A call to improve practice concerning cultural sensitivity in advance directives: a review of the literature.

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Zager, B Sue; Yancy, Margaret

2011-12-01

The Patient Self Determination Act of 1990 mandates healthcare providers (HCP) to speak with patients about end-of-life preferences and advance directives (AD). HCP work with patients of varying cultures, and standard ADs do not address cultural differences. In order to understand various cultural beliefs, cultural sensitivity is important especially when discussing advance care planning (ACP). Individuals from differing ethnic backgrounds are likely to turn to their traditional norms of practice when ill or treatment choices must be made. An AD that addresses varying cultural values and beliefs was sought. A comprehensive review of the literature was conducted. Articles selected for review included qualitative and quantitative studies. The evidence was evaluated and synthesized for information related to cultural sensitivity and ADs. Three common themes emerged related to ACP discussions and culture. Healthcare provider awareness, communication, and education concerning cultural differences and ACP assisted in meeting the needs for end-of-life planning in the current era of increased globalization. Education for HCP on cultural differences and how to lead discussions promoted ACP. ADs are an essential part of health care and promote patient-centered care. (HCP) should be able to recognize differing cultural values and beliefs in order to initiate conversations about end of life. Initiating conversations about ACP can be facilitated by using open-ended questions that respect the values and beliefs of various cultures. Copyright ©2011 Sigma Theta Tau International.

Do senior management cultures affect performance? Evidence from Italian public healthcare organizations.

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Prenestini, Anna; Lega, Federico

2013-01-01

Healthcare organizations are often characterized by diffuse power, ambiguous goals, and a plurality of actors. In this complex and pluralistic context, senior healthcare managers are expected to provide strategic direction and lead their organizations toward their goals and performance targets. The present work explores the relationship between senior management team culture and performance by investigating Italian public healthcare organizations in the Tuscany region. Our assessment of senior management culture was accomplished through the use of an established framework and a corresponding tool, the competing values framework, which supports the idea that specific aspects of performance are related to a dominant management culture. Organizational performance was assessed using a wide range of measures collected by a multidimensional performance evaluation system, which was developed in Tuscany to measure the performance of its 12 local health authorities (LHAs) and four teaching hospitals (THs). Usable responses were received from 80 senior managers of 11 different healthcare organizations (two THs and nine LHAs). Our findings show that Tuscan healthcare organizations are characterized by various dominant cultures: developmental, clan, rational, and hierarchical. These variations in dominant culture were associated with performance measures. The implications for management theory, professional practice, and public policy are discussed.

Influence of organizational culture on quality healthcare delivery.

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Carney, Marie

2011-01-01

The purpose of this paper is to identify if aspects of organizational culture may indicate a new terrain in the cultural influences-quality healthcare relationship. This research stems from the author's belief that viewing the role of head of department or directorate as pivotal to health care management is critical to health care planning and quality healthcare delivery. Interviews were undertaken among 50 professional clinician and non-clinician managers working in the role of head of department, in acute care hospitals in Ireland. The sample was drawn from the total population of 850 managers, utilized in a previous survey study. Organizational culture is more complex than was previously thought. Several cultural influences such as excellence in care delivery, ethical values, involvement, professionalism, value-for-money, cost of care, commitment to quality and strategic thinking were found to be key cultural determinants in quality care delivery. Health care managers perceive that in order to deliver quality focused care they need to act in a professional, committed manner and to place excellence at the forefront of care delivery, whilst at the same time being capable of managing the tensions that exist between cost effectiveness and quality of care. These tensions require further research in order to determine if quality of care is affected in a negative manner by those tensions. Originality relates to the new cultural terrain presented in this paper that recognizes the potential of health service managers to influence the organizations' culture and through this influence to take a greater part in ensuring that quality health care is delivered to their patients. It also seems to be important that value-for-money is viewed as an ethical means of delivering healthcare, and not as a conflict between quality and cost.

Safety culture relationships with hospital nursing sensitive metrics.

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Brown, Diane Storer; Wolosin, Robert

2013-01-01

Public demand for safer care has catapulted the healthcare industry's efforts to understand relationships between patient safety and hospital performance. This study explored linkages between staff perceptions of safety culture (SC) and ongoing measures of hospital nursing unit-based structures, care processes, and adverse patient outcomes. Relationships between nursing-sensitive measures of hospital performance and SC were explored at the unit-level from 9 California hospitals and 37 nursing units. SC perceptions were measured 6 months prior to collection of nursing metrics and relationships between the two sets of data were explored using correlational and regression analyses. Significant relationships were found with reported falls and process measures for fall prevention. Multiple associations were identified with SC and the structure of care delivery: skill mix, staff turnover, and workload intensity demonstrated significant relationships with SC, explaining 22-45% of the variance. SC was an important factor to understand in the quest to advance safe patient care. These findings have affordability and care quality implications for hospital leadership. When senior leaders prioritized a safety culture, patient outcomes may have improved with less staff turnover and more productivity. A business case could be made for investing in patient safety systems to provide reliably safe care. © 2013 National Association for Healthcare Quality.

Sensitization predicts asthma development among wheezing toddlers in secondary healthcare.

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Boersma, Nienke A; Meijneke, Ruud W H; Kelder, Johannes C; van der Ent, Cornelis K; Balemans, Walter A F

2017-06-01

Some wheezing toddlers develop asthma later in childhood. Sensitization is known to predict asthma in birth cohorts. However, its predictive value in secondary healthcare is uncertain. This study examines the predictive value of sensitization to inhalant allergens among wheezing toddlers in secondary healthcare for the development of asthma at school age (≥6 years). Preschool children (1-3 years) who presented with wheezing in secondary healthcare were screened on asthma at school age with the International Study of Asthma and Allergies in Childhood questionnaire. The positive and negative predictive value (PPV and NPV) of specific IgE to inhalant allergens (cut-off concentration 0.35 kU/L) and several non-invasive variables from a child's history (such as hospitalization, eczema, and parental atopy) were calculated. The additional predictive value of sensitization when combined with non-invasive predictors was examined in multivariate analysis and by ROC curves. Of 116 included children, 63% developed asthma at school age. Sensitization to inhalant allergens was a strong asthma predictor. The odds ratio (OR), PPV and NPV were 7.4%, 86%, and 55%, respectively. Eczema (OR 3.4) and hospital admission (OR 2.6) were significant non-invasive determinants. Adding sensitization to these non-invasive predictors in multivariate analysis resulted in a significantly better asthma prediction. The area under the ROC curve increased from 0.70 with only non-invasive predictors to 0.79 after adding sensitization. Sensitization to inhalant allergens is a strong predictor of school age asthma in secondary healthcare and has added predictive value when combined with non-invasive determinants. Pediatr Pulmonol. 2017;52:729-736. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

[Assessment of the patient-safety culture in a healthcare district].

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Pozo Muñoz, F; Padilla Marín, V

2013-01-01

1) To describe the frequency of positive attitudes and behaviours, in terms of patient safety, among the healthcare providers working in a healthcare district; 2) to determine whether the level of safety-related culture differs from other studies; and 3) to analyse negatively valued dimensions, and to establish areas for their improvement. A descriptive, cross-sectional study based on the results of an evaluation of the safety-related culture was conducted on a randomly selected sample of 247 healthcare providers, by using the Spanish adaptation of the Hospital Survey on Patient Safety Culture (HSOPSC) designed by the Agency for Healthcare Research and Quality (AHRQ), as the evaluation tool. Positive and negative responses were analysed, as well as the global score. Results were compared with international and national results. A total of 176 completed survey questionnaires were analysed (response rate: 71.26%); 50% of responders described the safety climate as very good, 37% as acceptable, and 7% as excellent. Strong points were: «Teamwork within the units» (80.82%) and «Supervisor/manager expectations and actions» (80.54%). Dimensions identified for potential improvement included: «Staffing» (37.93%), «Non-punitive response to error» (41.67%), and «Frequency of event reporting» (49.05%). Strong and weak points were identified in the safety-related culture of the healthcare district studied, together with potential improvement areas. Benchmarking at the international level showed that our safety-related culture was within the average of hospitals, while at the national level, our results were above the average of hospitals. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

HIV health-care providers' burnout: can organizational culture make a difference?

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Ginossar, Tamar; Oetzel, John; Hill, Ricky; Avila, Magdalena; Archiopoli, Ashley; Wilcox, Bryan

2014-01-01

One of the major challenges facing those working with people living with HIV (PLWH) is the increased potential for burnout, which results in increased turnover and reduces quality of care provided for PLWH. The goal of this study was to examine the relationship among HIV health-care providers' burnout (emotional exhaustion and depersonalization) and organizational culture including teamwork, involvement in decision-making, and critical appraisal. Health-care providers for PLWH (N = 47) in federally funded clinics in a southwestern state completed a cross-sectional survey questionnaire about their perceptions of organizational culture and burnout. The results of multiple regression analysis indicated that positive organizational culture (i.e., teamwork) was negatively related to emotional burnout (p organizational culture (i.e., critical appraisal) was positively related to depersonalization (p organizational communication interventions might protect HIV health-care providers from burnout.

Culture-sensitive psychotraumatology

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Schnyder, Ulrich; Bryant, Richard A.; Ehlers, Anke; Foa, Edna B.; Hasan, Aram; Mwiti, Gladys; Kristensen, Christian H.; Neuner, Frank; Oe, Misari; Yule, William

2016-01-01

Background Although there is some evidence of the posttraumatic stress disorder (PTSD) construct's cross cultural validity, trauma-related disorders may vary across cultures, and the same may be true for treatments that address such conditions. Experienced therapists tailor psychotherapy to each patient's particular situation, to the nature of the patient's psychopathology, to the stage of therapy, and so on. In addition, culture-sensitive psychotherapists try to understand how culture enhances the meaning of their patient's life history, the cultural components of their illness and help-seeking behaviors, as well as their expectations with regard to treatment. We cannot take for granted that all treatment-seeking trauma survivors speak our language or share our cultural values. Therefore, we need to increase our cultural competencies. Methods The authors of this article are clinicians and/or researchers from across the globe, working with trauma survivors in various settings. Each author focused on one or more specific cultural aspects of working with trauma survivors and highlighted the following aspects. Results As a result of culture-specific individual and collective meanings linked to trauma and trauma-related disorders survivors may be exposed to (self-)stigma in the aftermath of trauma. Patients who are reluctant to talk about their traumatic experiences may instead be willing to write or use other ways of accessing the painful memories such as drawing. In other cultures, community and family cohesion are crucial elements of recovery. While awareness of culture-specific aspects is important, we also need to beware of premature cultural stereotyping. When disseminating empirically supported psychotherapies for PTSD across cultures, a number of additional challenges need to be taken into account: many low and middle income countries have very limited resources available and suffer from a poor health infrastructure. Conclusions In summary, culture-sensitive

Religious values and healthcare accommodations: voices from the American Muslim community.

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Padela, Aasim I; Gunter, Katie; Killawi, Amal; Heisler, Michele

2012-06-01

Minority populations receive a lower quality healthcare in part due to the inadequate assessment of, and cultural adaptations to meet, their culturally informed healthcare needs. The seven million American Muslims, while ethnically and racially diverse, share religiously informed healthcare values that influence their expectations of healthcare. There is limited empirical research on this community's preferences for cultural modifications in healthcare delivery. Identify healthcare accommodations requested by American Muslims. Using community-based participatory research (CBPR) methods, we partnered with four community organizations in the Greater Detroit area to design and conduct thirteen focus groups at area mosques serving African American, Arab American, and South Asian American Muslims. Qualitative content analysis utilized a framework team-based approach. Participants reported stigmatization within the healthcare system and voiced the need for culturally competent healthcare providers. In addition, they identified three key healthcare accommodations to address Muslim sensitivities: the provision of (1) gender-concordant care, (2) halal food and (3) a neutral prayer space. Gender concordance was requested based on Islamic conceptions of modesty and privacy. Halal food was deemed to be health-promoting and therefore integral to the healing process. Lastly, a neutral prayer space was requested to ensure security and privacy during worship. This study informs efforts to deliver high-quality healthcare to American Muslims in several ways. We note three specific healthcare accommodations requested by this community and the religious values underlying these requests. Healthcare systems can further cultural sensitivity, engender trust, and improve the healthcare experiences of American Muslims by understanding and then attempting to accommodate these values as much as possible.

Cultural diversity training for UK healthcare professionals: a comprehensive nationwide cross-sectional survey.

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Bentley, Paul; Jovanovic, Ana; Sharma, Pankaj

2008-10-01

Healthcare inequalities within the UK based on patients' ethnicity have been found over the last five years in a large number of medical specialties. One possible explanation for this lies in ignorance of ethnic minority healthcare needs among professionals. Cultural diversity programmes have been shown to improve patient outcomes including compliance, yet these are not as yet requirements for any UK healthcare professionals with the exception of psychiatrists. This paper documents the frequency, regional variation, characteristics and motivations for cultural diversity training through a questionnaire survey of the educational leads of every UK medical school, postgraduate deanery and schools of nursing, physiotherapy, occupational therapy, speech and language therapy, and pharmacy. The results showed a wide variation in teaching practices between healthcare professions and geographical regions. This study provides evidence for the need for national guidelines to incorporate cultural competency training by all UK healthcare professional training bodies.

The importance of moral emotions for effective collaboration in culturally diverse healthcare teams.

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Cook, Catherine; Brunton, Margaret

2018-04-01

Moral emotions shape the effectiveness of culturally diverse teams. However, these emotions, which are integral to determining ethically responsive patient care and team relationships, typically go unrecognised. The contribution of emotions to moral deliberation is subjugated within the technorational environment of healthcare decision-making. Contemporary healthcare organisations rely on a multicultural workforce charged with the ethical care of vulnerable people. Limited extant literature examines the role of moral emotions in ethical decision-making among culturally diverse healthcare teams. Moral emotions are evident in ethnocentric moral perspectives that construct some colleagues' practices as 'other'. This article examines how moral emotions are evoked when cultural dissonance influences nurses' moral perceptions. We use a qualitative investigation of teamwork within culturally diverse healthcare organisations. We use Haidt's () account of moral emotions to examine practice-based accounts of 36 internationally educated and 17 New Zealand educated nurses practising in New Zealand. The study provides evidence that moral emotions are frequently elicited by communication and care practices considered 'foreign'. The main implication is that although safe practice in healthcare organisations is reliant on highly functioning teams, collaboration is challenged by interprofessional power relations of contested culturally shaped values. We address practice-based strategies that enable engagement with moral emotions to enhance effective teamwork. © 2017 John Wiley & Sons Ltd.

Sensitization predicts asthma development among wheezing toddlers in secondary healthcare

NARCIS (Netherlands)

Boersma, Nienke A.; Meijneke, Ruud W.H.; Kelder, Johannes C.; van der Ent, Cornelis K.; Balemans, Walter A.F.

2017-01-01

Introduction: Some wheezing toddlers develop asthma later in childhood. Sensitization is known to predict asthma in birth cohorts. However, its predictive value in secondary healthcare is uncertain. Aim: This study examines the predictive value of sensitization to inhalant allergens among wheezing

The effectiveness of strategies to change organisational culture to improve healthcare performance.

Science.gov (United States)

Parmelli, Elena; Flodgren, Gerd; Schaafsma, Mary Ellen; Baillie, Nick; Beyer, Fiona R; Eccles, Martin P

2011-01-19

Organisational culture is an anthropological metaphor used to inform research and consultancy and to explain organisational environments. Great emphasis has been placed during the last years on the need to change organisational culture in order to pursue effective improvement of healthcare performance. However, the precise nature of organisational culture in healthcare policy often remains underspecified and the desirability and feasibility of strategies to be adopted has been called into question. To determine the effectiveness of strategies to change organisational culture in order to improve healthcare performance.To examine the effectiveness of these strategies according to different patterns of organisational culture. We searched the following electronic databases for primary studies: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Sociological Abstracts, Web of Knowledge, PsycINFO, Business and Management, EThOS, Index to Theses, Intute, HMIC, SIGLE, and Scopus until October 2009. The Database of Abstracts of Reviews of Effectiveness (DARE) was searched for related reviews. We also searched the reference lists of all papers and relevant reviews identified, and we contacted experts in the field for advice on further potential studies. We considered randomised controlled trials (RCTs) or well designed quasi-experimental studies, controlled clinical trials (CCTs), controlled before and after studies (CBAs) and interrupted time series analyses (ITS) meeting the quality criteria used by the Cochrane Effective Practice and Organisation of Care Group (EPOC). Studies should be set in any type of healthcare organisation in which strategies to change organisational culture in order to improve healthcare performance were applied. Our main outcomes were objective measures of professional performance and patient outcome. At least two review authors independently applied the criteria for inclusion and exclusion criteria to scan titles and

Keeping patients safe in healthcare organizations: a structuration theory of safety culture.

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Groves, Patricia S; Meisenbach, Rebecca J; Scott-Cawiezell, Jill

2011-08-01

This paper presents a discussion of the use of structuration theory to facilitate understanding and improvement of safety culture in healthcare organizations. Patient safety in healthcare organizations is an important problem worldwide. Safety culture has been proposed as a means to keep patients safe. However, lack of appropriate theory limits understanding and improvement of safety culture. The proposed structuration theory of safety culture was based on a critique of available English-language literature, resulting in literature published from 1983 to mid-2009. CINAHL, Communication and Mass Media Complete, ABI/Inform and Google Scholar databases were searched using the following terms: nursing, safety, organizational culture and safety culture. When viewed through the lens of structuration theory, safety culture is a system involving both individual actions and organizational structures. Healthcare organization members, particularly nurses, share these values through communication and enact them in practice, (re)producing an organizational safety culture system that reciprocally constrains and enables the actions of the members in terms of patient safety. This structurational viewpoint illuminates multiple opportunities for safety culture improvement. Nurse leaders should be cognizant of competing value-based culture systems in the organization and attend to nursing agency and all forms of communication when attempting to create or strengthen a safety culture. Applying structuration theory to the concept of safety culture reveals a dynamic system of individual action and organizational structure constraining and enabling safety practice. Nurses are central to the (re)production of this safety culture system. © 2011 Blackwell Publishing Ltd.

Developing cross-cultural healthcare workers: content, process and mentoring

Directory of Open Access Journals (Sweden)

Mark A Strand

2016-01-01

Full Text Available Career service in cross-cultural healthcare mission work is the ambition of many people around the world. However, premature termination of this expected long-term service mitigates against achieving the goals of the individual and the organization. The lingering challenge of high rates of missionary attrition impacts the long-term effectiveness of the work and the health and well-being of the workers. One of the keys to reducing premature attrition is cross-cultural training for these individuals, provided it offers the right content, through the best medium, at the time of greatest perceived need by the missionary. This paper applies the Dreyfus Model of skills acquisition to the process of mentoring career healthcare missionaries in a progressive manner, utilizing a mentoring method. These missionaries can flourish in their work and more effectively achieve their individual and organizational goals through strategic mentorship that clearly defines a pathway for growing their cross-cultural skills.

Culture, Personality, Health, and Family Dynamics: Cultural Competence in the Selection of Culturally Sensitive Treatments

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Sperry, Len

2010-01-01

Cultural sensitivity and cultural competence in the selection of culturally sensitive treatments is a requisite for effective counseling practice in working with diverse clients and their families, particularly when clients present with health issues or medical problems. Described here is a strategy for selecting culturally sensitive treatments…

Culture-sensitive psychotraumatology

Directory of Open Access Journals (Sweden)

Ulrich Schnyder

2016-07-01

Full Text Available Background: Although there is some evidence of the posttraumatic stress disorder (PTSD construct's cross cultural validity, trauma-related disorders may vary across cultures, and the same may be true for treatments that address such conditions. Experienced therapists tailor psychotherapy to each patient's particular situation, to the nature of the patient's psychopathology, to the stage of therapy, and so on. In addition, culture-sensitive psychotherapists try to understand how culture enhances the meaning of their patient's life history, the cultural components of their illness and help-seeking behaviors, as well as their expectations with regard to treatment. We cannot take for granted that all treatment-seeking trauma survivors speak our language or share our cultural values. Therefore, we need to increase our cultural competencies. Methods: The authors of this article are clinicians and/or researchers from across the globe, working with trauma survivors in various settings. Each author focused on one or more specific cultural aspects of working with trauma survivors and highlighted the following aspects. Results: As a result of culture-specific individual and collective meanings linked to trauma and trauma-related disorders survivors may be exposed to (self-stigma in the aftermath of trauma. Patients who are reluctant to talk about their traumatic experiences may instead be willing to write or use other ways of accessing the painful memories such as drawing. In other cultures, community and family cohesion are crucial elements of recovery. While awareness of culture-specific aspects is important, we also need to beware of premature cultural stereotyping. When disseminating empirically supported psychotherapies for PTSD across cultures, a number of additional challenges need to be taken into account: many low and middle income countries have very limited resources available and suffer from a poor health infrastructure. Conclusions: In summary

The Relationship between Leadership Style, Organizational Culture, and Job Satisfaction in the U.S. Healthcare Industry

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Mouhamadou Sow

2017-03-01

Full Text Available The purpose of this quantitative, correlational study, based on the theoretical framework of transformational leadership, was to examine the relationships between leadership style, organizational culture, and job satisfaction in the U.S. healthcare industry. The study addressed a problem faced by U.S. healthcare leaders, who are currently unaware as to how transformational leadership and organizational culture can impact job satisfaction in an industry with high burnout and low satisfaction levels. The following research questions were posed: (1 Is there a statistically significant relationship between transformational leadership and job satisfaction in the U.S. healthcare industry? (2 Is there a statistically significant relationship between organizational culture and job satisfaction in the U.S. healthcare industry? (3 Is the relationship between transformational leadership and job satisfaction in the U.S. healthcare industry mediated by organizational culture? Data to answer the research questions were collected through simple random sampling processes that resulted in a sample of 111 American healthcare employees and analyzed with Stata software. The main finding of the study was that an apparent effect of transformational leadership on job satisfaction disappeared when organizational culture variables were taken into consideration. The results suggest that healthcare organizations should attempt to move away from externally focused cultures in order to increase job satisfaction. Such a move could improve social outcomes by improving the quality of work for millions of stressed American healthcare employees.

Work culture among healthcare personnel in a palliative medicine unit.

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André, Beate; Sjøvold, Endre; Rannestad, Toril; Holmemo, Marte; Ringdal, Gerd I

2013-04-01

Understanding and assessing health care personnel's work culture in palliative care is important, as a conflict between "high tech" and "high touch" is present. Implementing necessary changes in behavior and procedures may imply a profound challenge, because of this conflict. The aim of this study was to explore the work culture at a palliative medicine unit (PMU). Healthcare personnel (N = 26) at a PMU in Norway comprising physicians, nurses, physiotherapists, and others filled in a questionnaire about their perception of the work culture at the unit. The Systematizing Person-Group Relations (SPGR) method was used for gathering data and for the analyses. This method applies six different dimensions representing different aspects of a work culture (Synergy, Withdrawal, Opposition, Dependence, Control, and Nurture) and each dimension has two vectors applied. The method seeks to explore which aspects dominate the particular work culture, identifying challenges, limitations, and opportunities. The findings were compared with a reference group of 347 ratings of well-functioning Norwegian organizations, named the "Norwegian Norm." The healthcare personnel working at the PMU had significantly higher scores than the "Norwegian Norm" in both vectors in the "Withdrawal" dimension and significant lower scores in both vectors in the "Synergy," "Control," and "Dependence" dimensions. Healthcare personnel at the PMU have a significantly different perception of their work culture than do staff in "well-functioning organizations" in several dimensions. The low score in the "Synergy" and "Control" dimensions indicate lack of engagement and constructive goal orientation behavior, and not being in a position to change their behavior. The conflict between "high tech" and "high touch" at a PMU seems to be an obstacle when implementing new procedures and alternative courses of action.

Demystifying and improving organizational culture in health-care.

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Pellegrin, Karen L; Currey, Hal S

2011-01-01

Organizational culture is defined as the shared values and beliefs that guide behavior within each organization, and it matters because it is related to performance. While culture is generally considered important, it is mysterious and intangible to most leaders. The first step toward understanding organizational culture is to measure it properly. This chapter describes methods for measuring culture in health-care organizations and how these methods were implemented in a large academic medical center. Because of the consistent empirical link between the dimension of communication, other culture dimensions, and employee satisfaction, special attention is focused in this area. Specifically, a case study of successful communication behaviors during a major "change management" initiative at a large academic medical center is described. In summary, the purpose of this chapter is to demystify the concept of culture and demonstrate how to improve it.

Family Counseling: Cultural Sensitivity, Relativism, and the Cultural Defense.

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May, Kathleen M.

1998-01-01

Cultural sensitivity, cultural relativism, and the cultural defense are defined and described. Each concept is addressed in terms of its relationship to couple and family counseling. The role of counselor must be broadened and deepened to include the role of cultural broker. (Author/EMK)

The effectiveness of strategies to change organisational culture to improve healthcare performance: a systematic review.

Science.gov (United States)

Parmelli, Elena; Flodgren, Gerd; Beyer, Fiona; Baillie, Nick; Schaafsma, Mary Ellen; Eccles, Martin P

2011-04-03

Organisational culture is an anthropological metaphor used to inform research and consultancy and to explain organisational environments. In recent years, increasing emphasis has been placed on the need to change organisational culture in order to improve healthcare performance. However, the precise function of organisational culture in healthcare policy often remains underspecified and the desirability and feasibility of strategies to be adopted have been called into question. The objective of this review was to determine the effectiveness of strategies to change organisational culture in order to improve healthcare performance. We searched the following electronic databases: The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, Sociological Abstracts, Web of Knowledge, PsycINFO, Business and Management, EThOS, Index to Theses, Intute, HMIC, SIGLE, and Scopus until October 2009. The Database of Abstracts of Reviews of Effectiveness (DARE) was searched for related reviews. We also searched the reference lists of all papers and relevant reviews identified, and we contacted experts in the field for advice on further potential studies. We considered randomised controlled trials (RCTs) or well designed quasi-experimental studies (controlled clinical trials (CCTs), controlled before and after studies (CBAs), and interrupted time series (ITS) analyses). Studies could be set in any type of healthcare organisation in which strategies to change organisational culture in order to improve healthcare performance were applied. Our main outcomes were objective measures of professional performance and patient outcome. The search strategy yielded 4,239 records. After the full text assessment, two CBA studies were included in the review. They both assessed the impact of interventions aimed at changing organisational culture, but one evaluated the impact on work-related and personal outcomes while the other measured clinical outcomes. Both were at high risk of

The importance of cultural competency in general pediatrics.

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Brotanek, Jane M; Seeley, Christina E; Flores, Glenn

2008-12-01

There is a growing awareness of the importance of cultural competency in pediatrics. The authors review the most recent studies that examine the impact of cultural competency on general pediatric care, explore cultural beliefs and practices affecting clinical care, and describe culturally sensitive interventions designed to address racial/ethnic health disparities. The beneficial effects of cultural competency embrace health outcomes, quality of care, and patient satisfaction, while failure to consider language and culture can have serious adverse consequences for clinical care, including patient safety and healthcare access. A five-component model of cultural competency has been developed, and a growing literature details an array of normative cultural values, folk illnesses, parent beliefs/practices, and provider behaviors that can have a profound impact on pediatric care. Culturally sensitive interventions are being developed to lessen racial/ethnic health disparities. A goal for the pediatrician is to provide culturally competent healthcare by using trained medical interpreters with limited English-proficient families, being familiar with normative cultural values that affect the healthcare of commonly encountered racial/ethnic groups, and asking about folk illness beliefs and ethnomedical treatments.

Culturally and linguistically diverse healthcare students' experiences of learning in a clinical environment: A systematic review of qualitative studies.

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Mikkonen, Kristina; Elo, Satu; Kuivila, Heli-Maria; Tuomikoski, Anna-Maria; Kääriäinen, Maria

2016-02-01

Learning in the clinical environment of healthcare students plays a significant part in higher education. The greatest challenges for culturally and linguistically diverse healthcare students were found in clinical placements, where differences in language and culture have been shown to cause learning obstacles for students. There has been no systematic review conducted to examine culturally and linguistically diverse healthcare students' experiences of their learning in the clinical environment. This systematic review aims to identify culturally and linguistically diverse healthcare students' experiences of learning in a clinical environment. The search strategy followed the guidelines of the Centre of Reviews and Dissemination. The original studies were identified from seven databases (CINAHL, Medline Ovid, Scopus, Web of Science, Academic Search Premiere, Eric and Cochrane Library) for the period 2000-2014. Two researchers selected studies based on titles, abstracts and full texts using inclusion criteria and assessed the quality of studies independently. Twelve original studies were chosen for the review. The culturally and linguistically diverse healthcare students' learning experiences were divided into three influential aspects of learning in a clinical environment: experiences with implementation processes and provision; experiences with peers and mentors; and experiences with university support and instructions. The main findings indicate that culturally and linguistically diverse healthcare students embarking on clinical placements initially find integration stressful. Implementing the process of learning in a clinical environment requires additional time, well prepared pedagogical orientation, prior cultural and language education, and support for students and clinical staff. Barriers to learning by culturally and linguistically diverse healthcare students were not being recognized and individuals were not considered motivated; learners experienced the

Managing risk in healthcare: understanding your safety culture using the Manchester Patient Safety Framework (MaPSaF).

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Parker, Dianne

2009-03-01

To provide sufficient information about the Manchester Patient Safety Framework (MaPSaF) to allow healthcare professionals to assess its potential usefulness. The assessment of safety culture is an important aspect of risk management, and one in which there is increasing interest among healthcare organizations. Manchester Patient Safety Framework offers a theory-based framework for assessing safety culture, designed specifically for use in the NHS. The framework covers multiple dimensions of safety culture, and five levels of safety culture development. This allows the generation of a profile of an organization's safety culture in terms of areas of relative strength and challenge, which can be used to identify focus issues for change and improvement. Manchester Patient Safety Framework provides a useful method for engaging healthcare professionals in assessing and improving the safety culture in their organization, as part of a programme of risk management.

Healthcare providers' attitudes and perceptions in infection ...

African Journals Online (AJOL)

EB

Objectives: To assess the attitudes and perceptions of healthcare providers ... antibiotics and only 32% always send a sample for culture sensitivity ..... resistance - A global issue of concern. Asian J. Pharma Clin Res. 2009; 2(2): 34 - 39. 4.

Is Ethical Sensitivity in Teaching Culturally Bound? Comparing Finnish and Iranian Teachers' Ethical Sensitivity

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Gholami, Khalil; Kuusisto, Elina; Tirri, Kirsi

2015-01-01

In this study, we investigated the culture-invariant and culture-dependent nature of teachers' ethical sensitivity in two countries. Our case study involves teachers from Finland (n = 864) representing Western culture, and from Iran (n = 556) representing Eastern culture. Culturally bound elements of ethical sensitivity were studied with the…

Influence of Handprint Culture Training on Compliance of Healthcare Workers with Hand Hygiene

Directory of Open Access Journals (Sweden)

Hala Fouad

2018-01-01

Full Text Available Objective. We aimed to study the effect of visual observation of bacterial growth from handprints on healthcare workers’ (HCWs compliance with hand hygiene (HH. Settings. Medical and postoperative cardiac surgery units. Design. Prospective cohort study. Subject. The study included 40 HCWs. Intervention. Each HCW was interviewed on 3 separate occasions. The 1st interview was held to obtain a handprint culture before and after a session demonstrating the 7 steps of HH using alcohol-based hand rub, allowing comparison of results before and after HH. A 2nd interview was held 6 weeks later to obtain handprint culture after HH. A 3rd interview was held to obtain a handprint culture before HH. One month before implementation of handprint cultures and during the 12-week study period, monitoring of HCWs for compliance with HH was observed by 2 independent observers. Main Results. There was a significant improvement in HH compliance following handprint culture interview (p<0.001. The frequency of positive cultures, obtained from patients with suspected healthcare-associated infections, significantly declined (blood cultures: p=0.001; wound cultures: p = 0,003; sputum cultures: p=0.005. Conclusion. The visual message of handprint bacterial growth before and after HH seems an effective method to improve HH compliance.

Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations

Directory of Open Access Journals (Sweden)

Russell Mannion

2015-08-01

Full Text Available ‘Whistleblowing’ has come to increased prominence in many health systems as a means of identifying and addressing quality and safety issues. But whistleblowing – and the reactions to it – have many complex and ambiguous aspects that need to be considered as part of the broader (organisational cultural dynamics of healthcare institutions.

Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations.

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Mannion, Russell; Davies, Huw To

2015-06-24

'Whistleblowing' has come to increased prominence in many health systems as a means of identifying and addressing quality and safety issues. But whistleblowing - and the reactions to it - have many complex and ambiguous aspects that need to be considered as part of the broader (organisational) cultural dynamics of healthcare institutions. © 2015 by Kerman University of Medical Sciences.

Development and Psychometric Evaluation of an Instrument to Assess Cross-Cultural Competence of Healthcare Professionals (CCCHP)

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Bernhard, Gerda; Knibbe, Ronald A.; von Wolff, Alessa; Dingoyan, Demet; Schulz, Holger; Mösko, Mike

2015-01-01

Background Cultural competence of healthcare professionals (HCPs) is recognized as a strategy to reduce cultural disparities in healthcare. However, standardised, valid and reliable instruments to assess HCPs’ cultural competence are notably lacking. The present study aims to 1) identify the core components of cultural competence from a healthcare perspective, 2) to develop a self-report instrument to assess cultural competence of HCPs and 3) to evaluate the psychometric properties of the new instrument. Methods The conceptual model and initial item pool, which were applied to the cross-cultural competence instrument for the healthcare profession (CCCHP), were derived from an expert survey (n = 23), interviews with HCPs (n = 12), and a broad narrative review on assessment instruments and conceptual models of cultural competence. The item pool was reduced systematically, which resulted in a 59-item instrument. A sample of 336 psychologists, in advanced psychotherapeutic training, and 409 medical students participated, in order to evaluate the construct validity and reliability of the CCCHP. Results Construct validity was supported by principal component analysis, which led to a 32-item six-component solution with 50% of the total variance explained. The different dimensions of HCPs’ cultural competence are: Cross-Cultural Motivation/Curiosity, Cross-Cultural Attitudes, Cross-Cultural Skills, Cross-Cultural Knowledge/Awareness and Cross-Cultural Emotions/Empathy. For the total instrument, the internal consistency reliability was .87 and the dimension’s Cronbach’s α ranged from .54 to .84. The discriminating power of the CCCHP was indicated by statistically significant mean differences in CCCHP subscale scores between predefined groups. Conclusions The 32-item CCCHP exhibits acceptable psychometric properties, particularly content and construct validity to examine HCPs’ cultural competence. The CCCHP with its five dimensions offers a comprehensive

Development and Psychometric Evaluation of an Instrument to Assess Cross-Cultural Competence of Healthcare Professionals (CCCHP).

