52,3 %. Fourteen patients (5,4 % searched for specific disease-related information and valued the retrieved information on an analogous scale (1 = not relevant, 5 = very relevant on median with 4,0. Internet use is age and education dependent. Only 36 (14,1 % respondents found the internet useful, whereas the vast majority would not use it. Electronic scheduling for ambulatory visits or postoperative telemedical monitoring were rather disapproved. Conclusion We conclude that Internet use is infrequent among our study population and the search for relevant health and disease related information is not well established.

  6. Different patterns of inappropriate antimicrobial use in surgical and medical units at a tertiary care hospital in Switzerland: a prevalence survey.

    Directory of Open Access Journals (Sweden)

    Alexia Cusini

    Full Text Available BACKGROUND: Unnecessary or inappropriate use of antimicrobials is associated with the emergence of antimicrobial resistance, drug toxicity, increased morbidity and health care costs. Antimicrobial use has been reported to be incorrect or not indicated in 9-64% of inpatients. We studied the quality of antimicrobial therapy and prophylaxis in hospitalized patients at a tertiary care hospital to plan interventions to improve the quality of antimicrobial prescription. METHODOLOGY/PRINCIPAL FINDINGS: Experienced infectious diseases (ID fellows performed audits of antimicrobial use at regular intervals among all patients--with or without antimicrobials--hospitalized in predefined surgical, medical, haemato-oncological, or intensive care units. Data were collected from medical and nursing patient charts with a standardized questionnaire. Appropriateness of antimicrobial use was evaluated using a modified algorithm developed by Gyssens et al.; the assessment was double-checked by a senior ID specialist. We evaluated 1577 patients of whom 700 (44.4% had antimicrobials, receiving a total of 1270 prescriptions. 958 (75.4% prescriptions were for therapy and 312 (24.6% for prophylaxis. 37.0% of therapeutic and 16.6% of prophylactic prescriptions were found to be inappropriate. Most frequent characteristics of inappropriate treatments included: No indication (17.5%; incorrect choice of antimicrobials (7.6%; incorrect application of drugs (9.3%; and divergence from institutional guidelines (8%. Characteristics of inappropriate prophylaxes were: No indication (9%; incorrect choice of antimicrobials (1%; duration too long or other inappropriate use (6.7%. Patterns of inappropriate antimicrobial varied widely in the different hospital units; empirical prescriptions were more frequently incorrect than prescriptions based on available microbiological results. CONCLUSIONS/SIGNIFICANCE: Audits of individual patient care provide important data to identify local

  7. Depression prevalence and primary care among vulnerable patients at a free outpatient clinic in Paris, France, in 2010: results of a cross-sectional survey.

    OpenAIRE

    Rondet, Claire; Cornet, Philippe; Kaoutar, Bacha; Lebas, Jacques; Chauvin, Pierre

    2013-01-01

    BACKGROUND: Data on the prevalence of depression and on how a depressive episode prompts the sufferer to seek primary care are not scarce, but the available evidence on the prevalence of depression among immigrants and poor people who frequent general practice facilities is scarce. The Baudelaire Outpatient Clinic at the Saint-Antoine Hospital in Paris provides free medical and social assistance to the poor and/or uninsured. The goal of our study was to estimate the prevalence of depression a...

  8. Musculoskeletal pain among critical-care nurses by availability and use of patient lifting equipment: An analysis of cross-sectional survey data

    OpenAIRE

    Lee, SJ; Faucett, J; Gillen, M; Krause, N.

    2013-01-01

    Background: Patient handling is a major risk factor for musculoskeletal injuries among nurses. Lifting equipment is a main component of safe patient handling programs that aim to prevent musculoskeletal injury. However, the actual levels of lift availability and usage are far from optimal. Objective: To examine the effect of patient lifting equipment on musculoskeletal pain by level of lift availability and lift use among critical-care nurses. Design and participants: A cross-sectional postal...

  9. Can Sierra Leone maintain the equitable delivery of their Free Health Care Initiative? The case for more contextualised interventions: results of a cross-sectional survey

    OpenAIRE

    Vallières, Frédérique; Cassidy, Emma Louise; McAuliffe, Eilish; Gilmore, Brynne; Bangura, Allieu S.; Musa, Joseph

    2016-01-01

    Background In 2010, the Ministry of Health and Sanitation in Sierra Leone launched their Free Health Care Initiative (FHCI) for pregnant and lactating mothers and children under-5. Despite an increase in the update of services, the inequitable distribution of health services and health facilities remain important factors underlying the poor performance of health systems to deliver effective services. This study identifies current gaps in service delivery across two rural locations served by t...

  10. The relationship between maternal education and mortality among women giving birth in health care institutions: Analysis of the cross sectional WHO Global Survey on Maternal and Perinatal Health

    OpenAIRE

    Gülmezoglu A Metin; Calles Dinorah L; Hogue Carol J; Souza João-Paulo; Say Lale; Karlsen Saffron; Raine Rosalind

    2011-01-01

    Abstract Background Approximately one-third of a million women die each year from pregnancy-related conditions. Three-quarters of these deaths are considered avoidable. Millennium Development Goal five calls for a reduction in maternal mortality and the establishment of universal access to high quality reproductive health care. There is evidence of a relationship between lower levels of maternal education and higher maternal mortality. This study examines the relationship between maternal edu...

  11. Use of hand hygiene agents as a surrogate marker of compliance in Hungarian long-term care facilities: first nationwide survey

    OpenAIRE

    Szabó, Rita; Morvai, Júlia; Bellissimo-Rodrigues, Fernando; Pittet, Didier

    2015-01-01

    Background Hand hygiene practice is an important measure for preventing infections in long-term care facilities (LTCFs). However, low compliance with hand hygiene has been reported in a number of studies. The purpose of this study was to provide an overview of the first reference data collected on alcohol-based handrub (ABHR) and antiseptic soap consumption, as surrogate markers for hand hygiene compliance by healthcare workers (HCWs) in Hungarian LTCFs. The objective was to inform stakeholde...

  12. Women’s empowerment and male involvement in antenatal care: analyses of Demographic and Health Surveys (DHS) in selected African countries

    OpenAIRE

    Jennings, Larissa; Na, Muzi; Cherewick, Megan; Hindin, Michelle; Mullany, Britta; Ahmed, Saifuddin

    2014-01-01

    Background Increasing women’s status and male involvement are important strategies in reducing preventable maternal morbidity and mortality. While efforts to both empower women and engage men in maternal health care-seeking can work synergistically, in practice they may result in opposing processes and outcomes. This study examines whether a woman’s empowerment status, in sum and across economic, socio-familial, and legal dimensions, is associated with male partner accompaniment to antenatal ...

  13. Teaching and learning evidence-based medicine: cross-sectional survey investigating knowledge and attitudes of teachers and learners in primary and secondary care

    OpenAIRE

    Siriwardena, A Niroshan; Sandars, John; Gemmell, Islay; Rashid, Aly

    2007-01-01

    Evidence-based medicine (EBM) is an important component of quality healthcare and a key part of the curriculum for doctors in training. There have been no previous studies comparing attitudes and knowledge of doctors in primary and secondary care towards EBM practice and teaching and this study sets out to investigate this area. We asked participants, a stratified sample of general practitioners, hospital consultants, GP registrars and junior hospital doctors in Leicester, Northamptonshire...

  14. A survey of Canadian regulated complementary and alternative medicine schools about research, evidence-based health care and interprofessional training, as well as continuing education

    OpenAIRE

    Toupin April, Karine; Gaboury, Isabelle

    2013-01-01

    Background While some effort has been made to integrate complementary and alternative medicine (CAM) information in conventional biomedical training, it is unclear whether regulated Canadian CAM schools’ students are exposed to research activities and continuing education, or whether topics such as evidence-based health care and interprofessional collaboration (IPC) are covered during their training. Since these areas are valued by the biomedical training field, this may help to bridge the at...