Science.gov (United States)

Bernhard, Gerda; Knibbe, Ronald A; von Wolff, Alessa; Dingoyan, Demet; Schulz, Holger; Mösko, Mike

2015-01-01

Cultural competence of healthcare professionals (HCPs) is recognized as a strategy to reduce cultural disparities in healthcare. However, standardised, valid and reliable instruments to assess HCPs' cultural competence are notably lacking. The present study aims to 1) identify the core components of cultural competence from a healthcare perspective, 2) to develop a self-report instrument to assess cultural competence of HCPs and 3) to evaluate the psychometric properties of the new instrument. The conceptual model and initial item pool, which were applied to the cross-cultural competence instrument for the healthcare profession (CCCHP), were derived from an expert survey (n = 23), interviews with HCPs (n = 12), and a broad narrative review on assessment instruments and conceptual models of cultural competence. The item pool was reduced systematically, which resulted in a 59-item instrument. A sample of 336 psychologists, in advanced psychotherapeutic training, and 409 medical students participated, in order to evaluate the construct validity and reliability of the CCCHP. Construct validity was supported by principal component analysis, which led to a 32-item six-component solution with 50% of the total variance explained. The different dimensions of HCPs' cultural competence are: Cross-Cultural Motivation/Curiosity, Cross-Cultural Attitudes, Cross-Cultural Skills, Cross-Cultural Knowledge/Awareness and Cross-Cultural Emotions/Empathy. For the total instrument, the internal consistency reliability was .87 and the dimension's Cronbach's α ranged from .54 to .84. The discriminating power of the CCCHP was indicated by statistically significant mean differences in CCCHP subscale scores between predefined groups. The 32-item CCCHP exhibits acceptable psychometric properties, particularly content and construct validity to examine HCPs' cultural competence. The CCCHP with its five dimensions offers a comprehensive assessment of HCPs' cultural competence, and has the

What About Leadership?: Comment on "Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations".

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Blenkinsopp, John; Snowden, Nicholas

2015-10-25

In their valuable discussion of whistleblowing in healthcare organisations, Mannion and Davies highlight the importance of organisational culture in influencing whether people raise concerns, and whether these concerns are listened to and acted upon. The role of leadership in shaping organisational culture is well-established and in this commentary, we will examine the influence of leaders in creating cultures of silence or cultures of voice. © 2016 by Kerman University of Medical Sciences.

Cultural sensitivity in public health: defined and demystified.

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Resnicow, K; Baranowski, T; Ahluwalia, J S; Braithwaite, R L

1999-01-01

There is consensus that health promotion programs should be culturally sensitive (CS). Yet, despite the ubiquitous nature of CS within public health research and practice, there has been surprisingly little attention given to defining CS or delineating a framework for developing culturally sensitive programs and practitioners. This paper describes a model for understanding CS from a public health perspective; describes a process for applying this model in the development of health promotion and disease prevention interventions; and highlights research priorities. Cultural sensitivity is defined by two dimensions: surface and deep structures. Surface structure involves matching intervention materials and messages to observable, "superficial" characteristics of a target population. This may involve using people, places, language, music, food, locations, and clothing familiar to, and preferred by, the target audience. Surface structure refers to how well interventions fit within a specific culture. Deep structure involves incorporating the cultural, social, historical, environmental and psychological forces that influence the target health behavior in the proposed target population. Whereas surface structure generally increases the "receptivity" or "acceptance" of messages, deep structure conveys salience. Techniques, borrowed from social marketing and health communication theory, for developing culturally sensitive interventions are described. Research is needed to determine the effectiveness of culturally sensitive programs.

Revising and Updating the Inventory of Cross-Cultural Sensitivity

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Mahon, Jennifer A.; Cushner, Kenneth

2014-01-01

The following article outlines research conducted to examine cross-cultural sensitivity in a sample of 949 incoming university students in the USA. The study was conducted during the process of updating an existing measure of cross-cultural sensitivity known as the Inventory of Cross-Cultural Sensitivity (ICCS), and to examine the various levels…

Cultural Sensitivity in English Language Teaching Materials

OpenAIRE

MEHMET, Sean Collin

2008-01-01

This expository paper will begin by uncovering and examining some lesser known, Western journal articles, ones that deal specifically with the issue of cultural sensitivity in language classrooms. This opening discussion will attempt to reveal that cultural sensitivity in teaching materials is by no means an issue limited solely to the Western world. After this, the discussion will focus on Edward Said's widely-known Culture and Imperialism. Said's monograph will be used as a springboard to e...

Quality of healthcare services and its relationship with patient safety culture and nurse-physician professional communication

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Akram Ghahramanian

2017-06-01

Full Text Available Background: This study investigated quality of healthcare services from patients’ perspectives and its relationship with patient safety culture and nurse-physician professional communication. Methods: A cross-sectional study was conducted among 300 surgery patients and 101 nurses caring them in a public hospital in Tabriz–Iran. Data were collected using the service quality measurement scale (SERVQUAL, hospital survey on patient safety culture (HSOPSC and nurse physician professional communication questionnaire. Results: The highest and lowest mean (±SD scores of the patients’ perception on the healthcare services quality belonged to the assurance 13.92 (±3.55 and empathy 6.78 (±1.88 domains,respectively. With regard to the patient safety culture, the mean percentage of positive answers ranged from 45.87% for "non-punitive response to errors" to 68.21% for "organizational continuous learning" domains. The highest and lowest mean (±SD scores for the nurse physician professional communication were obtained for "cooperation" 3.44 (±0.35 and "non participative decision-making" 2.84 (±0.34 domains, respectively. The "frequency of reported errors by healthcare professionals" (B=-4.20, 95% CI = -7.14 to -1.27, P<0.01 and "respect and sharing of information" (B=7.69, 95% CI=4.01 to 11.36, P<0.001 predicted the patients’perceptions of the quality of healthcare services. Conclusion: Organizational culture in dealing with medical error should be changed to non punitive response. Change in safety culture towards reporting of errors, effective communication and teamwork between healthcare professionals are recommended.

Quality of healthcare services and its relationship with patient safety culture and nurse-physician professional communication.

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Ghahramanian, Akram; Rezaei, Tayyebeh; Abdullahzadeh, Farahnaz; Sheikhalipour, Zahra; Dianat, Iman

2017-01-01

Background: This study investigated quality of healthcare services from patients' perspectives and its relationship with patient safety culture and nurse-physician professional communication. Methods: A cross-sectional study was conducted among 300 surgery patients and 101 nurses caring them in a public hospital in Tabriz-Iran. Data were collected using the service quality measurement scale (SERVQUAL), hospital survey on patient safety culture (HSOPSC) and nurse physician professional communication questionnaire. Results: The highest and lowest mean (±SD) scores of the patients' perception on the healthcare services quality belonged to the assurance 13.92 (±3.55) and empathy 6.78 (±1.88) domains,respectively. With regard to the patient safety culture, the mean percentage of positive answers ranged from 45.87% for "non-punitive response to errors" to 68.21% for "organizational continuous learning" domains. The highest and lowest mean (±SD) scores for the nurse physician professional communication were obtained for "cooperation" 3.44 (±0.35) and "non-participative decision-making" 2.84 (±0.34) domains, respectively. The "frequency of reported errors by healthcare professionals" (B=-4.20, 95% CI = -7.14 to -1.27, P<0.01) and "respect and sharing of information" (B=7.69, 95% CI=4.01 to 11.36, P<0.001) predicted the patients'perceptions of the quality of healthcare services. Conclusion: Organizational culture in dealing with medical error should be changed to non-punitive response. Change in safety culture towards reporting of errors, effective communication and teamwork between healthcare professionals are recommended.

What About Leadership?; Comment on “Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations”

Directory of Open Access Journals (Sweden)

John Blenkinsopp

2016-02-01

Full Text Available In their valuable discussion of whistleblowing in healthcare organisations, Mannion and Davies highlight the importance of organisational culture in influencing whether people raise concerns, and whether these concerns are listened to and acted upon. The role of leadership in shaping organisational culture is well-established1 and in this commentary, we will examine the influence of leaders in creating cultures of silence or cultures of voice.

A review of barriers to effective asthma management in Puerto Ricans: cultural, healthcare system and pharmacogenomic issues.

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Alicea-Alvarez, Norma; Swanson-Biearman, Brenda; Kelsen, Steven G

2014-02-01

Among the Hispanic community, Puerto Ricans have the highest prevalence of asthma and manifest the worst outcomes. The expected growth of the Hispanic population in the USA in the next several decades make elimination of disparate care in Puerto Rican asthmatics a matter of national importance. The purpose of this review of the literature (ROL) is to examine a variety of health system, genetic and cultural barriers in the Puerto Rican community which have created disparities in asthma care and outcomes among adult and pediatric Hispanic populations. In addition, this ROL describes several culturally sensitive, community-based educational interventions which can be used as a framework for future projects to improved asthma outcomes. Databases searched included Medline, PubMED, EBSCOhost, PsycINFO, CINAHL, Google Scholar and ERIC. Papers published in English from January 1990 to January 2012 were reviewed. Health system policies, insurer compensation patterns, clinician attitudes and cultural values/folk remedies in the Puerto Rican community represent barriers to effective asthma management, the use of controller medication and the implementation of educational interventions. In addition, genetic factors involving the beta-2 adrenergic receptor gene, which impair the response to albuterol, appear to contribute to poorer outcomes in Puerto Rican asthmatics. In contrast, several comprehensive, community-based, culturally sensitive educational interventions such as Controlling Asthma in American Cities Project (CAACP), the Racial and Ethnic Approach to Community Health in the US Program and Healthy Hoops programs (REACH) have been described. We believe that culturally sensitive community-based asthma education programs can serve as models for programs targeted toward Puerto Ricans to help decrease asthma morbidity. Moreover, greater sensitivity to Puerto Rican mores and folk remedies on the part of healthcare providers may improve the patient-clinician rapport and

The Relationship between Leadership Style, Organizational Culture, and Job Satisfaction in the U.S. Healthcare Industry

OpenAIRE

Mouhamadou Sow; Jeanie Murphy; Rosa Osuoha

2017-01-01

The purpose of this quantitative, correlational study, based on the theoretical framework of transformational leadership, was to examine the relationships between leadership style, organizational culture, and job satisfaction in the U.S. healthcare industry. The study addressed a problem faced by U.S. healthcare leaders, who are currently unaware as to how transformational leadership and organizational culture can impact job satisfaction in an industry with high burnout and low satisfaction l...

A Culture-Sensitive Agent in Kirman's Ant Model

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Chen, Shu-Heng; Liou, Wen-Ching; Chen, Ting-Yu

The global financial crisis brought a serious collapse involving a "systemic" meltdown. Internet technology and globalization have increased the chances for interaction between countries and people. The global economy has become more complex than ever before. Mark Buchanan [12] indicated that agent-based computer models will prevent another financial crisis and has been particularly influential in contributing insights. There are two reasons why culture-sensitive agent on the financial market has become so important. Therefore, the aim of this article is to establish a culture-sensitive agent and forecast the process of change regarding herding behavior in the financial market. We based our study on the Kirman's Ant Model[4,5] and Hofstede's Natational Culture[11] to establish our culture-sensitive agent based model. Kirman's Ant Model is quite famous and describes financial market herding behavior from the expectations of the future of financial investors. Hofstede's cultural consequence used the staff of IBM in 72 different countries to understand the cultural difference. As a result, this paper focuses on one of the five dimensions of culture from Hofstede: individualism versus collectivism and creates a culture-sensitive agent and predicts the process of change regarding herding behavior in the financial market. To conclude, this study will be of importance in explaining the herding behavior with cultural factors, as well as in providing researchers with a clearer understanding of how herding beliefs of people about different cultures relate to their finance market strategies.

Moving healthcare quality forward with nursing-sensitive value-based purchasing.

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Kavanagh, Kevin T; Cimiotti, Jeannie P; Abusalem, Said; Coty, Mary-Beth

2012-12-01

To underscore the need for health system reform and emphasize nursing measures as a key component in our healthcare reimbursement system. Nursing-sensitive value-based purchasing (NSVBP) has been proposed as an initiative that would help to promote optimal staffing and practice environment through financial rewards and transparency of structure, process, and patient outcome measures. This article reviews the medical, governmental, institutional, and lay literature regarding the necessity for, method of implementation of, and potential impact of NSVBP. Research has shown that adverse events and mortality are highly dependent on nurse staffing levels and skill mix. The National Database of Nursing Quality Indicators (NDNQI), along with other well-developed indicators, can be used as nursing-sensitive measurements for value-based purchasing initiatives. Nursing-sensitive measures are an important component of value-based purchasing. Value-based purchasing is in its infancy. Devising an effective system that recognizes and incorporates nursing measures will facilitate the success of this initiative. NSVBP needs to be designed and incentivized to decrease adverse events, hospital stays, and readmission rates, thereby decreasing societal healthcare costs. NSVBP has the potential for improving the quality of nursing care by financially motivating hospitals to have an optimal nurse practice environment capable of producing optimal patient outcomes by aligning cost effectiveness for hospitals to that of the patient and society. © 2012 Sigma Theta Tau International.

Development and testing of the ‘Culture of Care Barometer’ (CoCB) in healthcare organisations: a mixed methods study

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Rafferty, Anne Marie; Philippou, Julia; Fitzpatrick, Joanne M; Pike, Geoff; Ball, Jane

2017-01-01

Objective Concerns about care quality have prompted calls to create workplace cultures conducive to high-quality, safe and compassionate care and to provide a supportive environment in which staff can operate effectively. How healthcare organisations assess their culture of care is an important first step in creating such cultures. This article reports on the development and validation of a tool, the Culture of Care Barometer, designed to assess perceptions of a caring culture among healthcare workers preliminary to culture change. Design/setting/participants An exploratory mixed methods study designed to develop and test the validity of a tool to measure ‘culture of care’ through focus groups and questionnaires. Questionnaire development was facilitated through: a literature review, experts generating items of interest and focus group discussions with healthcare staff across specialities, roles and seniority within three types of public healthcare organisations in the UK. The tool was designed to be multiprofessional and pilot tested with a sample of 467 nurses and healthcare support workers in acute care and then validated with a sample of 1698 staff working across acute, mental health and community services in England. Exploratory factor analysis was used to identify dimensions underlying the Barometer. Results Psychometric testing resulted in the development of a 30-item questionnaire linked to four domains with retained items loading to four factors: organisational values (α=0.93, valid n=1568, M=3.7), team support (α=0.93, valid n=1557, M=3.2), relationships with colleagues (α=0.84, valid n=1617, M=4.0) and job constraints (α=0.70, valid n=1616, M=3.3). Conclusions The study developed a valid and reliable instrument with which to gauge the different attributes of care culture perceived by healthcare staff with potential for organisational benchmarking. PMID:28821526

Development and testing of the 'Culture of Care Barometer' (CoCB) in healthcare organisations: a mixed methods study.

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Rafferty, Anne Marie; Philippou, Julia; Fitzpatrick, Joanne M; Pike, Geoff; Ball, Jane

2017-08-18

Concerns about care quality have prompted calls to create workplace cultures conducive to high-quality, safe and compassionate care and to provide a supportive environment in which staff can operate effectively. How healthcare organisations assess their culture of care is an important first step in creating such cultures. This article reports on the development and validation of a tool, the Culture of Care Barometer, designed to assess perceptions of a caring culture among healthcare workers preliminary to culture change. An exploratory mixed methods study designed to develop and test the validity of a tool to measure 'culture of care' through focus groups and questionnaires. Questionnaire development was facilitated through: a literature review, experts generating items of interest and focus group discussions with healthcare staff across specialities, roles and seniority within three types of public healthcare organisations in the UK. The tool was designed to be multiprofessional and pilot tested with a sample of 467 nurses and healthcare support workers in acute care and then validated with a sample of 1698 staff working across acute, mental health and community services in England. Exploratory factor analysis was used to identify dimensions underlying the Barometer. Psychometric testing resulted in the development of a 30-item questionnaire linked to four domains with retained items loading to four factors: organisational values (α=0.93, valid n=1568, M=3.7), team support (α=0.93, valid n=1557, M=3.2), relationships with colleagues (α=0.84, valid n=1617, M=4.0) and job constraints (α=0.70, valid n=1616, M=3.3). The study developed a valid and reliable instrument with which to gauge the different attributes of care culture perceived by healthcare staff with potential for organisational benchmarking. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless

A Taiwan Study Abroad Program on Aging, Culture, and Healthcare

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Hou, Su-I

2018-01-01

This article introduces a Taiwan Study Abroad program on aging, culture, and healthcare. The program is a short-term academic summer program (6 credits) to bring U.S. students to Taiwan. During 2011 ~ 2015, a total of four groups including over 54 students and faculty members participated. This program partnered with multiple universities,…

Development and evaluation of a web-based breast cancer cultural competency course for primary healthcare providers.

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Palmer, Richard C; Samson, Raquel; Triantis, Maria; Mullan, Irene D

2011-08-15

To develop and evaluate a continuing medical education (CME) course aimed at improving healthcare provider knowledge about breast cancer health disparities and the importance of cross-cultural communication in provider-patient interactions about breast cancer screening. An interactive web-based CME course was developed and contained information about breast cancer disparities, the role of culture in healthcare decision making, and demonstrated a model of cross-cultural communication. A single group pre-/post-test design was used to assess knowledge changes. Data on user satisfaction was also collected. In all, 132 participants registered for the CME with 103 completing both assessments. Differences between pre-/post-test show a significant increase in knowledge (70% vs. 94%; p training was an appropriate tool to train healthcare providers about cultural competency and health disparities. There was an overall high level of satisfaction among all users. Users felt that learning objectives were met and the web-based format was appropriate and easy to use and suggests that web-based CME formats are an appropriate tool to teach cultural competency skills. However, more information is needed to understand how the CME impacted practice behaviors.

Cross-cultural barriers to health care.

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Vidaeff, Alex C; Kerrigan, Anthony J; Monga, Manju

2015-01-01

Culturally sensitive health care represents a real ethical and practical need in a Western healthcare system increasingly serving a multiethnic society. This review focuses on cross-cultural barriers to health care and incongruent aspects from a cultural perspective in the provision of health care. To overcome difficulties in culturally dissimilar interactions and eventually remove cross-cultural barriers to health care, a culturally sensitive physician considers his or her own identity, values, and beliefs; recognizes the similarities and differences among cultures; understands what those similarities and differences mean; and is able to bridge the differences to accomplish clear and effective communication.

Digital health is a cultural transformation of traditional healthcare.

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Meskó, Bertalan; Drobni, Zsófia; Bényei, Éva; Gergely, Bence; Győrffy, Zsuzsanna

2017-01-01

Under the term "digital health", advanced medical technologies, disruptive innovations and digital communication have gradually become inseparable from providing best practice healthcare. While the cost of treating chronic conditions is increasing and doctor shortages are imminent worldwide, the needed transformation in the structure of healthcare and medicine fails to catch up with the rapid progress of the medical technology industry. This transition is slowed down by strict regulations; the reluctance of stakeholders in healthcare to change; and ignoring the importance of cultural changes and the human factor in an increasingly technological world. With access and adoption of technology getting higher, the risk of patients primarily turning to an accessible, but unregulated technological solution for their health problem is likely to increase. In this paper, we discuss how the old paradigm of the paternalistic model of medicine is transforming into an equal level partnership between patients and professionals and how it is aided and augmented by disruptive technologies. We attempt to define what digital health means and how it affects the status quo of care and also the study design in implementing technological innovations into the practice of medicine.

Digital health is a cultural transformation of traditional healthcare

Science.gov (United States)

Drobni, Zsófia; Bényei, Éva; Gergely, Bence; Győrffy, Zsuzsanna

2017-01-01

Under the term “digital health”, advanced medical technologies, disruptive innovations and digital communication have gradually become inseparable from providing best practice healthcare. While the cost of treating chronic conditions is increasing and doctor shortages are imminent worldwide, the needed transformation in the structure of healthcare and medicine fails to catch up with the rapid progress of the medical technology industry. This transition is slowed down by strict regulations; the reluctance of stakeholders in healthcare to change; and ignoring the importance of cultural changes and the human factor in an increasingly technological world. With access and adoption of technology getting higher, the risk of patients primarily turning to an accessible, but unregulated technological solution for their health problem is likely to increase. In this paper, we discuss how the old paradigm of the paternalistic model of medicine is transforming into an equal level partnership between patients and professionals and how it is aided and augmented by disruptive technologies. We attempt to define what digital health means and how it affects the status quo of care and also the study design in implementing technological innovations into the practice of medicine. PMID:29184890

Realizing good care within a context of cross-cultural diversity: an ethical guideline for healthcare organizations in Flanders, Belgium.

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Denier, Yvonne; Gastmans, Chris

2013-09-01

In our globalizing world, health care professionals and organizations increasingly experience cross-cultural challenges in care relationships, which give rise to ethical questions regarding "the right thing to do" in such situations. For the time being, the international literature lacks examples of elaborated ethical guidelines for cross-cultural healthcare on the organizational level. As such, the ethical responsibility of healthcare organizations in realizing cross-cultural care remains underexposed. This paper aims to fill this gap by offering a case-study that illustrates the bioethical practice on a large-scale organizational level by presenting the ethical guideline developed in the period 2007-2011 by the Ethics Committee of Zorgnet Vlaanderen, a Christian-inspired umbrella organization for over 500 social profit healthcare organizations in Flanders, Belgium. The guideline offers an ethical framework within which fundamental ethical values are being analyzed within the context of cross-cultural care. The case study concludes with implications for healthcare practice on four different levels: (1) the level of the healthcare organization, (2) staff, (3) care receivers, and (4) the level of care supply. The study combines content-based ethics with process-based benchmarks. Copyright © 2013. Published by Elsevier Ltd.

An investigation of culturally competent terminology in healthcare policy finds ambiguity and lack of definition.

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Grant, Julian; Parry, Yvonne; Guerin, Pauline

2013-06-01

This research explored how the concept of cultural competence was represented and expressed through health policies that were intended to improve the quality and efficacy of healthcare provided to families from culturally marginalised communities, particularly women and children with refugee backgrounds. A critical document analysis was conducted of policies that inform healthcare for families from culturally marginalised communities in two local government areas in South Australia. The analysis identified two major themes: lack of, or inconsistent, definitions of 'culture' and 'cultural competency' and related terms; and the paradoxical use of language to determine care. Cultural competence within health services has been identified as an important factor that can improve the health outcomes for families from marginalised communities. However, inconsistency in definitions, understanding and implementation of cultural competence in health practice makes it difficult to implement care using these frameworks. Clearly defined pathways are necessary from health policy to inform culturally competent service delivery. The capacity for policy directives to effectively circumvent the potential deleterious outcomes of culturally incompetent services is only possible when that policy provides clear definitions and instructions. Consultation and partnership are necessary to develop effective definitions and processes relating to cultural competence. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

Cultural consultation as a model for training multidisciplinary mental healthcare professionals in cultural competence skills: preliminary results.

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Owiti, J A; Ajaz, A; Ascoli, M; de Jongh, B; Palinski, A; Bhui, K S

2014-01-01

Lack of cultural competence in care contributes to poor experiences and outcomes from care for migrants and racial and ethnic minorities. As a result, health and social care organizations currently promote cultural competence of their workforce as a means of addressing persistent poor experiences and outcomes. At present, there are unsystematic and diverse ways of promoting cultural competence, and their impact on clinician skills and patient outcomes is unknown. We developed and implemented an innovative model, cultural consultation service (CCS), to promote cultural competence of clinicians and directly improve on patient experiences and outcomes from care. CCS model is an adaptation of the McGill model, which uses ethnographic methodology and medical anthropological knowledge. The method and approach not only contributes both to a broader conceptual and dynamic understanding of culture, but also to learning of cultural competence skills by healthcare professionals. The CCS model demonstrates that multidisciplinary workforce can acquire cultural competence skills better through the clinical encounter, as this promotes integration of learning into day-to-day practice. Results indicate that clinicians developed a broader and patient-centred understanding of culture, and gained skills in narrative-based assessment method, management of complexity of care, competing assumptions and expectations, and clinical cultural formulation. Cultural competence is defined as a set of skills, attitudes and practices that enable the healthcare professionals to deliver high-quality interventions to patients from diverse cultural backgrounds. Improving on the cultural competence skills of the workforce has been promoted as a way of reducing ethnic and racial inequalities in service outcomes. Currently, diverse models for training in cultural competence exist, mostly with no evidence of effect. We established an innovative narrative-based cultural consultation service in an inner

Impact of culture on healthcare seeking behavior of Asian Indians.

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Gupta, Vidya Bhushan

2010-01-01

Healthcare seeking behavior is a dynamic process that evolves through the stages of self evaluation of symptoms, self treatment, seeking professional advice and acting on professional advice. (Weaver, 1970) This article explores the influence of culture at each of these stages in the context of Asian Indian culture. Although Asian-Indians constitute only 1.5% of the US population they are among the fastest growing minorities in the United States. Through the example of Asian Indian culture this article informs the clinicians that at the initial visit they should explore what the symptoms mean to the patient and what modalities including complementary and alternative (CAM) were used by the patient to address them and at subsequent visits they should explore how their advise was filtered through the prism of the patient's culture and what was adhered to and what was not. In the case of disability and death the clinicians should explore religious beliefs such as karma that help the patient in coping.

Development and testing of culturally sensitive patient information material for Turkish, Polish, Russian and Italian migrants with depression or chronic low back pain (KULTINFO): study protocol for a double-blind randomized controlled trial.

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Hölzel, Lars P; Ries, Zivile; Zill, Jördis M; Kriston, Levente; Dirmaier, Jörg; Härter, Martin; Bermejo, Isaac

2014-07-04

Many of the approximately 15 million people with a migration background living in Germany (19% of the population) are inadequately reached by existing healthcare provision. In the literature, the necessity for cultural adaptation of information material for patients with a migration background is often cited as a measure for improving healthcare.In this study, culturally sensitive information material will be developed and evaluated for patients with a migration background and depression or chronic low back pain. In this respect, it will be examined whether culturally sensitive information material is judged as more useful by the patients than standard translated patient information without cultural adaptation. The implementation and evaluation of culturally sensitive patient information material will occur in the framework of a double-blind randomized controlled parallel-group study in four study centres in Germany. Primary care patients with a Turkish, Polish, Russian or Italian migration background with a diagnosis of depressive disorder or chronic low back pain will be included and randomly allocated to the intervention group or the control group. In the intervention group, culturally sensitive patient information will be handed to the patient at the end of the physician consultation, while in the control group, standard translated patient information material will be provided. The patients will be surveyed by means of questionnaires following the consultation as well as after 8 weeks and 6 months. In addition to the primary outcome (subjective usefulness), several patient- and physician-rated secondary outcomes will be considered. The study will provide an empirical answer to the question of whether persons with a migration background perceive culturally sensitive patient information material as more useful than translated information material without cultural adaptation. Deutsches Register Klinischer Studien (DRKS-ID) DRKS00004241 and Universal Trial Number

Using Indigenous Australian drama to break cultural barriers in healthcare relationships.

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Matharu, K

2009-06-01

Since colonisation, the marginalisation of Indigenous Australians has adversely affected their language, culture and health. Mainstream society has failed to address social differences and establish culturally-appropriate health programmes for these groups. This paper extracts important humanistic themes within the context of health from four Indigenous Australian plays written during a period of social unrest in response to past oppression: (1) The dreamers, by Jack David; (2) Murras, by Eva Johnson; (3) Coordah, by Richard Walley; and (4) The keepers, by Bob Maza. These plays will be analysed to (a) illuminate human suffering from an indigenous perspective, based upon social and cultural planes of analysis; (b) understand the socio-cultural basis of poor health; and (c) instruct healthcare professionals that health is a social construct that can be interpreted as the product of select plays that are not solely based upon an illness narrative.

Validation of a patient-centered culturally sensitive health care office staff inventory.

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Tucker, Carolyn M; Wall, Whitney; Marsiske, Michael; Nghiem, Khanh; Roncoroni, Julia

2015-09-01

Research suggests that patient-perceived culturally sensitive health care encompasses multiple components of the health care delivery system including the cultural sensitivity of front desk office staff. Despite this, research on culturally sensitive health care focuses almost exclusively on provider behaviors, attitudes, and knowledge. This is due in part to the paucity of instruments available to assess the cultural sensitivity of front desk office staff. Thus, the objective of the present study is to determine the psychometric properties of the pilot Tucker-Culturally Sensitive Health Care Office Staff Inventory-Patient Form (T-CSHCOSI-PF), which is an instrument designed to enable patients to evaluate the patient-defined cultural sensitivity of their front desk office staff. A sample of 1648 adult patients was recruited by staff at 67 health care sites across the United States. These patients anonymously completed the T-CSHCOSI-PF, a demographic data questionnaire, and a patient satisfaction questionnaire. Findings Confirmatory factor analyses of the TCSHCOSI-PF revealed that this inventory has two factors with high internal consistency reliability and validity (Cronbach's αs=0.97 and 0.95). It is concluded that the T-CSHCOSI-PF is a psychometrically strong and useful inventory for assessing the cultural sensitivity of front desk office staff. This inventory can be used to support culturally sensitive health care research, evaluate the job performance of front desk office staff, and aid in the development of trainings designed to improve the cultural sensitivity of these office staff.

Perceptions of patient safety culture among healthcare employees in tertiary hospitals of Heilongjiang province in northern China: a cross-sectional study.

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Li, Ying; Zhao, Yanming; Hao, Yanhua; Jiao, Mingli; Ma, Hongkun; Teng, Baijun; Yang, Kai; Sun, Tongbo; Wu, Qunhong; Qiao, Hong

2018-04-19

Assessing the patient safety culture is necessary for improving patient safety. Research on patient safety culture has attracted considerable attention. Currently, there is little research on patient safety culture in China generally, and in Heilongjiang in northern China specifically. The aim of the study is to explore the perception of healthcare employees about patient safety culture and to determine whether perception differs per sex, age, profession, years of experience, education level and marital status. Cross-sectional study. Thirteen tertiary hospitals in Heilongjiang, northern China. About 1024 healthcare employees. The perception of healthcare employees was measured using the safety attitude questionnaire, which include six dimensions. Higher scores represented more positive attitudes. An analysis of variance was used to compare socio-demographic differences per position, marital status and education; t-tests were used for sex, age and experience. A total of 1024 (85.33%) valid questionnaires were returned. The mean score of the six dimensions was 73.74/100; work conditions (80.19) had the highest score of all the dimensions, and safety climate (70.48) had the lowest. Across distinct dimensions, there were significant differences in perceptions of patient safety culture per sex, age, years of experience, position, marital status and education level (P culture among healthcare employees and identifying dimensions that require improvement. Interventions aimed at specific socio-demographic groups are necessary to improve patient safety culture.

Transcultural healthcare immersion: a unique interprofessional experience poised to influence collaborative practice in cultural settings.

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Morton, Jennifer

2012-01-01

This paper describes a model for interprofessional and transcultural learning established by the author and supported by the University of New England and Ghana Health Mission, Inc. The model for interprofessional immersion in cultural settings represents a guiding framework predicated on a conceptual "brick and mortar" process for building cultural proficiency among individuals and within teams. It encompasses social, clinical and behavioral components (brick) and personal desire, cultural humility and values (mortar). The ``bounty'' aspect of the model is achieved by way of successful student learning outcomes, positive interprofessional and community-based collaborations, and finally, and to be measured over time, favorable patient and population (programmatic) outcomes. In partnership with the Ghana Health Mission, Inc and local community health workers, students and faculty from a range of health professions took part in a cultural-clinical experience known as Transcultural Immersion in Healthcare. The goal of the experience was to advance cultural proficiency and knowledge through intensive cultural immersion. An urban setting in Ghana, located in West Africa served as the setting for this unique experience. The transcultural immersion in healthcare experience achieved its ``bounty'' as seen in the enhanced cultural proficiency of students and faculty, seamless interprofessional communication and collaboration, and provision of primary care and related services to patients and the Ghanaian community. Future research is in development to test the Model for Interprofessional Immersion in Cultural Settings (MIICS) in a variety of other settings and with a cross section of health disciplines.

Integrating Cultural Humility into Health Care Professional Education and Training

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Chang, E-shien; Simon, Melissa; Dong, XinQi

2012-01-01

As US populations become increasing diverse, healthcare professionals are facing a heightened challenge to provide cross-cultural care. To date, medical education around the world has developed specific curricula on cultural competence training in acknowledgement of the importance of culturally sensitive and grounded services. This article…

Cultural sensitivity and supportive expressive psychotherapy: an integrative approach to treatment.

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White, Tracela M; Gibbons, Mary Beth Connolly; Schamberger, Megan

2006-01-01

Cultural sensitivity is a concept that has become increasingly important in psychotherapy research and practice. In response to the growing ethnic minority population and the increased demand for psychological services among minority clients, many therapists and researchers have attempted to identify competencies and guidelines for providing culturally sensitive approaches to treatment. However, many cultural sensitivity concepts are theoretical and have rarely been integrated into an established psychotherapeutic framework. The purpose of this manuscript is to operationalize the concepts of cultural sensitivity into specific therapeutic techniques using a manual-guided Supportive Expressive Psychotherapy approach. Developing these strategies may serve to further assist therapists with the delivery of mental health services to ethnic minority clients.

Cultural aspects of communication in cancer care.

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Surbone, A

2006-01-01

Cancer is increasing in incidence and prevalence worldwide, and the WHO has recently included cancer and its treatments as a health priority in developed and developing countries. The cultural diversity of oncology patients is bound to increase, and cultural sensitivity and competence are now required of all oncology professionals. A culturally competent cancer care leads to improved therapeutic outcome and it may decrease disparities in medical care. Cultural competence in medicine is a complex multilayered accomplishment, requiring knowledge, skills and attitudes whose acquisition is needed for effective cross-cultural negotiation in the clinical setting. Effective cultural competence is based on knowledge of the notion of culture; on awareness of possible biases and prejudices related to stereotyping, racism, classism, sexism; on nurturing appreciation for differences in health care values; and on fostering the attitudes of humility, empathy, curiosity, respect, sensitivity and awareness. Cultural competence in healthcare relates to individual professionals, but also to organizations and systems. A culturally competent healthcare system must consider in their separateness and yet in there reciprocal influences social, racial and cultural factors. By providing a framework of reference to interpret the external world and relate to it, culture affects patients' perceptions of disease, disability and suffering; degrees and expressions of concern about them; their responses to treatments and their relationship to individual physicians and to the healthcare system. Culture also influences the interpretation of ethical norms and principles, and especially of individual autonomy, which can be perceived either as synonymous with freedom or with isolation depending on the cultural context. This, in turn, determines the variability of truth-telling attitudes and practices worldwide as well as the different roles of family in the information and decision-making process of

Influence of organizational culture on provider adherence to the diabetic clinical practice guideline: using the competing values framework in Palestinian Primary Healthcare Centers.

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Radwan, Mahmoud; Akbari Sari, Ali; Rashidian, Arash; Takian, Amirhossein; Abou-Dagga, Sanaa; Elsous, Aymen

2017-01-01

Diabetes mellitus (DM) is a serious chronic disease and an important public health issue. This study aimed to identify the predominant culture within the Palestinian Primary Healthcare Centers of the Ministry of Health (PHC-MoH) and the Primary Healthcare Centers of the United Nations Relief and Works Agency for Palestine Refugees (PHC-UNRWA) by using the competing values framework (CVF) and examining its influence on the adherence to the Clinical Practice Guideline (CPG) for DM. A cross-sectional design was employed with a census sample of all the Palestinian family doctors and nurses (n=323) who work within 71 PHC clinic. A cross-cultural adaptation framework was followed to develop the Arabic version of the CVF questionnaire. The overall adherence level to the diabetic guideline was disappointingly suboptimal (51.5%, p culture was the most predominant (mean =41.13; standard deviation [SD] =8.92), followed by hierarchical (mean =33.14; SD=5.96), while in the PHC-UNRWA, hierarchical was the prevailing culture (mean =48.43; SD =12.51), followed by clan/group (mean =29.73; SD =8.37). Although a positively significant association between the adherence to CPG and the rational culture and a negatively significant association with the developmental archetype were detected in the PHC-MoH, no significant associations were found in the PHC-UNRWA. Our study demonstrates that the organizational culture has a marginal influence on the adherence to the diabetic guideline. Future research should preferably mix quantitative and qualitative approaches and explore the use of more sensitive instruments to measure such a complex construct and its effects on guideline adherence in small-sized clinics.

A Wicked Problem? Whistleblowing in Healthcare Organisations Comment on "Cultures of Silence And Cultures of Voice: The Role Of Whistleblowing in Healthcare Organisations".

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Hyde, Paula

2016-01-08

Mannion and Davies' article recognises whistleblowing as an important means of identifying quality and safety issues in healthcare organisations. While 'voice' is a useful lens through which to examine whistleblowing, it also obscures a shifting pattern of uncertain 'truths.' By contextualising cultures which support or impede whislteblowing at an organisational level, two issues are overlooked; the power of wider institutional interests to silence those who might raise the alarm and changing ideas about what constitutes adequate care. A broader contextualisation of whistleblowing might illuminate further facets of this multi-dimensional problem. © 2016 by Kerman University of Medical Sciences.

Development and evaluation of a web-based breast cancer cultural competency course for primary healthcare providers

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Triantis Maria

2011-08-01

Full Text Available Abstract Background To develop and evaluate a continuing medical education (CME course aimed at improving healthcare provider knowledge about breast cancer health disparities and the importance of cross-cultural communication in provider-patient interactions about breast cancer screening. Methods An interactive web-based CME course was developed and contained information about breast cancer disparities, the role of culture in healthcare decision making, and demonstrated a model of cross-cultural communication. A single group pre-/post-test design was used to assess knowledge changes. Data on user satisfaction was also collected. Results In all, 132 participants registered for the CME with 103 completing both assessments. Differences between pre-/post-test show a significant increase in knowledge (70% vs. 94%; p Conclusion There was an overall high level of satisfaction among all users. Users felt that learning objectives were met and the web-based format was appropriate and easy to use and suggests that web-based CME formats are an appropriate tool to teach cultural competency skills. However, more information is needed to understand how the CME impacted practice behaviors.

Methodological Challenges in Examining the Impact of Healthcare Predictive Analytics on Nursing-Sensitive Patient Outcomes.

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Jeffery, Alvin D

2015-06-01

The expansion of real-time analytic abilities within current electronic health records has led to innovations in predictive modeling and clinical decision support systems. However, the ability of these systems to influence patient outcomes is currently unknown. Even though nurses are the largest profession within the healthcare workforce, little research has been performed to explore the impact of clinical decision support on their decisions and the patient outcomes associated with them. A scoping literature review explored the impact clinical decision support systems containing healthcare predictive analytics have on four nursing-sensitive patient outcomes (pressure ulcers, failure to rescue, falls, and infections). While many articles discussed variable selection and predictive model development/validation, only four articles examined the impact on patient outcomes. The novelty of predictive analytics and the inherent methodological challenges in studying clinical decision support impact are likely responsible for this paucity of literature. Major methodological challenges include (1) multilevel nature of intervention, (2) treatment fidelity, and (3) adequacy of clinicians' subsequent behavior. There is currently insufficient evidence to demonstrate efficacy of healthcare predictive analytics-enhanced clinical decision support systems on nursing-sensitive patient outcomes. Innovative research methods and a greater emphasis on studying this phenomenon are needed.

Knowledge of Good Blood Culture Sampling Practice among Healthcare Staffs in An Emergency Department - Are We Getting It Right?

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Chew, K S; Mohd Hashairi, F; Jusoh, A F; Aziz, A A; Nik Hisamuddin, N A R; Siti Asma, H

2013-08-01

Although a vital test, blood culture is often plagued with the problem of contamination and false results, especially in a chaotic emergency department setting. The objectives of this pilot study is to find out the level of understanding among healthcare staffs in emergency department, Hospital Universiti Sains Malaysia (HUSM) regarding good blood culture sampling practice. All healthcare staffs in emergency department, HUSM who consented to this study were given a set of selfadministered anonymous questionnaire to fill. More than half (53.1%) of the 64 participants are emergency medicine residents. Majority of them (75%) have been working in the emergency medicine, HUSM for more than 2 years. More than half of them were able to answer correctly the amount of blood volume needed for culture in adult and pediatric patients. When asked what are the factors required to improve the true yield as well as to reduce the risk of culture contamination, the four commonest answers given were observing proper aseptic technique during blood sampling, donning sterile glove, proper hand scrubbing as well as ensuring the sterility of the equipments. This study suggests that there is a lack of proper knowledge of good blood culture sampling practice among our healthcare staffs in emergency department.

Exploring the Barriers: A Qualitative Study about the Experiences of Mid-SES Roma Navigating the Spanish Healthcare System.

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Aiello, Emilia; Flecha, Ainhoa; Serradell, Olga

2018-02-22

Whereas the topic of the 'cultural sensitivity' of healthcare systems has been addressed extensively in the US and the UK, literature on the subject in most European countries, specifically looking at the situation of Roma, is still scarce. Drawing on qualitative research conducted mainly in the city of Barcelona under the communicative approach with Roma subjects who have stable socioeconomic positions and higher cultural capitals (end-users, professionals of the healthcare system, and key informants of a regional policy oriented to the improvement of Roma living conditions), the present study aims to fill this gap. We explore the barriers that the Roma face in accessing the healthcare system, reflecting on how these barriers are accentuated by the existing anti-Roma prejudices and institutional arrangements that do not account for minority cultures. Our results point out a series of obstacles at two levels, in the interaction with healthcare professionals, and in relation to existing institutional arrangements, which prevent Roma families from having equal access to the healthcare system. Education stands up as a mechanism to contest anti-Roma sentiments among healthcare professionals.

Creating a successful culturally sensitive home care program.

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Blanter, R; Page, P M

1995-12-01

Providing quality home care services to immigrants requires an integrated, holistic approach that genuinely addresses language and cultural differences. One home care agency in Massachusetts developed a team-oriented, culturally sensitive outreach program that ensures non-English-speaking patients the same level of service that the general population receives.

A Wicked Problem? Whistleblowing in Healthcare Organisations; Comment on “Cultures of Silence And Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations”

Directory of Open Access Journals (Sweden)

Paula Hyde

2016-04-01

Full Text Available Mannion and Davies’ article recognises whistleblowing as an important means of identifying quality and safety issues in healthcare organisations. While ‘voice’ is a useful lens through which to examine whistleblowing, it also obscures a shifting pattern of uncertain ‘truths.’ By contextualising cultures which support or impede whislteblowing at an organisational level, two issues are overlooked; the power of wider institutional interests to silence those who might raise the alarm and changing ideas about what constitutes adequate care. A broader contextualisation of whistleblowing might illuminate further facets of this multi-dimensional problem.

Using Co-Design to Develop a Collective Leadership Intervention for Healthcare Teams to Improve Safety Culture

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Marie E. Ward

2018-06-01

Full Text Available While co-design methods are becoming more popular in healthcare; there is a gap within the peer-reviewed literature on how to do co-design in practice. This paper addresses this gap by delineating the approach taken in the co-design of a collective leadership intervention to improve healthcare team performance and patient safety culture. Over the course of six workshops healthcare staff, patient representatives and advocates, and health systems researchers collaboratively co-designed the intervention. The inputs to the process, exercises and activities that took place during the workshops and the outputs of the workshops are described. The co-design method, while challenging at times, had many benefits including grounding the intervention in the real-world experiences of healthcare teams. Implications of the method for health systems research are discussed.

Teaching ethics: when respect for autonomy and cultural sensitivity collide.

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Minkoff, Howard

2014-04-01

Respect for autonomy is a key ethical principle. However, in some cultures other moral domains such as community (emphasizing the importance of family roles) and sanctity (emphasizing the sacred and the spiritual side of human nature) hold equal value. Thus, an American physician may sometimes perceive a conflict between the desire to practice ethically and the wish to be sensitive to the mores of other cultures. For example, a woman may appear to be making what the physician thinks is a bad clinical choice because her spouse is speaking on her behalf. That physician may find it difficult to reconcile the sense that the patient had not exercised freely her autonomy with the desire to be culturally sensitive. In this article, the means by which a physician can reconcile respect for other cultures with respect for autonomy is explored. The question of whether physicians must always defer to patients' requests solely because they are couched in the language of cultural sensitivity is also addressed. Copyright © 2014 Mosby, Inc. All rights reserved.

Implementation and evaluation of a low health literacy and culturally sensitive diabetes education program.

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Swavely, Deborah; Vorderstrasse, Allison; Maldonado, Edgardo; Eid, Sherrine; Etchason, Jeff

2014-01-01

Low health literacy is more prevalent in persons with limited education, members of ethnic minorities, and those who speak English as a second language, and is associated with multiple adverse diabetes-related health outcomes. This study examined the effectiveness of a low health literacy and culturally sensitive diabetes education program for economically and socially disadvantaged adult patients with type 2 diabetes. A pre-post prospective study design was used to examine outcomes over 12 months. Outcome measures included diabetes knowledge, self-efficacy, and self-care, measured using reliable and valid survey tools, and A1C. Over this period of time 277 patients were enrolled in the program, with 106 participants completing survey data. At the completion of the program patients had significant improvements in diabetes knowledge (p literacy improves short-term outcomes. © 2013 National Association for Healthcare Quality.

Development of culturally sensitive dialog tools in diabetes education

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Nana Folmann Hempler

2015-01-01

Full Text Available Person-centeredness is a goal in diabetes education, and cultural influences are important to consider in this regard. This report describes the use of a design-based research approach to develop culturally sensitive dialog tools to support person-centered dietary education targeting Pakistani immigrants in Denmark with type 2 diabetes. The approach appears to be a promising method to develop dialog tools for patient education that are culturally sensitive, thereby increasing their acceptability among ethnic minority groups. The process also emphasizes the importance of adequate training and competencies in the application of dialog tools and of alignment between researchers and health care professionals with regards to the educational philosophy underlying their use.

The Role of Employee Whistleblowing and Raising Concerns in an Organizational Learning Culture - Elusive and Laudable?: Comment on "Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations".

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Jones, Aled

2015-10-05

It is inevitable that healthcare workers throughout their careers will witness actual or potential threats to patient safety in the course of their work. Some of these threats will result in serious harm occurring to others, whilst at other times such threats will result in minimal harm, or a 'near miss' where harm is avoided at the last minute. Despite organizations encouraging employees to 'speak up' about such threats, healthcare systems globally struggle to engage their staff to do so. Even when staff do raise concerns they are often ignored by those with a responsibility to listen and act. Learning how to create the conditions where employees continuously raise and respond to concerns is essential in creating a continuous and responsive learning culture that cherishes keeping patients and employees safe. Workplace culture is a real barrier to the creation of such a learning system but examples in healthcare exist from which we can learn. © 2016 by Kerman University of Medical Sciences.

[Patient safety culture based on a non-punitive response to error and freedom of expression of healthcare professionals].

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Mahjoub, Mohamed; Bouafia, Nabiha; Cheikh, Asma Ben; Ezzi, Olfa; Njah, Mansour

2016-11-25

This study provided an overview of healthcare professionals’ perception of patient safety based on analysis of the concept of freedom of expression and non-punitive response in order to identify and correct errors in our health system. This concept is a cornerstone of the patient safety culture among healthcare professionals and plays a central role in the quality improvement strategy..

Whistleblowing Need not Occur if Internal Voices Are Heard: From Deaf Effect to Hearer Courage: Comment on "Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations".

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Cleary, Sonja R; Doyle, Kerrie E

2015-09-29

Whistleblowing by health professionals is an infrequent and extraordinary event and need not occur if internal voices are heard. Mannion and Davies' editorial on "Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations" asks the question whether whistleblowing ameliorates or exacerbates the 'deaf effect' prevalent in healthcare organisations. This commentary argues that the focus should remain on internal processes and hearer courage . © 2016 by Kerman University of Medical Sciences.

How can healthcare organizations implement patient-centered care? Examining a large-scale cultural transformation.

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Bokhour, Barbara G; Fix, Gemmae M; Mueller, Nora M; Barker, Anna M; Lavela, Sherri L; Hill, Jennifer N; Solomon, Jeffrey L; Lukas, Carol VanDeusen

2018-03-07

Healthcare organizations increasingly are focused on providing care which is patient-centered rather than disease-focused. Yet little is known about how best to transform the culture of care in these organizations. We sought to understand key organizational factors for implementing patient-centered care cultural transformation through an examination of efforts in the US Department of Veterans Affairs. We conducted multi-day site visits at four US Department of Veterans Affairs medical centers designated as leaders in providing patient-centered care. We conducted qualitative semi-structured interviews with 108 employees (22 senior leaders, 42 middle managers, 37 front-line providers and 7 staff). Transcripts of audio recordings were analyzed using a priori codes based on the Consolidated Framework for Implementation Research. We used constant comparison analysis to synthesize codes into meaningful domains. Sites described actions taken to foster patient-centered care in seven domains: 1) leadership; 2) patient and family engagement; 3) staff engagement; 4) focus on innovations; 5) alignment of staff roles and priorities; 6) organizational structures and processes; 7) environment of care. Within each domain, we identified multi-faceted strategies for implementing change. These included efforts by all levels of organizational leaders who modeled patient-centered care in their interactions and fostered willingness to try novel approaches to care amongst staff. Alignment and integration of patient centered care within the organization, particularly surrounding roles, priorities and bureaucratic rules, remained major challenges. Transforming healthcare systems to focus on patient-centered care and better serve the "whole" patient is a complex endeavor. Efforts to transform healthcare culture require robust, multi-pronged efforts at all levels of the organization; leadership is only the beginning. Challenges remain for incorporating patient-centered approaches in the

When Whistle-blowers Become the Story: The Problem of the 'Third Victim': Comment on "Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations".

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Waring, Justin

2015-11-01

In the healthcare context, whistleblowing has come to the fore of political, professional and public attention in the wake of major service scandals and mounting evidence of the routine threats to safety that patients face in their care. This paper offers a commentary and wider contextualisation of Mannion and Davies, 'Cultures of silence and cultures of voice: the role of whistleblowing in healthcare organisations.' It argues that closer attention is needed to the way in which whistle-blowers can become the focus and victim of raising concerns and speaking up. © 2016 by Kerman University of Medical Sciences.

Work life and patient safety culture in Canadian healthcare: connecting the quality dots using national accreditation results.

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Mitchell, Jonathan I

2012-01-01

Fostering quality work life is paramount to building a strong patient safety culture in healthcare organizations. Data from two patient safety culture and work-life questionnaires used for Accreditation Canada's national program were analyzed. Strong team leadership was reported in that units were doing a good job of identifying, assessing and managing risks to patients. Seventy-one percent of respondents gave their unit a positive overall grade on patient safety, and 79% of respondents felt that they could often do their best-quality work in their job. However, healthcare workers felt that they did not have enough time to do their jobs adequately and indicated that co-workers were cutting corners in patient care in order to save time. This article discusses engaging both senior leadership and the entire organization in the change process, ensuring supervisory support, and using performance measures to focus organizational efforts on key priorities all as improvement strategies relevant to these findings. These strategies can be used by organizations across sectors and jurisdictions and by healthcare leaders to positively affect work life and patient safety.

Whistleblowing Need not Occur if Internal Voices Are Heard: From Deaf Effect to Hearer Courage; Comment on “Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations”

Directory of Open Access Journals (Sweden)

Sonja R. Cleary

2016-01-01

Full Text Available Whistleblowing by health professionals is an infrequent and extraordinary event and need not occur if internal voices are heard. Mannion and Davies’ editorial on “Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations” asks the question whether whistleblowing ameliorates or exacerbates the ‘deaf effect’ prevalent in healthcare organisations. This commentary argues that the focus should remain on internal processes and hearer courage.

Study of bacterial flora associated with mobile phones of healthcare workers and non-healthcare workers.

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Morubagal, Raghavendra Rao; Shivappa, Sowmya Govindanahalli; Mahale, Rashmi Padmanabha; Neelambike, Sumana Mhadevaiah

2017-06-01

Despite improvements in modern diagnosis and therapies, hospital acquired infections remain a leading problem of global health systems. Healthcare workers mobile phones is a reservoir for potential pathogens. Despite the high possibility of being contaminated, mobile phones are rarely clean and are often touched during or after examination of patients and handling of specimens without proper hand washing. The main objective of the present study was to isolate, identify different types of bacteria and their antibiotic sensitivity from mobile phones of healthcare workers and non-health-care workers. Samples were collected aseptically by rolling over the exposed surfaces of the mobile phones inoculated on the agar plates and incubated aerobically. After incubation, plates were examined for growth. Bacteria were identified and antibiotic sensitivity was tested as per standard microbiological procedures. In this study a total of 175 samples were examined, out of which 125 samples were from healthcare workers (HCWs), 50 samples were from non-healthcare workers (non-HCWs). Among the mobile phones of HCW's from ICUs, Acinetobacter baumannii (36.84%) was the predominant organism isolated followed by methicillin resistant Staphylococcus aureus (MRSA) (21.05%). Predominant organism isolated from HCW's in operation theater theater was MRSA (46.66%). Out of 50 worker's non-HCWs mobile phones samples cultured, 23 (46.00%) samples yielded growth of six different types of bacteria. Our study reveals that there is definite colonization of bacteria on mobile phones of the HCWs. It is not only capable of transferring message but also disease-producing microbes. In order to reduce incidence of nosocomial infections, there should be implementation of hand washing practices and regulations around the use of mobile telephones in hospital settings.

Spanish-speaking patients' satisfaction with clinical pharmacists' communication skills and demonstration of cultural sensitivity.

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Kim-Romo, Dawn N; Barner, Jamie C; Brown, Carolyn M; Rivera, José O; Garza, Aida A; Klein-Bradham, Kristina; Jokerst, Jason R; Janiga, Xan; Brown, Bob

2014-01-01

OBJECTIVE To assess Spanish-speaking patients' satisfaction with their clinical pharmacists' communication skills and demonstration of cultural sensitivity, while controlling for patients' sociodemographic, clinical, and communication factors, as well as pharmacist factors, and to identify clinical pharmacists' cultural factors that are important to Spanish-speaking patients. DESIGN Cross-sectional study. SETTING Central Texas during August 2011 to May 2012. PARTICIPANTS Spanish-speaking patients of federally qualified health centers (FQHCs). MAIN OUTCOME MEASURE(S) A Spanish-translated survey assessed Spanish-speaking patients' satisfaction with their clinical pharmacists' communication skills and demonstration of cultural sensitivity. RESULTS Spanish-speaking patients (N = 101) reported overall satisfaction with their clinical pharmacists' communication skills and cultural sensitivity. Patients also indicated that pharmacists' cultural rapport (e.g., ability to speak Spanish, respectfulness) was generally important to Spanish speakers. Multiple linear regression analyses showed that cultural rapport was significantly related to satisfaction with pharmacists' communication skills and demonstration of cultural sensitivity. CONCLUSION Overall, patients were satisfied with pharmacists' communication skills and cultural sensitivity. Patient satisfaction initiatives that include cultural rapport should be developed for pharmacists who provide care to Spanish-speaking patients with limited English proficiency.

The effects of citizenship status on service utilization and general satisfaction with healthcare: a cross-cultural study.

Science.gov (United States)

Khaled, Salma M; Shockley, Bethany; Abdul Rahim, Hanan F

2017-02-01

To explore the role of citizenship status as a predictor of general satisfaction with healthcare services in Qatar, including potential interaction with utilization and health insurance coverage type. A cross-sectional survey conducted in 2012. A household survey in the State of Qatar in the Arab Gulf. A nationally representative sample of 2750 citizens and noncitizens aged 18 years and older. General satisfaction status with Qatar's healthcare system. Citizenship status, healthcare utilization, health insurance type. Citizens were significantly less likely to be satisfied with Qatar's healthcare system than noncitizens (odds ratio (OR) = 0.30, P citizenship (P citizenship groups. These differences may stem from different expectations with respect to healthcare services. Understanding these expectations may have important policy implications for cross-cultural contexts. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Influence of Culture and Language Sensitive Physics on Science Attitude Enhancement

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Morales, Marie Paz E.

2015-01-01

The study critically explored how culture and language sensitive curriculum materials in physics improve Pangasinan learners' attitude towards science. Their cultural dimensions, epistemological beliefs, and views on integration of culture and language in the teaching and learning process determined their cultural preference or profile. Design and…

When Whistle-blowers Become the Story: The Problem of the ‘Third Victim’; Comment on “Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations”

Directory of Open Access Journals (Sweden)

Justin Waring

2016-02-01

Full Text Available In the healthcare context, whistleblowing has come to the fore of political, professional and public attention in the wake of major service scandals and mounting evidence of the routine threats to safety that patients face in their care. This paper offers a commentary and wider contextualisation of Mannion and Davies, ‘Cultures of silence and cultures of voice: the role of whistleblowing in healthcare organisations.’ It argues that closer attention is needed to the way in which whistle-blowers can become the focus and victim of raising concerns and speaking up.

The Role of Employee Whistleblowing and Raising Concerns in an Organizational Learning Culture – Elusive and Laudable?; Comment on “Cultures of Silence and Cultures of Voice: The Role of Whistleblowing in Healthcare Organisations”

Directory of Open Access Journals (Sweden)

Aled Jones

2016-01-01

Full Text Available It is inevitable that healthcare workers throughout their careers will witness actual or potential threats to patient safety in the course of their work. Some of these threats will result in serious harm occurring to others, whilst at other times such threats will result in minimal harm, or a ‘near miss’ where harm is avoided at the last minute. Despite organizations encouraging employees to ‘speak up’ about such threats, healthcare systems globally struggle to engage their staff to do so. Even when staff do raise concerns they are often ignored by those with a responsibility to listen and act. Learning how to create the conditions where employees continuously raise and respond to concerns is essential in creating a continuous and responsive learning culture that cherishes keeping patients and employees safe. Workplace culture is a real barrier to the creation of such a learning system but examples in healthcare exist from which we can learn.

Blueprint for Sustainable Change in Diversity Management and Cultural Competence: Lessons From the National Center for Healthcare Leadership Diversity Demonstration Project.

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Dreachslin, Janice L; Weech-Maldonado, Robert; Gail, Judith; Epané, Josué Patien; Wainio, Joyce Anne

How can healthcare leaders build a sustainable infrastructure to leverage workforce diversity and deliver culturally and linguistically appropriate care to patients? To answer that question, two health systems participated in the National Center for Healthcare Leadership's diversity leadership demonstration project, November 2008 to December 2013. Each system provided one intervention hospital and one control hospital.The control hospital in each system participated in pre- and postassessments but received no preassessment feedback and no intervention support. Each intervention hospital's C-suite leadership and demonstration project manager worked with a diversity coach provided by the National Center for Healthcare Leadership to design and implement an action plan to improve diversity and cultural competence practices and build a sustainable infrastructure. Plans explored areas of strength and areas for improvement that were identified through preintervention assessments. The assessments focused on five competencies of strategic diversity management and culturally and linguistically appropriate care: diversity leadership, strategic human resource management, organizational climate, diversity climate, and patient cultural competence.This article describes each intervention hospital's success in action plan implementation and reports results of postintervention interviews with leadership to provide a blueprint for sustainable change.

The Exploration of Culturally Sensitive Nursing Care in Pediatric Setting: a Qualitative Study

Directory of Open Access Journals (Sweden)

Leila Valizadeh

2017-02-01

Full Text Available Background: One of the essential aspects of the provision of care is cultural issues. Cultural sensitivity is the key for cultural care. The aim of this study was to explore culturally sensitive care in pediatric nursing care in Iran.Materials and Methods: This study was a conventional content analysis. Participants were consisted of 25 nurses and 9 parents selected through purposive sampling from three pediatric referral centers in Tabriz and Tehran, Iran. Data was collected using semi-structured interviews and field notes and were concurrently analyzed by using Graneheim and Lundman (2004 method. Data was transcribed verbatim, words, sentences, and phrases were considered meaning units, abstracted, labeled and compared for developing categories.Results: Culturally sensitive care of a sick child was consisted of three themes: ‘cultural exposure’, ‘intercultural communication’ and ‘the reconciliation of cultural conflict in families/care’. During the ‘cultural exposure’ nurses were informed of the cultural manifestations, strived to identify and understand patients/families with cultural diversities and respect their cultural beliefs. The nurse used the native language in ‘intercultural communication’ or a combination of verbal and nonverbal communication methods to reach a common understanding. Finally, a nurse in the conflict between the culture of child/family and care took actions for making decisions to develop a compliance between care and the family culture and amended parents’ harmful desires through negotiation and appropriate care.Conclusion: Understanding the concept of culturally sensitive care, can help with resolving the problems of cultural exchanges in Pediatric wards. Providing cultural facilities and interpreters to communicate with patients/family increase their satisfaction.

Influence of culture and language sensitive physics on science attitude enhancement

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Morales, Marie Paz E.

2015-12-01

The study critically explored how culture and language sensitive curriculum materials in physics improve Pangasinan learners' attitude towards science. Their cultural dimensions, epistemological beliefs, and views on integration of culture and language in the teaching and learning process determined their cultural preference or profile. Design and development of culture and language sensitive curriculum materials in physics were heavily influenced by these learners' cultural preference or profile. Pilot-study using interviews and focus group discussions with natives of Pangasinan and document analysis were conducted to identify the culture, practices, and traditions integrated in the lesson development. Comparison of experimental participants' pretest and posttest results on science attitude measure showed significant statistical difference. Appraisal of science attitude enhancement favored the experimental group over the control group. Qualitative data deduced from post implementation interviews, focus group discussions, and journal log entries showed the same trend in favor of the experimental participants. The study revealed that culture and language integration in the teaching and learning process of physics concepts enabled students to develop positive attitude to science, their culture, and native language.

International Cultural Immersion: Assessing the Influence of a Group Intervention on Intercultural Sensitivity for Counselor Trainees

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Barden, Sejal M.; Shannonhouse, Laura; Mobley, Keith

2015-01-01

Scholars (e.g., Bemak & Chung, 2004) underscore the need for group workers to be culturally sensitive. One group training strategy, cultural immersion, is often employed to develop cultural sensitivity. However, no studies have utilized quasi-experimental methodologies to assess differences in cultural sensitivity between trainees that immerse…

Exploring the influence of design culture on ICT healthcare product and service design for rural China

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Jiang, J.; Kandachar, P.V.; Freudenthal, A.

2010-01-01

Design culture is usually considered as one of the important aspects that influence designers’ decisions and actions, especially in Design for Base of the Pyramid projects including ICT Healthcare Product Design in Rural China (IHDRC). There are two research questions in this issue: what are the

Culturally Sensitive and Environment-Friendly Outcome Measures in

African Journals Online (AJOL)

Dr Olaleye

A systematic review of evidence on culturally sensitive and environment-friendly outcome measures in ..... which included manual grass cutting/hoeing, assuming the Islamic ... who opined that the starting point for any outcome measure is to ...

Student nurses' experiences of living and studying in a different culture to their own and the development of cultural sensitivity

DEFF Research Database (Denmark)

Ruddock, Heidi

With the increase of culturally diverse people residing in Denmark, it has become imperative to provide student nurses with knowledge and skills that will enable them to become culturally sensitive in order interact effectively with clients from culturally diverse backgrounds. The aim of this study...... was to explore whether student nurses develop cultural sensitivity as a consequence of living and studying in a culture that is different from their own. Seven Danish student nurses who had participated in student exchanges in Jamaica, Australia, Malta and Greenland took part in this study. A qualitative...

A knowledge synthesis of culturally- and spiritually-sensitive end-of-life care: findings from a scoping review.

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Fang, Mei Lan; Sixsmith, Judith; Sinclair, Shane; Horst, Glen

2016-05-18

Multiple factors influence the end-of-life (EoL) care and experience of poor quality services by culturally- and spiritually-diverse groups. Access to EoL services e.g. health and social supports at home or in hospices is difficult for ethnic minorities compared to white European groups. A tool is required to empower patients and families to access culturally-safe care. This review was undertaken by the Canadian Virtual Hospice as a foundation for this tool. To explore attitudes, behaviours and patterns to utilization of EoL care by culturally and spiritually diverse groups and identify gaps in EoL care practice and delivery methods, a scoping review and thematic analysis of article content was conducted. Fourteen electronic databases and websites were searched between June-August 2014 to identify English-language peer-reviewed publications and grey literature (including reports and other online resources) published between 2004-2014. The search identified barriers and enablers at the systems, community and personal/family levels. Primary barriers include: cultural differences between healthcare providers; persons approaching EoL and family members; under-utilization of culturally-sensitive models designed to improve EoL care; language barriers; lack of awareness of cultural and religious diversity issues; exclusion of families in the decision-making process; personal racial and religious discrimination; and lack of culturally-tailored EoL information to facilitate decision-making. This review highlights that most research has focused on decision-making. There were fewer studies exploring different cultural and spiritual experiences at the EoL and interventions to improve EoL care. Interventions evaluated were largely educational in nature rather than service oriented.

East-West cultural differences in context-sensitivity are evident in early childhood.

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Imada, Toshie; Carlson, Stephanie M; Itakura, Shoji

2013-03-01

Accumulating evidence suggests that North Americans tend to focus on central objects whereas East Asians tend to pay more attention to contextual information in a visual scene. Although it is generally believed that such culturally divergent attention tendencies develop through socialization, existing evidence largely depends on adult samples. Moreover, no past research has investigated the relation between context-sensitivity and other domains of cognitive development. The present study examined children in the United States and Japan (N = 175, age 4-9 years) to investigate the developmental pattern in context-sensitivity and its relation to executive function. The study found that context-sensitivity increased with age across cultures. Nevertheless, Japanese children showed significantly greater context-sensitivity than American children. Also, context-sensitivity fully mediated the cultural difference in a set-shifting executive function task, which might help explain past findings that East Asian children outperformed their American counterparts on executive function. © 2012 Blackwell Publishing Ltd.

Organizational culture and its implications for infection prevention and control in healthcare institutions.

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De Bono, S; Heling, G; Borg, M A

2014-01-01

It is not uncommon for infection prevention and control (IPC) interventions to be successful in one hospital yet fail, or have significantly less success, when implemented in another healthcare institution. Organizational factors have been postulated to be a major reason. As a result, there has been an increasing drive in recent years to understand and address organizational culture (OC) in order to achieve improved healthcare performance. To examine the inter-relationship between OC and behavioural attitudes by healthcare professionals; to determine whether and how OC may impact on IPC compliance; and to highlight the potential for OC modification interventions to improve IPC practices within hospitals. Previous literature is reviewed and synthesized, using both IPC journals as well as publications focusing on human behaviour and organizational change. The article evaluates the theory of OC within healthcare settings and identifies how various elements appear to impact on IPC-related behaviour. It highlights the paucity of well-designed studies but identifies sporadic literature suggesting that well-designed and customized OC change initiatives can have a positive impact on IPC practices, such as hand hygiene. OC change appears to be a promising, albeit challenging, target for IPC improvement campaigns - both from a theoretical perspective as well as from the results of the few available studies. However, more data and quality information are needed to identify effective strategies that can elicit effective and sustained change. Published by Elsevier Ltd.

Sensitive and selective culture medium for detection of environmental Clostridium difficile isolates without requirement for anaerobic culture conditions.

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Cadnum, Jennifer L; Hurless, Kelly N; Deshpande, Abhishek; Nerandzic, Michelle M; Kundrapu, Sirisha; Donskey, Curtis J

2014-09-01

Effective and easy-to-use methods for detecting Clostridium difficile spore contamination would be useful for identifying environmental reservoirs and monitoring the effectiveness of room disinfection. Culture-based detection methods are sensitive for detecting C. difficile, but their utility is limited due to the requirement of anaerobic culture conditions and microbiological expertise. We developed a low-cost selective broth medium containing thioglycolic acid and l-cystine, termed C. difficile brucella broth with thioglycolic acid and l-cystine (CDBB-TC), for the detection of C. difficile from environmental specimens under aerobic culture conditions. The sensitivity and specificity of CDBB-TC (under aerobic culture conditions) were compared to those of CDBB (under anaerobic culture conditions) for the recovery of C. difficile from swabs collected from hospital room surfaces. CDBB-TC was significantly more sensitive than CDBB for recovering environmental C. difficile (36/41 [88%] versus 21/41 [51%], respectively; P = 0.006). C. difficile latex agglutination, an enzyme immunoassay for toxins A and B or glutamate dehydrogenase, and a PCR for toxin B genes were all effective as confirmatory tests. For 477 total environmental cultures, the specificity of CDBB-TC versus that of CDBB based upon false-positive yellow-color development of the medium without recovery of C. difficile was 100% (0 false-positive results) versus 96% (18 false-positive results), respectively. False-positive cultures for CDBB were attributable to the growth of anaerobic non-C. difficile organisms that did not grow in CDBB-TC. Our results suggest that CDBB-TC provides a sensitive and selective medium for the recovery of C. difficile organisms from environmental samples, without the need for anaerobic culture conditions. Copyright © 2014, American Society for Microbiology. All Rights Reserved.

Influence of organizational culture on provider adherence to the diabetic clinical practice guideline: using the competing values framework in Palestinian Primary Healthcare Centers

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Radwan M

2017-08-01

Full Text Available Mahmoud Radwan,1 Ali Akbari Sari,1 Arash Rashidian,1 Amirhossein Takian,1 Sanaa Abou-Dagga,2 Aymen Elsous1 1Department of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences, Tehran, Iran; 2Department of Research Affairs and Graduates Studies, Islamic University of Gaza, Gaza Strip, Palestine Background: Diabetes mellitus (DM is a serious chronic disease and an important public health issue. This study aimed to identify the predominant culture within the Palestinian Primary Healthcare Centers of the Ministry of Health (PHC-MoH and the Primary Healthcare Centers of the United Nations Relief and Works Agency for Palestine Refugees (PHC-UNRWA by using the competing values framework (CVF and examining its influence on the adherence to the Clinical Practice Guideline (CPG for DM.Methods: A cross-sectional design was employed with a census sample of all the Palestinian family doctors and nurses (n=323 who work within 71 PHC clinic. A cross-cultural adaptation framework was followed to develop the Arabic version of the CVF questionnaire. Results: The overall adherence level to the diabetic guideline was disappointingly suboptimal (51.5%, p<0.001; 47.3% in the PHC-MoH and 55.5% in the PHC-UNRWA. In the PHC-MoH, the clan/group culture was the most predominant (mean =41.13; standard deviation [SD] =8.92, followed by hierarchical (mean =33.14; SD=5.96, while in the PHC-UNRWA, hierarchical was the prevailing culture (mean =48.43; SD =12.51, followed by clan/group (mean =29.73; SD =8.37. Although a positively significant association between the adherence to CPG and the rational culture and a negatively significant association with the developmental archetype were detected in the PHC-MoH, no significant associations were found in the PHC-UNRWA. Conclusion: Our study demonstrates that the organizational culture has a marginal influence on the adherence to the diabetic guideline. Future research

Understanding Afghan healthcare providers: a qualitative study of the culture of care in a Kabul maternity hospital.