  15. A survey study on use of over the counter (OTC) drugs among medical students, nursing and clerical staff of a tertiary care teaching rural hospital

    OpenAIRE

    Devang Parikh; B. M. Sattigeri; Ashok Kumar; Shruti Brahmbhatt

    2013-01-01

    Aim: The study was conducted to evaluate use of over the counter (OTC) drugs among the medical students, nursing and clerical staff of tertiary care teaching rural hospital to determine the awareness and disadvantages on use of OTC. Methods: Responses to a feedback questionnaire covering various aspects on usage of OTC drugs were obtained from 100 medical students, 100 nursing and 100 clerical staff. Results: Among 300 respondents, 84% used OTC, commonly purchased by self. Majority of them st...

  16. The relationship between general practice characteristics and quality of care: a national survey of quality indicators used in the UK Quality and Outcomes Framework, 2004–5

    Directory of Open Access Journals (Sweden)

    Armstrong David

    2006-11-01

    Full Text Available Abstract Background The descriptive information now available for primary care in the UK is unique in international terms. Under the 'Quality and Outcomes Framework' (QOF, data for 147 performance indicators are available for each general practice. We aimed to determine the relationship between the quality of primary care, as judged by the total QOF score, social deprivation and practice characteristics. Methods We obtained QOF data for each practice in England and linked these with census derived data (deprivation indices and proportion of patients born in a developing country. Characteristics of practices were also obtained. QOF and census data were available for 8480 practices. Results The median QOF score was 999.7 out of a possible maximum of 1050 points. Three characteristics were independently associated with higher QOF scores: training practices, group practices and practices in less socially deprived areas. In a regression model, these three factors explained 14.6% of the variation in QOF score. Higher list sizes per GP, turnover of registered patients, chronic disease prevalence, proportions of elderly patients or patients born in a developing country did not contribute to lower QOF scores in the final model. Conclusion Socially deprived areas experience a lower quality of primary care, as judged by QOF scores. Social deprivation itself is an independent predictor of lower quality. Training and group practices are independent predictors of higher quality but these types of practices are less well represented in socially deprived areas.

  17. Impact of caring for persons with Alzheimer’s disease or dementia on caregivers’ health outcomes: findings from a community based survey in Japan

    OpenAIRE

    Goren, Amir; Montgomery, William; Kahle-Wrobleski, Kristin; Nakamura, Tomomi; Ueda, Kaname

    2016-01-01

    Background This study assessed how family caregivers for patients with Alzheimer’s disease (AD) or dementia in Japan differed from non-caregivers in characteristics and health outcomes (i.e., comorbidities, health-related quality of life [HRQoL], productivity, and resource use). Caregivers were hypothesized to experience significantly poorer outcomes than non-caregivers. Methods Data were combined from the 2012 and 2013 National Health and Wellness Survey in Japan (n = 60000). Caregivers for ...

  18. Morbidity and health-care use of people with intellectual disabilities in general practice: first results of a survey in the Netherlands.

    OpenAIRE

    Schrojenstein Lantman-de Valk, H.J.M. van; Wierik, M.J.M. te; Akker, M. van den; Wullink, M.; Schellevis, F.G.; Dinant, G. J.; Metsemakers, J. F. M.

    2004-01-01

    Reported here are the preliminary results of the second Dutch National Survey of General Practice in which data were collected on all contacts with general practitioners (GPs) during a 12-month period to determine characteristics of patients with intellectual disabilities (ID). Sociodemographic characteristics differed significantly between people with ID and controls, indicating significant differences in morbidity between the two groups (people with ID were found to have more psychological ...

  19. European survey of contact lens wearers and eye care professionals on satisfaction with a new water gradient daily disposable contact lens

    OpenAIRE

    Pérez-Gómez I; Giles T

    2014-01-01

    Inma Pérez-Gómez,1 Tim Giles2 1Alcon Management SA, Geneva, Switzerland; 2Alcon Laboratories, Inc., Fort Worth, TX, USA Background: Delefilcon A daily disposable water gradient contact lenses (CLs; DAILIES TOTAL1®) have radically different properties at the lens surface when compared with the core, resulting in high oxygen transmissibility with a lubricious surface. Purpose: To assess the real-world success of delefilcon A daily disposable CLs using a European survey, and t...

  20. The AGN content of deep radio surveys and radio emission in radio-quiet AGN. Why every astronomer should care about deep radio fields

    CERN Document Server

    Padovani, P; Miller, N; Kellermann, K I; Mainieri, V; Rosati, P; Tozzi, P; Vattakunnel, S

    2014-01-01

    We present our very recent results on the sub-mJy radio source populations at 1.4 GHz based on the Extended Chandra Deep Field South VLA survey, which reaches ~ 30 {\\mu}Jy, with details on their number counts, evolution, and luminosity functions. The sub-mJy radio sky turns out to be a complex mix of star-forming galaxies and radio-quiet AGN evolving at a similar, strong rate and declining radio-loud AGN. While the well-known flattening of the radio number counts below 1 mJy is mostly due to star-forming galaxies, these sources and AGN make up an approximately equal fraction of the sub-mJy sky. Our results shed also light on a fifty-year-old issue, namely radio emission from radio-quiet AGN, and suggest that it is closely related to star formation, at least at z ~ 1.5 - 2. The implications of our findings for future, deeper radio surveys, including those with the Square Kilometre Array, are also discussed. One of the main messages, especially to non-radio astronomers, is that radio surveys are reaching such f...

  1. Does depression screening have an effect on the diagnosis and treatment of mood disorders in general medical settings?: an instrumental variable analysis of the national ambulatory medical care survey.

    Science.gov (United States)

    Mojtabai, Ramin

    2011-08-01

    This study examined the association of depression screening with the diagnoses of mood disorders and prescription of antidepressants in 73,712 visits to nonpsychiatrist physician offices drawn from the 2005-2007 U.S. National Ambulatory Medical Care Survey. Physicians used depression screening selectively for patients whom they perceived as more likely to have a mood disorder. In bivariate probit analyses with instrumental variables, depression screening did not increase the prevalence of either mood disorder diagnoses or prescription of antidepressants. However, screening was associated with lower rates of antidepressants prescription without a diagnosis of a mood disorder. In visits in which antidepressants were prescribed, 47.4% of the screened visits compared with 16.3% of nonscreened visits had a mood disorder diagnosis. As currently practiced in medical settings, depression screening may help improve targeting and appropriate use of antidepressant medications. Wider use of depression screening may help curb the growing trend of off-label antidepressant prescriptions. PMID:21454246

  2. Environmental surveillance and molecular epidemiology of waterborne pathogen Legionella pneumophila in health-care facilities of Northeastern Greece: a 4-year survey.

    Science.gov (United States)

    Alexandropoulou, Ioanna G; Ntougias, Spyridon; Konstantinidis, Theocharis G; Parasidis, Theodoros A; Panopoulou, Maria; Constantinidis, Theodoros C

    2015-05-01

    A 4-year proactive environmental surveillance of Legionella spp. in the water distribution and cooling systems of five health-care facilities was carried out as part of the strategy for the prevention of hospital-acquired Legionnaires' disease in Northeastern Greece. Legionella spp. were detected in 71 out of 458 collected samples. The majority of strains belonged to Legionella pneumophila serogroups 2-15 (75.0%), while all L. pneumophila serogroup 1 strains (23.6%) were isolated from a single hospital. The highest percentage of positive samples was found in distal sites (19.4%), while no Legionella strains were detected in cooling systems. Each hospital was colonized at least once with L. pneumophila, while remedial actions resulted in significant reduction of Legionella concentration. The molecular epidemiology of environmental L. pneumophila strains was also investigated using random amplified polymorphic DNA (RAPD) and multi-gene sequence-based analysis. Based on RAPD patterns, L. pneumophila serogroups 2-15 and serogroup 1 strains were classified into 24 and 9 operational taxonomic units (OTUs), respectively. Sequencing of housekeeping and diversifying pressure-related genes recommended by European Working Group for Legionella Infections (EWGLI) revealed not only a high intraspecies variability but also the circulation and persistence of one specific genotyping profile in the majority of hospitals. This study highlights the necessity for diachronic surveillance of Legionella in health-care facilities by adopting both cultural and molecular methods. PMID:25712880

  3. Importance of Client Orientation Domains in Non-Clinical Quality of Care: A Household Survey in High and Low Income Districts of Mashhad

    Science.gov (United States)