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Arnold, R; van Teijlingen, E; Ryan, K; Holloway, I

2015-01-01

To analyse the culture of a Kabul maternity hospital to understand the perspectives of healthcare providers on their roles, experiences, values and motivations and the impact of these determinants on the care of perinatal women and their babies. Qualitative ethnographic study. A maternity hospital, Afghanistan. Doctors, midwives and care assistants. Six weeks of observation followed by 22 semi-structured interviews and four informal group discussions with staff, two focus group discussions with women and 41 background interviews with Afghan and non-Afghan medical and cultural experts. The culture of care in an Afghan maternity hospital. A large workload, high proportion of complicated cases and poor staff organisation affected the quality of care. Cultural values, social and family pressures influenced the motivation and priorities of healthcare providers. Nepotism and cronyism created inequality in clinical training and support and undermined the authority of management to improve standards of care. Staff without powerful connections were vulnerable in a punitive inequitable environment-fearing humiliation, blame and the loss of employment. Suboptimal care put the lives of women and babies at risk and was, in part, the result of conflicting priorities. The underlying motivation of staff appeared to be the socio-economic survival of their own families. The hospital culture closely mirrored the culture and core values of Afghan society. In setting priorities for women's health post-2015 Millennium Development Goals, understanding the context-specific pressures on staff is key to more effective programme interventions and sustainability. © 2014 Royal College of Obstetricians and Gynaecologists.

Increased sensitivity to ET-1 in rat cerebral arteries following organ culture

DEFF Research Database (Denmark)

Hansen-Schwartz, J; Edvinsson, L

2000-01-01

Endothelin-1 (ET-1) is recognized as being involved in the pathophysiology of cerebrovascular diseases. Using organ culture as a model for possible pathological changes we studied changes in ET(A) and ETB receptor function using a sensitive in vitro method. We observed an up-regulation of the ET......(B) receptor and an amazingly increased sensitivity to ET-1 by 3 log units in pEC50; pEC50(fresh) was 8.7 +/- 0.1, and pEC50(cultured) was 11.7 +/- 0.3. pA2 for FR139317 in the fresh vessel was 7.0 +/- 0.2 whereas it could not be obtained for the cultured vessel, indicating a possible cross-talk between the ET......(A) and ET(B) receptors. The increased sensitivity to ET-1 could also take place during cerebrovascular disease such as stroke or haemorrhage rendering the vessels considerably more sensitive to ET-1....

Culturally Sensitive and Environment-Friendly Outcome Measures in

African Journals Online (AJOL)

Dr Olaleye

to review research studies on outcome measures that were developed for ... A systematic review of evidence on culturally sensitive and environment- ... Various databases including Google Scholar, PEDro and PubMed were accessed to search for relevant empirical ... utilization of disease-specific, patient-centered outcome.

A human error taxonomy for analysing healthcare incident reports: assessing reporting culture and its effects on safety perfomance

DEFF Research Database (Denmark)

Itoh, Kenji; Omata, N.; Andersen, Henning Boje

2009-01-01

The present paper reports on a human error taxonomy system developed for healthcare risk management and on its application to evaluating safety performance and reporting culture. The taxonomy comprises dimensions for classifying errors, for performance-shaping factors, and for the maturity...

The Relationship Between Cultural Sensitivity and Assertiveness in Nursing Students from Turkey.

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Kılıç, Serap Parlar; Sevinç, Sibel

2017-07-01

As foreigners live in and visit Turkey for various reasons, it is essential to provide culturally appropriate health care. This study was conducted to determine the relationship between cultural sensitivity and assertiveness in university nursing students. This descriptive, cross-sectional study was conducted at two universities in the cities of Kilis and Elazığ, Turkey. The study sample consisted of 444 nursing students. Data collection tools included a questionnaire about participant sociodemographic characteristics, Chen and Starosta's Intercultural Sensitivity Scale, and the Rathus Assertiveness Scale. The mean age of participants was 21.09 years. Most students (71.6%) were female and 34.7% of the students stayed at the hostel. Of the students, 44.4%, 27.5%, and 28.2% attended were the second-, third-, and fourth-year students, respectively. Participants were asked about problems related to caring for patients who speak different languages. The mean score for the Intercultural Sensitivity Scale was 89.42 ± 13.55 and the total score for all students for the Assertiveness Scale was 112.64 ± 15.61. We identified a positive relationship between total scores for the Intercultural Sensitivity Scale and the Assertiveness Scale ( p assertiveness and year of nursing education and want to work overseas. Nursing students at both schools had a moderate level of cultural sensitivity and assertiveness. It has been determined that as assertiveness level of the students increased, intercultural sensitivity of them also increased. Consequently, it is concluded that training as assertive and self-confident individuals during the nursing education of students has a contribution to making patient-specific and culture-sensitive care.

Low health literacy and healthcare utilization among immigrants and non-immigrants in Switzerland.

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Mantwill, Sarah; Schulz, Peter J

2017-11-01

This study aimed at investigating the association between functional health literacy and knowledge on when to seek medical help for potentially harmless (overutilization) or serious (underutilization) situations among immigrants and non-immigrants in Switzerland. Data was collected among three immigrant groups and the native population (N=1146) in the German- and Italian-speaking part of Switzerland. Health literacy was assessed with the Short Test of Functional Health Literacy (S-TOFHLA) and three Brief Health Literacy Screeners. Over- and underutilization of healthcare services was assessed with items asking participants about when to seek medical help for minor, respectively major, physical symptoms. Immigrants were more likely to seek medical help when unwarranted (overutilization). Health literacy, when assessed with the S-TOFHLA, was significantly associated with over- and underutilization. Yet, once controlled for covariates, the association between health literacy and overutilization was negative. Immigration background and micro-cultural differences emerged as important predictors of utilization. Results suggest that functional health literacy is directly related to healthcare utilization. The effects might be amplified by (micro-)cultural differences. Healthcare providers should be aware of differences in health literacy and utilization patterns among different population groups. Communication between patients and providers should be literacy and culturally sensitive. Copyright © 2017 Elsevier B.V. All rights reserved.

Healthcare preferences of lesbian, gay, bisexual, transgender and questioning youth.

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Hoffman, Neal D; Freeman, Katherine; Swann, Stephanie

2009-09-01

home and family. Subgroup analyses underscore the need for greater sensitivity to both cultural and developmental differences among LGBTQ youth. These results provide a foundation for further research about healthcare services and delivery systems for youth, training initiatives for healthcare providers, and the role of utilizing the Internet for health research purposes to access and recruit hard-to-reach youth.

Autonomy, culture and healthcare

DEFF Research Database (Denmark)

Riis, Anita Holm

2018-01-01

a Scandinavian and mostly a Danish context. A key point of the analysis indicates that a highly efficient health sector may entail an implicit duality: On the one hand, the therapist can relate pragmatically to the patient when engaging in cultural meetings. On the other hand, the therapist may be personally......This article aims to present a theoretical view of how cultural thinking and action in meetings between patient and therapist can be analyzed with special attention to raising awareness of underlying prejudices and preconceptions in such encounters. The examples in the article are all taken from...... challenged when cultural thinking leads to ethical dilemmas....

Mediating Effect of School Nurses' Self Efficacy between Multicultural Attitude and Cultural Sensitivity in Korean Elementary Schools.

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Suk, Min Hyun; Oh, Won Oak; Im, Yeo Jin; Cho, Hun Ha

2015-09-01

This study examined the mediating effect of school nurses' self efficacy, which is one of the significant cognitive factors influencing cultural sensitivity, on the mutual relationships between multicultural attitude and cultural sensitivity in Korean elementary schools. A cross-sectional descriptive survey design was used. Participants were 157 school nurses in elementary schools located in Gyeonggi-do, South Korea. The survey instruments included Teacher Multicultural Attitude Survey, Teacher Efficacy Scale, and Multicultural Sensitivity Scale. Data were analyzed using three regression equations to test the mediation model. The mean score of the school nurses' cultural sensitivity was relatively low. A positive correlation among multicultural attitude, self efficacy, and cultural sensitivity was noted. Self efficacy of school nurses showed a significant mediating effect on the relationships between multicultural attitude and cultural sensitivity. Given the meaningful influence of positive multicultural attitude on cultural sensitivity and significant mediator effect of self efficacy as a school nurse between the two variables, the strategies to cultivate a positive multicultural attitude and enhance school nurses' self efficacy in their unique role should be considered in a training program. School nurses' health care services will benefit from the improvement of cultural sensitivity toward young children from multicultural families. Copyright © 2015. Published by Elsevier B.V.

Equality in Healthcare: The Formation and Ongoing Legacy of an LGBT Advisory Council.

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Rosa, William; Fullerton, Chelsea; Keller, Ronald

2015-12-01

This article provides a broad overview of the literature on lesbian, gay, bisexual, transgender (LGBT) health disparities and workplace discrimination, as well as the context that led to the formation of an institutional LGBT Advisory Council. The Council was developed in order to demonstrate our ongoing commitment to LGBT inclusion and to improve the lived experiences for both LGBT patients and staff. A retrospective approach is utilized to explore the LGBT Advisory Council's journey to spearhead advocacy efforts at our institution. The Council's accomplishments include taking a leadership role in obtaining nationally recognized designations such as the Healthcare Equality Index and the Magnet Exemplar for Cultural Sensitivity, as well as adding sexual orientation, gender identity, and gender expression fields to our institution's electronic medical record system. Additionally, the Council guides and promotes ongoing house-wide cultural sensitivity staff training efforts. Most recently, the Council marched as a contingency in the world's largest Pride March for the first time in institutional history. It is our hope that our Council will become an inspiration and exemplar for similar groups to form at healthcare institutions and organizations across the nation. Allowing LGBT members of each individual healthcare community the agency to determine the direction of advocacy efforts is incredibly important; however, this must be coupled with an organizational commitment on behalf of leadership to follow through on these initiatives and to provide them with the resources they need in order to be successful.

Alginate foam-based three-dimensional culture to investigate drug sensitivity in primary leukaemia cells.

Science.gov (United States)

Karimpoor, Mahroo; Yebra-Fernandez, Eva; Parhizkar, Maryam; Orlu, Mine; Craig, Duncan; Khorashad, Jamshid S; Edirisinghe, Mohan

2018-04-01

The development of assays for evaluating the sensitivity of leukaemia cells to anti-cancer agents is becoming an important aspect of personalized medicine. Conventional cell cultures lack the three-dimensional (3D) structure of the bone marrow (BM), the extracellular matrix and stromal components which are crucial for the growth and survival of leukaemia stem cells. To accurately predict the sensitivity of the leukaemia cells in an in vitro assay a culturing system containing the essential components of BM is required. In this study, we developed a porous calcium alginate foam-based scaffold to be used for 3D culture. The new 3D culture was shown to be cell compatible as it supported the proliferation of both normal haematopoietic and leukaemia cells. Our cell differential assay for myeloid markers showed that the porous foam-based 3D culture enhanced myeloid differentiation in both leukaemia and normal haematopoietic cells compared to two-dimensional culture. The foam-based scaffold reduced the sensitivity of the leukaemia cells to the tested antileukaemia agents in K562 and HL60 leukaemia cell line model and also primary myeloid leukaemia cells. This observation supports the application of calcium alginate foams as scaffold components of the 3D cultures for investigation of sensitivity to antileukaemia agents in primary myeloid cells. © 2018 The Author(s).

Focus Groups in Qualitative Research: Culturally Sensitive Methodology for the Arabian Gulf?

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Thomas, Andrew

2008-01-01

This article explores whether focus groups can constitute a culturally sensitive method of data gathering for educational leadership, management and related areas in a Gulf-Arab cultural context. Reviewing the literature on focus groups and cross-cultural psychology for the Arab region, it identifies key notions related to societal values such as…

Patient safety culture shapes presenteeism and absenteeism: a cross-sectional study among Croatian healthcare workers.

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Brborović, Hana; Brborović, Ognjen

2017-09-26

Healthcare workers have high rates of injuries and illnesses at the workplace, and both their absence from work due to illness (absenteeism) or working ill (presenteeism) can compromise patient safety and the quality of health care delivered. Following this premise, we wanted to determine whether presenteeism and absenteeism were associated with patient safety culture (PSC) and in what way. Our sample consisted of 595 Croatian healthcare workers (150 physicians and 445 nurses) who answered the short-form WHO Health and Work Performance Questionnaire and the Hospital Survey on Patient Safety Culture. The results have confirmed the association with both presenteeism and absenteeism in several PSC dimensions, but not as we expected based on the premise from which we started. Opposite to our expectations, lower job performance (as a measure of presenteeism) was associated with higher PSC instead of lower PSC. Absenteeism, in turn, was associated with lower PSC, just as we expected. These findings suggest that it is the PSC that shapes presenteeist and absenteeist behaviour and not the other way around. High PSC leads to presenteeism, and low PSC to absenteeism. We also believe that the presenteeism questionnaires should be adjusted to health care and better define what lower performance means both quantitatively and qualitatively in a hospital setting.

Culture-sensitive neural substrates of human cognition: a transcultural neuroimaging approach.

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Han, Shihui; Northoff, Georg

2008-08-01

Our brains and minds are shaped by our experiences, which mainly occur in the context of the culture in which we develop and live. Although psychologists have provided abundant evidence for diversity of human cognition and behaviour across cultures, the question of whether the neural correlates of human cognition are also culture-dependent is often not considered by neuroscientists. However, recent transcultural neuroimaging studies have demonstrated that one's cultural background can influence the neural activity that underlies both high- and low-level cognitive functions. The findings provide a novel approach by which to distinguish culture-sensitive from culture-invariant neural mechanisms of human cognition.

Integrative Report on a culture-sensitive quality & curriculum framework

NARCIS (Netherlands)

Sylva, Kathy; Ereky-Stevens, Katharina; Pastori, Giulia; Slot, P.L.; Lerkkanen, Marja-Kristiina

This report draws together research findings that support a comprehensive culture-sensitive European curriculum and quality assessment framework that can inform practice, teacher education and policy. The aim of this integrative report is to inform the development of a comprehensive,

Teaching Strategies and Practices that Promote a Culturally Sensitive Nursing Education: A Delphi Study

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Dewald, Robin J.

2010-01-01

The purpose of this study was to explore teaching strategies that promote a culturally sensitive nursing education and culturally sensitive nursing. The diversity of Americans has increased. Thus, the nursing student population and patient population have both become more diverse. Nursing education programs, therefore, need to know the best…

Reliability of direct sensitivity determination of blood cultures

International Nuclear Information System (INIS)

Noman, F.; Ahmed, A.

2008-01-01

The aim of this study was to evaluate the error in interpreting antimicrobial sensitivity by direct method when compared to standard method and find out if specific antibiotic-organism combination had more discrepancies. All blood culture samples received at Microbiology Laboratory from 1st July 2006 to 31st August 2006 were ncluded in the study. All samples were inoculated in automated blood culture system BACTEC 9240 which contained enriched Soybean-Casein Digest broth with CO/sub 2/. Once positive, bottles were removed from system; gram staining of the positive broths was done. Susceptibility test was performed from positive broth, on MHA (Mueller-Hinton Agar), with antibiotics panel according to gram stain result. All positive broths were also sub-cultured on blood agar, chocolate agar and McConkey agar for only gram-negative rods. Next day, the zone sizes of all antibiotics were recorded using measuring scale and at the same time susceptibility test was repeated from isolated colonies from subcultures, with inoculums prepared of McFarland 0.5 standard 0.2 Staphylococcus aureus (ATCC 29213); E.coli (ATCC 25922) and Pseudomonas aeruginosa (ATCC 27853) were included as quality control strain. Zone sizes were interpreted as sensitive (S), resistant (R) and intermediate (I) according to CLSI recommendation. Two results were compared and recorded. Out of a total 1083 combinations, zone diameters by standard method were either equal or greater than direct zone diameter (never smaller). Most of the discrepancies were in b-lactam/b-lactamase combinations and aminoglycosides. While reporting these groups of antibiotics with direct sensitivity test, one should be cautious. These are the major antibiotic used for life-threatening infections. In case of being heavy/lighter standard inoculums or marginal zones, repeating with standard method should be preferred to minimize the chances of error. (author)

[Art, mental health, and public healthcare: profile of a care culture in the history of São Paulo city].

Science.gov (United States)

Galvanese, Ana Tereza Costa; D'Oliveira, Ana Flávia Pires Lucas; Lima, Elizabeth Maria Freire de Araújo; Pereira, Lygia Maria de França; Nascimento, Ana Paula; Nascimento, Andréia de Fátima

2016-01-01

By studying the inclusion of artistic and cultural activities in the care provided throughout the history of public mental healthcare in greater São Paulo, Brazil, we can better understand and characterize the practices adopted in the Psychosocial Care Centers in the city today. Experiments carried out between the 1920s and 1990s are investigated, based on bibliographic research. The contemporary data were obtained from research undertaken at 126 workshops at 21 Psychosocial Care Centers in the same city between April 2007 and April 2008. The findings indicate that the current trend in mental healthcare, whose clinical perspective spans the realms of art and mental health and has territorial ramifications, has maintained some of the features encountered in earlier mental healthcare experiments.

Changing Job Satisfaction, Absenteeism, and Healthcare Claims Costs In a Hospital Culture

Science.gov (United States)

Newsome, Misty; Pearsall, Cynthia; Ryan, Teresa; Starlin, Pamela

2014-01-01

Introduction: Fairfield Medical Center is a 222-bed community hospital located in Lancaster, Ohio. Organizational leadership chose to invest in the Transforming Stress Workshop, a 6-hour workshop with a 2-hour follow-up workshop, in order to improve the well-being of its staff and physicians. Special thought and consideration were given to being able to sustain any benefits and/or improvements long-term. As a result, strategies were developed to integrate the program into our culture. Methods: Four staff members from a variety of disciplines were selected and sent to HeartMath Train-the-Trainer to gain proficiency in HeartMath methodology and tools, expanding their duties to deliver the classes. Biweekly workshops were offered from August 2007 through December 2010, educating a total of 975 employees, or 48% of the staff. Other tactics providing a sustainable program included senior leadership support and championing, management team training, positive employee comments published internally, use of tools in committee and department meetings, incorporation into orientation and on-boarding processes, part of major initiative roll-outs, element in clinical ladder, expansion to include Transforming Team Workshops, sharing of Participant and Organizational Quality Assessment-Revised data, a lead HeartMath instructor who provides consulting to other organizations, provision of classes to local educators, and open workshops for employee family members. Results: Three metrics were selected to measure the success of the program: employee satisfaction, absenteeism rates, and healthcare claims cost. Statistically significant cultural and financial return on investment were demonstrated. Employees who received HeartMath training experienced a 2:1 savings on healthcare claims as compared to employees who had not received training. Employee Opinion Survey results demonstrated that employees who had HeartMath training had higher overall satisfaction scores than those who had not

Resources for Middle Eastern patients: online resources for culturally and linguistically appropriate services in home healthcare and hospice, part 3.

Science.gov (United States)

Young, Judith S

2013-01-01

As the population of patients for whom English is not their primary language grows, home care and hospice clinicians are challenged to provide culturally respectful and acceptable patient-centered care for cultures and languages unfamiliar to them. This article identifies resources for understanding the culture of Middle Eastern-born patients and appropriate patient education materials in most of the languages spoken by this population. The resources have been made available for free on the Web by healthcare professionals, government agencies, and support organizations from around the world.

Healthcare barriers and supports for American Indian women with cancer.

Science.gov (United States)

Liddell, Jessica L; Burnette, Catherine E; Roh, Soonhee; Lee, Yeon-Shim

2018-05-18

Although American Indian (AI) women continue to experience cancer at higher rates and have not seen the same decline in cancer prevalence as the general U.S. population, little research examines how interactions with health care providers may influence and exacerbate these health disparities. The purpose of the study was to understand the experiences of AI women who receive cancer treatment, which is integral for eradication of AI cancer disparities among women. A qualitative descriptive methodology was used with a sample of 43 AI women with breast, cervical, colon, and other types of cancer from the Northern Plains region of South Dakota. Interviews were conducted from June 2014 to February 2015. Qualitative content analysis revealed that women experienced: (a) health concerns being ignored or overlooked; (b) lack of consistent and qualified providers; (c) inadequate healthcare infrastructure; (d) sub-optimal patient-healthcare provider relationships; (e) positive experiences with healthcare providers; and (f) pressure and misinformation about treatment. Results indicate the types of support AI women may need when accessing healthcare. Culturally informed trainings for healthcare professionals may be needed to provide high-quality and sensitive care for AI women who have cancer, and to support those providers already providing proper care.

Convex Programming and Bootstrap Sensitivity for Optimized Electricity Bill in Healthcare Buildings under a Time-Of-Use Pricing Scheme

Directory of Open Access Journals (Sweden)

Rodolfo Gordillo-Orquera

2018-06-01

Full Text Available Efficient energy management is strongly dependent on determining the adequate power contracts among the ones offered by different electricity suppliers. This topic takes special relevance in healthcare buildings, where noticeable amounts of energy are required to generate an adequate health environment for patients and staff. In this paper, a convex optimization method is scrutinized to give a straightforward analysis of the optimal power levels to be contracted while minimizing the electricity bill cost in a time-of-use pricing scheme. In addition, a sensitivity analysis is carried out on the constraints in the optimization problems, which are analyzed in terms of both their empirical distribution and their bootstrap-estimated statistical distributions to create a simple-to-use tool for this purpose, the so-called mosaic-distribution. The evaluation of the proposed method was carried out with five-year consumption data on two different kinds of healthcare buildings, a large one given by Hospital Universitario de Fuenlabrada, and a primary care center, Centro de Especialidades el Arroyo, both located at Fuenlabrada (Madrid, Spain. The analysis of the resulting optimization shows that the annual savings achieved vary moderately, ranging from −0.22 % to +27.39%, depending on the analyzed year profile and the healthcare building type. The analysis introducing mosaic-distribution to represent the sensitivity score also provides operative information to evaluate the convenience of implementing energy saving measures. All this information is useful for managers to determine the appropriate power levels for next year contract renewal and to consider whether to implement demand response mechanisms in healthcare buildings.

Haloxyfop mode of action in liquid cultures of proso millet: An analysis of haloxyfop sensitivity changes during growth

International Nuclear Information System (INIS)

Irzyk, G.P.

1989-01-01

Haloxyfop is a grass-selective herbicide that inhibits acetyl-CoA carboxylase in species that are not tolerant to the herbicide. Liquid cultures of proso millet (Panicum miliaceum) cells treated with haloxyfop at different phases of growth exhibited different levels of sensitivity to the herbicide. Treatment of 1-d cultures with 1 μM haloxyfop completely inhibited growth within 48 h. In contrast, 1 mM haloxyfop was required to elicit a similar response in 4-, 7-, or 10-d cultures. Calculated IC 50 values indicated a 300-fold decrease in haloxyfop sensitivity during the period from 1 to 4 d. This period of growth coincided with the greatest increase in cell number during culture growth and suggested that dividing cells are most sensitive to haloxyfop. Uptake and metabolism of 14 C-haloxyfop in 1-d and 4-d cultures were compared. In both cultures, amounts of radiolabel uptake were similar. Almost all radioactivity extracted from 1- and 4-d cells was present as the parent compound. These results suggested that the sensitivity change was related to other factors. Acetyl-CoA carboxylase activity of proso millet cells, measured in vitro by the acetyl-CoA-dependent incorporation of 14 C-bicarbonate into an acid-stable product, was essentially constant during culture growth. Micromolar concentrations of haloxyfop significantly inhibited acetyl-CoA carboxylase activity from both sensitive and insensitive cultures. Thus, the change in the sensitivity of cultures to haloxyfop was not correlated with changes in acetyl-CoA carboxylase abundance, activity, or sensitivity to haloxyfop during culture growth. In vivo incorporation of 14 C-acetate into lipids was decreased by 1 μM haloxyfop in both 1-d and 4-d cultures at the earliest sampling times but the amount of inhibition was significantly greater in the sensitive cultures

Comparison of the sensitivity of typhi dot test with blood culture in typhoid

Energy Technology Data Exchange (ETDEWEB)

Rizvi, Q [Hamdard College of Medicine, Karachi (Pakistan). Dept. of Pharmacology

2006-10-15

To evaluate the sensitivity of Typhi Dot test in comparison to Blood Culture for the diagnosis of Typhoid Fever in our setup. Fifty patients who fulfilled the clinical criteria of having Typhoid Fever. The data of all the patients was documented, and they were submitted to the Typhi Dot and Blood Culture tests, apart from other routine investigations. Out of the total 50 patients, 47(94%) had their Blood Culture positive for Typhoid bacillus, while in 49 (98%) the Typhi Dot test was positive. Two patients which were found positive on Typhi dot test, gave negative results on Blood Culture. One patient with the signs and symptoms of Typhoid Fever was found neither positive on Typhi Dot test nor upon Blood Culture. There was no significant difference between the results of Blood Culture and Typhi Dot test in the diagnosis of Typhoid Fever. However, Typhi Dot has the advantages of being less expensive and quicker in giving results with excellent sensitivity. (author)

Comparison of the sensitivity of typhi dot test with blood culture in typhoid

International Nuclear Information System (INIS)

Rizvi, Q.

2006-01-01

To evaluate the sensitivity of Typhi Dot test in comparison to Blood Culture for the diagnosis of Typhoid Fever in our setup. Fifty patients who fulfilled the clinical criteria of having Typhoid Fever. The data of all the patients was documented, and they were submitted to the Typhi Dot and Blood Culture tests, apart from other routine investigations. Out of the total 50 patients, 47(94%) had their Blood Culture positive for Typhoid bacillus, while in 49 (98%) the Typhi Dot test was positive. Two patients which were found positive on Typhi dot test, gave negative results on Blood Culture. One patient with the signs and symptoms of Typhoid Fever was found neither positive on Typhi Dot test nor upon Blood Culture. There was no significant difference between the results of Blood Culture and Typhi Dot test in the diagnosis of Typhoid Fever. However, Typhi Dot has the advantages of being less expensive and quicker in giving results with excellent sensitivity. (author)

Pushing boundaries-culture-sensitive care in oncology and palliative care: a qualitative study.

Science.gov (United States)

Schrank, Beate; Rumpold, Tamara; Amering, Michaela; Masel, Eva Katharina; Watzke, Herbert; Schur, Sophie

2017-06-01

In increasingly globalized societies, patient-centered cancer care requires culture-sensitive approaches in order to ensure patients well-being. While migrant patients' needs are frequently reported in the literature, staff members' perception of work with migrant patients, associated challenges, or individual work approaches are largely unknown. This study addresses this research gap through qualitative exploration of experiences of multicultural health care professionals in supportive oncology and palliative care, working with patients from different cultural backgrounds. This study aims to understand staff experience of the impact of culture on cancer care. This study was conducted at the Medical University of Vienna, including staff from different settings of oncology and palliative care, in different professional positions, and with a range of individual migration backgrounds. Semistructured interviews were conducted with 21 staff members working with patients from different cultural backgrounds. Interviews explored views on the impact of culture on care were audio-taped, transcribed, and analyzed using a rigorous method of thematic analysis, enhanced with grounded theory techniques. Interviews revealed 4 key topics: culture-specific differences, assumed reasons for differences, consequences of multicultural care, and tools for culture-sensitive care. Strategies to better deal with migrant patients and their families were suggested to improve work satisfaction amongst staff. This study identifies relevant staff challenges in work with migrant patients. Concrete suggestions for improvement include measures on an organizational level, team level, and personal tools. The suggested measures are applicable to improve work satisfaction and culture-sensitive care not only in cancer care but also in other areas of medicine. Copyright © 2016 John Wiley & Sons, Ltd.

Comparative sensitivity of human and rat neural cultures to chemical-induced inhibition of neurite outgrowth

Energy Technology Data Exchange (ETDEWEB)

Harrill, Joshua A.; Freudenrich, Theresa M.; Robinette, Brian L.; Mundy, William R., E-mail: mundy.william@epa.gov

2011-11-15

There is a need for rapid, efficient and cost-effective alternatives to traditional in vivo developmental neurotoxicity testing. In vitro cell culture models can recapitulate many of the key cellular processes of nervous system development, including neurite outgrowth, and may be used as screening tools to identify potential developmental neurotoxicants. The present study compared primary rat cortical cultures and human embryonic stem cell-derived neural cultures in terms of: 1) reproducibility of high content image analysis based neurite outgrowth measurements, 2) dynamic range of neurite outgrowth measurements and 3) sensitivity to chemicals which have been shown to inhibit neurite outgrowth. There was a large increase in neurite outgrowth between 2 and 24 h in both rat and human cultures. Image analysis data collected across multiple cultures demonstrated that neurite outgrowth measurements in rat cortical cultures were more reproducible and had higher dynamic range as compared to human neural cultures. Human neural cultures were more sensitive than rat cortical cultures to chemicals previously shown to inhibit neurite outgrowth. Parallel analysis of morphological (neurite count, neurite length) and cytotoxicity (neurons per field) measurements were used to detect selective effects on neurite outgrowth. All chemicals which inhibited neurite outgrowth in rat cortical cultures did so at concentrations which did not concurrently affect the number of neurons per field, indicating selective effects on neurite outgrowth. In contrast, more than half the chemicals which inhibited neurite outgrowth in human neural cultures did so at concentrations which concurrently decreased the number of neurons per field, indicating that effects on neurite outgrowth were secondary to cytotoxicity. Overall, these data demonstrate that the culture models performed differently in terms of reproducibility, dynamic range and sensitivity to neurite outgrowth inhibitors. While human neural

Comparative sensitivity of human and rat neural cultures to chemical-induced inhibition of neurite outgrowth

International Nuclear Information System (INIS)

Harrill, Joshua A.; Freudenrich, Theresa M.; Robinette, Brian L.; Mundy, William R.

2011-01-01

There is a need for rapid, efficient and cost-effective alternatives to traditional in vivo developmental neurotoxicity testing. In vitro cell culture models can recapitulate many of the key cellular processes of nervous system development, including neurite outgrowth, and may be used as screening tools to identify potential developmental neurotoxicants. The present study compared primary rat cortical cultures and human embryonic stem cell-derived neural cultures in terms of: 1) reproducibility of high content image analysis based neurite outgrowth measurements, 2) dynamic range of neurite outgrowth measurements and 3) sensitivity to chemicals which have been shown to inhibit neurite outgrowth. There was a large increase in neurite outgrowth between 2 and 24 h in both rat and human cultures. Image analysis data collected across multiple cultures demonstrated that neurite outgrowth measurements in rat cortical cultures were more reproducible and had higher dynamic range as compared to human neural cultures. Human neural cultures were more sensitive than rat cortical cultures to chemicals previously shown to inhibit neurite outgrowth. Parallel analysis of morphological (neurite count, neurite length) and cytotoxicity (neurons per field) measurements were used to detect selective effects on neurite outgrowth. All chemicals which inhibited neurite outgrowth in rat cortical cultures did so at concentrations which did not concurrently affect the number of neurons per field, indicating selective effects on neurite outgrowth. In contrast, more than half the chemicals which inhibited neurite outgrowth in human neural cultures did so at concentrations which concurrently decreased the number of neurons per field, indicating that effects on neurite outgrowth were secondary to cytotoxicity. Overall, these data demonstrate that the culture models performed differently in terms of reproducibility, dynamic range and sensitivity to neurite outgrowth inhibitors. While human neural

Working with culture: culturally appropriate mental health care for Asian Americans.

Science.gov (United States)

Park, Mijung; Chesla, Catherine A; Rehm, Roberta S; Chun, Kevin M

2011-11-01

The aim of this study is to describe how mental healthcare providers adapted their practice to meet the unique needs of Asian Americans. As the number of ethnic minorities and multicultural patients and families rapidly increases, cultural competency becomes an essential skill for all healthcare providers. The lack of knowledge about how healthcare providers grapple with diverse cultures and cultural competency limits the ability of others to deliver patient-centred care across cultural lines. Interpretive phenomenology guided the design and conduct of this study. Twenty mental healthcare providers who treated Asian Americans were recruited. Narrative data were collected through face-to-face, in-depth interviews between 2006 and 2007. Three characteristics of culturally appropriate care for Asian Americans were identified. Cultural brokering: providers addressed issues stemming from cultural differences via bicultural skills education. Asian American patients generally received broader education than current literature recommended. Supporting families in transition: providers assisted Asian American families during transition from and to professional care. Using cultural knowledge to enhance competent care: providers' knowledge of Asian culture and flexible attitudes affected the care that they provided. Culturally competent providers were able to identify cultural issues that were relevant to the specific situation, and incorporated cultural solutions into the care provided. Culturally appropriate care is nuanced and context specific. Thus, more sophisticated and broader conceptualizations are necessary to prepare nurses for such complex practice. © 2011 Blackwell Publishing Ltd.

Cultural acceptance of robotic telestroke medicine among patients and healthcare providers in Saudi Arabia

Science.gov (United States)

Al-Khathaami, Ali M.; Alshahrani, Saeed M.; Kojan, Suleiman M.; Al-Jumah, Mohammed A.; Alamry, Ahmed A.; El-Metwally, Ashraf A.

2015-01-01

Objectives: To determine the degree of satisfaction and acceptance of stroke patients, their relatives, and healthcare providers toward using telestroke technology in Saudi Arabia. Methods: A cross-sectional study was conducted between October and December 2012 at King Abdulaziz Medical City, Ministry of National Guard Affairs, Riyadh, Saudi Arabia. The Remote Presence Robot (RPR), the RP-7i® (FDA- cleared) provided by InTouch Health was used in the study. Patients and their relatives were informed that the physician would appear through a screen on top of a robotic device, as part of their clinical care. Stroke patients admitted through the emergency department, and their relatives, as well as healthcare providers completed a self-administered satisfaction questionnaire following the telestroke consultation sessions. Results: Fifty participants completed the questionnaire. Most subjects agreed that the remote consultant interview was useful and that the audiovisual component of the intervention was of high quality; 98% agreed that they did not feel shy or embarrassed during the remote interview, were able to understand the instruction of the consultant, and recommended its use in stroke management. Furthermore, 92% agreed or strongly agreed that the use of this technology can efficiently replace the physical presence of a neurologist. Conclusion: Results suggest that the use of telestroke medicine is culturally acceptable among stroke patients and their families in Saudi Arabia and favorably received by healthcare providers. PMID:25630777

Cultural and spiritual considerations in palliative care.

Science.gov (United States)

Long, Carol O

2011-10-01

Culture is a fundamental part of one's being. Spirituality is integrated with culture and both play a significant role in a person's journey through life. Yet, culture and spirituality are often misunderstood and may not seem to be important in healthcare settings. For adults with cancer and their families, this cannot be ignored. This paper reviews The Purnell Model of Cultural Competence as a framework for considering culture and spirituality in healthcare and discusses the importance of acknowledging and incorporating practices that support culture and spirituality in healthcare settings. Examples of how to include cultural and spiritual care in palliative and end-of-life care in healthcare settings are provided.

Greek Immigrants in Australia: Implications for Culturally Sensitive Practice.

Science.gov (United States)

Georgiades, Savvas Daniel

2015-10-01

This exploratory research examined adjustment challenges, resiliencies, attitudes, emotional health, economic stability, criminal involvement, victimization and service experiences, and some cultural propensities of Greek Immigrants (GIs) in Australia using a convenient multi-generational sample (n = 123; response rate = .5). Data were collected via surveys, telephone, and personal-interviews in four major Australian cities. Among other things, the study revealed that Greek identity and cultural customs are often significant to first generation GIs. Adjustment challenges upon entry include primarily language, housing, and transportation difficulties, nostalgia for relatives and the motherland, unfamiliarity with socio-cultural systems, unemployment, money challenges, and lack of friendships. Christian faith, the extended family, family values and traditions, cultural pride for ancient Greek achievements, and a hard 'work ethic' are notable resiliencies that support GIs in their struggles and solidify their pursuit for happiness and success. Financial concerns, aging, and nostalgia for relatives and the motherland were the primary causes of socio-emotional instability. Attitudinal differences in the respondents based on age, gender, and socio-economic status, cross-cultural comparisons, and recommendations for culturally-sensitive practice with GIs are analyzed and methodological limitations illuminated. Future research needs in the field are also highlighted.

Cultural aspects of primary healthcare in india: A case- based analysis

Directory of Open Access Journals (Sweden)

Worthington Roger P

2011-06-01

Full Text Available Abstract Delivering quality primary care to large populations is always challenging, and that is certainly the case in India. While the sheer magnitude of patients can create difficulties, not all challenges are about logistics. Sometimes patient health-seeking behaviour leads to delays in obtaining medical help for reasons that have more to do with culture, social practice and religious belief. When primary care is accessed via busy state-run outpatient departments there is often little time for the physician to investigate causes behind a patient's condition, and these factors can adversely affect patient outcomes. We consider the case of a woman with somatic symptoms seemingly triggered by psychological stresses associated with social norms and familial cultural expectations. These expectations conflict with her personal and professional aspirations, and although she eventually receives psychiatric help and her problems are addressed, initially, psycho-social factors underlying her condition posed a hurdle in terms of accessing appropriate medical care. While for many people culture, belief and social norms exert a stabilising, positive influence, in situations where someone's personal expectations differ significantly from accepted social norms, individual autonomy can be directly challenged, and in which case, something has to give. The result of such challenges can negatively impact on health and well-being, and for patients with immature defence mechanisms for dealing with inner conflict, such an experience can be damaging and ensuing somatic disturbances are often difficult to treat. Patients with culture-bound symptoms are not uncommon within primary care in India or in other Asian countries and communities. We argue that such cases need to be properly understood if satisfactory patient outcomes are to be achieved. While some causes are structural, having to do with how healthcare is accessed and delivered, others are about cultural

Cultural aspects of primary healthcare in india: A case- based analysis.

Science.gov (United States)

Worthington, Roger P; Gogne, Anupriya

2011-06-16

Delivering quality primary care to large populations is always challenging, and that is certainly the case in India. While the sheer magnitude of patients can create difficulties, not all challenges are about logistics. Sometimes patient health-seeking behaviour leads to delays in obtaining medical help for reasons that have more to do with culture, social practice and religious belief. When primary care is accessed via busy state-run outpatient departments there is often little time for the physician to investigate causes behind a patient's condition, and these factors can adversely affect patient outcomes. We consider the case of a woman with somatic symptoms seemingly triggered by psychological stresses associated with social norms and familial cultural expectations. These expectations conflict with her personal and professional aspirations, and although she eventually receives psychiatric help and her problems are addressed, initially, psycho-social factors underlying her condition posed a hurdle in terms of accessing appropriate medical care. While for many people culture, belief and social norms exert a stabilising, positive influence, in situations where someone's personal expectations differ significantly from accepted social norms, individual autonomy can be directly challenged, and in which case, something has to give. The result of such challenges can negatively impact on health and well-being, and for patients with immature defence mechanisms for dealing with inner conflict, such an experience can be damaging and ensuing somatic disturbances are often difficult to treat. Patients with culture-bound symptoms are not uncommon within primary care in India or in other Asian countries and communities. We argue that such cases need to be properly understood if satisfactory patient outcomes are to be achieved. While some causes are structural, having to do with how healthcare is accessed and delivered, others are about cultural values, social practices and

Safety and Accountability in Healthcare From Past to Present

International Nuclear Information System (INIS)

Hendee, William R.

2008-01-01

Healthcare is transitioning into a new era-an era of accountability. This era demands heightened awareness of the quality, cost, and safety of healthcare, with value (quality/cost) and safety being the watchwords of accountability. Many factors are driving this transition, and it is affecting all healthcare disciplines, including radiation oncology. The transition is accompanied by the transformation of healthcare from a craft-based culture to an information-age culture in which patient needs and information are given top priority. These changes call for new measures to quantify and document the value and safety of procedures in radiation oncology

Online resources for culturally and linguistically appropriate services in home healthcare and hospice, part 2: resources for Asian patients.

Science.gov (United States)

Young, Judith S

2012-04-01

Home care and hospice clinicians are increasingly working with patients for whom English is not their primary language. Provision of culturally respectful and acceptable patient-centered care includes both an awareness of cultural beliefs that influence the patient's health and also the ability to provide the patient with health information in the language with which he or she is most comfortable. This article identifies resources for understanding the cultural norms of Asian-born patients and appropriate patient education materials in the many languages spoken by this population. The resources have been made available free on the Web by healthcare professionals and government agencies from around the world.

Sensitivity Analysis of an Agent-Based Model of Culture's Consequences for Trade

NARCIS (Netherlands)

Burgers, S.L.G.E.; Jonker, C.M.; Hofstede, G.J.; Verwaart, D.

2010-01-01

This paper describes the analysis of an agent-based model’s sensitivity to changes in parameters that describe the agents’ cultural background, relational parameters, and parameters of the decision functions. As agent-based models may be very sensitive to small changes in parameter values, it is of

Culture-bound syndrome and a culturally sensitive approach: from a viewpoint of medical anthropology.

Science.gov (United States)

Shimoji, A; Miyakawa, T

2000-08-01

Some aspects of the culture-bound syndrome are presented for discussion. From the psychiatric and medical anthropological viewpoints, kamidaari is described as an initiatory illness for seeing a shaman, and focus on clinical realities developing between different therapeutic subcultures in the same culture and the complementary practices of two epistemological ones, namely, the shamanistic and modern psychiatric system in the shamanistic climate. It is suggested that the culture-bound syndrome that reflects cultural influences on disease patterns and renders them difficult to place in a universal classificatory system should be seen as a vernacular bricolage or as tactics used by people within the web of their own local culture of origin. Therapists who treat patients in a cross-epistemological milieu should be aware of the subcultural-epistemological issues that may affect the clinical process. It should be recognized that, depending on the nature of a particular psychiatric crisis, the clinical encounter is straddling the boundaries of multiple clinical realities. At every stage in the clinical field, there is an intersection, consonance, or interruption of rejoinders in the open dialog by all those engaged in the clinical time. Aspects of climatic, culturally sensitive psychotherapy will be described, and the concept of the culture-bound syndrome will be reconsidered. Our approach could be seen as 'situation- and fudo-bound'.

Intercultural Sensitivity, Gender, and Nationality of Third Culture Kids Attending an International High School

Science.gov (United States)

Morales, Antonio

2017-01-01

Due to the globalization and interconnectedness of people from different cultures, intercultural competence is a prerequisite to communicating effectively across different cultures. The Intercultural Sensitivity Inventory (ICSI) measures a person's ability to modify behavior in culturally appropriate ways when coming into contact with diverse…

Cultural considerations for South Asian women with breast cancer.

Science.gov (United States)

Bedi, Manveen; Devins, Gerald M

2016-02-01

Cultural values shape a woman's experience of disease and introduce novel stressors that influence psychosocial needs and adaptation. This literature review examines the psychosocial impact of breast cancer in South Asian women, a large group that has received little attention in this regard. We conducted a comprehensive review of the literature published before April 2014 using Ovid MEDLINE, PsychINFO, PubMED, CINHAL, EMBASE, and Sociological Abstracts. We searched for articles about the psychosocial impact of breast cancer in South Asian women. We retained 23 studies for review. The literature concerning South Asian women's experiences identified culturally linked themes that play significant roles in shaping the illness experience; e.g., stigma and breast cancer, low priority of women's health, collective experience of disease, and religion and spirituality. There is a growing need for culturally sensitive care for South Asian women. By understanding the core cultural values and integrating them into clinical practice, Western healthcare providers may improve the quality of care they deliver and help women to extract the maximum benefit. Developing culturally competent support services may enhance effectiveness in addressing the healthcare needs of South Asian women and may serve other ethnic minorities in North America.

Critical Incident Stress Management (CISM) in complex systems: cultural adaptation and safety impacts in healthcare.

Science.gov (United States)

Müller-Leonhardt, Alice; Mitchell, Shannon G; Vogt, Joachim; Schürmann, Tim

2014-07-01

In complex systems, such as hospitals or air traffic control operations, critical incidents (CIs) are unavoidable. These incidents can not only become critical for victims but also for professionals working at the "sharp end" who may have to deal with critical incident stress (CIS) reactions that may be severe and impede emotional, physical, cognitive and social functioning. These CIS reactions may occur not only under exceptional conditions but also during every-day work and become an important safety issue. In contrast to air traffic management (ATM) operations in Europe, which have readily adopted critical incident stress management (CISM), most hospitals have not yet implemented comprehensive peer support programs. This survey was conducted in 2010 at the only European general hospital setting which implemented CISM program since 2004. The aim of the article is to describe possible contribution of CISM in hospital settings framed from the perspective of organizational safety and individual health for healthcare professionals. Findings affirm that daily work related incidents also can become critical for healthcare professionals. Program efficiency appears to be influenced by the professional culture, as well as organizational structure and policies. Overall, findings demonstrate that the adaptation of the CISM program in general hospitals takes time but, once established, it may serve as a mechanism for changing professional culture, thereby permitting the framing of even small incidents or near misses as an opportunity to provide valuable feedback to the system. Copyright © 2014 Elsevier Ltd. All rights reserved.

The intersection of disability and healthcare disparities: a conceptual framework.

Science.gov (United States)

Meade, Michelle A; Mahmoudi, Elham; Lee, Shoou-Yih

2015-01-01

This article provides a conceptual framework for understanding healthcare disparities experienced by individuals with disabilities. While health disparities are the result of factors deeply rooted in culture, life style, socioeconomic status, and accessibility of resources, healthcare disparities are a subset of health disparities that reflect differences in access to and quality of healthcare and can be viewed as the inability of the healthcare system to adequately address the needs of specific population groups. This article uses a narrative method to identify and critique the main conceptual frameworks that have been used in analyzing disparities in healthcare access and quality, and evaluating those frameworks in the context of healthcare for individuals with disabilities. Specific models that are examined include the Aday and Anderson Model, the Grossman Utility Model, the Institute of Medicine (IOM)'s models of Access to Healthcare Services and Healthcare Disparities, and the Cultural Competency model. While existing frameworks advance understandings of disparities in healthcare access and quality, they fall short when applied to individuals with disabilities. Specific deficits include a lack of attention to cultural and contextual factors (Aday and Andersen framework), unrealistic assumptions regarding equal access to resources (Grossman's utility model), lack of recognition or inclusion of concepts of structural accessibility (IOM model of Healthcare Disparities) and exclusive emphasis on supply side of the healthcare equation to improve healthcare disparities (Cultural Competency model). In response to identified gaps in the literature and short-comings of current conceptualizations, an integrated model of disability and healthcare disparities is put forth. We analyzed models of access to care and disparities in healthcare to be able to have an integrated and cohesive conceptual framework that could potentially address issues related to access to

Teaching International Business as an Opportunity to Develop Cultural Sensitivity

Science.gov (United States)

Frank, Ellen J.

2017-01-01

Business program graduates are expected to perform with cultural sensitivity in international and intercultural professional environments. In order to support student development of the necessary mindset, a variety of assignments and activities have been integrated into the undergraduate International Business (IB) course. This article describes…

[Culture and health services: studying the participation of cultural traits of Brazilian society in the work process of primary healthcare services].

Science.gov (United States)

Pinto, Alessandra Maria Silva; Najar, Alberto Lopes

2011-11-01

The analysis of institutions is a widely researched area of health. The culture of organizations is understood as a symbolic possibility contained in a larger dimension, called "national culture". This premise justifies the incorporation of the social anthropological approach to the study of organizational culture. This study sought to establish the perceptions of employees of two primary healthcare services in Niterói, State of Rio de Janeiro, regarding commonly used social navigation strategies from the theory developed by Roberto DaMatta. The results showed the relational character associated with the stereotype of the Brazilian people manifested by conflicts arising from the existence of values based on the `individual' and the `person'. Among them are the distortions observed between discourse and practice, and the mobilization strategies of social navigation like "making do" - to establish a mediation between the person and the impersonal law. The organization of the services of the Niterói Family Medical Program apparently sets its employees the concrete challenge of balancing the egalitarian principle that underpins the Unified Health System (SSU) with the set of values upon which personal relations are based in Brazilian society.

Culturally Sensitive Risk Behavior Prevention Programs for African American Adolescents: A Systematic Analysis

Science.gov (United States)

Metzger, Isha; Cooper, Shauna M.; Zarrett, Nicole; Flory, Kate

2013-01-01

The current review conducted a systematic assessment of culturally sensitive risk prevention programs for African American adolescents. Prevention programs meeting the inclusion and exclusion criteria were evaluated across several domains: (1) theoretical orientation and foundation; (2) methodological rigor; (3) level of cultural integration; (4)…

[On the Way to Culture-Sensitive Patient Information Materials: Results of a Focus Group Study].

Science.gov (United States)

Ries, Zivile; Frank, Fabian; Bermejo, Isaac; Kalaitsidou, Chariklia; Zill, Jördis; Dirmaier, Jörg; Härter, Martin; Bengel, Jürgen; Hölzel, Lars

2018-06-01

This study was part of a double-blind randomised controlled trial aimed to evaluate the effects of culture-sensitive patient information materials (PIM) compared with standard translated material. The study aimed to obtain the data for the development of culture sensitive PIM about unipolar depression for the 4 largest migrant groups in Germany (Turkish, Polish, Russian and Italian migration background). A qualitative study using 4 manual-based focus groups (FG), one for each migrant group, with 29 participants (9 with a Turkish (TüG), 8 with a Polish (PoG), 5 with a Russian (RuG) and 7 with an Italian (ItG) migration background) was conducted. The discussions were recorded, transcribed and analyzed using qualitative content analysis. 7 categories were identified. For the (1.) development of a good culture-sensitive PIM an easy language, a clear structure, an assessable extent of information and the avoidance of stereotypes were highlighted cross-culturally in all four FG. RuG and PoG had the largest (2.) lack of information about the German health care system. Concerning the (3.) illness perception RuG named problems with recognizing and understanding depression. PoG, RuG and TüG thematized (4.) feared consequences of the illness and of professional helpseeking. ItG, PoG, RuG had fears concerning (5.) psychotropic drugs as a result from insufficient knowledge about medication. For (6.) doctor-patient relationship cultural specifics were identified in RuG and TüG and for (7.) migration or culture specific reasons for depression in RuG, ItG and TüG. Although the identified categories were relevant for all or for the majority of migrant groups, for most categories specific cultural aspects were discovered. These findings show the importance of a culture sensitive adaptation of PIM. © Georg Thieme Verlag KG Stuttgart · New York.

Improving Medical Decision Making and Health Promotion through Culture-Sensitive Health Communication : an Agenda for Science and Practice

OpenAIRE

Betsch, Cornelia; Böhm, Robert; Airhihenbuwa, Collins O.; Butler, Robb; Chapman, Gretchen B.; Haase, Niels; Herrmann, Benedikt; Igarashi, Tasuku; Kitayama, Shinobu; Korn, Lars; Nurm, Ülla-Karin; Rohrmann, Bernd; Rothman, Alexander J.; Shavitt, Sharon; Updegraff, John A.

2016-01-01

This review introduces the concept of culture-sensitive health communication. The basic premise is that congruency between the recipient's cultural characteristics and the respective message will increase the communication's effectiveness. Culture-sensitive health communication is therefore defined as the deliberate and evidence-informed adaptation of health communication to the recipients' cultural background in order to increase knowledge and improve preparation for medical decision making ...

Does a Culturally Sensitive Smoking Prevention Program Reduce Smoking Intentions among Aboriginal Children? A Pilot Study

Science.gov (United States)

McKennitt, Daniel W.; Currie, Cheryl L.

2012-01-01

The aim of the study was to determine if a culturally sensitive smoking prevention program would have short-term impacts on smoking intentions among Aboriginal children. Two schools with high Aboriginal enrollment were selected for the study. A grade 4 classroom in one school was randomly assigned to receive the culturally sensitive smoking…

Perfect match? Generation Y as change agents for information communication technology implementation in healthcare.

Science.gov (United States)

Yee, Kwang Chien; Miils, Erin; Airey, Caroline

2008-01-01

The current healthcare delivery model will not meet future healthcare demands. The only sustainable healthcare future is one that best leverages advances in technology to improve productivity and efficiency. Information communication technology (ICT) has, therefore, been touted as the panacea of future healthcare challenges. Many ICT projects in healthcare, however, fail to deliver on their promises to transform the healthcare system. From a technologist's perspective, this is often due to the lack of socio-technical consideration. From a socio-cultural perspective, however, there is often strong inertia to change. While the utilisation of user-centred design principles will generate a new wave of enthusiasm among technologists, this has to be matched with socio-cultural changes within the healthcare system. Generation Y healthcare workers might be the socio-cultural factor required, in combination with new technology, to transform the healthcare system. Generation Y has generated significant technology-driven changes in many other industries. The socio-cultural understanding of generation Y healthcare workers is essential to guide the design and implementation of ICT solutions for a sustainable healthcare future. This paper presents the initial analysis of our qualitative study which aims to generate in-depth conceptual insights of generation Y healthcare workers and their view of ICT in healthcare. Our results show that generation Y healthcare workers might assist future ICT implementation in healthcare. This paper, however, argues that significant changes to the current healthcare organisation will be required in order to unleash the full potential of generation Y workers and ICT implementation. Finally, this paper presents some strategies to empower generation Y workers as change agents for a sustainable future healthcare system.

Digital health is a cultural transformation of traditional healthcare

OpenAIRE

Meskó, Bertalan; Drobni, Zsófia; Bényei, Éva; Gergely, Bence; Győrffy, Zsuzsanna

2017-01-01

Under the term “digital health”, advanced medical technologies, disruptive innovations and digital communication have gradually become inseparable from providing best practice healthcare. While the cost of treating chronic conditions is increasing and doctor shortages are imminent worldwide, the needed transformation in the structure of healthcare and medicine fails to catch up with the rapid progress of the medical technology industry. This transition is slowed down by strict regulations; th...

Is the Front Line Prepared for the Changing Faces of Patients? Predictors of Cross-Cultural Preparedness Among Clinical Nurses and Resident Physicians in Lausanne, Switzerland.

Science.gov (United States)

Casillas, Alejandra; Paroz, Sophie; Green, Alexander R; Wolff, Hans; Weber, Orest; Faucherre, Florence; Ninane, Françoise; Bodenmann, Patrick

2015-01-01

PHENOMENON: Assuring quality medical care for all persons requires that healthcare providers understand how sociocultural factors affect a patient's health beliefs/behaviors. Switzerland's changing demographics highlight the importance of provider cross-cultural preparedness for all patients-especially those at risk for social/health precarity. We evaluated healthcare provider cross-cultural preparedness for commonly encountered vulnerable patient profiles. A survey on cross-cultural care was mailed to Lausanne University hospital's "front-line healthcare providers": clinical nurses and resident physicians at our institution. Preparedness items asked "How prepared do you feel to care for … ?" (referring to example patient profiles) on an ascending 5-point Likert scale. We examined proportions of "4 - well/5 - very well prepared" and the mean composite score for preparedness. We used linear regression to examine the adjusted effect of demographics, work context, cultural-competence training, and cross-cultural care problem awareness, on preparedness. Of 885 questionnaires, 368 (41.2%) were returned: 124 (33.6%) physicians and 244 (66.4%) nurses. Mean preparedness composite was 3.30 (SD = 0.70), with the lowest proportion of healthcare providers feeling prepared for patients "whose religious beliefs affect treatment" (22%). After adjustment, working in a sensitized department (β = 0.21, p = .01), training on the history/culture of a specific group (β = 0.25, p = .03), and awareness regarding (a) a lack of practical experience caring for diverse populations (β = 0.25, p = .004) and (b) inadequate cross-cultural training (β = 0.18, p = .04) were associated with higher preparedness. Speaking French as a dominant language and physician role (vs. nurse) were negatively associated with preparedness (β = -0.26, p = .01; β = -0.22, p = .01). INSIGHTS: The state of cross-cultural care preparedness among Lausanne's front-line healthcare providers leaves room for

Educational Policy vs. Culturally Sensitive Programs in Turkish Educational System

Science.gov (United States)

Arslan, Hasan

2009-01-01

The purpose of this study is to examine the perceptions of elementary school teachers about the sensitiveness of principals, teachers, and curriculum on multicultural education. Education provides the transmission and the advancement of its culture while it is developing and enhancing the common values, the integrity and the progress of…

[Safety culture: definition, models and design].

Science.gov (United States)

Pfaff, Holger; Hammer, Antje; Ernstmann, Nicole; Kowalski, Christoph; Ommen, Oliver

2009-01-01

Safety culture is a multi-dimensional phenomenon. Safety culture of a healthcare organization is high if it has a common stock in knowledge, values and symbols in regard to patients' safety. The article intends to define safety culture in the first step and, in the second step, demonstrate the effects of safety culture. We present the model of safety behaviour and show how safety culture can affect behaviour and produce safe behaviour. In the third step we will look at the causes of safety culture and present the safety-culture-model. The main hypothesis of this model is that the safety culture of a healthcare organization strongly depends on its communication culture and its social capital. Finally, we will investigate how the safety culture of a healthcare organization can be improved. Based on the safety culture model six measures to improve safety culture will be presented.

Assessing the cultural in culturally sensitive printed patient-education materials for Chinese Americans with type 2 diabetes.

Science.gov (United States)

Ho, Evelyn Y; Tran, Henrietta; Chesla, Catherine A

2015-01-01

Type 2 diabetes affects Chinese Americans at an alarming rate. To address this health disparity, research in the area of cultural sensitivity and health literacy provides useful guidelines for creating culturally appropriate health education. In this article, we use discourse analysis to examine a group of locally available, Chinese- and English-language diabetes print documents from a surface level and deep structure level of culture. First, we compared these documents to research findings about printed health information to determine whether and how these documents apply current best practices for health literacy and culturally appropriate health communication. Second, we examined how diabetes as a disease and diabetes management is being constructed. The printed materials addressed surface level culture through the use of Chinese language, pictures, foods, and exercises. From a deeper cultural level, the materials constructed diabetes management as a matter of measurement and control that contrasted with previous research suggesting an alternative construction of balance. A nuanced assessment of both surface and deeper levels of culture is essential for creating health education materials that are more culturally appropriate and can lead to increased health literacy and improved health outcomes.

Healthcare Quality: A Concept Analysis.

Science.gov (United States)

Allen-Duck, Angela; Robinson, Jennifer C; Stewart, Mary W

2017-10-01

Worsening quality indicators of health care shake public trust. Although safety and quality of care in hospitals can be improved, healthcare quality remains conceptually and operationally vague. Therefore, the aim of this analysis is to clarify the concept of healthcare quality. Walker and Avant's method of concept analysis, the most commonly used in nursing literature, provided the framework. We searched general and medical dictionaries, public domain websites, and 5 academic literature databases. Search terms included health care and quality, as well as healthcare and quality. Peer-reviewed articles and government publications published in English from 2004 to 2016 were included. Exclusion criteria were related concepts, discussions about the need for quality care, gray literature, and conference proceedings. Similar attributes were grouped into themes during analysis. Forty-two relevant articles were analyzed after excluding duplicates and those that did not meet eligibility. Following thematic analysis, 4 defining attributes were identified: (1) effective, (2) safe, (3) culture of excellence, and (4) desired outcomes. Based on these attributes, the definition of healthcare quality is the assessment and provision of effective and safe care, reflected in a culture of excellence, resulting in the attainment of optimal or desired health. This analysis proposes a conceptualization of healthcare quality that defines its implied foundational components and has potential to improve the provision of quality care. Theoretical and practice implications presented promote a fuller, more consistent understanding of the components that are necessary to improve the provision of healthcare and steady public trust. © 2017 Wiley Periodicals, Inc.

Photodamage of the cells in culture sensitized with bilirubin

Science.gov (United States)

Kozlenkova, O. A.; Plavskaya, L. G.; Mikulich, A. V.; Leusenko, I. A.; Tretyakova, A. I.; Plavskii, V. Yu

2016-08-01

It has been shown that exposure to radiation of LED sources of light with an emission band maximum at about 465 and 520 nm having substantially identical damaging effects on animal cells in culture, that are in a logarithmic growth phase and preincubated with pigment. Photobiological effect is caused by photodynamic processes involving singlet oxygen generated by triplet excited sensitizer. Mono-exponential type dependence of cell survival on the energy dose indicates that it is bilirubin that acts as a sensitizer but not its photoproducts. The inclusion of bilirubin in the cells, where it is primarily localized in the mitochondria cells, it is accompanied by multiple amplification photochemical stability compared to pigment molecules bound with albumin

Design research and the globalization of healthcare environments.

Science.gov (United States)

Shepley, Mardelle McCuskey; Song, Yilin

2014-01-01

Global healthcare practice has expanded in the past 20 years. At the same time the incorporation of research into the design process has gained prominence as a best practice among architects. The authors of this study investigated the status of design research in a variety of international settings. We intended to answer the question, "how pervasive is healthcare design research outside of the United States?" The authors reviewed the international literature on the design of healthcare facilities. More than 500 international studies and conference proceedings were incorporated in this literature review. A team of five research assistants searched multiple databases comparing approximately 16 keywords to geographic location. Some of those keywords included: evidence-based design, salutogenic design, design research, and healthcare environment. Additional articles were gathered by contacting prominent researchers and asking for their personal assessment of local health design research studies. While there are design researchers in most parts of the world, the majority of studies focus on the needs of populations in developed countries and generate guidelines that have significant cost and cultural implications that prohibit their implementation in developing countries. Additionally, the body of literature discussing the role of culture in healthcare environments is extremely limited. Design researchers must address the cultural implications of their studies. Additionally, we need to expand our research objectives to address healthcare design in countries that have not been previous considered. © 2014 Vendome Group, LLC.

Importance and promotion of linguistic safety in the healthcare setting.

Science.gov (United States)

Diaz, Desiree A; Allchin, Lynn

2013-08-01

The United States has always been and will continue to be a nation of many cultures and languages. In the healthcare arena, this means safety will depend on clear, linguistically appropriate communication between the patient and family and the healthcare provider. Three obstacles exist to this type of essential communication: limited English proficiency, low health literacy, and cultural barriers.

A fast and highly sensitive blood culture PCR method for clinical detection of Salmonella enterica serovar Typhi

Directory of Open Access Journals (Sweden)

Zhou Liqing

2010-04-01

Full Text Available Abstract Background Salmonella Typhi causes an estimated 21 million new cases of typhoid fever and 216,000 deaths every year. Blood culture is currently the gold standard for diagnosis of typhoid fever, but it is time-consuming and takes several days for isolation and identification of causative organisms. It is then too late to initiate proper antibiotic therapy. Serological tests have very low sensitivity and specificity, and no practical value in endemic areas. As early diagnosis of the disease and prompt treatment are essential for optimal management, especially in children, a rapid sensitive detection method for typhoid fever is urgently needed. Although PCR is sensitive and rapid, initial research indicated similar sensitivity to blood culture and lower specificity. We developed a fast and highly sensitive blood culture PCR method for detection of Salmonella Typhi, allowing same-day initiation of treatment after accurate diagnosis of typhoid. Methods An ox bile tryptone soy broth was optimized for blood culture, which allows the complete lysis of blood cells to release intracellular bacteria without inhibiting the growth of Salmonella Typhi. Using the optimised broth Salmonella Typhi bacteria in artificial blood samples were enriched in blood culture and then detected by a PCR targeting the fliC-d gene of Salmonella Typhi. Results Tests demonstrated that 2.4% ox bile in blood culture not only lyzes blood cells completely within 1.5 hours so that the intracellular bacteria could be released, but also has no inhibiting effect on the growth of Salmonella Typhi. Three hour enrichment of Salmonella Typhi in tryptone soya broth containing 2.4% ox bile could increase the bacterial number from 0.75 CFU per millilitre of blood which is similar to clinical typhoid samples to the level which regular PCR can detect. The whole blood culture PCR assay takes less than 8 hours to complete rather than several days for conventional blood culture

Deaf women: experiences and perceptions of healthcare system access.

Science.gov (United States)

Steinberg, Annie G; Wiggins, Erin A; Barmada, Carlin Henry; Sullivan, Vicki Joy

2002-10-01

The authors investigated the knowledge, attitudes, and healthcare experiences of Deaf women. Interviews with 45 deaf women who participated in focus groups in American Sign Language were translated, transcribed, and analyzed. Deaf women's understanding of women's health issues, knowledge of health vocabulary in both English and American Sign Language, common health concerns among Deaf women, and issues of access to information, including pathways and barriers, were examined. As a qualitative study, the results of this investigation are limited and should be viewed as exploratory. A lack of health knowledge was evident, including little understanding of the meaning or value of cancer screening, mammography, or Pap smears; purposes of prescribed medications, such as hormone replacement therapy (HRT); or necessity for other medical or surgical interventions. Negative experiences and avoidance or nonuse of health services were reported, largely due to the lack of a common language with healthcare providers. Insensitive behaviors were also described. Positive experiences and increased access to health information were reported with practitioners who used qualified interpreters. Providers who demonstrated minimal signing skills, a willingness to use paper and pen, and sensitivity to improving communication were appreciated. Deaf women have unique cultural and linguistic issues that affect healthcare experiences. Improved access to health information may be achieved with specialized resource materials, improved prevention and targeted intervention strategies, and self-advocacy skills development. Healthcare providers must be trained to become more effective communicators with Deaf patients and to use qualified interpreters to assure access to healthcare for Deaf women.

The making of a European healthcare union

DEFF Research Database (Denmark)

Vollaard, Hans; van de Bovenkamp, Hester M.; Martinsen, Dorte Sindbjerg

2016-01-01

that federalism offers the most fruitful way to do so because of its sensitivity to the EU’s institutional settings and to the territorial dimension of politics. The division of competences and national diversity of healthcare systems have been major obstacles for the formation of a healthcare union. However......, the EU obtained a role in healthcare through the impact of non-healthcare legislation, voluntary co-operation, court rulings, governments’ joint-decision traps, and fiscal stress of member states. The emerging European healthcare union is a system of cooperative federalism without much cost-sharing...

Group cognitive-behavioral therapy for depression in Spanish: culture-sensitive manualized treatment in practice.

Science.gov (United States)

Aguilera, Adrian; Garza, Monica J; Muñoz, Ricardo F

2010-08-01

The authors applied cognitive-behavioral therapy (CBT) for depression using the Healthy Management of Reality treatment manual. This 16-week group treatment comprised four 4-week modules: thoughts (cognitive restructuring), activities (behavioral activation), people (interpersonal skills training), and health (addresses physical health and depression). They illustrated the use of the culture-sensitive treatment manuals by way of the member characteristics and clinical process of a Spanish-language CBT group for depression. They highlighted the challenges and satisfactions of working with a Spanish-speaking population in the public sector, and focused on how culture and socioeconomic status influence patients, and how to adapt treatment to these factors. Last, they demonstrated how technological advances integrate with culture-sensitive, evidence-based treatments to better serve this population and reduce disparities.

How Can Information and Communication Technology Improve Healthcare Inequalities and Healthcare Inequity? The Concept of Context Driven Care.

Science.gov (United States)

Yee, Kwang Chien; Bettiol, Silvana; Nash, Rosie; Macintyrne, Kate; Wong, Ming Chao; Nøhr, Christian

2018-01-01

Advances in medicine have improved health and healthcare for many around the world. The challenge is achieving the best outcomes of health via healthcare delivery to every individual. Healthcare inequalities exist within a country and between countries. Health information technology (HIT) has provided a mean to deliver equal access to healthcare services regardless of social context and physical location. In order to achieve better health outcomes for every individual, socio-cultural factors, such as literacy and social context need to consider. This paper argues that HIT while improves healthcare inequalities by providing access, might worsen healthcare inequity. In order to improve healthcare inequity using HIT, this paper argues that we need to consider patients and context, and hence the concept of context driven care. To improve healthcare inequity, we need to conceptually consider the patient's view and methodologically consider design methods that achieve participatory outcomes.

Cross-Cultural Understanding of Robotics

DEFF Research Database (Denmark)

Peronard, Jean-Paul

2013-01-01

This article aims to improve our understanding of how people in a healthcare context adopt robot technology and, in particular, the importance of culture in this process. The adoption of technology can be problematic when transferring technology from one culture to another. Differences in values...... and beliefs about robotics can affect the motivation for as well as the practice of using robotics in healthcare. Therefore, this paper seeks to develop a deeper theoretical understanding of the cultural impact on robotics adoption by using a cross-cultural perspective to explain variation in priorities...... and discuss possible guidelines to help build a strategy for introducing robotics into a culture’s healthcare sector and broaden the current agenda in international technology marketing....

[Managing the cold chain in healthcare facilities].

Science.gov (United States)

Royer, Mathilde; Breton Marchand, Justine; Pons, David

2017-11-01

The storage of temperature-sensitive healthcare products requires control of the cold chain. Healthcare facilities must have the appropriate equipment at their disposal and ensure the traceability and monitoring of temperatures. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Response to Marie Paz Morales' ``Influence of culture and language sensitive physics on science attitude achievement''

Science.gov (United States)

Cole, Mikel Walker

2015-12-01

This response to Marie Paz Morales' "Influence of culture and language sensitive physics on science attitude achievement" explores the ideas of culturally responsive pedagogy and critical literacy to examine some implications for culturally responsive science instruction implicit in the original manuscript.

Cross-cultural adaptation of an environmental health measurement instrument: Brazilian version of the health-care waste management • rapid assessment tool.

Science.gov (United States)

Cozendey-Silva, Eliana Napoleão; da Silva, Cintia Ribeiro; Larentis, Ariane Leites; Wasserman, Julio Cesar; Rozemberg, Brani; Teixeira, Liliane Reis

2016-09-05

Periodic assessment is one of the recommendations for improving health-care waste management worldwide. This study aimed at translating and adapting the Health-Care Waste Management - Rapid Assessment Tool (HCWM-RAT), proposed by the World Health Organization, to a Brazilian Portuguese version, and resolving its cultural and legal issues. The work focused on the evaluation of the concepts, items and semantic equivalence between the original tool and the Brazilian Portuguese version. A cross-cultural adaptation methodology was used, including: initial translation to Brazilian Portuguese; back translation to English; syntheses of these translation versions; formation of an expert committee to achieve consensus about the preliminary version; and evaluation of the target audience's comprehension. Both the translated and the original versions' concepts, items and semantic equivalence are presented. The constructs in the original instrument were considered relevant and applicable to the Brazilian context. The Brazilian version of the tool has the potential to generate indicators, develop official database, feedback and subsidize political decisions at many geographical and organizational levels strengthening the Monitoring and evaluation (M&E) mechanism. Moreover, the cross-cultural translation expands the usefulness of the instrument to Portuguese-speaking countries in developing regions. The translated and original versions presented concept, item and semantic equivalence and can be applied to Brazil.