    Fazaeli, Somayeh; Yousefi, Mehdi; Banikazemi, Seyed Hasan; Hashemi, Seyed Amir Hossein Ghazizadeh; Vakilzadeh, Ali Khorsand; Aval, Narges Hoseinzadeh

    2016-01-01

    Responsiveness introduced by WHO as a key indicator to assess the performance of health systems and measures by common set of domains that are categorized in to two main categories “Respect for persons” and “client orientation”. This study measured importance of client orientation domains in high and low income districts of Mashhad. In this cross-sectional and explanatory study, Sample of 923 households were selected randomly from two high and low income districts of Mashhad. World Health Organization (WHO) questionnaire was used for data collection. Standard frequency analyses and Ordinal logistic regression (OLR) was employed for data analysis. In general, respondents selected quality of basic amenities as the most important domain and access to social support networks was identified as the least important domain. Households in high income area scored higher domains of prompt attentions and choice Compared to low income. There was a significant relationship between variables of ages, having member that need to care and self-assessed health with the ranking of client orientation domains. Study of households’ view on ranking of non-clinical aspects of quality of care, especially when faced with limited resources, can help to conduct efforts towards subjects that are more important, and lead to improve the health system performance and productivity. PMID:26925911

  4. A Survey Study of Cryptosporidium Infection in Children under 10 Years Old Referred to the Health Care Centers of Hamadan District in 2013

    Directory of Open Access Journals (Sweden)

    M. Asadi

    2014-10-01

    Full Text Available Introduction & Objective: Cryptosporidium is one of the most important zoonotic and oppor-tunistic protozoa and can cause diarrhea in those with impaired immune systems, as well as the children. Considering the high sensitivity of children against infection caused by crypto-sporidium, its zoonotic nature and lack of treatment, this study aimed to determine the prevalence of cryptosporidium infection in children under 10 years old, referred to the health care centers of Hamadan district. Materials & Methods: This study was conducted in 2013 on 420 children (222 males and 198 females, who were referred to urban and rural health care centers in Hamadan district. Stool samples were examined using formalin-ether method and modified Ziehl-Neelsen staining technique. The results were analyzed with chi-square test. Results: Of the 420 children studied, 2 individuals (0.47% (A 16-month-old boy and a 6-year-old girl were infected with cryptosporidium spp. The infection was observed only in rural areas and in children that were in direct contact with the animals. Conclusion: The results of this study showed a presence of cryptosporidium in rural areas compared to urban areas and in children in contact with animals. Therefore it is necessary to promote the public health awareness of rural population. (Sci J Hamadan Univ Med Sci 2014; 21 (3: 211-217

  5. Importance of Client Orientation Domains in Non-Clinical Quality of Care: A Household Survey in High and Low Income Districts of Mashhad.

    Science.gov (United States)

    Fazaeli, Somayeh; Yousefi, Mehdi; Banikazemi, Seyed Hasan; Ghazizadeh Hashemi, Seyed Amir Hossein; Vakilzadeh, Ali Khorsand; Hoseinzadeh Aval, Narges

    2016-01-01

    Responsiveness introduced by WHO as a key indicator to assess the performance of health systems and measures by common set of domains that are categorized in to two main categories "Respect for persons" and "client orientation". This study measured importance of client orientation domains in high and low income districts of Mashhad. In this cross-sectional and explanatory study, Sample of 923 households were selected randomly from two high and low income districts of Mashhad. World Health Organization (WHO) questionnaire was used for data collection. Standard frequency analyses and Ordinal logistic regression (OLR) was employed for data analysis. In general, respondents selected quality of basic amenities as the most important domain and access to social support networks was identified as the least important domain. Households in high income area scored higher domains of prompt attentions and choice Compared to low income. There was a significant relationship between variables of ages, having member that need to care and self-assessed health with the ranking of client orientation domains.Study of households' view on ranking of non-clinical aspects of quality of care, especially when faced with limited resources, can help to conduct efforts towards subjects that are more important, and lead to improve the health system performance and productivity. PMID:26925911

  6. Preventing catheter-associated infections in the Pediatric Intensive Care Unit: impact of an educational program surveying policies for insertion and care of central venous catheters in a Brazilian teaching hospital

    Directory of Open Access Journals (Sweden)

    Marcelo Luiz Abramczyk

    2011-12-01

    Full Text Available Objectives: To determine the impact of an educational program on the prevention of central venous catheter-related infections in a Brazilian Pediatric Intensive Care Unit. Patients and Methods: All patients admitted to the unit between February 2004 and May 2005 were included in the cohort study in a longitudinal assessment. An educational program was developed based on the Centers for Disease Control and Prevention recommendations for prevention of catheter-associated infections and was adapted to local conditions and resources after an initial observational phase. Incidence of catheter-associated infections was measured by means of on-site surveillance. Results: One hundred eighteen nosocomial infections occurred in 253 patients (46.6 infections per 100 admissions and in 2,954 patient-days (39.9 infections per 1,000 patient-days. The incidence-density of catheter infections was 31.1 episodes per 1.000 venous central catheter-days before interventions, and 16.5 episodes per 1,000 venous central catheter-days afterwards (relative risk 0.53 [95% CI 0.28-1.01]. Corresponding rates for exit-site catheter infections were 8.0 and 2.5 episodes per 1,000 venous central catheter-days [0.32 (0.07-1.49], and the rates for bloodstream infections were 23.1 and 13.9 episodes per 1,000 venous central catheter-days, before and after interventions [0.61 (0.32-1.14]. Conclusion: A prevention strategy targeted at the insertion and maintenance of vascular access can decrease rates of vascular-access infections in pediatric intensive care unit.

  7. Factors associated with four or more antenatal care services among pregnant women: a cross-sectional survey in eight South Central Coast provinces of Vietnam

    Directory of Open Access Journals (Sweden)

    Ha BTT

    2015-07-01

    Full Text Available Bui TT Ha,1 Pham V Tac,2 Duong M Duc,1,3 Doan TT Duong,1 Le M Thi1 1Department of Reproductive Health, Hanoi School of Public Health, 2Department of Personnel and Organization, Ministry of Health, Ba Dinh, Ha Noi, Vietnam; 3International Maternal and Child Health (IMCH, Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden Background: In Vietnam, four or more antenatal care (ANC4+ visits/services among pregnant women have not been officially reported in the health system. Moreover, the factors associated with the use of ANC4+ services have not been studied in previous studies. In this study, we conducted an exploratory analysis to identify the rate of utilization of ANC4+ services and factors associated with use of ANC4+ services among pregnant women in rural areas of Vietnam.Methods: The study was conducted in eight provinces in the South Central Coast region of Vietnam between August 2013 and May 2014. A total of 907 women, who delivered in the past 1 year, participated in the study. Multivariate logistic regression model was used to examine the association between all potential factors and utilization of ANC4+ services.Results: The rate of utilization of ANC4+ services by women in eight South Central Coast provinces was 53.9%. Factors negatively associated with using ANC4+ services were belonging to ethnic minority groups having lower education, doing informal works, having lower income, having lower knowledge on ANC4+ services, and receiving no financial support from the husband. In particular, financial support from the husband was considered important in improving the use of ANC4+ services by women in rural areas.Conclusion: The study asserted an inadequacy for ANC4+ utilization and can contribute to missed opportunities to achieve better maternal outcomes for women in rural areas of Vietnam. The necessity of introducing ANC4+ services in the national guidelines on maternal health care should be disseminated

  8. DENTAL HEALTH CARE PERSONNEL HAND HYGIENE COMPLIANCE AND COUNTERMEASURES SURVEY%口腔科医护人员手卫生依从性情况调查分析及其对策

    Institute of Scientific and Technical Information of China (English)