Highly Sensitive Bacteriophage-Based Detection of Brucella abortus in Mixed Culture and Spiked Blood.

Science.gov (United States)

Sergueev, Kirill V; Filippov, Andrey A; Nikolich, Mikeljon P

2017-06-10

For decades, bacteriophages (phages) have been used for Brucella species identification in the diagnosis and epidemiology of brucellosis. Traditional Brucella phage typing is a multi-day procedure including the isolation of a pure culture, a step that can take up to three weeks. In this study, we focused on the use of brucellaphages for sensitive detection of the pathogen in clinical and other complex samples, and developed an indirect method of Brucella detection using real-time quantitative PCR monitoring of brucellaphage DNA amplification via replication on live Brucella cells. This assay allowed the detection of single bacteria (down to 1 colony-forming unit per milliliter) within 72 h without DNA extraction and purification steps. The technique was equally efficient with Brucella abortus pure culture and with mixed cultures of B . abortus and α-proteobacterial near neighbors that can be misidentified as Brucella spp., Ochrobactrum anthropi and Afipia felis . The addition of a simple short sample preparation step enabled the indirect phage-based detection of B . abortus in spiked blood, with the same high sensitivity. This indirect phage-based detection assay enables the rapid and sensitive detection of live B . abortus in mixed cultures and in blood samples, and can potentially be applied for detection in other clinical samples and other complex sample types.

Highly Sensitive Bacteriophage-Based Detection of Brucella abortus in Mixed Culture and Spiked Blood

Science.gov (United States)

Sergueev, Kirill V.; Filippov, Andrey A.; Nikolich, Mikeljon P.

2017-01-01

For decades, bacteriophages (phages) have been used for Brucella species identification in the diagnosis and epidemiology of brucellosis. Traditional Brucella phage typing is a multi-day procedure including the isolation of a pure culture, a step that can take up to three weeks. In this study, we focused on the use of brucellaphages for sensitive detection of the pathogen in clinical and other complex samples, and developed an indirect method of Brucella detection using real-time quantitative PCR monitoring of brucellaphage DNA amplification via replication on live Brucella cells. This assay allowed the detection of single bacteria (down to 1 colony-forming unit per milliliter) within 72 h without DNA extraction and purification steps. The technique was equally efficient with Brucella abortus pure culture and with mixed cultures of B. abortus and α-proteobacterial near neighbors that can be misidentified as Brucella spp., Ochrobactrum anthropi and Afipia felis. The addition of a simple short sample preparation step enabled the indirect phage-based detection of B. abortus in spiked blood, with the same high sensitivity. This indirect phage-based detection assay enables the rapid and sensitive detection of live B. abortus in mixed cultures and in blood samples, and can potentially be applied for detection in other clinical samples and other complex sample types. PMID:28604602

Practitioners' Perspectives on Cultural Sensitivity in Latina/o Teen Pregnancy Prevention

Science.gov (United States)

Wilkinson-Lee, Ada M.; Russell, Stephen T.; Lee, Faye C. H.

2006-01-01

This study examined practitioners' understandings of cultural sensitivity in the context of pregnancy prevention programs for Latina teens. Fifty-eight practitioners from teen pregnancy prevention programs in California were interviewed in a guided conversation format. Three themes emerged in our analysis. First, practitioners' definitions of…

Utility-preserving privacy protection of textual healthcare documents.

Science.gov (United States)

Sánchez, David; Batet, Montserrat; Viejo, Alexandre

2014-12-01

The adoption of ITs by medical organisations makes possible the compilation of large amounts of healthcare data, which are quite often needed to be released to third parties for research or business purposes. Many of this data are of sensitive nature, because they may include patient-related documents such as electronic healthcare records. In order to protect the privacy of individuals, several legislations on healthcare data management, which state the kind of information that should be protected, have been defined. Traditionally, to meet with current legislations, a manual redaction process is applied to patient-related documents in order to remove or black-out sensitive terms. This process is costly and time-consuming and has the undesired side effect of severely reducing the utility of the released content. Automatic methods available in the literature usually propose ad-hoc solutions that are limited to protect specific types of structured information (e.g. e-mail addresses, social security numbers, etc.); as a result, they are hardly applicable to the sensitive entities stated in current regulations that do not present those structural regularities (e.g. diseases, symptoms, treatments, etc.). To tackle these limitations, in this paper we propose an automatic sanitisation method for textual medical documents (e.g. electronic healthcare records) that is able to protect, regardless of their structure, sensitive entities (e.g. diseases) and also those semantically related terms (e.g. symptoms) that may disclose the former ones. Contrary to redaction schemes based on term removal, our approach improves the utility of the protected output by replacing sensitive terms with appropriate generalisations retrieved from several medical and general-purpose knowledge bases. Experiments conducted on highly sensitive documents and in coherency with current regulations on healthcare data privacy show promising results in terms of the practical privacy and utility of the

Group Cognitive-Behavioral Therapy for Depression in Spanish: Culture-Sensitive Manualized Treatment in Practice

Science.gov (United States)

Aguilera, Adrian; Garza, Monica J.; Muñoz, Ricardo F.

2014-01-01

The authors applied cognitive-behavioral therapy (CBT) for depression using the Healthy Management of Reality treatment manual. This 16-week group treatment comprised four 4-week modules: thoughts (cognitive restructuring), activities (behavioral activation), people (interpersonal skills training), and health (addresses physical health and depression). They illustrated the use of the culture-sensitive treatment manuals by way of the member characteristics and clinical process of a Spanish-language CBT group for depression. They highlighted the challenges and satisfactions of working with a Spanish-speaking population in the public sector, and focused on how culture and socioeconomic status influence patients, and how to adapt treatment to these factors. Last, they demonstrated how technological advances integrate with culture-sensitive, evidence-based treatments to better serve this population and reduce disparities. PMID:20549680

Developing a Culturally Sensitive Lifestyle Behavior Change Program for Older Latinas.

Science.gov (United States)

Schwingel, Andiara; Linares, Deborah E; Gálvez, Patricia; Adamson, Brynn; Aguayo, Liliana; Bobitt, Julie; Castañeda, Yvette; Sebastião, Emerson; Marquez, David X

2015-12-01

Despite the burgeoning U.S. Latino population and their increased risk of chronic disease, little emphasis had been placed on developing culturally sensitive lifestyle interventions in this area. This article examines older Latinas' sociocultural context relative to health with the goal of developing a culturally sensitive health behavior intervention. Photo-elicitation indicated two emerging themes that influenced lifestyle choices: family caregiving and religion. Researchers partnered with a faith-based organization to develop and implement a 6-month lifestyle intervention for Latinas ages 50 and older: Abuelas en Acción (AEA). At completion, interviews were conducted to understand women's experiences and the influence AEA had on their lifestyles and health. Findings suggest that religious content empowered and deeply affected women; however, the intergenerational content presented significant challenges for instruction, retention, and implementation. We discuss findings in relation to the health intervention literature and provide suggestions for future interventions drawing on religion, family, and health behavior change. © The Author(s) 2015.

Issues on Luck Egalitarianism, Responsibility, and Intercultural Healthcare Policies.

Science.gov (United States)

De Hoyos, Adalberto

2016-04-01

This article analyzes the criteria for the distribution of healthcare services through different justice theories such as utilitarianism and liberalism, pointing out the problems that arise when providing services to a culturally diverse population. The international epidemiological setting is a favorable one for discussing personal responsibility and luck egalitarianism; however, some provisions have to be made so that healthcare institutions do not treat ethnic, cultural, religious, and linguistic minorities unfairly. The article concludes by proposing that accommodations and culturally sensible attention should be provided when possible, without affecting the equal opportunity of others to access these services.

Gender identity, healthcare access, and risk reduction among Malaysia's mak nyah community.

Science.gov (United States)

Gibson, Britton A; Brown, Shan-Estelle; Rutledge, Ronnye; Wickersham, Jeffrey A; Kamarulzaman, Adeeba; Altice, Frederick L

2016-01-01

Transgender women (TGW) face compounded levels of stigma and discrimination, resulting in multiple health risks and poor health outcomes. TGW identities are erased by forcing them into binary sex categories in society or treating them as men who have sex with men (MSM). In Malaysia, where both civil and religious law criminalise them for their identities, many TGW turn to sex work with inconsistent prevention methods, which increases their health risks. This qualitative study aims to understand how the identities of TGW sex workers shapes their healthcare utilisation patterns and harm reduction behaviours. In-depth, semi-structured interviews were conducted with 21 male-to-female transgender (mak nyah) sex workers in Malaysia. Interviews were transcribed, translated into English, and analysed using thematic coding. Results suggest that TGW identity is shaped at an early age followed by incorporation into the mak nyah community where TGW were assisted in gender transition and introduced to sex work. While healthcare was accessible, it failed to address the multiple healthcare needs of TGW. Pressure for gender-affirming health procedures and fear of HIV and sexually transmitted infection screening led to potentially hazardous health behaviours. These findings have implications for developing holistic, culturally sensitive prevention and healthcare services for TGW.

Response to Marie Paz Morales' "Influence of Culture and Language Sensitive Physics on Science Attitude Achievement"

Science.gov (United States)

Cole, Mikel Walker

2015-01-01

This response to Marie Paz Morales' "Influence of culture and language sensitive physics on science attitude achievement" explores the ideas of culturally responsive pedagogy and critical literacy to examine some implications for culturally responsive science instruction implicit in the original manuscript. [For "Influence of…

Minority mothers' healthcare beliefs, commonly used alternative healthcare practices, and potential complications for infants and children.

Science.gov (United States)

Hannan, Jean

2015-06-01

Complementary and alternative healthcare practices have increased substantially in the United States especially with low-income ethnic minority mothers. These mothers often have provider mistrust, language barriers, differing health belief systems, and as a result are less likely to seek preventive health screening, access healthcare services, and use alternative remedies for their infants and children that are potentially harmful or lethal. Therefore, the purpose of this article is to examine healthcare beliefs, commonly used alternative healthcare practices, and their potential complications for infants and children. A search of CINAHL and PubMed (1980-2012) was conducted using the following terms: alternative healthcare practice, mothers' health beliefs, cultural health beliefs, folk remedies, and infant health practices. Given the changing U.S. population and an increasing immigrant population, examining alternative healthcare practices mothers use for their infants and children is especially important for providers in addressing healthcare for this group. The use of alternative healthcare practices is rarely discussed by parents with healthcare providers for fear of disapproval. When interviewing ethnic minority mothers and caregivers questions should include the use of alternative healthcare practices for infants and children and information regarding the potential dangers should be provided to them. ©2014 American Association of Nurse Practitioners.

Establishing values-based leadership and value systems in healthcare organizations.

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Graber, David R; Kilpatrick, Anne Osborne

2008-01-01

The importance of values in organizations is often discussed in management literature. Possessing strong or inspiring values is increasingly considered to be a key quality of successful leaders. Another common theme is that organizational values contribute to the culture and ultimate success of organizations. These conceptions or expectations are clearly applicable to healthcare organizations in the United States. However, healthcare organizations have unique structures and are subject to societal expectations that must be accommodated within an organizational values system. This article describes theoretical literature on organizational values. Cultural and religious influences on Americans and how they may influence expectations from healthcare providers are discussed. Organizational cultures and the training and socialization of the numerous professional groups in healthcare also add to the considerable heterogeneity of value systems within healthcare organizations. These contribute to another challenge confronting healthcare managers--competing or conflicting values within a unit or the entire organization. Organizations often fail to reward members who uphold or enact the organization's values, which can lead to lack of motivation and commitment to the organization. Four key elements of values-based leadership are presented for healthcare managers who seek to develop as values-based leaders. 1) Recognize your personal and professional values, 2) Determine what you expect from the larger organization and what you can implement within your sphere of influence, 3) Understand and incorporate the values of internal stakeholders, and 4) Commit to values-based leadership.

Improving Medical Decision Making and Health Promotion through Culture-Sensitive Health Communication: An Agenda for Science and Practice.

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Betsch, Cornelia; Böhm, Robert; Airhihenbuwa, Collins O; Butler, Robb; Chapman, Gretchen B; Haase, Niels; Herrmann, Benedikt; Igarashi, Tasuku; Kitayama, Shinobu; Korn, Lars; Nurm, Ülla-Karin; Rohrmann, Bernd; Rothman, Alexander J; Shavitt, Sharon; Updegraff, John A; Uskul, Ayse K

2016-10-01

This review introduces the concept of culture-sensitive health communication. The basic premise is that congruency between the recipient's cultural characteristics and the respective message will increase the communication's effectiveness. Culture-sensitive health communication is therefore defined as the deliberate and evidence-informed adaptation of health communication to the recipients' cultural background in order to increase knowledge and improve preparation for medical decision making and to enhance the persuasiveness of messages in health promotion. To achieve effective health communication in varying cultural contexts, an empirically and theoretically based understanding of culture will be indispensable. We therefore define culture, discuss which evolutionary and structural factors contribute to the development of cultural diversity, and examine how differences are conceptualized as scientific constructs in current models of cultural differences. In addition, we will explicate the implications of cultural differences for psychological theorizing, because common constructs of health behavior theories and decision making, such as attitudes or risk perception, are subject to cultural variation. In terms of communication, we will review both communication strategies and channels that are used to disseminate health messages, and we will discuss the implications of cultural differences for their effectiveness. Finally, we propose an agenda both for science and for practice to advance and apply the evidence base for culture-sensitive health communication. This calls for more interdisciplinary research between science and practice but also between scientific disciplines and between basic and applied research. © The Author(s) 2015.

Highly Sensitive Bacteriophage-Based Detection of Brucella abortus in Mixed Culture and Spiked Blood

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Kirill V. Sergueev

2017-06-01

Full Text Available For decades, bacteriophages (phages have been used for Brucella species identification in the diagnosis and epidemiology of brucellosis. Traditional Brucella phage typing is a multi-day procedure including the isolation of a pure culture, a step that can take up to three weeks. In this study, we focused on the use of brucellaphages for sensitive detection of the pathogen in clinical and other complex samples, and developed an indirect method of Brucella detection using real-time quantitative PCR monitoring of brucellaphage DNA amplification via replication on live Brucella cells. This assay allowed the detection of single bacteria (down to 1 colony-forming unit per milliliter within 72 h without DNA extraction and purification steps. The technique was equally efficient with Brucella abortus pure culture and with mixed cultures of B. abortus and α-proteobacterial near neighbors that can be misidentified as Brucella spp., Ochrobactrum anthropi and Afipia felis. The addition of a simple short sample preparation step enabled the indirect phage-based detection of B. abortus in spiked blood, with the same high sensitivity. This indirect phage-based detection assay enables the rapid and sensitive detection of live B. abortus in mixed cultures and in blood samples, and can potentially be applied for detection in other clinical samples and other complex sample types.

Whistle-blowing and workplace culture in older peoples' care: qualitative insights from the healthcare and social care workforce.

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Jones, Aled; Kelly, Daniel

2014-09-01

Inquiries in the UK into mistreatment of older people by healthcare employees over the last 30 years have focused on introducing or supporting employee whistle-blowing. Although whistle-blowers have made an important contribution to patient safety it remains a controversial activity. The fate of whistle-blowers is bleak, often resulting in personal and professional sacrifices. Here we draw on the views of healthcare and social care employees working with older people to explore perceptions of whistle-blowing as well as alternative strategies that may be used to raise concerns about the mistreatment of patients by co-workers. Whistle-blowing was perceived as a negative term. Managers said they promoted open cultures underpinned by regular team meetings and an open-door ethos. Others described workplace norms that were somewhat at odds with these open culture ideals. Whistle-blowing was considered risky, and this led to staff creating informal channels through which to raise concerns. Those who witnessed wrongdoing were aware that support was available from external agencies but preferred local solutions and drew upon personal ethics rather than regulatory edicts to shape their responses. We argue that the importance of workplace relationships and informal channels for raising concerns should be better understood to help prevent the mistreatment of vulnerable groups. © 2014 The Authors. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Cross-cultural adaptation of an environmental health measurement instrument: Brazilian version of the health-care waste management • rapid assessment tool

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Eliana Napoleão Cozendey-Silva

2016-09-01

Full Text Available Abstract Background Periodic assessment is one of the recommendations for improving health-care waste management worldwide. This study aimed at translating and adapting the Health-Care Waste Management - Rapid Assessment Tool (HCWM-RAT, proposed by the World Health Organization, to a Brazilian Portuguese version, and resolving its cultural and legal issues. The work focused on the evaluation of the concepts, items and semantic equivalence between the original tool and the Brazilian Portuguese version. Methods A cross-cultural adaptation methodology was used, including: initial translation to Brazilian Portuguese; back translation to English; syntheses of these translation versions; formation of an expert committee to achieve consensus about the preliminary version; and evaluation of the target audience’s comprehension. Results Both the translated and the original versions’ concepts, items and semantic equivalence are presented. The constructs in the original instrument were considered relevant and applicable to the Brazilian context. The Brazilian version of the tool has the potential to generate indicators, develop official database, feedback and subsidize political decisions at many geographical and organizational levels strengthening the Monitoring and evaluation (M&E mechanism. Moreover, the cross-cultural translation expands the usefulness of the instrument to Portuguese-speaking countries in developing regions. Conclusion The translated and original versions presented concept, item and semantic equivalence and can be applied to Brazil

Defining and assessing organizational culture.

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Bellot, Jennifer

2011-01-01

Using theories from several disciplines, the concept of organizational culture remains controversial. Conflicting definitions, lack of semantic clarity, and debate over the most appropriate methods for assessing organizational culture have led to disagreement over the value and validity of such inquiry. This paper reviews development of the concept of organizational culture and methods for assessing organizational culture, focusing on the healthcare environment. Most work on organizational culture concerns the traditional corporation. Therefore, some adaptation to the central goals and focus of a human services organization are necessary before application to healthcare settings. © 2011 Wiley Periodicals, Inc.

'Good culture, bad culture': polygyny, cultural change and structural drivers of HIV in Papua New Guinea.

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Shih, Patti; Worth, Heather; Travaglia, Joanne; Kelly-Hanku, Angela

2017-09-01

Culture is often problematised as a key structural driver of HIV transmission in Papua New Guinea. Official HIV programmes, as well as church teachings, tend to focus on customary marital practices of polygyny and bride price payments as 'harmful traditions'. This focus can oversimplify the effects of current and historical nuances of cultural, political and economic change on sexual concurrency and gender inequality. Community-based healthcare workers in Southern Highlands Province explain that customary marital practices are now highly reconfigured from their traditional forms. A recent mining boom has financially advantaged local and travelling men, who are driving an increase of sexual concurrency, transactional sex and inflation of bride price payments. Healthcare workers suggest that the erosion of important social relationships and kinship obligations by the expanding cash economy has caused an intensification of individual male power while enhancing the vulnerability of women. Yet without the means to challenge the effects of uneven economic development, healthcare workers are left to target 'culture' as the central influence on individual behaviours. A commitment to address structural inequality by political leadership and in HIV prevention programmes and a careful contextualisation of cultural change is needed.

Gender identity, healthcare access, and risk reduction among Malaysia’s mak nyah community

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Gibson, Britton A.; Brown, Shan-Estelle; Rutledge, Ronnye; Wickersham, Jeffrey A.; Kamarulzaman, Adeeba; Altice, Frederick L.

2016-01-01

Transgender women (TGW) face compounded levels of stigma and discrimination, resulting in multiple health risks and poor health outcomes. TGW identities are erased by forcing them into binary sex categories in society or treating them as men who have sex with men (MSM). In Malaysia, where both civil and religious law criminalize them for their identities, many TGW turn to sex work with inconsistent prevention methods, which increases their health risks. This qualitative study aims to understand how the identities of TGW sex workers shapes their healthcare utilization patterns and harm reduction behaviours. In-depth, semi-structured interviews were conducted with 21 male-to-female transgender (mak nyah) sex workers in Malaysia. Interviews were transcribed, translated into English, and analysed using thematic coding. Results suggest that TGW identity is shaped at an early age followed by incorporation into the mak nyah community where TGW were assisted in gender transition and introduced to sex work. While healthcare was accessible, it failed to address the multiple healthcare needs of TGW. Pressure for gender-affirming health procedures and fear of HIV and sexually transmitted infection screening led to potentially hazardous health behaviours. These findings have implications for developing holistic, culturally-sensitive prevention and healthcare services for TGW. PMID:26824463

Infrastructuring Multicultural Healthcare Information Systems.

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Dreessen, Katrien; Huybrechts, Liesbeth; Grönvall, Erik; Hendriks, Niels

2017-01-01

This paper stresses the need for more research in the field of Participatory Design (PD) and in particular into how to design Health Information Technology (HIT) together with care providers and -receivers in multicultural settings. We contribute to this research by describing a case study, the 'Health-Cultures' project, in which we designed HIT for the context of home care of older people with a migration background. The Health-Cultures project is located in the city of Genk, Belgium, which is known for its multicultural population, formed by three historical migration waves of people coming to work in the nowadays closed coal mines. Via a PD approach, we studied existing means of dialogue and designed HIT that both care receivers and care providers in Genk can use in their daily exchanges between cultures in home care contexts. In discussing relevant literature as well as the results of this study, we point to the need and the ways of taking spatio-historical aspects of a specific healthcare situation into account in the PD of HIT to support multicultural perspectives on healthcare.

Implementation of the national tuberculosis guidelines on culture and drug sensitivity testing in Guatemala, 2013.

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Samayoa-Peláez, Maritza; Ayala, Nancy; Yadon, Zaida E; Heldal, Einar

2016-01-01

Objective To assess whether the National Tuberculosis Program (NTP) guidelines for culture and drug sensitivity testing (DST) in Guatemala were successfully implemented, particularly in cases of smear-negative pulmonary tuberculosis (TB) or previously treated TB, by documenting notification rates by department (geographic area), disease type and category, and culture and DST results. Methods This was a cross-sectional, operational research study that merged and linked all patients registered by the NTP and the National Reference Laboratory in 2013, eliminating duplicates. The proportions with culture (for new smear negative pulmonary cases) and culture combined with DST (for previously treated patients) were estimated and analyzed by department. Data were analyzed using EpiData Analysis version 2.2. Results There were 3 074 patients registered with TB (all forms), for a case notification rate of 20/100 000 population. Of these, 2 842 had new TB, of which 2 167 (76%) were smear-positive pulmonary TB (PTB), 385 (14%) were smear-negative PTB, and 290 (10%) were extrapulmonary TB. There were 232 (8%) previously treated cases. Case notification rates (all forms) varied by department from 2-68 per 100 000 population, with the highest rates seen in the southwest and northeast part of Guatemala. Of new TB patients, 136 had a culture performed and 55 had DST of which the results were 33 fully sensitive, 9 monoresistant, 3 polyresistant, and 10 multidrug resistant TB (MDR-TB). Only 21 (5%) of new smear-negative PTB patients had cultures. Of 232 previously treated patients, 54 (23%) had a culture and 47 (20%) had DST, of which 29 were fully sensitive, 7 monoresistant, 2 polyresistant, and 9 MDR-TB. Of 22 departments (including the capital), culture and DST was performed in new smear-negative PTB in 7 departments (32%) and in previously treated TB in 13 departments (59%). Conclusions Despite national guidelines, only 5% of smear-negative PTB cases had a culture and only 20% of

Implementation of the national tuberculosis guidelines on culture and drug sensitivity testing in Guatemala, 2013

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Maritza Samayoa-Peláez

Full Text Available ABSTRACT Objective To assess whether the National Tuberculosis Program (NTP guidelines for culture and drug sensitivity testing (DST in Guatemala were successfully implemented, particularly in cases of smear-negative pulmonary tuberculosis (TB or previously treated TB, by documenting notification rates by department (geographic area, disease type and category, and culture and DST results. Methods This was a cross-sectional, operational research study that merged and linked all patients registered by the NTP and the National Reference Laboratory in 2013, eliminating duplicates. The proportions with culture (for new smear negative pulmonary cases and culture combined with DST (for previously treated patients were estimated and analyzed by department. Data were analyzed using EpiData Analysis version 2.2. Results There were 3 074 patients registered with TB (all forms, for a case notification rate of 20/100 000 population. Of these, 2 842 had new TB, of which 2 167 (76% were smear-positive pulmonary TB (PTB, 385 (14% were smear-negative PTB, and 290 (10% were extrapulmonary TB. There were 232 (8% previously treated cases. Case notification rates (all forms varied by department from 2–68 per 100 000 population, with the highest rates seen in the southwest and northeast part of Guatemala. Of new TB patients, 136 had a culture performed and 55 had DST of which the results were 33 fully sensitive, 9 monoresistant, 3 polyresistant, and 10 multidrug resistant TB (MDR-TB. Only 21 (5% of new smear-negative PTB patients had cultures. Of 232 previously treated patients, 54 (23% had a culture and 47 (20% had DST, of which 29 were fully sensitive, 7 monoresistant, 2 polyresistant, and 9 MDR-TB. Of 22 departments (including the capital, culture and DST was performed in new smear-negative PTB in 7 departments (32% and in previously treated TB in 13 departments (59%. Conclusions Despite national guidelines, only 5% of smear-negative PTB cases had a culture and

A four-country comparison of healthcare systems, implementation of diagnostic criteria, and treatment availability for functional gastrointestinal disorders: a report of the Rome Foundation Working Team on cross-cultural, multinational research.

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Schmulson, M; Corazziari, E; Ghoshal, U C; Myung, S-J; Gerson, C D; Quigley, E M M; Gwee, K-A; Sperber, A D

2014-10-01

Variations in healthcare provision around the world may impact how patients with functional gastrointestinal disorder (FGIDs) are investigated, diagnosed, and treated. However, these differences have not been reviewed. The Multinational Working Team of the Rome Foundation, established to make recommendations on the conduct of multinational, cross-cultural research in FGIDs, identified seven key issues that are analyzed herein: (i) coverage afforded by different healthcare systems/providers; (ii) level of the healthcare system where patients with FGIDs are treated; (iii) extent/types of diagnostic procedures typically undertaken to diagnose FGIDs; (iv) physicians' familiarity with and implementation of the Rome diagnostic criteria in clinical practice; (v) range of medications approved for FGIDs and approval process for new agents; (vi) costs involved in treating FGIDs; and (vii) prevalence and role of complementary/alternative medicine (CAM) for FGIDs. Because it was not feasible to survey all countries around the world, we compared a selected number of countries based on their geographical and ethno-cultural diversity. Thus, we included Italy and South Korea as representative of nations with broad-based coverage of healthcare in the population and India and Mexico as newly industrialized countries where there may be limited provision of healthcare for substantial segments of the population. In light of the paucity of formal publications on these issues, we included additional sources from the medical literature as well as perspectives provided by local experts and the media. Finally, we provide future directions on healthcare issues that should be taken into account and implemented when conducting cross-cultural and multinational research in FGIDs. © 2014 John Wiley & Sons Ltd.

Older LGBT people's experiences and concerns with healthcare professionals and services in Ireland.

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Sharek, Danika Burke; McCann, Edward; Sheerin, Fintan; Glacken, Michele; Higgins, Agnes

2015-09-01

The specific healthcare needs and concerns for older lesbian, gay, bisexual and transgender (LGBT) persons have not been explored to any degree within Ireland. The aim of this paper, which is part of a larger study, is to detail older LGBT persons' usage, experiences and concerns with accessing healthcare services, disclosing their LGBT identity to professionals, preferences for care and their suggestions for improvement in services, including nursing services. A mixed methods research design combining quantitative survey and qualitative interview approaches of equal significance was used. 144 respondents completed an 84-item questionnaire concerning their use of healthcare services, experiences and needs. The qualitative phase involved in-depth interviews where 36 participants' experiences and concerns around health services were explored more in-depth. Quantitative data were analysed using descriptive statistics. Qualitative analysis employed the constant comparative process to generate the leading themes. Only one in three participants believed that healthcare professionals have sufficient knowledge of LGBT issues, and less than half (43%) felt respected as an LGBT person by healthcare professionals. Although 26% had chosen not to reveal their LGBT status for fear of a negative response, many positive encounters of coming out to healthcare professionals were relayed in the interviews. LGBT persons have specific concerns around residential care, particularly in relation to the perception that the Irish healthcare services emanate a heteronormative culture. Irish healthcare services need to reflect on how they currently engage with older LGBT persons at both an organisational and practitioner level. Consideration needs to be given to the specific concerns of ageing LGBT persons, particularly in relation to long-term residential care. Healthcare practitioners need to be knowledgeable of, and sensitive to, LGBT issues. © 2014 John Wiley & Sons Ltd.

Kikiskawâwasow - prenatal healthcare provider perceptions of effective care for First Nations women: an ethnographic community-based participatory research study.

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Oster, Richard T; Bruno, Grant; Montour, Margaret; Roasting, Matilda; Lightning, Rick; Rain, Patricia; Graham, Bonny; Mayan, Maria J; Toth, Ellen L; Bell, Rhonda C

2016-08-11

Pregnant Indigenous women suffer a disproportionate burden of risk and adverse outcomes relative to non-Indigenous women. Although there has been a call for improved prenatal care, examples are scarce. Therefore, we explored the characteristics of effective care with First Nations women from the perspective of prenatal healthcare providers (HCPs). We conducted an ethnographic community-based participatory research study in collaboration with a large Cree First Nations community in Alberta, Canada. We carried out semi-structured interviews with 12 prenatal healthcare providers (HCPs) that were recorded, transcribed, and subjected to qualitative content analysis. According to the participants, relationships and trust, cultural understanding, and context-specific care were key features of effective prenatal care and challenge the typical healthcare model. HCPs that are able to foster sincere, non-judgmental, and enjoyable interactions with patients may be more effective in treating pregnant First Nations women, and better able to express empathy and understanding. Ongoing HCP cultural understanding specific to the community served is crucial to trusting relationships, and arises from real experiences and learning from patients over and above relying only on formal cultural sensitivity training. Consequently, HCPs report being better able to adapt a more flexible, all-inclusive, and accessible approach that meets specific needs of patients. Aligned with the recommendations of the Truth and Reconciliation Commission of Canada, improving prenatal care for First Nations women needs to allow for genuine relationship building with patients, with enhanced and authentic cultural understanding by HCPs, and care approaches tailored to women's needs, culture, and context.

A moral framework for multicultural education in healthcare.

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Vaught, Wayne

2003-01-01

The goal of this paper is two-fold. First, I begin by reviewing several of the major points of emphasis among health educators as they begin to incorporate multicultural issues into healthcare education. I then consider the role of moral relativism, which is currently being endorsed by some health educators, as the foundation for resolving cross-cultural conflicts in healthcare. I argue that moral relativism is ultimately inconsistent with the stated goals in multicultural curricular proposals and fails to provide an effective framework for considering moral conflicts in cross-cultural settings. Instead, I propose that those methods seeking to establish a common morality, built upon mutually shared values, offer the most promising means of resolving cross-cultural conflicts. This leads to my second goal, to compare recent work in moral pragmatism with what is now widely known in bioethics as moral "principlism." I argue that while proponents of principlism and pragmatism each seek to establish a common foundation for moral deliberation, they fail to appreciate significant similarities between their respective approaches. Instead of offering two completely unique and independent methods of moral deliberation, I suggest that principlism and pragmatism embrace common themes that point us in a positive direction, providing an effective framework useful for considering cross-cultural conflicts in healthcare.

Incorporating Cultural Sensitivity into Interactive Entertainment-Education for Diabetes Self-Management Designed for Hispanic Audiences.

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Kline, Kimberly N; Montealegre, Jane R; Rustveld, Luis O; Glover, Talar L; Chauca, Glori; Reed, Brian C; Jibaja-Weiss, Maria L

2016-06-01

Diabetes self-management education can improve outcomes in adults with Type 2 diabetes mellitus (T2DM). However, Hispanics, a group that carries a large burden of disease, may not participate in diabetes education programs. Audience engagement with entertainment-education has been associated with improved health education outcomes and may engage and empower Hispanic users to active self-care. Successful use of entertainment-education relies on the use of characters and situations with whom the viewers can feel some sense of involvement and for Hispanic audiences is encouraged when storylines and characters are culturally sensitive. In this study, we used a mixed methods approach that included descriptive statistics of closed-ended and content analysis of open-ended questions to measure the cultural sensitivity of the telenovela portion of a novel technology-based application called Sugar, Heart, and Life (SHL). Specifically, we analyzed the responses of 123 male and female patients diagnosed with uncontrolled T2DM to determine viewer involvement with characters and situations in the telenovela, viewer perceived self-efficacy in following recommendations, as well as viewer satisfaction with the program. Our findings indicate that the SHL application achieved its goal of creating a user-friendly program that depicted realistic, culturally sensitive characters and storylines that resonated with Hispanic audiences and ultimately fostered perceived self-efficacy related to following recommendations given about healthy lifestyle changes for diabetes self-management. These findings suggest that the SHL application is a culturally sensitive health education intervention for use by Hispanic male and female individuals that may empower them in self-management of T2DM.

Mediating Effect of School Nurses' Self Efficacy between Multicultural Attitude and Cultural Sensitivity in Korean Elementary Schools

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Min Hyun Suk, PhD, RN

2015-09-01

Conclusions: Given the meaningful influence of positive multicultural attitude on cultural sensitivity and significant mediator effect of self efficacy as a school nurse between the two variables, the strategies to cultivate a positive multicultural attitude and enhance school nurses' self efficacy in their unique role should be considered in a training program. School nurses' health care services will benefit from the improvement of cultural sensitivity toward young children from multicultural families.

Teaching at primary healthcare services within the Brazilian national health system (SUS in Brazilian healthcare professionals' training

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Ramona Fernanda Ceriotti Toassi

2013-06-01

Full Text Available The aim of this study was to analyze the role of teaching at primary healthcare services within the Brazilian National Health System (SUS in dentists' training, at a public university in the south of Brazil. A qualitative methodological approach (case study was used. Interviews were conducted with 12 dentistry students, six dentists who were preceptors working in public primary healthcare services and three teachers connected with this curricular training. Our findings showed that the curricular training in SUS primary healthcare services had an impact on the dentists' education through establishment of bonds, autonomy in problem-solving and multiprofessional teamwork. It was seen that they learned about how healthcare services function, about healthcare and about development of cultural competence. There is a need to maintain constant questioning regarding these practices, and to ensure the presence of infrastructure and qualified professionals for teaching at these services.

Bridging Culture On-Line: Strategies for Teaching Cultural Sensitivity.

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Wendler, M. Cecilia; Struthers, Roxanne

2002-01-01

An online cross-cultural health course for nurses sought to provide access to cultural experiences by culturally congruent use of a minority visiting scholar and required participation in cultural enrichment activities. Course and faculty evaluations were designed to be appropriate for the asynchronous environment. (Contains 25 references.) (SK)

How Business Cycles Affect the Healthcare Sector: A Cross-country Investigation.