    于婷

    2011-01-01

    [Objective] To investigate the influencing factors of rival dental health awareness and medical support of hos pital infection, investigate the hand hygiene of dental health care compliance and dental health care personnel hand hygiene compliance, and improve the health care workersself-protection awareness of the importance of hospital infection control mea sures. [ Methods] To investigate the dental health care personnel with questionnaire survey, and the questionnaires mainly were objective questions. We mastered the dental health care personnel hand hygiene compliance of the relevant circumstances. [Results] The dental health care personnel had the high awareness rate of transmitted diseases, with the rate of 88.52%. The awareness rate of hand disinfection was the lowest, and was 57.38%; The main influencing factors of dental health care person nel hand hygiene compliance were heavy workload (91.80%) , followed hy treatment and care priority (86.89%) , and lack of personal responsibility ( 1.64%). [Conclusion] We conducted investigation on the medical staff compliance with hand hygiene behavior and analyzed the factors to take control measures to improve compliance of hand washing, hand hygiene can be effec tive in preventing caused by hospital infections.%[目的]口腔科医护人员对手卫生的认知及支持是控制医院感染的重要影响因素,通过对口腔科医护人员手卫生依从性调查,掌握口腔科医护人员手卫生依从性情况,提高医护人员的自我防护意识,探讨控制医院感染的重要措施. [方法]对口腔科的医护人员进行问卷调查,以客观性问题为主,掌握口腔科医护人员手卫生依从性相关情况.[结果]口腔科医护人员对经手传播疾病的概念认知率最高,为88.52%,手消毒方法掌握率最低,为57.38%;影响口腔科医护人员手卫生依从性的因素主要为工作量大(91.80%),其次为治疗护理优先权(86.89%),影响

  9. 五家渠市居民对老年人家庭护理服务认知现状调查%Survey of cognition status quo of residents in Wuj iaqu city on home care service for elderly

    Institute of Scientific and Technical Information of China (English)

    刘茜; 徐雪雁; 沈燕; 董汉奎

    2015-01-01

    Objective:To know about the cognitive status quo,level of attitude,service demand of residents in Wujiaqu city in Xinjiang Uygur autonomous region on home care services for the elderly and its influencing fac-tors,so as to provide a theoretical basis for carrying out the elderly family nursing service and improving their health care.Methods:The cognitive questionnaire of home care services for elderly was used for a questionnaire survey of 1 8 years old to 5 9 years old residents conducted in Army Road,People Road,Green Lake Road 3 streets in Wuj iaqu city.Results:There was statistically significant in cognitive status among different age,educa-tion level and ethnic residents for family care (P<0.05 or P<0.01).The government service for the aged ex-pected higher.Compared with the expected situation differences on different gender elderly service government, education,national,community residents were statistically significant(P<0.01).Home care services for the eld-erly need for maj or chronic diseases,diet nursing care and health guidance.Conclusion:Most of people’s cogni-tion in Wujiaqu City on home care service for elderly is not comprehensive.Howerver,there is a great demand for it.To carry out home care services for the elderly should be focused on.%[目的]了解新疆维吾尔自治区五家渠市18岁~59岁居民对老年人家庭护理服务的认知现状、态度水平、服务需求及其影响因素,为进一步开展老年人家庭护理、提高老年人医疗保健服务提供理论依据。[方法]采用老年人家庭护理服务问题认知调查问卷,对五家渠市军垦路、人民路、青湖路3个街道的18岁~59岁居民进行问卷调查。[结果]不同年龄、学历、民族的居民对家庭护理的认知现状比较差异有统计学意义(P<0.05或P<0.01);对政府老年服务的期待较高,不同性别、学历、民族、社区的居民对政府老年服务的期待情况比较差异有统计学意义(P<0.01);老

  10. Child and adolescent psychiatry: which knowledge and skills do primary care physicians need to have? A survey in general practitioners and paediatricians.

    Science.gov (United States)

    Lempp, Thomas; Heinzel-Gutenbrunner, Monika; Bachmann, Christian

    2016-04-01

    Primary care physicians (PCPs) play a key role in the initial assessment and management of children and adolescents with mental health problems. However, it is unclear whether current medical education curricula sufficiently equip PCPs for this task. The aim of this study was to investigate, which child and adolescent psychiatry (CAP)-related skills and knowledge PCPs say they require in their daily practice. A questionnaire was generated, employing a modified two-step Delphi approach. Besides socio-demographic items, the questionnaire contained 17 CAP-related knowledge items and 13 CAP-related skills items, which had to be rated by importance in daily practice. The questionnaire was distributed to 348 office-based paediatricians and 500 general practitioners (GPs) in Germany. The overall return rate was 51.3 % (435/848). Regarding CAP-related knowledge, both paediatricians and GPs rated somatoform disorders and obesity as highly important for daily practice. Moreover, paediatricians also deemed regulatory disorders during infancy (e.g. crying, sleep disorders) as important, while GPs assessed knowledge on paediatric depression as relevant. For paediatricians and GPs, the most relevant CAP-related skills were communicating with children and adolescents and their parents. Additionally, paediatricians rated differentiating between non-pathologic and clinically relevant behaviour problems very relevant, while GPs considered basic psychotherapeutic skills essential. The CAP-related knowledge and skills perceived relevant for doctors in primary care differ from the majority of current medical school CAP curricula, which cover mainly typical, epitomic CAP disorders and are predominantly knowledge-oriented. Therefore, medical education in CAP should be amended to reflect the needs of PCPs to improve healthcare for children and adolescents with mental health problems. PMID:26250895

  11. Knowledge, attitudes and practice survey about antimicrobial resistance and prescribing among physicians in a tertiary care teaching hospital in Eastern India

    Directory of Open Access Journals (Sweden)

    Abhishek Ghosh

    2016-02-01

    Results: All doctors agreed that antimicrobial resistance is a problem in India and also in their daily practice. Doctors were lacking on the aspect of regular educational activities regarding appropriate use of antimicrobials, which they felt extremely important. Also many of them were unaware about the hospital formularies, current susceptibility pattern of common pathogens. Majority said that a local guideline would be more useful than the international one. Conclusions: This survey identified topics to address in the containment of antimicrobials resistance like dissemination of information about local antimicrobial resistance rates, the revision and dissemination of local guidelines, and emphasization on regular educational activities among physicians. [Int J Basic Clin Pharmacol 2016; 5(1.000: 180-187

  12. Awareness of disaster reduction frameworks and risk perception of natural disaster: a questionnaire survey among Philippine and Indonesian health care personnel and public health students.

    Science.gov (United States)

    Usuzawa, Motoki; O Telan, Elizabeth; Kawano, Razel; S Dizon, Carmela; Alisjahbana, Bachti; Ashino, Yugo; Egawa, Shinichi; Fukumoto, Manabu; Izumi, Takako; Ono, Yuichi; Hattori, Toshio

    2014-01-01

    As the impacts of natural disasters have grown more severe, the importance of education for disaster medicine gains greater recognition. We launched a project to establish an international educational program for disaster medicine. In the present study, we surveyed medical personnel and medical/public health students in the Philippines (n = 45) and Indonesia (n = 67) for their awareness of the international frameworks related to disaster medicine: the Human Security (securing individual life and health), the Sphere Project (international humanitarian response), and the Hyogo Framework for Action 2005-2015 (international strategy for disaster reduction). In both countries, more than 50% responders were aware of human security, but only 2 to 12% were aware of the latter two. The survey also contained questions about the preferred subjects in prospective educational program, and risk perception on disaster and disaster-related infections. In the Philippines, significant disasters were geophysical (31.0%), hydrological (33.3%), or meteorological (24.8%), whereas in Indonesia, geophysical (63.0%) and hydrological (25.3%) were significant. Moreover, in the Philippines, leptospirosis (27.1%), dengue (18.6%), diarrhea (15.3%), and cholera (10.2%) were recognized common disaster-related infections. In Indonesia, diarrhea (22.0%) and respiratory infection (20.3%) are major disaster-related infections. Water-related infections were the major ones in both countries, but the profiles of risk perception were different (Pearson's chi-square test, p = 1.469e-05). The responders tended to overestimate the risk of low probability and high consequence such as geophysical disaster. These results are helpful for the development of a postgraduate course for disaster medicine in Asia Pacific countries. PMID:24814669

  13. Measuring integrated care

    DEFF Research Database (Denmark)

    Strandberg-Larsen, Martin

    2011-01-01

    respond to these needs, patients and providers face the multiple challenges of today's healthcare environment. Decision makers, planners and managers need evidence based policy options and information on the scope of the integrated care challenges they are facing. The US managed care organization Kaiser...... and performance of the Danish healthcare system and the managed care organization Kaiser Permanente, California, US. 5) To compare primary care clinicians' perception of clinical integration in two healthcare systems: Kaiser Permanente, Northern California and the Danish healthcare system. Further to examine...... of secondary data from the Danish healthcare system and Kaiser Permanente, California were used to compare population characteristics, professional staff, delivery structure, utilisation, quality measures and direct costs. A cross-sectional survey among primary care clinicians in Denmark and in Kaiser...