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Cleeren, Kathleen; Lamey, Lien; Meyer, Jan-Hinrich; De Ruyter, Ko

2016-07-01

The long-term relationship between the general economy and healthcare expenditures has been extensively researched, to explain differences in healthcare spending between countries, but the midterm (i.e., business cycle) perspective has been overlooked. This study explores business cycle sensitivity in both public and private parts of the healthcare sector across 32 countries. Responses to the business cycle vary notably, both across spending sources and across countries. Whereas in some countries, consumers and/or governments cut back, in others, private and/or public healthcare buyers tend to spend more. We also assess long-term consequences of business cycle sensitivity and show that public cost cutting during economic downturns deflates the mortality rates, whereas private cut backs increase the long-term growth in total healthcare expenditures. Finally, multiple factors help explain variability in cyclical sensitivity. Private cost cuts during economic downturns are smaller in countries with a predominantly publicly funded healthcare system and more preventive public activities. Public cut backs during contractions are smaller in countries that rely more on tax-based resources rather than social health insurances. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Latex glove sensitivity amongst diagnostic imaging healthcare personnel: a self-reporting investigation

International Nuclear Information System (INIS)

Healy, Jan; Brennan, Patrick C.; Bowden, Julie Anne

2003-01-01

The use of latex gloves has risen dramatically among healthcare workers resulting in an increase in the number of workers experiencing reactions to gloves. Little evidence of reactions among Irish healthcare workers is available. The current, self-reporting study investigated the prevalence to latex gloves amongst four professional groups within three Diagnostic Imaging Departments. Prevalence is similar to that demonstrated elsewhere with 18.3% of individuals expressing latex associated symptoms. Symptoms included itching and redness of hands, dry cracked skin, soreness of eyes and upper respiratory tract complaints. These results indicate that latex hypersensitivity is a real problem amongst Irish healthcare workers. This preliminary work provides the basis of a much larger controlled study currently being planned

Cultural competency of health-care providers in a Swiss University Hospital: self-assessed cross-cultural skillfulness in a cross-sectional study.

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Casillas, Alejandra; Paroz, Sophie; Green, Alexander R; Wolff, Hans; Weber, Orest; Faucherre, Florence; Ninane, Françoise; Bodenmann, Patrick

2014-01-30

As the diversity of the European population evolves, measuring providers' skillfulness in cross-cultural care and understanding what contextual factors may influence this is increasingly necessary. Given limited information about differences in cultural competency by provider role, we compared cross-cultural skillfulness between physicians and nurses working at a Swiss university hospital. A survey on cross-cultural care was mailed in November 2010 to front-line providers in Lausanne, Switzerland. This questionnaire included some questions from the previously validated Cross-Cultural Care Survey. We compared physicians' and nurses' mean composite scores and proportion of "3-good/4-very good" responses, for nine perceived skillfulness items (4-point Likert-scale) using the validated tool. We used linear regression to examine how provider role (physician vs. nurse) was associated with composite skillfulness scores, adjusting for demographics (gender, non-French dominant language), workplace (time at institution, work-unit "sensitized" to cultural-care), reported cultural-competence training, and cross-cultural care problem-awareness. Of 885 questionnaires, 368 (41.2%) returned the survey: 124 (33.6%) physicians and 244 (66.4%) nurses, reflecting institutional distribution of providers. Physicians had better mean composite scores for perceived skillfulness than nurses (2.7 vs. 2.5, p cross-cultural training (β = 0.14, p = 0.01) and lack of practical experience caring for diverse populations (β = 0.11, p = 0.04). In stratified analyses among physicians alone, having French as a dominant language (β = -0.34, p cultural competency improvement among providers. These results support the need for cross-cultural skills training with an inter-professional focus on nurses, education that attunes provider awareness to the local issues in cross-cultural care, and increased diversity efforts in the work force, particularly among physicians.

Enhanced primary mental healthcare for Indigenous Australians: service implementation strategies and perspectives of providers.

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Reifels, Lennart; Nicholas, Angela; Fletcher, Justine; Bassilios, Bridget; King, Kylie; Ewen, Shaun; Pirkis, Jane

2018-01-01

Improving access to culturally appropriate mental healthcare has been recognised as a key strategy to address the often greater burden of mental health issues experienced by Indigenous populations. We present data from the evaluation of a national attempt at improving access to culturally appropriate mental healthcare for Indigenous Australians through a mainstream primary mental healthcare program, the Access to Allied Psychological Services program, whilst specifically focusing on the implementation strategies and perspectives of service providers. We conducted semi-structured interviews with 31 service providers (primary care agency staff, referrers, and mental health professionals) that were analysed thematically and descriptively. Agency-level implementation strategies to enhance service access and cultural appropriateness included: the conduct of local service needs assessments; Indigenous stakeholder consultation and partnership development; establishment of clinical governance frameworks; workforce recruitment, clinical/cultural training and supervision; stakeholder and referrer education; and service co-location at Indigenous health organisations. Dedicated provider-level strategies to ensure the cultural appropriateness of services were primarily aimed at the context and process of delivery (involving, flexible referral pathways, suitable locations, adaptation of client engagement and service feedback processes) and, to a lesser extent, the nature and content of interventions (provision of culturally adapted therapy). This study offers insights into key factors underpinning the successful national service implementation approach. Study findings highlight that concerted national attempts to enhance mainstream primary mental healthcare for Indigenous people are critically dependent on effective local agency- and provider-level strategies to optimise the integration, adaptation and broader utility of these services within local Indigenous community and

Cultural competence and social relationships: a social network analysis.

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Dauvrin, M; Lorant, V

2017-06-01

This study investigated the role of social relationships in the sharing of cultural competence by testing two hypotheses: cultural competence is a socially shared behaviour; and central healthcare professionals are more culturally competent than non-central healthcare professionals. Sustaining cultural competence in healthcare services relies on the assumption that being culturally competent is a socially shared behaviour among health professionals. This assumption has never been tested. Organizational aspects surrounding cultural competence are poorly considered. This therefore leads to a heterogeneous implementation of cultural competence - especially in continental Europe. We carried out a social network analysis in 24 Belgian inpatient and outpatient health services. All healthcare professionals (ego) were requested to fill in a questionnaire (Survey on social relationships of health care professionals) on their level of cultural competence and to identify their professional relationships (alter). We fitted regression models to assess whether (1) at the dyadic level, ego cultural competence was associated with alter cultural competence, and (2) health professionals of greater centrality had greater cultural competence. At the dyadic level, no significant associations were found between ego cultural competence and alter cultural competence, with the exception of subjective exposure to intercultural situations. No significant associations were found between centrality and cultural competence, except for subjective exposure to intercultural situations. Being culturally competent is not a shared behaviour among health professionals. The most central healthcare professionals are not more culturally competent than less central health professionals. Culturally competent health care is not yet a norm in health services. Health care and training authorities should either make cultural competent health care a licensing criteria or reward culturally competent health care

Building a Healthcare System's Innovation Program.

Science.gov (United States)

Conger, Michelle D

2016-01-01

OSF HealthCare, based in Peoria, Illinois, has developed an innovative strategy to adapt to the changes and forces disrupting the healthcare environment. This strategy evolved organically from the performance improvement efforts we began more than 15 years ago, as well as from the lessons we learned from years of research into the innovative practices and platforms of other healthcare institutions and of companies in other industries. More important, the strategy reflects our mission "to serve persons with the greatest care and love."The OSF innovation model has three components: internal innovations, partnering with external entities, and validating innovations through simulation. OSF has an ongoing and comprehensive commitment to innovation. Examples include our initiative to transform our model of care in primary care clinics by expanding access, reducing costs, and increasing efficiency; our partnerships with outside entities to find revolutionary solutions and products in which we can invest; and our establishment of a world-class simulation and education center.OSF HealthCare could not do any of this if it lacked the support of its people. To that end, we continue to work on embedding a culture of innovation across all of our facilities. Ours is a culture in which everyone is encouraged to voice creative ideas and no one is afraid to fail-all for the betterment of our organization and the patients we serve.

The Effects of the Japan Bridge Project on Third Graders' Cultural Sensitivity

Science.gov (United States)

Meyer, Lindsay; Sherman, Lilian; MaKinster, James

2006-01-01

This study examines the effects of the Japan BRIDGE Project, a global education program, on its third grade participants. Characterization of lessons and analysis of student interviews were used to investigate the nature of the curriculum and whether or not student participants were more culturally sensitive due to participation. Results indicate…

Cultural Competence among Maternal Healthcare Providers in Bahir Dar City Administration, Northwest Ethiopia: Cross sectional Study.

Science.gov (United States)

Aragaw, Amanu; Yigzaw, Tegbar; Tetemke, Desalegn; G/Amlak, Wubalem

2015-09-24

Cultural competency is now a core requirement for maternal health providers working in multicultural society. However, it has not yet received due attention in Ethiopia. This study aimed to determine the level of cultural competence and its associated factors among maternal health care providers in Bahir Dar City Administration, Northwest Ethiopia. Institution based cross-sectional study was carried out using both quantitative and qualitative methods. Maternal health care providers from all health facilities were our study participants. Structured Questionnaire with some modification of Campinha Bacote's tool was used to collect quantitative data from health workers and semi structured guide line was used for qualitative data among women. While quantitative data analysis was done using SPSS, qualitative data was analyzed using open code software. P-value of less than 0.05 was taken to determine statistical significance. Cronbach's alpha was used to test internal reliability and a factor loading of 0.3 or greater was the criterion used to retain items. Two hundred seventy four health workers and seven women were involved in the study. The overall competency level was 57.3 % thought vary in different subscales or stages. Of the cultural competent health workers near to three fourth (73.0 %) were in awareness stage which is the earliest stage of competence in which individuals were aware only their own culture but not the world view of their clients. The voices of mothers in the qualitative assessment also showed discordance in cultural competence with their healthcare providers. Female health workers almost six times [AOR,5.5; 2.71, 11.30] more competent than male providers and those who got in-service training related to maternal care provided services more culturally competent than their counter parts with [AOR,3.5; 1.4, 8.64]. Reliability Cronbach's α coefficient value of cultural competence subscales showed 0.672,0 .719, 0.658, 0.714, and 0.631 for cultural

Bioimpedance monitoring of 3D cell culturing-Complementary electrode configurations for enhanced spatial sensitivity

DEFF Research Database (Denmark)

Canali, Chiara; Heiskanen, Arto; Muhammad, Haseena Bashir

2015-01-01

A bioimpedance platform is presented as a promising tool for non-invasive real-time monitoring of the entire process of three-dimensional (3D) cell culturing in a hydrogel scaffold. In this study, the dynamics involved in the whole process of 3D cell culturing, starting from polymerisation...... spectroscopic (EIS) characterisation were used to determine the configurations' sensitivity field localisation. The 2T setup gives insight into the interfacial phenomena at both electrode surfaces and covers the central part of the 3D cell culture volume, while the four 3T modes provide focus on the dynamics...... the tested biomimetic environment, paving the way to further developments in bioimpedance tracking of 3D cell cultures and tissue engineering....

Research activity and capacity in primary healthcare: the REACH study: a survey.

LENUS (Irish Health Repository)

Glynn, Liam G

2009-01-01

BACKGROUND: Despite increased investment in primary care research and development (R&D), the level of engagement of primary healthcare professionals with research remains poor. The aim of this study is to assess the level of research activity and capacity for research among primary healthcare professionals in a health authority of over one million people in a mixed urban\\/rural setting in the West of Ireland. METHODS: A questionnaire, incorporating the R+D Culture Index, was sent to primary healthcare professionals in the HSE Western Region. Baseline characteristics were analysed with the use of one-way ANOVA and Chi-square test and the dependence of R&D Culture Index score on all sixteen available covariates was examined using multiple regression and regression tree modelling. RESULTS: There was a 54% response rate to the questionnaire. Primary healthcare professionals appeared to have an interest in and awareness of the importance of research in primary care but just 15% were found to be research active in this study. A more positive attitude towards an R&D culture was associated with having had previous research training, being currently involved in research and with not being a general practitioner (GP) (p < 0.001), but much variability in the R&D culture index score remained unexplained. CONCLUSION: Despite awareness of the importance of R&D in primary care and investment therein, primary healthcare professionals remain largely unengaged with the R&D process. This study highlights the issues that need to be addressed in order to encourage a shift towards a culture of R&D in primary care: lack of research training particularly in basic research skills and increased opportunities for research involvement. The use of the R&D Culture Index may enable groups to be identified that may be more research interested and can therefore be targeted in any future R&D strategy.

Measurement of organizational culture and climate in healthcare.

Science.gov (United States)

Gershon, Robyn R M; Stone, Patricia W; Bakken, Suzanne; Larson, Elaine

2004-01-01

Although there is increasing interest in the relationship between organizational constructs and health services outcomes, information on the reliability and validity of the instruments measuring these constructs is sparse. Twelve instruments were identified that may have applicability in measuring organizational constructs in the healthcare setting. The authors describe and characterize these instruments and discuss the implications for nurse administrators.

Sensitivity of PCR IS6110 in relation to culture and staining in Pott′s disease

Directory of Open Access Journals (Sweden)

Manoj Kumar

2013-01-01

Full Text Available Background: Rapid diagnosis is essential to decrease the morbidity and mortality of Pott′s disease. The bacteriological methods are time-consuming or insensitive. Polymerase chain reaction (PCR provides a rapid diagnostic tool and hope for early diagnosis of this disease. The aim of this study was to compare and assess of a rapid and effective method among diagnostic battery (Ziehl-Neelsen (ZN microscopy, BACTEC culture and PCR of Pott′s disease. Materials and Methods: Sixty-five specimens from clinico-radiological suspected cases of Pott′s disease were included in this study. They were processed for ZN microscopy, BACTEC culture, and PCR IS6110. The tests tool′s efficiency, positive agreement Kc (Kappa coefficient, and significance level (P value were calculated for correlation between PCR and performed tests. Results: The PCR sensitivity reached to 96% and 46.3% among positive and negative specimens on ZN microscopy. Further, 94% and 36.4% sensitivity were found among positive and negative specimens by BACTEC culture. The total 38 (58.5% specimens were detected either ZN microscopy or by BACTEC culture. Thus, the overall sensitivity and specificity of PCR were 95% and 74.1%. The kappa coefficient and P value, calculated for PCR against BACTEC culture and combined results of performed bacteriological tests were (Kc=0.60, (P<0.001 and (Kc=0.70, (P<0.001, respectively. Above statistical relations showed a fair agreement with significant differences. Conclusion: The PCR IS6110 may be useful in rapid detection of clinico-radiological suspected cases of Pott′s disease and those that are negative with bacteriological methods.

Interorganisational Integration: Healthcare Professionals’ Perspectives on Barriers and Facilitators within the Danish Healthcare System

Directory of Open Access Journals (Sweden)

Anne Marie Lyngsø

2016-03-01

Full Text Available Introduction: Despite many initiatives to improve coordination of patient pathways and intersectoral cooperation, Danish health care is still fragmented, lacking intra- and interorganisational integration. This study explores barriers to and facilitators of interorganisational integration as perceived by healthcare professionals caring for patients with chronic obstructive pulmonary disease within the Danish healthcare system. Methods: Seven focus groups were conducted in January through July 2014 with 21 informants from general practice, local healthcare centres and a pulmonary department at a university hospital in the Capital Region of Denmark. Results and discussion: Our results can be grouped into five influencing areas for interorganisational integration: communication/information transfer, committed leadership, patient engagement, the role and competencies of the general practitioner and organisational culture. Proposed solutions to barriers in each area hold the potential to improve care integration as experienced by individuals responsible for supporting and facilitating it. Barriers and facilitators to integrating care relate to clinical, professional, functional and normative integration. Especially, clinical, functional and normative integration seems fundamental to developing integrated care in practice from the perspective of healthcare professionals.

Culture and drug sensitivity testing among patients with pulmonary tuberculosis in Mexico: national data for 2009-2013.

Science.gov (United States)

Orejel, Ivonne; Castellanos, Martin; Marín, Diana; Mendoza, Alberto; Harries, Anthony D

2016-01-01

This study documented the number and results of mycobacterial culture and drug sensitivity testing (CDST) in Mexico from 2009-2013 and assessed whether states with a higher risk of multidrug-resistant tuberculosis (MDR-TB) performed more CDST and had more cultures showing MDR-TB. Data for this longitudinal, descriptive, operational research study came from the electronic records of 31 state public health laboratories in Mexico. The total number of CDSTs was 6 470, increasing from 2 143 in the first 2 years to 4 327 in the latter 3 years. There was a significant increase in the proportion of cultures showing sensitivity to all drugs, from 53.1% to 60.9% in 2011-2013 (P tuberculosis were Mexico, particularly in high-risk MDR-TB states where a higher proportion of cultures showed MDR-TB. Scale up and wider coverage of CDST should continue.

Crew resource management: applications in healthcare organizations.

Science.gov (United States)

Oriol, Mary David

2006-09-01

Healthcare organizations continue their struggle to establish a culture of open communication and collaboration. Lessons are learned from the aviation industry, which long ago acknowledged that most errors were the result of poor communication and coordination rather than individual mistakes. The author presents a review of how some healthcare organizations have successfully adopted aviation's curriculum called Crew Resource Management, which promotes and reinforces the conscious, learned team behaviors of cooperation, coordination, and sharing.

Healthcare liquid waste management.

Science.gov (United States)

Sharma, D R; Pradhan, B; Pathak, R P; Shrestha, S C

2010-04-01

The management of healthcare liquid waste is an overlooked problem in Nepal with stern repercussions in terms of damaging the environment and affecting the health of people. This study was carried out to explore the healthcare liquid waste management practices in Kathmandu based central hospitals of Nepal. A descriptive prospective study was conducted in 10 central hospitals of Kathmandu during the period of May to December 2008. Primary data were collected through interview, observation and microbiology laboratory works and secondary data were collected by records review. For microbiological laboratory works,waste water specimens cultured for the enumeration of total viable counts using standard protocols. Evidence of waste management guidelines and committees for the management of healthcare liquid wastes could not be found in any of the studied hospitals. Similarly, total viable counts heavily exceeded the standard heterotrophic plate count (p=0.000) with no significant difference in such counts in hospitals with and without treatment plants (p=0.232). Healthcare liquid waste management practice was not found to be satisfactory. Installation of effluent treatment plants and the development of standards for environmental indicators with effective monitoring, evaluation and strict control via relevant legal frameworks were realized.

Distrust and patients in intercultural healthcare: A qualitative interview study.

Science.gov (United States)

Alpers, Lise-Merete

2018-05-01

The importance of trust between patients and healthcare personnel is emphasised in nurses' and physicians' ethical codes. Trust is crucial for an effective healthcare personnel-patient relationship and thus for treatment and treatment outcomes. Cultural and linguistic differences may make building a trusting and positive relationship with ethnic minority patients particularly challenging. Although there is a great deal of research on cultural competence, there is a conspicuous lack of focus on the concepts of trust and distrust concerning ethnic minority patients, particularly in relation to the concept of 'othering'. To study which factors help build trust or create distrust in encounters between healthcare professionals and hospitalised ethnic minority patients, as well as study the dynamic complexities inherent within the process of 'othering'. Qualitative design, in-depth interviews and hermeneutic analysis. Participants and research context: The interviewees were 10 immigrant patients (six women and four men - eight Asians, two Africans - ages 32-85 years) recruited from a south-eastern Norwegian hospital. Ethical considerations: Study approval was obtained from the hospital's Privacy Ombudsman for Research and the hospital's leadership. Participation was voluntary and participants signed an informed consent form. Distrust and othering may be caused by differences in belief systems, values, perceptions, expectations, and style of expression and behaviour. Othering is a reciprocal phenomenon in minority ethnic patient-healthcare personnel encounters, and it influences trust building negatively. Besides demonstrating general professional skill and competence, healthcare personnel require cultural competence to create trust.

'The way things are around here': organisational culture is a concept missing from New Zealand healthcare policy, development, implementation, and research.

Science.gov (United States)

Scahill, Shane L

2012-01-20

Internationally, healthcare sectors are coming under increasing pressure to perform and to be accountable for the use of public funds. In order to deliver on stakeholder expectation, transformation will need to occur across all levels of the health system. Outside of health care it has been recognised for some time that organisational culture (OC) can have a significant influence on performance and that it is a mediator for change. The health sector has been slow to adopt organisational theory and specifically the benefits of understanding OC and impacts on performance. During a visit to health research units in the United Kingdom (UK) I realised the stark differences in the practice of health reform and its evaluation. OC is a firmly established concept within policy development, implementation and research in the UK. Unfortunately, the same cannot be said for New Zealand. There has been unrelenting reform and structural redesign, particularly of the primary healthcare sector under multiple governments over the past 20 to 30 years. However, there has been an underwhelming focus on the human aspects of organisational change. This seems set to continue and the aim of this viewpoint is to introduce the concept of OC and outline why New Zealand policy reformists and health services researchers should be thinking explicitly about OC. Culture is not solely the domain of the organisational scientist and current understandings of the influence of OC on performance are outlined in this commentary. Potential benefits of thinking about culture are argued and a proposed research agenda is presented.

Lean in healthcare from employees' perspectives.

Science.gov (United States)

Drotz, Erik; Poksinska, Bozena

2014-01-01

The purpose of this paper is to contribute toward a deeper understanding of the new roles, responsibilities, and job characteristics of employees in Lean healthcare organizations. The paper is based on three cases studies of healthcare organizations that are regarded as successful examples of Lean applications in the healthcare context. Data were collected by methods including interviews, observations, and document studies. The implementation of Lean in healthcare settings has had a great influence on the roles, responsibilities, and job characteristics of the employees. The focus has shifted from healthcare professionals, where clinical autonomy and professional skills have been the guarding principles of patient care, to process improvement and teamwork. Different job characteristics may make it difficult to implement certain Lean practices in healthcare. Teamwork and decentralization of authority are examples of Lean practices that could be considered countercultural because of the strong professional culture and uneven power distribution, with doctors as the dominant decision makers. Teamwork, value flow orientation, and company-wide involvement in CI were associated with positive effects on the organizations' working environment, staff development, and organizational performance. In order to succeed with Lean healthcare, it is important to understand and recognize the differences in job characteristics between Lean manufacturing and healthcare. This paper provides insights into how Lean implementation changes the roles, responsibilities, and job characteristics of healthcare staff and the challenges and implications that may follow from this.

Global software development: Commitment, trust, and cultural sensitivity in strategic partnerships

DEFF Research Database (Denmark)

Søderberg, Anne-marie; Krishna, S; Bjørn, Pernille

2013-01-01

as through conscious relationship management with the clients. Three major themes describe important aspects of the strategic partnerships: 1) senior management commitment and employee identification with the projects, 2) mutual trust and transparency, and 3) cross-cultural understanding and sensitivity....... The article draws attention to the important collaborative work done by people who are able to span boundaries in the complex organizational set-up of global IT development projects....

Rectal culture-directed antibiotic prophylaxis before transrectal prostate biopsy: Reduced infectious complications and healthcare costs.

Science.gov (United States)

Baldissera-Aradas, J V; Rodríguez-Villamil, L; Blanco-Fernández, R; Pérez-García, C; Viejo de la Guerra, G; González-Rodríguez, I; Mosquera-Madera, J

2018-01-10

Transrectal ultrasound-guided prostate biopsy (TUPB) is associated with infectious complications (ICs), which are related to a greater prevalence of ciprofloxacin-resistant bacteria (CRB) in rectal flora. We examined the ICs that occurred in 2 groups: A guided antibiotic prophylaxis (GP) group and an empiric prophylaxis (EP) group. We assessed the financial impact of GP. The GP group was studied prospectively (June 2013 to July 2014). We collected rectal cultures (RCs) before the TUPB, which were seeded on selective media with ciprofloxacin to determine the presence of CRB. The patients with sensitive bacteria were administered ciprofloxacin. Patients with resistant bacteria were administered GP according to the RC antibiogram. The EP group was studied retrospectively (January 2011 to June 2009). RCs were not performed, and all patients were treated with ciprofloxacin as prophylaxis. The ICs in both groups were recorded during a period no longer than 30 days following TUPB (electronic medical history). Three hundred patients underwent TUPB, 145 underwent GP, and 155 underwent EP. In the GP group, 23 patients (15.86%) presented CRB in the RCs. Only one patient (0.7%) experienced a UTI. In the EP group, 26 patients (16.8%) experienced multiple ICs (including 2 cases of sepsis) (P<.005). The estimated total cost, including the management of the ICs, was €57,076 with EP versus €4802.33 with GP. The average cost per patient with EP was €368.23 versus €33.11 with GP. GP achieved an estimated total savings of €52,273.67. Six patients had to undergo GP to prevent an IC. GP is associated with a marked decrease in the incidence of ICs caused by CRB and reduced healthcare costs. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Intercultural communication between patients and health care providers: an exploration of intercultural communication effectiveness, cultural sensitivity, stress, and anxiety.

Science.gov (United States)

Ulrey, K L; Amason, P

2001-01-01

Cultural diversity is becoming increasingly more important in the workplace. This is particularly true in health care organizations facing demographic shifts in the patients served and their families. This study serves to aid the development of intercultural communication training programs for health care providers by examining how cultural sensitivity and effective intercultural communication, besides helping patients, personally benefit health care providers by reducing their stress. Effective intercultural communication and cultural sensitivity were found to be related. Health care providers' levels of intercultural anxiety also were found to correlate with effective intercultural communication.

The Erasure of Sex and Gender Minorities in the Healthcare System

Directory of Open Access Journals (Sweden)

Marianne LeBreton

2013-09-01

Full Text Available Socio-cultural notions of gender and sex influence the structuring of healthcare systems. This case study exemplifies how the Western gender binary, and cisnormativity in particular, can create barriers to accessing healthcare services for transgender populations and lead to erasure.

You can't improve what you don't measure: Safety climate measures available in the German-speaking countries to support safety culture development in healthcare.

Science.gov (United States)

Manser, Tanja; Brösterhaus, Mareen; Hammer, Antje

2016-01-01

Safety climate measurement is a key input into safety culture development. The aim of this review is to provide an overview of the safety climate measures that have been evaluated for their psychometric properties in a German-speaking country and to make recommendations on how to use them in quality and patient safety improvement. A systematic search strategy was implemented to obtain relevant articles. PubMed and Web of Science databases were searched, and 128 abstracts were identified. After application of limits, 33 full texts were retrieved for subsequent evaluation. Studies were included on the basis of predetermined inclusion criteria and independent assessment by two reviewers. Publications were reviewed concerning healthcare setting, target group, safety culture dimensions covered and results of their psychometric evaluation. This review identified 11 instruments for safety climate assessment in different healthcare settings (i. e. hospitals, nursing homes, primary care, dental care and community pharmacy) for which acceptable to good internal consistency was reported. We observed wide variability concerning the number of dimensions (1 to 14; in some cases including outcome dimensions) and items (9 to 128) that the instruments were comprised of. Nevertheless, consistency with regard to the thematic areas covered was rather high. While there is clear evidence that we can assess safety climate in healthcare, the application of safety climate measures by quality and patient safety practitioners has so far been rather limited. This review bridges this gap between research and improvement practice by highlighting the central role of safety climate assessment in a mixed methods approach to inform safety culture development. Copyright © 2016. Published by Elsevier GmbH.

Quality dementia care - Prerequisites and relational ethics among multicultural healthcare providers

OpenAIRE

Sellevold, Gerd Sylvi

2017-01-01

Background: Many nursing homes are multicultural workplaces where the majority of healthcare providers have an ethnic minority background. This environment creates challenges linked to communication, interaction and cultural differences. Further, the healthcare providers have varied experiences and understanding of what quality care of patients with dementia involves. Purpose: The aim of this study is to illuminate multi-ethnic healthcare providers´ lived experiences of their own workin...

Cultural acceptance of robotic telestroke medicine among patients and healthcare providers in Saudi Arabia. Results of a pilot study.

Science.gov (United States)

Al-Khathaami, Ali M; Alshahrani, Saeed M; Kojan, Suleiman M; Al-Jumah, Mohammed A; Alamry, Ahmed A; El-Metwally, Ashraf A

2015-01-01

To determine the degree of satisfaction and acceptance of stroke patients, their relatives, and healthcare providers toward using telestroke technology in Saudi Arabia. A cross-sectional study was conducted between October and December 2012 at King Abdulaziz Medical City, Ministry of National Guard Affairs, Riyadh, Saudi Arabia. The Remote Presence Robot (RPR), the RP-7i (FDA- cleared) provided by InTouch Health was used in the study. Patients and their relatives were informed that the physician would appear through a screen on top of a robotic device, as part of their clinical care. Stroke patients admitted through the emergency department, and their relatives, as well as healthcare providers completed a self-administered satisfaction questionnaire following the telestroke consultation sessions. Fifty participants completed the questionnaire. Most subjects agreed that the remote consultant interview was useful and that the audiovisual component of the intervention was of high quality; 98% agreed that they did not feel shy or embarrassed during the remote interview, were able to understand the instruction of the consultant, and recommended its use in stroke management. Furthermore, 92% agreed or strongly agreed that the use of this technology can efficiently replace the physical presence of a neurologist. Results suggest that the use of telestroke medicine is culturally acceptable among stroke patients and their families in Saudi Arabia and favorably received by healthcare providers.

Language, culture and emotions: exploring ethnic minority patients' emotional expressions in primary healthcare consultations.

Science.gov (United States)

De Maesschalck, Stéphanie; Deveugele, Myriam; Willems, Sara

2011-09-01

This study explores ethnic minority patients' expression of emotional cues and concerns in primary healthcare, and examines relationships with patient, provider and consultation attributes. 191 video-recorded consultations were analyzed using the VR-CoDES. Patients were interviewed before the consultation. Generalized Estimating Equations models (GEE) were used to test for associations. Psychosocial versus bio-medically oriented encounters contained significantly more cues (p≤0.05). Patients with poor versus good language proficiency expressed significantly less cues (p≤0.001). No significant correlations were found with patients' cultural values, patients' or physicians' gender or the presence of an interpreter. Female patients express more concerns (p≤0.05), female physicians have a higher number of concerns expressed by patients (p≤0.02). This study shows that independent of physician and diagnosis, patients' language proficiency has a more important impact on the number of cues expressed by the patient than cultural difference. Medical schools and Continuing Medical Education should focus on training programs for recognizing and handling linguistic barriers between physicians and patients. Patient education programs should encourage patients who experience language barriers to open up to physicians. In situations where language is a barrier, physicians and patients should be encouraged to use interpreters to enhance the expression of emotions. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Social Responsibility and Healthcare in Finland.

Science.gov (United States)

Ahola-Launonen, Johanna

2016-07-01

This article examines current trends and prospects in Finnish healthcare literature and discussion. The Finnish healthcare system was long considered to manifest an equal, universal, and solidaristic welfare scheme. However, recent data reveals structural inequalities in access to healthcare that result in health differences among socioeconomic groups. The political will aims at tackling these inequalities, but the ideological trend toward responsibilization of the individual taking place across political spheres elsewhere in Europe creates potential challenges to this goal. The applications of this trend have a theoretical background in the responsibility-sensitive egalitarian-or luck egalitarian-tradition. The theory, which is unfit for real-life policy applications, has explicit appeal in considerations aiming at the responsibilization of the individual within the healthcare sector. It remains to be seen in which direction the Finnish welfare schemes will continue to develop.

A comparative study of contemporary user involvement within healthcare systems across England, Poland and Slovenia.

Science.gov (United States)

Lichon, Mateusz; Kavcic, Matic; Masterson, Daniel

2015-01-01

The purpose of this paper is to explore how healthcare-users' engagement is perceived, how it occurs and how these perceptions differ between three European countries: England, Poland and Slovenia, using the concepts of voice, choice and coproduction. This comparative, qualitative study is based on a review of legal documents, academic literature and semi-structured interviews conducted in October and November 2011. A research sample consisted of 21 interviewees representing various stakeholders including healthcare-users, doctors and managers. Primary and secondary data were analysed using theoretical thematic analysis. Emerging themes were identified from the interviews and related to the indicators describing healthcare-users' involvement in the voice, choice and coproduction model. Results of the comparative qualitative research suggest that the healthcare-users' influence is strongly grounded in England where the healthcare system and professionals are prepared to include healthcare-users in the decision-making process. In Slovenia, cultural development of healthcare-users' involvement seems to proceed the institutional development. In Poland, institutions are ready to involve healthcare-users in decision-making process although the cultural desirability of involving users among doctors and patients is lacking. The notion of user involvement is increasingly gaining importance and research attention, yet there is still little known about the way cultural, political, historical differences between various European countries influence it. This paper explores this little known area using the original approach of user involvement (Dent et al., 2011) with input from various stakeholders including patients, healthcare representatives and academics.

Enhancing the Australian healthcare sector's responsiveness to environmental sustainability issues: suggestions from Australian healthcare professionals.

Science.gov (United States)

Dunphy, Jillian L

2013-05-01

Identify strategies to implement change across the Australian healthcare sector to better support social and natural environments. Methods. Qualitative analysis of semi-structured interviews with Australian healthcare professionals. Interviewees described multiple barriers to implementing change and numerous strategies to overcome these barriers. They argued that action must be taken at the individual and systemic levels to produce substantial and effective change. The strategies recommended fall into four main categories: altering workplace cultures and professional identities, community engagement, political activity, and change from within. The overarching goals of these strategies are to reduce negative impacts on the natural environment, and increase social equity within and across generations. By implementing the strategies described, a more cohesive effort to address sustainability issues across the sector can be made. This may improve local and global health, within current and future generations. WHAT IS KNOWN ABOUT THE TOPIC? Healthcare has a significant impact on the natural and social environments, which in turn have a significant impact upon health and healthcare. WHAT DOES THIS PAPER ADD? This paper describes strategies to alter healthcare to better support environmental sustainability. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? Collective implementation of the described strategies may allow a more cohesive and effective response across the Australian healthcare sector, to enhance local and global health for current and future generations.

Cultural Humility and Hospital Safety Culture.

Science.gov (United States)

Hook, Joshua N; Boan, David; Davis, Don E; Aten, Jamie D; Ruiz, John M; Maryon, Thomas

2016-12-01

Hospital safety culture is an integral part of providing high quality care for patients, as well as promoting a safe and healthy environment for healthcare workers. In this article, we explore the extent to which cultural humility, which involves openness to cultural diverse individuals and groups, is related to hospital safety culture. A sample of 2011 hospital employees from four hospitals completed measures of organizational cultural humility and hospital safety culture. Higher perceptions of organizational cultural humility were associated with higher levels of general perceptions of hospital safety, as well as more positive ratings on non-punitive response to error (i.e., mistakes of staff are not held against them), handoffs and transitions, and organizational learning. The cultural humility of one's organization may be an important factor to help improve hospital safety culture. We conclude by discussing potential directions for future research.

Device Data Protection in Mobile Healthcare Applications

Science.gov (United States)

Weerasinghe, Dasun; Rajarajan, Muttukrishnan; Rakocevic, Veselin

The rapid growth in mobile technology makes the delivery of healthcare data and services on mobile phones a reality. However, the healthcare data is very sensitive and has to be protected against unauthorized access. While most of the development work on security of mobile healthcare today focuses on the data encryption and secure authentication in remote servers, protection of data on the mobile device itself has gained very little attention. This paper analyses the requirements and the architecture for a secure mobile capsule, specially designed to protect the data that is already on the device. The capsule is a downloadable software agent with additional functionalities to enable secure external communication with healthcare service providers, network operators and other relevant communication parties.