  14. Common mental health disorders in children and adolescents in primary care: A survey of knowledge, skills and attitudes among general practitioners in a newly developed European country

    Directory of Open Access Journals (Sweden)

    Kurt Buhagiar

    2012-09-01

    Full Text Available Background and Objectives: General Practitioners (GPs are generally the first point of contact for children and adolescents with mental health problems. This study investigates the confidence, beliefs, and knowledge of GPs regarding common mental health problems in youngsters. Methods: A self-designed questionnaire was distributed to nearly all registered GPs in a middle-income European country in order to address the aims of the study. Results: Response rate was 58%. Many GPs reported relatively low confidence on a number of issues, including diagnosis (70.0%, initiating management (86.6%, assessing the child-caregiver relationship (72.0% and the ability to distinguish between normal and pathological behavioural problems (75.1%. However, GPs showed greater inclination to conduct follow-up care after assessment by specialist services (53.5%. Few GPs considered psychosocial interventions to play a role in the treatment of anxiety disorders (18.5%, hyperkinetic disorders (24.2%, depression (22.9% and disruptive behaviour disorders (18.5% and this largely came from younger GPs (p < 0.001. Conclusions: Confidence of GPs in the management of youngsters with mental health problems is generally low. They may require significant back-up from specialist services in the form of both training and clinical collaboration.

  15. FLEXI Project Management Survey

    Science.gov (United States)

    Rohunen, Anna; Krzanik, Lech; Kuvaja, Pasi; Similä, Jouni; Rodriguez, Pilar; Hyysalo, Jarkko; Linna, Tommi

    FLEXI Project Management Survey (FLEXI PMS) has been established to gain detailed knowledge on how the software industry - in particular successful companies - manages agile software development. FLEXI PMS investigates the actual agile values, principles, practices and contexts. The survey is supported by a careful literature review and analysis of existing studies. Special attention is attached to large, multi-site, multi-company and distributed projects - the target area of FLEXI project. The survey is intended to provide solid data for further knowledge acquisition and project/company positioning with regard to feasible agile management practices.

  16. A carefully characterised and tracked Trans-Neptunian survey, the size-distribution of the Plutinos and the number of Neptunian Trojans

    CERN Document Server

    Alexandersen, Mike; Kavelaars, J J; Petit, Jean-Marc; Gwyn, Stephen; Shankman, Cory

    2014-01-01

    The Trans-Neptunian Objects (TNOs) may preserve evidence of planet building in their orbital and size-distributions. While all populations show steep size-distributions for large objects, recently relative deficit of Neptunian Trojans and scattering objects with diameters $D<100\\,\\mathrm{km}$ were detected. We have investigated this deficit with a 32 square degree survey, detecting 77 TNOs to a limiting $r$-band magnitude of 24.6. Our Plutinos sample (18 objects in 3:2 mean motion resonance with Neptune) also shows a deficit of $D<100\\,\\mathrm{km}$ objects. We reject a single power-law size-distribution and find that the Plutinos favour a divot. The Plutinos are thus added the list of populations with a deficit of $D<100\\,\\mathrm{km}$ objects. The fact that three independent samples of three different populations show this trend suggests that it is a real feature, possibly shared by all hot TNO populations as a remnant of "born big" planetesimal formation processes. We surmise the existence of $9000\\...

  17. A survey and analysis of the responsiveness of rural health care system in Jiangmen city%江门市农村卫生系统反应性调查与分析

    Institute of Scientific and Technical Information of China (English)

    罗小燕; 梁伯进; 廖勇彬; 甄沛林; 张晋昕; 李伟栋; 余少兰; 赵玲杰; 韩春春

    2010-01-01

    Objective To understand the performance of health care system in Jiangmen rural areas, to find the weakness and to analyze the reasons, to take measures to improve the overall service level of the system. Methods A survey on 208 people who received public health services in the past year at three districts and four counties in Jiangmen was conducted by questionnaires. All the questionnaires were coded with two-input logic proof by Epidata and processed by the SPSS 16.0 software. Results Of the best rural health system response was dignity 89.9%, and social support network 89%. Considered poor or very poor response to the first three is the quality of infrastructure, 8.2%, 3.4% selected heath care workers to patients in a timely manner and accounted for 1.4% interest. Conclusions Imvestment should be increased to the rural health care system to improve the basic structures. Autonomy, prompt attention, confidentiality, and selection of medical staff should be further improved to enhance the responsiveness of rural health care system.%目的 了解江门市农村卫生系统绩效状况,发现不足,分析原因,研究对策,以改善农村卫生系统整体服务水平.方法 随机调查在过去一年中接受过江门市三区四县十镇农村医疗机构服务的208名公众,对他们进行问卷调查.所有问卷进行编码,经Epidata双录入逻辑校对,由SPSS16.0软件处理.结果 农村卫生系统反应性最好的是尊严占89.9%,社会支持网络占89%.认为反应性差或很差的前三位是基础设施质量占8.2%,选择医护人员占3.4%以及对病人的及时关注占1.4%.结论 增加政府对农村卫生系统的投入,改善基础设施建设,在自主性、及时关注、保密性以及选择医护人员方面应进一步改进,以提高农村医疗系统的反应性.

  18. Prenatal Care

    Science.gov (United States)

    ... am thinking about getting pregnant. How can I take care of myself? You should start taking care of ... What should I do — or not do — to take care of myself and my unborn baby? Follow these ...

  19. Self Care

    Science.gov (United States)

    ... Care Connections Experiences Research Learning Evaluation Print Email Self Care If you are living with a chronic ... help you cope can make a real difference. Self-care techniques are things you can do for ...

  20. Prevalence and determinants of diabetic retinopathy in Al Hasa region of Saudi Arabia: primary health care centre based cross-sectional survey, 2007-2009

    Directory of Open Access Journals (Sweden)

    Khan Ataur

    2010-01-01

    Full Text Available Purpose: To evaluate the prevalence of diabetic retinopathy (DR in the urban and rural areas of Al Hasa region of Saudi Arabia and to determine risk factors related to DR. Materials and Methods: This study was conducted on patient attending primary health care centers between July 2007 and June 2009. A retrospective chart review was conducted on subjects with diabetes mellitus greater than 18 years old. Ophthalmologists examined DR status through dilated pupils by using direct, indirect, and slit lamp bio-microscopy. Frequencies, percentage, and their 95% confidence intervals (CIs were calculated. Odd′s ratio was used to associate DR with possible risk factors. A P value less than 0.05 was considered statistically significant. Results: The prevalence of DR among 473 diabetic subjects was 30% (95% CI: 25.80-34.20. The odd ratios (ORs of DR among diabetic residing in an urban area was significantly higher than diabetics residing in rural areas [OR = 1.94 (95% CI of OR 0.82-2.89]. DR was associated to the duration of diabetes (adjusted OR = 1.70, uncontrolled blood sugar level (adjusted OR = 1.96, hyperlipidemia (adjusted OR = 2.04, and hypercholesterolemia (adjusted OR = 2.80. Conclusions: DR appears to be a public health problem in the Al Hasa district of Saudi Arabia, and a planned approach is required to avoid severe visual impairment in patients with diabetes mellitus. Primary prevention and early detection could be implemented through primary health centers and non-ophthalmologists.

  1. Survey of characteristics of neonatal death in neonatal intensive care unit of Boo-Ali Sina educational & therapeutic center between 2003-2006

    Directory of Open Access Journals (Sweden)

    Azita Bala Ghafari

    2009-01-01

    Full Text Available , , , (Received 24 June, 2009 ; Accepted 16 September, 2009AbstractBackground and purpose: The neonatal mortality rate is an important index for evaluation of public health. It involves the death of infants under 28 days. Obviously, recognizing the characteristics of neonatal mortality in this center, may be useful for promoting the procedures in the NICU, as well as planning to impede the severe complications or death.Materials and methods: This is a descriptive study performed by analyzing the available data from the medical records of NICU patients at Boo-Ali Sina Educational & Therapeutic Center during 2003 and 2006. The number of deaths, names, and medical records number of the dead infants were collected. Among 1238 patients in the NICU, 363 deaths were reported. According to medical records, 222 deaths occurred in neonates aged 0 to 27 days. Data were collected using a checklist, the validity and reliability of which were approved by clinicians. The Descriptive methods were used in analyzing the data.Results: The findings include: 140 subjects were male (63.1%; 72 from single birth (77.5%; the age-group of mothers of 38 cases (37.7% was 20-24 y; 132 cases (59.5% resided in villages; 129 cases (58.1% with prenatal care; 120 cased of Caesarian section (54%; 155 cases (76% with birth weight lower than 2500 grams and 154 preterm (75.5%. Mortality during neonatal period was divided in two groups: early death (0-6 days 142 cases (62% and late death (7-27 days 80 cases (36%.Conclusion: Correct and exact completion of NICU forms would help undertaking descriptive and analytic epidemiologic studies.Key words: Neonatal mortality, early neonatal mortality, late neonatal mortality, NICUJ Mazand Univ Med Sci 2009; 20(74: 79-83 (Persian

  2. A survey study on use of over the counter (OTC drugs among medical students, nursing and clerical staff of a tertiary care teaching rural hospital

    Directory of Open Access Journals (Sweden)

    Devang Parikh

    2013-04-01

    Full Text Available Aim: The study was conducted to evaluate use of over the counter (OTC drugs among the medical students, nursing and clerical staff of tertiary care teaching rural hospital to determine the awareness and disadvantages on use of OTC. Methods: Responses to a feedback questionnaire covering various aspects on usage of OTC drugs were obtained from 100 medical students, 100 nursing and 100 clerical staff. Results: Among 300 respondents, 84% used OTC, commonly purchased by self. Majority of them started self medication within 2 days of their illness. The frequently reported illness that prompted self-medication included headache, cough and cold, fever, generalised weakness, acidity, dysmenorrhoea, and sleep disturbances. Majority of them obtained OTC by mentioning name of drug (81%, 35% by telling symptom and 15% by showing old prescription. We found that 87% people share OTC among relatives and friends. Conclusions: Usage of OTC was highest amongst medical students and nursing staff. Time consumption for consultation, the consultation fees and frequent visits were the commonly mentioned reasons for self medication. It was analysed that none of the clerical staff were aware of the drug, dose, frequency of administration and adverse reactions. While very little awareness of medication was found even among nursing staff and medical students. Therefore it is suggested that the public has to be educated on the type of illnesses to be self-diagnosed and medicated, dangers of OTC on misuse which would possibly lead to delay in detection of more serious underlying ailment and timely medication. [Int J Res Med Sci 2013; 1(2.000: 83-86

  3. Pharmaceuticals and personal care products in effluent matrices: A survey of transformation and removal during wastewater treatment and implications for wastewater management.

    Science.gov (United States)

    Oulton, Rebekah L; Kohn, Tamar; Cwiertny, David M

    2010-11-01

    Pharmaceuticals and personal care products (PPCPs) represent pollutants of emerging concern, originating in surface and drinking waters largely from their persistence in wastewater effluent. Accordingly, a wealth of recent investigations has examined PPCP fate during wastewater treatment, focusing on their removal during conventional (e.g., activated sludge) and advanced (e.g., ozonation and membrane filtration) treatment processes. Here, we compile nearly 1500 data points from over 40 published sources pertaining to influent and effluent PPCP concentrations measured at pilot- and full-scale wastewater treatment facilities to identify the most effective series of technologies for minimizing effluent PPCP levels. Available data suggest that at best a 1-log(10) concentration unit (90%) of PPCP removal can be achieved at plants employing only primary and secondary treatment, a performance trend that is maintained over the range of reported PPCP influent concentrations (ca. 0.1-10(5) ng L(-1)). Relatively few compounds (15 of 140 PPCPs considered) are consistently removed beyond this threshold at facilities using solids removal and conventional activated sludge (CAS), and most PPCPs are removed to a far lesser extent. Further, increases in CAS hydraulic retention time or sludge retention time do not appreciably increase removal beyond this limit. In contrast, plants employing advanced treatment methodologies, particularly ozonation and/or membranes, remove the vast majority of PPCPs beyond 1-log(10) concentration unit and oftentimes to levels below analytical detection limits in effluent. Data also indicate that passive approaches for tertiary treatment (e.g., wetlands and lagoons) represent promising options for PPCP removal. We conclude by addressing future challenges and frontiers in wastewater management posed by PPCPs including analytical needs for their real-time measurement, energy demands associated with advanced treatment technologies, and byproducts arising

  4. Response to post-donation counseling is still a challenge in outdoor voluntary blood donation camps: A survey from a tertiary care regional blood center in Eastern India

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    Somnath Mukherjee

    2014-01-01

    Full Text Available Background: Blood transfusion carries the risk of transmission of several infectious agents. The latest method for blood screening, nucleic acid testing is not affordable in developing countries. Aim: The study was aimed to find response to post-donation counseling for reactive markers among the voluntary blood donors donating in blood donation camps. Material and Methods: This 1 year study was conducted in 2011. Transfusion transmitted infections testing was performed by routine enzyme linked immunosorbent assay method. The initial human immunodeficiency virus (HIV reactive donors who returned back to the blood bank were confidentially counseled and referred to the Integrated Counseling Cum Testing Center (ICTC. The hepatitis B surface antigen (HBsAg and anti-hepatitis C virus (HCV reactive donors were referred to the gastroenterology department for confirmation by qualitative polymerase chain reaction (PCR, Roche Diagnostics, Germany and followed-up. Results: Twenty seven thousand two hundred forty six 27,246 units were collected during the survey. One hundred twenty nine129 units were reactive for HIV 1 and 2, 99 were reactive for HCV, 206 for hepatitis B virus (HBV. Of these reactive donors, 138 could be personally communicated. Out of 47, 27 donors who returned for counseling were initially reactive for HIV 1 and 2, 8 for HBsAg and 12 for anti-HCV. Two were positive for HBV deoxyribonucleic acid and one was positive for HCV ribonucleic acid. The HIV positivity was detected in 1 of 27 donors at ICTC. Conclusion: The response to the post-donation counseling appears in this study to be only 34% (47/138, which is still a challenge.

  5. Debt and Foregone Medical Care

    Science.gov (United States)

    Kalousova, Lucie; Burgard, Sarah A.

    2013-01-01

    Most American households carry debt, yet we have little understanding of how debt influences health behavior, especially health care seeking. We examined associations between foregone medical care and debt using a population-based sample of 914 southeastern Michigan residents surveyed in the wake of the late-2000s recession. Overall debt and…

  6. National Natality Survey/National Maternal and Infant Health Survey (NMIHS)

    Science.gov (United States)

    The survey provides data on socioeconomic and demographic characteristics of mothers, prenatal care, pregnancy history, occupational background, health status of mother and infant, and types and sources of medical care received.

  7. 锦州市围生期妇女保健需求的调查分析%Survey of perinatal health care demand in Jinzhou

    Institute of Scientific and Technical Information of China (English)

    王怡涵; 王红霞; 侯晓瑛; 卢静; 宫建美

    2016-01-01

    Objective To understand perinatal health care and demand status, and explore the influence factors of perinatal health in Jinzhou area. Methods Randomly investigate 996 mothers from three hospital in Jinzhou. Results Seeking pregnancy health service demand rate: general hospital of obstetrics and gynecology accounted for 52.2%(520/996), maternity hospitals accounted for 39.5%(393/996), family planning services accounted for 8.3% (83/996). Good crowd in pregnancy cognition, > 30 65.3% (297/455), 30 years old or less accounted for 34.7% (158/455). Medical personnel in maternal knowledge acquirement accounted for 33.2% (331/996), pregnant women school training accounted for 23.9% (238/996), network way accounted for 16.2% (161/996), the relatives and friends accounted for 10.7% (107/996), books accounted for 10.8% (108/996), the other way accounted for 5.1% (51/996).The related factors of postpartum depression are marital status, antenatal education, the way of breastfeeding. Conclusions The family planning service has not fully played its efficiency. Women under t he age of 30 need to enhance conciousness about health care before pregnancy. The network platform still has space to play education function. It′s necessary that puerperal nursing routine should add postnatal depression questionnaire in the future.%目的:了解锦州地区妇女围生期保健需求,并探讨影响妇女围生期健康的相关因素。方法随机选取996例产后复查的产妇,对其一般情况、孕前保健认知和信息获取途径情况、孕产期知识获取途径情况和产后抑郁情况进行问卷调查。结果寻求孕前保健服务的需求率:综合性医院妇产科占52.2%(520/996),妇产科专科医院占39.5%(393/996),计划生育服务所占8.3%(83/996)。在围孕期认知良好的人群中,>30岁占65.3%(297/455),≤30岁占34.7%(158/455)。在孕产期知识获取途径中医务人员占33.2%(331/996

  8. Access and care issues in urban urgent care clinic patients

    Directory of Open Access Journals (Sweden)

    Adams Jill C

    2009-12-01

    Full Text Available Abstract Background Although primary care should be the cornerstone of medical practice, inappropriate use of urgent care for non-urgent patients is a growing problem that has significant economic and healthcare consequences. The characteristics of patients who choose the urgent care setting, as well as the reasoning behind their decisions, is not well established. The purpose of this study was to determine the motivation behind, and characteristics of, adult patients who choose to access health care in our urgent care clinic. The relevance of understanding the motivation driving this patient population is especially pertinent given recent trends towards universal healthcare and the unclear impact it may have on the demands of urgent care. Methods We conducted a cross-sectional survey of patients seeking care at an urgent care clinic (UCC within a large acute care safety-net urban hospital over a six-week period. Survey data included demographics, social and economic information, reasons that patients chose a UCC, previous primary care exposure, reasons for delaying care, and preventive care needs. Results A total of 1, 006 patients were randomly surveyed. Twenty-five percent of patients identified Spanish as their preferred language. Fifty-four percent of patients reported choosing the UCC due to not having to make an appointment, 51.2% because it was convenient, 43.9% because of same day test results, 42.7% because of ability to get same-day medications and 15.1% because co-payment was not mandatory. Lack of a regular physician was reported by 67.9% of patients and 57.2% lacked a regular source of care. Patients reported delaying access to care for a variety of reasons. Conclusion Despite a common belief that patients seek care in the urgent care setting primarily for economic reasons, this study suggests that patients choose the urgent care setting based largely on convenience and more timely care. This information is especially applicable to

  9. Survey of stress ulcer prophylaxis

    OpenAIRE

    Erstad, Brian L; Barletta, Jeffrey F; Jacobi, Judith; Killian, Aaron D; Kramer, Katherine M; Martin, Steven J.

    1999-01-01

    Background: No surveys of stress ulcer prophylaxis prescribing in the USA have been conducted since 1995. Since that time, the most comprehensive meta-analysis and largest randomized study to date concerning stress ulcer prophylaxis have been published. Results: Three hundred sixty-eight surveys were sent to all members of the Section of Pharmacy and Pharmacology of the Society of Critical Care Medicine. One hundred fifty-three (42%) surveys were returned. Representatives from 86% of institut...

  10. The survey of behaviors and related knowledge about foot care of patients with diabetes from suburbs%郊区糖尿病患者足部护理行为及相关知识的调查分析

    Institute of Scientific and Technical Information of China (English)

    王辉; 刘金莲; 孙玉梅

    2010-01-01

    Objective To investigate the status of foot care behavior and related knowledge of patients with type 2 diabetes in suburbs of Beijing, and analyze their possible influencing factors. Methods A convenient sample of 108 patients with type 2 diabetes was surveyed using questionnaire. Results The patients'average scores of daily foot care behaviors were (4.85 ± 4.48 ), among 10 behaviors, the correct rate of "checking feet" and "trimming nails" were lower. Average scores of related knowledge about foot care were (14.03 ±4.46), among 20 items, the correct rate of "shoes with bootlace and velcro should be chosen "、"diabetic foot was related to misfeasance in wearing socks and lightish socks was suitable for patients with diabetes" were lower. By multiple stepwise regression analysis, scores of the behaviors were related to the patients' identity level with preventability of diabetic foot, and scores of the related knowledge were related to patients' identity with importance of foot care and patients' course of disease. Conclusions The behaviors and related knowledge about foot care of suburban patients with type 2 diabetes should be improved.%目的 了解郊区糖尿病患者足部护理行为及相关知识现状,并分析其可能的影响因素.方法 方便选取北京市某郊区医院的108例2型糖尿病患者进行问卷调查.结果 糖尿病患者日常足部护理行为平均分为(4.85±4.48)分,其中正确率较低的是"足部检查"和"剪指甲"行为;足部护理相关知识平均为(14.03±4.46)分,其中正确率较低的是"应该选择有鞋带或尼龙搭扣的鞋子"、"穿着袜子不当与糖尿病足的发生有关"、"浅色袜子最适合糖尿病患者穿着";多元逐步回归分析显示,患者的日常护理行为得分与患者对糖尿病足的可预防性的认识有关;护理相关知识得分与其对糖尿病足部护理重要性的认识及病程有关.结论 郊区糖尿病患者对足部护理重要性的认识、相关

  11. Survey on Awareness on Recent Health Care Reform in Medical Staff and Patients of Shaanxi%陕西医患双方对新医改认知的调查

    Institute of Scientific and Technical Information of China (English)

    李全义; 师社会; 王明旭

    2012-01-01

    目的 了解医患双方对新医改的感受和认知,分析其影响因素.方法采用问卷调查的方法.结果 医患双方在学历和职称两方面存在显著性差异(x2=25.74,P<0.01)、(x=104.74,P<0.01),但在收入上无差异(x2=8.60,P>0.05).医患双方分别有8.12%和27.61%的人不知道我国目前已稚行新医改,医务人员对新医改的认识主要来自于工作经历(89.68%),公众的认知主要来自于亲身感受(81.40%)和家人、亲戚朋友口口相传(14.65%).医务人员关心的是个人收入变化(48.56%)和医疗环境改善(40.61%),公众更在意医保报销比例(37.20%)和医药费用降低(25.08%).与医改前相比,医患双方均认为“看病难、看病责”问题有所缓解,但问题依然存在.个人收入变化是形成医方对医改认知的最主要因素(P<0.01),而医保参加情况则是影响公众对医改认知的重要原因(P<0.01).结论 陕西医患双方对新医改认识不同;个人收入变化、医保参加情况是影响医患双方对新医改认知的因素.%Objective; To survey the awareness and feeling about the recent health care reform in medical staff and patients, and analyze the influencing factors. Methods: Questionnaires method was used in this study. Re-SliltS; There was significant difference between medical staff and patients in educational background and technical title(x2 =25.74,P 0. 05 ). 8. 12% of medical staff and 27. 61% of patients did not know the new health care reform. The cognition of medical staff on new health care reform mainly came work experience (89. 68% ). For the patients, it mainly came from personal feeling ( 81. 40% ) and hearing from families and friends (14. 65% ). Most of medical staff concerned about personal incomes (48. 56% ) and the improvement of medical environment (40. 61% ). The public concerned about the proportion of medical compensation(37. 20% ) and reduction of medical costs(25.08% ). Comparing with before

  12. Quality systems in Dutch health care institutions.

    OpenAIRE

    Casparie, Anton; Sluijs, Emmy; Wagner, Cordula; de Bakker, Dinny

    1997-01-01

    The implementation of quality systems in Dutch health care was supervised by a national committee during 1990-1995. To monitor the progress of implementation a large survey was conducted in the beginning of 1995. The survey enclosed all subsectors in health care. A postal questionnaire-derived from the European Quality Award-was sent to 1594 health care institutions; the response was 74%. The results showed that in 13% of the institutions a coherent quality system had been implemented. These ...

  13. Impact of active and passive smoking as risk factors for asthma and COPD in women presenting to primary care in Syria: first report by the WHO-GARD survey group

    Directory of Open Access Journals (Sweden)

    Mohammad Y

    2013-10-01

    Full Text Available Yousser Mohammad,1 Rafea Shaaban,1 Bassam Abou Al-Zahab,2 Nikolai Khaltaev,3 Jean Bousquet,4,5 Basim Dubaybo6 1National Center for Research in Chronic Respiratory Diseases, Tishreen University School of Medicine, Latakia, Syria; 2Ministry of Health, Damascus, Syria; 3Global Alliance Against Chronic Respiratory Diseases, World Health Organization, Geneva, Switzerland; 4Department of Respiratory Diseases, University Hospital, Hôpital Arnaud de Villeneuve, Montpellier, France; 5Inserm, CESP Centre for Research in Epidemiology and Population Health, U1018, Respiratory and Environmental Epidemiology Team, Villejuif, France; 6Department of Internal Medicine, Wayne State University School of Medicine, Detroit, MI, USA Background: The burden of chronic respiratory disease (CRD is alarming. International studies suggest that women with CRD are undersurveyed and underdiagnosed by physicians worldwide. It is unclear what the prevalence of CRD is in the general population of Syria, particularly among women, since there has never been a survey on CRD in this nation. The purpose of this study was to investigate the impact of different patterns of smoking on CRD in women. Materials and methods: We extracted data on smoking patterns and outcome in women from the Global Alliance Against Chronic Respiratory Diseases survey. Using spirometric measurements before and after the use of inhaled bronchodilators, we tracked the frequency of CRD in females active and passive narghile or cigarette smokers presenting to primary care. We administered the questionnaire to 788 randomly selected females seen during 1 week in the fiscal year 2009–2010 in 22 primary care centers in six different regions of Syria. Inclusion criteria were age >6 years, presenting for any medical complaint. In this cross-sectional study, three groups of female subjects were evaluated: active smokers of cigarettes, active smokers of narghiles, and passive smokers of either cigarettes or narghiles

  14. Surveys of the patient satisfaction in four hand operation main points in the production process of complete denture care%全口义齿四手操作配合及患者满意度调查

    Institute of Scientific and Technical Information of China (English)

    张景; 张琴; 陆豫; 石春红

    2014-01-01

    目的:探讨全口义齿制作过程中四手操作护理配合要点及患者的满意度。方法选择行全口义齿修复患者64例,按照全口义齿四手操作护理配合要点参与修复治疗全过程,调查患者满意度。结果(1)患者对全口义齿制作过程中护理操作、医护配合、人文关怀、护理态度评价为满意分别占98.4%、96.9%、93.8%、100.0%。(2)患者对全口义齿外观、语言、咀嚼能力、义齿稳固性、舒适性评价为满意分别占90.6%、98.4%、89.1%、93.8%、96.9%。(3)患者预期目的完全达到58例(90.6%);基本达到6例(9.4%)。结论四手操作在全口义齿诊疗中可提高医生工作效率和患者满意度,并减轻医护工作的疲劳;应积极提倡培养口腔护士四手操作的能力。%Objective In the production process of complete denture care with the main points and the anal-ysis of the results of patient satisfaction surveys.Methods Select 64 clinical pre complete dentures pa-tients,compliance with care with the main points involved in the rehabilitation treatment of the whole process,fill out the satisfaction questionnaire and statistically analyze the results.Results Attitude toward nursing care operation with humanistic care nursing satisfaction evaluation of denture patients 63(98.4%),62(96.9%),60(93.8%),64(100.0%),respectively.The appearance language chewing ability denture stability comfort satisfaction evaluation 58 (90.6%),63 (98.4%),57 (89.1%),60 (93.8%), 62(96.9%),respectively.Patients expected goal attainment shows completely reach 58 cases,accounting for 90.6%;Basically reach 6 cases,accounting for 9.4%.Conclusion Four hand operation Applied in com-plete denture repair can improve the quality of treatment and the patient satisfaction,reduce fatigued of doctors and nurse.which should be wildly used in clinical nursing.

  15. 转型期农村家庭养老的困境与对策——河南Q村空巢家庭的养老状况调查%Isssues and countermeasures of the family care model for old-age in rural areas in transition process——the survey of the care condition for old-age of the empty-nest family in Q village

    Institute of Scientific and Technical Information of China (English)

    李瑞平; 李松柏

    2009-01-01

    During the process of social transition,because of the outflow of rural labor and the implementation of family planning policy and other reasons,the empty-nest families in rural increase and care issues for the old arise.Through the survey of 30 empty-nest families in Hennan Province in central,found that:the traditional family care model,although subjected to the impact of old-age service,not will completely replaced by the social care,for many reasons.So it should be organically combined with the social care,family care continue to play a role to improve the aged security in rural areas.%在社会转型期由于农村劳动力的外流及计划生育政策的实行等原因,农村的空巢家庭增多,养老问题凸显,通过对河南中部Q村30户空巢家庭的调查发现,传统的家庭养老模式虽面临困境遭受冲击但不会完全被社会养老取代,原因是多方面的,因此应将其与社会养老有机结合,继续发挥家庭养老的作用,完善农村的养老保障事业.

  16. 42 CFR 488.314 - Survey teams.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Survey teams. 488.314 Section 488.314 Public Health...-Term Care Facilities § 488.314 Survey teams. (a) Team composition. (1) Surveys must be conducted by an interdisciplinary team of professionals, which must include a registered nurse. (2) Examples of...

  17. Children with special health care needs: Impact of health care expenditures on family financial burden

    OpenAIRE

    Lindley, Lisa C.; Mark, Barbara A.

    2010-01-01

    We investigated the relationship between health care expenditures for Special Health Care Needs (SHCN) children and family perception of financial burden. Using 2005/2006 National Survey of Children with Special Health Care Needs data, a multivariate logistic regression model was used to estimate the relationship between the SHCN child’s health care expenditure and perceived financial burden, while controlling for family and child characteristics. Our analysis suggests that health care expend...

  18. Primary care patient and provider preferences for diabetes care managers

    Directory of Open Access Journals (Sweden)

    Ramona S DeJesus

    2010-06-01

    Full Text Available Ramona S DeJesus1, Kristin S Vickers2, Robert J Stroebel1, Stephen S Cha31Division of Primary Care Internal Medicine, Mayo Clinic, Rochester, MN, USA; 2Department of Psychiatry and Psychology, Mayo Clinic, MN, USA; 3Department of Biostatistics, Mayo Clinic, Rochester, MN, USAPurpose: The collaborative care model, using care managers, has been shown to be effective in achieving sustained treatment outcomes in chronic disease management. Little effort has been made to find out patient preferences for chronic disease care, hence, we conducted a study aimed at identifying these.Methods: A 20-item questionnaire, asking for patients’ and providers’ preferences and perceptions, was mailed out to 1000 randomly selected patients in Olmsted County, Minnesota, identified through a diabetes registry to have type 2 diabetes mellitus, a prototypical prevalent chronic disease. Surveys were also sent to 42 primary care providers.Results: There were 254 (25.4% patient responders and 28 (66% provider responders. The majority of patients (>70% and providers (89% expressed willingness to have various aspects of diabetes care managed by a care manager. Although 75% of providers would be comfortable expanding the care manager role to other chronic diseases, only 39.5% of patient responders would be willing to see a care manager for other chronic problems. Longer length of time from initial diagnosis of diabetes was associated with decreased patient likelihood to work with a care manager.Conclusion: Despite study limitations, such as the lack of validated measures to assess perceptions related to care management, our results suggest that patients and providers are willing to collaborate with a care manager and that both groups have similar role expectations of a care manager.Keywords: care manager, collaborative care, patient preference, diabetes care

  19. Daily Care

    Science.gov (United States)

    ... to Know Online Tools Enhancing Daily Life Daily Plan Activities Communication Food & Eating Music & Art Personal Care Incontinence Bathing ... Tweet Email | Print Create a Daily Routine Daily Plan Activities Communication Food/Eating Get Tips on Personal Care Bathing ...

  20. Hair Care

    Science.gov (United States)

    ... Body Looking and feeling your best Hair care Hair care Short, long, curly, straight, up, down. Hair options can seem endless! Not all of what makes your hair look good comes from the outside, though. Good ...