Leading ladies: women in healthcare leadership.

Science.gov (United States)

Fontenot, Teri

2012-01-01

Women represent an overwhelming majority of the healthcare workforce, yet they are significantly underrepresented in leadership positions, particularly at the executive and board levels. However, women are uniquely positioned to leverage traits such as compassion, transparency, and the ability to foster teamwork to lead organizations into the next phase of contemporary healthcare delivery. In the future, the pace with which women gain access to the C-suite will accelerate as organizations embrace diversity and select the best qualified leaders in terms of both experience and leadership style that supports organizational culture. While the future for women in healthcare leadership looks bright, many women are currently struggling to reach the executive office, facing glass ceilings, competing priorities, and lack of access to support and guidance. In this article I discuss the role of women in healthcare leadership and offer practical suggestions on how women can reach the top echelon and achieve their goals and aspirations.

The sensitivity and specificity of potassium hydroxide smear and fungal culture relative to clinical assessment in the evaluation of tinea pedis: a pooled analysis.

Science.gov (United States)

Levitt, Jacob Oren; Levitt, Barrie H; Akhavan, Arash; Yanofsky, Howard

2010-01-01

Background. There are relatively few studies published examining the sensitivity and specificity of potassium hydroxide (KOH) smear and fungal culture examination of tinea pedis. Objective. To evaluate the sensitivity and specificity of KOH smear and fungal culture for diagnosing tinea pedis. Methods. A pooled analysis of data from five similarly conducted bioequivalence trials for antifungal drugs was performed. Data from 460 patients enrolled in the vehicle arms of these studies with clinical diagnosis of tinea pedis supported by positive fungal culture were analyzed 6 weeks after initiation of the study to determine the sensitivity and specificity of KOH smear and fungal culture. Results. Using clinical assessment as the gold standard, the sensitivities for KOH smear and culture were 73.3% (95% CI: 66.3 to 79.5%) and 41.7% (34.6 to 49.1%), respectively. The respective specificities for culture and KOH smear were 77.7% (72.2 to 82.5%) and 42.5% (36.6 to 48.6%). Conclusion. KOH smear and fungal culture are complementary diagnostic tests for tinea pedis, with the former being the more sensitive test of the two, and the latter being more specific.

The Sensitivity and Specificity of Potassium Hydroxide Smear and Fungal Culture Relative to Clinical Assessment in the Evaluation of Tinea Pedis: A Pooled Analysis

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Jacob Oren Levitt

2010-01-01

Full Text Available Background. There are relatively few studies published examining the sensitivity and specificity of potassium hydroxide (KOH smear and fungal culture examination of tinea pedis. Objective. To evaluate the sensitivity and specificity of KOH smear and fungal culture for diagnosing tinea pedis. Methods. A pooled analysis of data from five similarly conducted bioequivalence trials for antifungal drugs was performed. Data from 460 patients enrolled in the vehicle arms of these studies with clinical diagnosis of tinea pedis supported by positive fungal culture were analyzed 6 weeks after initiation of the study to determine the sensitivity and specificity of KOH smear and fungal culture. Results. Using clinical assessment as the gold standard, the sensitivities for KOH smear and culture were 73.3% (95% CI: 66.3 to 79.5% and 41.7% (34.6 to 49.1%, respectively. The respective specificities for culture and KOH smear were 77.7% (72.2 to 82.5% and 42.5% (36.6 to 48.6%. Conclusion. KOH smear and fungal culture are complementary diagnostic tests for tinea pedis, with the former being the more sensitive test of the two, and the latter being more specific.

Clinical engagement: improving healthcare together.

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Riches, E; Robson, B

2014-02-01

Clinical engagement can achieve lasting change in the delivery of healthcare. In October 2011, Healthcare Improvement Scotland formulated a clinical engagement strategy to ensure that a progressive and sustainable approach to engaging healthcare professionals is firmly embedded in its health improvement and public assurance activities. The strategy was developed using a 90-day process, combining an evidence base of best practice and feedback from semi-structured interviews and focus groups. The strategy aims to create a culture where clinicians view working with Healthcare Improvement Scotland as a worthwhile venture, which offers a number of positive benefits such as training, career development and research opportunities. The strategy works towards developing a respectful partnership between Healthcare Improvement Scotland, the clinical community and key stakeholders whereby clinicians' contributions are recognised in a non-financial reward system. To do this, the organisation needs a sustainable infrastructure and an efficient, cost-effective approach to clinical engagement. There are a number of obstacles to achieving successful clinical engagement and these must be addressed as key drivers in its implementation. The implementation of the strategy is supported by an action and resource plan, and its impact will be monitored by a measurement plan to ensure the organisation reviews its approaches towards clinical engagement.

Culture shock and healthcare workers in remote Indigenous communities of Australia: what do we know and how can we measure it?

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Muecke, A; Lenthall, S; Lindeman, M

2011-01-01

Culture shock or cultural adaptation is a significant issue confronting non-Indigenous health professionals working in remote Indigenous communities in Australia. This article is presented in two parts. The first part provides a thorough background in the theory of culture shock and cultural adaptation, and a comprehensive analysis of the consequences, causes, and current issues around the phenomenon in the remote Australian healthcare context. Second, the article presents the results of a comprehensive literature review undertaken to determine if existing studies provide tools which may measure the cultural adaptation of remote health professionals. A comprehensive literature review was conducted utilising the meta-databases CINAHL and Ovid Medline. While there is a plethora of descriptive literature about culture shock and cultural adaptation, empirical evidence is lacking. In particular, no empirical evidence was found relating to the cultural adaptation of non-Indigenous health professionals working in Indigenous communities in Australia. In all, 15 international articles were found that provided empirical evidence to support the concept of culture shock. Of these, only 2 articles contained tools that met the pre-determined selection criteria to measure the stages of culture shock. The 2 instruments identified were the Culture Shock Profile (CSP) by Zapf and the Culture Shock Adaptation Inventory (CSAI) by Juffer. There is sufficient evidence to determine that culture shock is a significant issue for non-Indigenous health professionals working in Indigenous communities in Australia. However, further research in this area is needed. The available empirical evidence indicates that a measurement tool is possible but needs further development to be suitable for use in remote Indigenous communities in Australia.

Drug and radiation sensitivity measurements of successful primary monolayer culturing of human tumor cells using cell-adhesive matrix and supplemented medium

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Baker, F.L.; Spitzer, G.; Ajani, J.A.

1986-01-01

The limitations of the agar suspension culture method for primary culturing of human tumor cells prompted development of a monolayer system optimized for cell adhesion and growth. This method grew 83% of fresh human tumor cell biopsy specimens, cultured and not contaminated, from a heterogeneous group of 396 tumors including lung cancer (93 of 114, 82%); melanoma (54 of 72, 75%); sarcoma (46 of 59, 78%); breast cancer (35 of 39, 90%); ovarian cancer (16 of 21, 76%); and a miscellaneous group consisting of gastrointestinal, genitourinary, mesothelioma, and unknown primaries (78 of 91, 86%). Cell growth was characterized morphologically with Papanicolaoustained coverslip cultures and cytogenetically with Giemsastained metaphase spreads. Morphological features such as nuclear pleomorphism, chromatin condensation, basophilic cytoplasm, and melanin pigmentation were routinely seen. Aneuploid metaphases were seen in 90% of evaluable cultures, with 15 of 28 showing 70% or more aneuploid metaphases. Colony-forming efficiency ranged between 0.01 and 1% of viable tumor cells, with a median efficiency of 0.2%. This culture system uses a low inoculum of 25,000 viable cells per well which permitted chemosensitivity testing of nine drugs at four doses in duplicate from 2.2 X 10(6) viable tumor cells and radiation sensitivity testing at five doses in quadruplicate from 0.6 X 10(6) cells. Cultures were analyzed for survival by computerized image analysis of crystal violet-stained cells. Drug sensitivity studies showed variability in sensitivity and in survival curve shape with exponential cell killing for cisplatin, Adriamycin, and etoposide, and shouldered survival curves for 5-fluorouracil frequently seen. Radiation sensitivity studies also showed variability in both sensitivity and survival curve shape. Many cultures showed exponential cell killing, although others had shouldered survival curves

Healthcare-associated infections: challenges to public health in Brazil.

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Padoveze, Maria Clara; Fortaleza, Carlos Magno Castelo Branco

2014-12-01

This study presents a critical evaluation of the scientific literature related to this subject, aiming to assess the policies and administrative issues regarding the prevention and magnitude of healthcare-associated infections and discuss the challenges for their prevention in Brazil. The topics discussed included historical and administrative issues, challenges imposed by the characteristics of the healthcare system and the territorial dimension, laboratorial support limitations, costs, institutional culture, professional qualification, and patient engagement. It is urgent to hold a nationwide discussion among government representatives, institutions, and healthcare workers and users to overcome these challenges.

Decision making and coping in healthcare: the Coping in Deliberation (CODE) framework.

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Witt, Jana; Elwyn, Glyn; Wood, Fiona; Brain, Kate

2012-08-01

To develop a framework of decision making and coping in healthcare that describes the twin processes of appraisal and coping faced by patients making preference-sensitive healthcare decisions. We briefly review the literature for decision making theories and coping theories applicable to preference-sensitive decisions in healthcare settings. We describe first decision making, then coping and finally attempt to integrate these processes by building on current theory. Deliberation in healthcare may be described as a six step process, comprised of the presentation of a health threat, choice, options, preference construction, the decision itself and consolidation post-decision. Coping can be depicted in three stages, beginning with a threat, followed by primary and secondary appraisal and ultimately resulting in a coping effort. Drawing together concepts from prominent decision making theories and coping theories, we propose a multidimensional, interactive framework which integrates both processes and describes coping in deliberation. The proposed framework offers an insight into the complexity of decision making in preference-sensitive healthcare contexts from a patient perspective and may act as theoretical basis for decision support. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Cultural Competence and Related Factors Among Taiwanese Nurses.

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Lin, Chin-Nu; Mastel-Smith, Beth; Alfred, Danita; Lin, Yu-Hua

2015-12-01

Taiwan is a multicultural and multiethnic society with a growing number of immigrants who have diverse ethnic, racial, and cultural needs. Although this diversity highlights the pressing need for culturally competent healthcare providers, cultural competence is a concept that is little understood and implemented only sporadically in Taiwan. This study investigates the cultural competence of Taiwanese nurses and the related factors of influence. An online self-report survey was used to collect data from 221 Taiwanese nurses from December 2012 through January 2013. Data from the demographic questionnaire, the Nurses' Cultural Competence Scale, and the Perceived Nurses' Cultural Competence Rating were analyzed using descriptive statistics, Pearson correlation, independent sample t tests, and multiple regressions. The cultural competence of the participants was in the "low to moderate" range, with relatively higher mean scores for the subscales of cultural awareness and cultural sensitivity and relatively lower scores for the subscales of cultural knowledge and cultural skills. Participants generally perceived themselves as being "not culturally competent." Variables found to predict cultural competence included years of work experience, hours of continuing education related to cultural nursing care, and frequency of caring for clients from culturally and ethnically diverse backgrounds. Participating Taiwanese nurses rated their level of cultural competence as in the low-to-moderate range and self-perceived as being not culturally competent. These findings support the need to further expand and enhance cultural-competence-related continuing education and to address the topic of cultural care in the nursing curricula.

Temperament trait of sensory processing sensitivity moderates cultural differences in neural response.

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Aron, Arthur; Ketay, Sarah; Hedden, Trey; Aron, Elaine N; Rose Markus, Hazel; Gabrieli, John D E

2010-06-01

This study focused on a possible temperament-by-culture interaction. Specifically, it explored whether a basic temperament/personality trait (sensory processing sensitivity; SPS), perhaps having a genetic component, might moderate a previously established cultural difference in neural responses when making context-dependent vs context-independent judgments of simple visual stimuli. SPS has been hypothesized to underlie what has been called inhibitedness or reactivity in infants, introversion in adults, and reactivity or responsivness in diverse animal species. Some biologists view the trait as one of two innate strategies-observing carefully before acting vs being first to act. Thus the central characteristic of SPS is hypothesized to be a deep processing of information. Here, 10 European-Americans and 10 East Asians underwent functional magnetic resonance imaging while performing simple visuospatial tasks emphasizing judgments that were either context independent (typically easier for Americans) or context dependent (typically easier for Asians). As reported elsewhere, each group exhibited greater activation for the culturally non-preferred task in frontal and parietal regions associated with greater effort in attention and working memory. However, further analyses, reported here for the first time, provided preliminary support for moderation by SPS. Consistent with the careful-processing theory, high-SPS individuals showed little cultural difference; low-SPS, strong culture differences.

Blood culture gram stain, acridine orange stain and direct sensitivity-based antimicrobial therapy of bloodstream infection in patients with trauma.

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Behera, B; Mathur, P; Gupta, B

2010-01-01

The purpose of this study was to ascertain if the simple practice of Gram stain, acridine orange stain and direct sensitivity determination of positive blood culture bottles could be used to guide early and appropriate treatment in trauma patients with clinical suspicion of sepsis. The study also aimed to evaluate the error in interpreting antimicrobial sensitivity by direct method when compared to standard method and find out if specific antibiotic-organism combination had more discrepancies. Findings from consecutive episodes of blood stream infection at an Apex Trauma centre over a 12-month period are summarized. A total of 509 consecutive positive blood cultures were subjected to Gram staining. AO staining was done in BacT/ALERT-positive Gram-stain negative blood cultures. Direct sensitivity was performed from 369 blood culture broths, showing single type of growth in Gram and acridine orange staining. Results of direct sensitivity were compared to conventional sensitivity for errors. No 'very major' discrepancy was found in this study. About 5.2 and 1.8% minor error rates were noted in gram-positive and gram-negative bacteria, respectively, while comparing the two methods. Most of the discrepancies in gram-negative bacteria were noted in beta lactam - beta lactamase inhibitor combinations. Direct sensitivity testing was not reliable for reporting of methicillin and vancomycin resistance in Staphylococci. Gram stain result together with direct sensitivity testing is required for optimizing initial antimicrobial therapy in trauma patients with clinical suspicion of sepsis. Gram staining and AO staining proved particularly helpful in the early detection of candidaemia.

Constructivism in cultural competence education.

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Hunter, Jennifer L; Krantz, Steven

2010-04-01

A graduate course on cultural diversity, based in constructivist theory and structured on the Process of Cultural Competence in the Delivery of Healthcare Services model, was developed and taught through classroom and online methods. The following research questions were explored: 1) Can an educational experience, built on constructivist learning theory tenets, change students' perceptions, attitudes, knowledge, and skills in the area of cultural competence? 2) Does the delivery method, online or traditional classroom, influence the degree of change? The study used a quasi-experimental, pretest-posttest control group design using the Inventory for Assessing the Process of Cultural Competence Among healthcare Professionals Revised. Findings showed significant changes (p<0.001) in cultural competence scores and subscores for all learners with both teaching modalities based on interval scale and in categories of cultural knowledge, skills, desire, and overall competence based on a nominal scale. The untaught construct of cultural desire showed the most significant improvement.

Essential education in communication skills and cultural sensitivities for global public health in an evolving veterinary world.

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Kurtz, S M; Adams, C L

2009-08-01

In the practise of veterinary medicine and global public health, communication skill is as critical as clinical reasoning and an extensive knowledge base. Effective communication skills and cross-cultural sensitivity are essential across the board for interdisciplinary, international, and local veterinary medicine. This paper offers an evidence-based, three-part framework for developing and sustaining curricula that enhance communication skills and cross-cultural sensitivity so that students are better prepared to practise veterinary medicine in an evolving world. These curricula may well also serve as a conduit for encouraging more veterinary graduates to choose global public health as a career path.

Experience of using an interdisciplinary task force to develop a culturally sensitive multipronged tool to improve stroke outcomes in Nigeria

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Oyedunni S. Arulogun

2016-09-01

Full Text Available The burden of stroke is on the rise in Nigeria. A multi-faceted strategy is essential for reducing this growing burden and includes promoting medication adherence, optimizing traditional biomarker risk targets (blood pressure, cholesterol and encouraging beneficial lifestyle practices. Successful implementation of this strategy is challenged by inadequate patient health literacy, limited patient/medical system resources, and lack of a coordinated interdisciplinary treatment approach. Moreover, the few interventions developed to improve medical care in Nigeria have generally been aimed at physicians (primarily and nurses (secondarily with minimal input from other key health care providers, and limited contributions from patients, caregivers, and the community itself. The Tailored Hospital-based Risk Reduction to Impede Vascular Events after Stroke (THRIVES study is assessing the efficacy of a culturally sensitive multidimensional intervention for controlling blood pressure in recent stroke survivors. A key component of the intervention development process was the constitution of a project task force comprising various healthcare providers and administrators. This paper describes the unique experience in Sub-Saharan Africa of utilizing of an interdisciplinary Task force to facilitate the development of the multipronged behavioral intervention aimed at enhancing stroke outcomes in a low-middle income country.

The Cultural Turn In Sociology: Can it Help Us Resolve an Age-Old Problem in Understanding Decision Making for Healthcare?

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Pescosolido, Bernice A.; Olafsdottir, Sigrun

2015-01-01

Culture has long shaped individuals’ response to problems. A classic puzzle in the sociology of health and illness is discrepancy between theory and research regarding cultural beliefs and medical care service use. “Utilization research,” examining individuals’ responses to the onset of health problems, has not consistently affected culture on the uptake of formal treatment. While ethnographic research often describes how culture shapes illness behaviors, survey-based studies rarely find significant effects of predispositions once “need” is controlled. In quantitative studies, individuals report supportive treatment beliefs or predispositions to use services but low utilization levels, reinforcing claims about lack of utility of cultural ideologies in health-care decision making. We ask whether innovations in the sociology of culture and cognition provide the theoretical scaffolding to conceptualize and measure culture in health service utilization. Examining data from the General Social Survey, we focus on how approaches to culture might explain the paradox of high cultural predispositions and low actual use. Children with mental health problems provide a comparison between suggestions and endorsements. Suggestions, sources of care offered by individuals in response to a case description without any other social cues, align with new cultural approaches, and are measured by responses to open-ended questions about what should be done for the child described meeting clinical criteria f or ADHD, major depression, asthma, or “daily troubles”). Endorsements, requiring less cognitive work and cultural resistance, align with traditional conceptualizations of culture, and are measured by closed-ended questions that ask respondents to agree or disagree with seeking help from different treatment options placed later in the survey. We find that suggestions reveal cultural predispositions to use services corresponding closely to reported utilization levels

Setting the stage for a business case for leadership diversity in healthcare: history, research, and leverage.

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Dotson, Ebbin; Nuru-Jeter, Amani

2012-01-01

Leveraging diversity to successfully influence business operations is a business imperative for many healthcare organizations as they look to leadership to help manage a new era of culturally competent, patient-centered care that reduces health and healthcare disparities. This article presents the foundation for a business case in leadership diversity within healthcare organizations and describes the need for research on managerial solutions to health and healthcare disparities. It provides a discussion of clinical, policy, and management implications that will help support a business case for improving the diversity of leadership in healthcare organizations as a way to reduce health and healthcare disparities. Historical contexts introduce aspects of the business case for leveraging leadership diversity based on a desire for a culturally competent care organization. Little research exists on the impact that the role of leadership plays in addressing health disparities from a healthcare management perspective. This article provides practitioners and researchers with a rationale to invest in leadership diversity. It discusses three strategies that will help set the stage for a business case. First, provide empirical evidence of the link between diversity and performance. Second, link investments in diversity to financial outcomes and organizational metrics of success. Third, make organizational leadership responsible for cultural competence as a performance measure. In order to address health and healthcare disparities, collaborations between researchers and practitioners are necessary to effectively implement these strategies.

Impact of stigma, culture and law on healthcare providers after occupational exposure to HIV and hepatitis C.

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Zaidi, Moazzam Ali; Griffiths, Robin; Newson-Smith, Mark; Levack, William

2012-01-01

Worldwide, approximately three million needlestick or sharps injuries occur annually during healthcare procedures, with an estimated 18-35 healthcare professionals (HCPs) acquiring HIV each year as a result. This qualitative study examined the lived experience of occupational exposure to HIV or hepatitis C reported by four HCPs working in a tertiary care hospital in United Arab Emirates (UAE). Findings were based on interviews conducted as part of a larger two-year study investigating an intervention to improve the reporting and management of blood and body fluid exposures (BBFE) in the hospital. The data showed that due to cultural differences, individuals exposed to the same disease within the same legal system could have different concerns. Five themes arose from the data: (1) experiencing the unexpected, (2) inevitability and finality, (3) impact of stigma, (4) responsibility and risk and (5) legal and financial implications. The participants' most important concerns and causes of stress arising from occupational BBFE were related to the social implications (i.e., stigma; legal and financial costs) rather than the biological consequences of the disease. Social implications like these may negatively impact on reporting of occupational BBFE in UAE, but may need to be addressed at a societal rather than organisational level.

Lack of diversity in behavioral healthcare leadership reflected in services.

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Rosenberg, Linda

2008-04-01

America's rapidly changing demographics present an enormous challenge for today's healthcare leaders to redesign the organization and delivery of care to accommodate people who now represent every language, culture and religious belief in the world. So will mental health and addictions services in this country be ready to address the unique needs of these multicultural patients? A survey of the present landscape in 2008 tells us that we have a long, long way to go. Not only are mental health and addictions fields lacking in cultural competency, but there is little diversity in our leadership ranks. Top administrators and executives in behavioral health today are overwhelmingly non-Hispanic whites. This lack of cultural diversity among our leaders will lead to an ever-widening gap in the current chasm of racial and ethnic disparities in healthcare.

Language awareness in the bilingual healthcare setting: a national survey.

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Roberts, Gwerfyl Wyn; Irvine, Fiona Elizabeth; Jones, Peter Reece; Spencer, Llinos Haf; Baker, Colin Ronald; Williams, Cen

2007-09-01

The significance of effective interpersonal communication in healthcare is well established, as is the importance of overcoming language barriers. This has a particular bearing for minority language speakers, where denying language choice can compromise the quality of healthcare provision. Nevertheless, there is limited empirical research exploring language awareness in healthcare and the factors that influence language choice for minority language speakers. This paper reports on the nurses, midwives and health visitors (NMHV) data set of the first phase of a large-scale national study, commissioned by the Welsh Assembly Government, to examine the nature and extent of Welsh language awareness amongst healthcare professionals in Wales, UK. The study involved a questionnaire survey of healthcare professionals working in the public, private and voluntary sectors of healthcare. A stratified random sample of 3358 healthcare professionals was surveyed, of which 1842 (55%) were nurses, midwives and health visitors. The researcher-designed self-administered questionnaire was distributed by post to participants between July and September 2003. A total of 1042 (57%) NMHV returned their questionnaires for analysis. A strong positive correlation is identified between the NMHV use of the Welsh language in practice and their Welsh language proficiency (planguage attitudes (planguage region (planguage attitude scores are more positive than expected, particularly amongst those with limited Welsh language proficiency and those working in regions with the lowest proportions of Welsh speakers. In view of the universal drive for culturally and linguistically appropriate healthcare practice, the findings have important implications for bilingual and multilingual healthcare settings worldwide. The evidence emerging from this survey confirms that cross-cultural communication is enhanced by NMHV language attitudes as well as their proficiency levels. Language awareness training is

Factors affecting access to healthcare services by intermarried Filipino women in rural Tasmania: a qualitative study.

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Hannah, Chona T; Lê, Quynh

2012-10-01

Access to health care services is vital for every migrant's health and wellbeing. However, migrants' cultural health beliefs and views can hinder their ability to access available services. This study examined factors affecting access to healthcare services for intermarried Filipino women in rural Tasmania, Australia. A qualitative approach using semi-structured interviews was employed to investigate the factors affecting access to healthcare services for 30 intermarried Filipino women in rural Tasmania. The study used grounded theory and thematic analysis for its data analysis. Nvivo v8 (www.qsrinternational.com) was also used to assist the data coding process and analysis. Five influencing factors were identified: (1) language or communication barriers; (2) area of origin in the Philippines; (3) cultural barriers; (4) length of stay in Tasmania; and (5) expectations of healthcare services before and after migration. Factors affecting intermarried Filipino women in accessing healthcare services are shaped by their socio-demographic and cultural background. The insights gained from this study are useful to health policy-makers, healthcare professionals and to intermarried female migrants. The factors identified can serve as a guide to improve healthcare access for Filipino women and other migrants.

Listening to the Third Voices of Pangasinan Students: Designing and Enacting Culturally Sensitive Curriculum

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Wilder, Phillip

2015-01-01

This response builds upon Marie Paz Morales' "Influence of culture and language sensitive physics on science attitude achievement" by exploring how an expanded understanding of the ubiquitous nature of adolescent literacy practices and identities challenge traditional notions of "in school" and "out of school"…

DIAGNOSIS OF CULTURE POSITIVE URINARY TRACT INFECTIONS AND THEIR ANTIMICROBIAL SENSITIVITY PROFILE IN TERTIARY CARE CENTRE

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Prince Sreekumar Pius

2016-12-01

Full Text Available BACKGROUND Urinary tract infection is very common all over the world and in India more than 10 million cases are reported per year. It is one of the common infections diagnosed in the outpatients as well as the hospitalised patients. Empirical treatment of community acquired urinary tract infections are determined by the antibiotic sensitivity in a population. This study was conducted to determine the antimicrobial sensitivity amongst the uropathogens to help establish local guidelines on treatment of urinary tract infection. MATERIALS AND METHODS In this study, we collected 1306 samples from patients in whom we suspected to have urinary tract infection based on clinical signs and symptoms (e.g. with fever (greater than 38°C without another explanation or from a patient who had at least one urinary symptom (dysuria, urgency, frequency, or suprapubic pain or tenderness in our hospital during January 2016-June 2016. RESULTS Urine cultures were positive for 18% of the patients. Among these cultures, Klebsiella pneumonia (41%, Escherichia coli (35% and Pseudomonas aeruginosa (7% were the common organisms found. Highest antimicrobial sensitivity amongst these pathogens was found with cefoperazone/sulbactam and amikacin. CONCLUSION Cefoperazone/sulbactam and amikacin were the highly sensitive systemic antibiotics while ciprofloxacin and norfloxacin were the sensitive oral antibiotics in our locality.

Creativity as a Key Driver for Designing Context Sensitive Health Informatics.

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Zhou, Chunfang; Nøhr, Christian

2017-01-01

In order to face the increasing challenges of complexity and uncertainty in practice of health care, this paper aims to discuss how creativity can contribute to design new technologies in health informatics systems. It will firstly introduce the background highlighting creativity as a missing element in recent studies on context sensitive health informatics. Secondly, the concept of creativity and its relationship with activities of technology design will be discussed from a socio-culture perspective. This will be thirdly followed by understanding the roles of creativity in designing new health informatics technologies for meeting needs of high context sensitivity. Finally, a series of potential strategies will be suggested to improve creativity among technology designers working in healthcare industries. Briefly, this paper innovatively bridges two areas studies on creativity and context sensitive health informatics by issues of technology design that also indicates its important significances for future research.

Understanding Muslim patients: cross-cultural dental hygiene care.

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Sirois, M L; Darby, M; Tolle, S

2013-05-01

Healthcare providers who understand the basic pillars of Islamic beliefs and common religious practices can apply these concepts, anticipate the needs of the Muslim patient and family, and attract Muslim patients to the practice. Cross cultural knowledge can motivate dental hygienists to adopt culturally acceptable behaviors, strengthen patient-provider relationships and optimize therapeutic outcomes. Trends in Muslim population growth, Islamic history and beliefs, modesty practices, healthcare beliefs, contraception, childbearing, childrearing, pilgrimage, dietary practices, dental care considerations and communication are explained. This paper reviews traditional Muslim beliefs and practices regarding lifestyle, customs, healthcare and religion as derived from the literature and study abroad experiences. Recommendations are offered on how to blend western healthcare with Islamic practices when making introductions, appointments, eye contact, and selecting a practitioner. The significance of fasting and how dental hygiene care can invalidate the fast are also discussed. The ultimate goal is for practitioners to be culturally competent in providing care to Muslim patients, while keeping in mind that beliefs and practices can vary widely within a culture. © 2012 John Wiley & Sons A/S.

Yeast Autolysis in Sparkling Wine Aging: Use of Killer and Sensitive Saccharomyces cerevisiae Strains in Co-Culture.

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Lombardi, Silvia Jane; De Leonardis, Antonella; Lustrato, Giuseppe; Testa, Bruno; Iorizzo, Massimo

2015-01-01

Sparkling wines produced by traditional method owe their characteristics to secondary fermentation and maturation that occur during a slow ageing in bottles. Yeast autolysis plays an important role during the sparkling wine aging. Using a combination of killer and sensitive yeasts is possible to accelerate yeast autolysis and reduce maturing time. killer and sensitive Saccharomyces cerevisiae strains, separately and in co-cultures, were inoculated in base wine and bottled on pilot-plant scale. Commercial Saccaromyces bayanus strain was also investigated. Protein free amino acid and polysaccharides contents and sensory analysis were determined on the wine samples at 3, 6 and 9 months of aging. Yeast autolysis that occurs during the production of sparkling wines, obtained with co-cultures of killer and sensitive strains, has influenced free amino acids, total protein and polysaccharides content after 3 months aging time: sparkling wines, produced without the use of these yeasts, have reached the same results only after 9 months aging time. These results demonstrate that killer and sensitive yeasts in co-culture can accelerate the onset of autolysis in enological conditions, and has a positive effect on the quality of the aroma and flavor of sparkling wine. This paper offers an interesting biotechnological method to reduce production time of sparkling wine with economical benefits for the producers. We revised all patents relating to sparkling wine considering only those of interest for our study.

Culture and Youth Psychopathology: Testing the Syndromal Sensitivity Model in Thai and American Adolescents

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Weisz, John R.; Weiss, Bahr; Suwanlert, Somsong; Chaiyasit, Wanchai

2006-01-01

Current widespread use of the same youth assessment measures and scales across different nations assumes that youth psychopathology syndromes do not differ meaningfully across nations. By contrast, the authors' syndromal sensitivity model posits 3 processes through which cultural differences can lead to cross-national differences in…

Barriers in the social and healthcare assistance for transgender persons: A systematic review of qualitative studies.

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Aylagas-Crespillo, Marina; García-Barbero, Óscar; Rodríguez-Martín, Beatriz

2017-11-01

To explore the barriers to requesting social and healthcare assistance perceived by transgender persons and professionals involved in the assistance. A meta-study, qualitative systematic review, of studies published in English or Spanish, exploring the barriers, perceived by transgender persons and social and healthcare professionals, that transgender persons have when they seek social and healthcare assistance was carried out in the following databases Medline (PubMed), Scopus, Web of Science, Spanish National Research Council, CUIDEN, ProQuest, PsycINFO and CINAHL. Two thousand two hundred and sixty-one articles were found in the databases searched. Seven articles met all inclusion criteria and were included in this review. The professionals highlight the uncertainty when treating transgender persons and their lack of training. Transgender persons highlight the lack of information and the sense of helplessness it creates. Perceptions of transphobia, the fragmentation of services, administrative barriers, the lack of cultural sensitivity and professional training are also considered barriers to assistance. The findings of this study provide key information for the design of plans and programmes to improve the quality of social and health care for transgender persons. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Intercultural and Interlinguistical Mediation in the Healthcare System: The Challenge of Conflict Management

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Federico Farini

2008-09-01

Full Text Available Nowadays, young women and their children are the most important migrant users of health-care services. In particular, these people may encounter different cultural constructions of health, disease, therapy, and motherhood. The observed difficulties in intercultural communication encourage healthcare systems to promote mediation. Mediation consists of the intervention of a third person, who promotes reciprocal understanding and acceptance between participants. The research presented in this article focuses on the intercultural communication that is produced in these services between health-care personnel and migrant patients. To achieve this goal, the research aims at integrating different theoretical and methodological approaches: conversation analysis, in order to observe the interaction between healthcare personnel and patients, pointing out the cues of the participants’ turn-taking sequences; analysis of the cultural presuppositions of the healthcare system as a communication system with a specific function in society, by highlighting contextualization cues, that is, cultural presuppositions that steer the interaction system, which result from the wider social context and are cues of the cultural identities that characterize it. It was observed that the patients in most cases have very few opportunities to answer the physicians’ questions or to pose questions or doubts. Substituting the patients as the main participants in interactions, the mediator never refuses the physicians’ indications, never expresses doubts, and never asks the patients if they have some reason to doubt or refuse. In these cases, interlinguistic and intercultural mediation de-emphasizes the importance of the larger social context, of the durability of relationships between the parties, and of their social and political recognition.

Sensitivity assessment of direct method for diagnosis of Trichomonas vaginalis in comparison with Dorset Culture media

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ebrahim badparva

2010-04-01

Full Text Available Trichomonas vaginalis is a flagellate protozoan that lives in the genital tract and causes trichomoniasis in women. About 200 million people all over the world are infected with T. vaginalis. There are various methods with different sensitivity and specificity for detection of this parasite, that one of them is direct smear of vaginal secretions which is simpler, rapid and cheaper than other diagnostic methods. Materials and Methods: Demographic data was gathered by a questionnaire which contained different variables. Vaginal secretions samples were taken by spicolum and two swaps that maintained in glucose solution in separate tubes from 160 women referred to health centers of Khorramabad. One of the vaginal samples was examined by direct smear in saline solution and the other was cultured in Dorse medium. Results: Of 160 women suspected of trichomoniasis, 11.8% and 18.75% were positive by direct smear and culture respectively. The sensitivity of the direct method was 63.3%. Our findings indicated that 30% of the infected women belonged to the 31 – 35 age group, which had the most relative frequency of positive cases. Most of the patients (43% were illiterate or had elementary educational level. Conclussion: The sensivity of direct method is 63% in compare to culture ( as a Gold standard , which is ralatively low . Although the efficacy of this test could be imporved by shortening the elapsed time between sampling and examination , use of skilled microscopists , and different samples , but we recommend that more sensitive methods such as culture and PCR should be used .

Mindful Application of Aviation Practices in Healthcare.

Science.gov (United States)

Powell-Dunford, Nicole; Brennan, Peter A; Peerally, Mohammad Farhad; Kapur, Narinder; Hynes, Jonny M; Hodkinson, Peter D

2017-12-01

Evidence supports the efficacy of incorporating select recognized aviation practices and procedures into healthcare. Incident analysis, debrief, safety brief, and crew resource management (CRM) have all been assessed for implementation within the UK healthcare system, a world leader in aviation-based patient safety initiatives. Mindful application, in which aviation practices are specifically tailored to the unique healthcare setting, show promise in terms of acceptance and long-term sustainment. In order to establish British healthcare applications of aviation practices, a PubMed search of UK authored manuscripts published between 2005-2016 was undertaken using search terms 'aviation,' 'healthcare,' 'checklist,' and 'CRM.' A convenience sample of UK-authored aviation medical conference presentations and UK-authored patient safety manuscripts were also reviewed. A total of 11 of 94 papers with UK academic affiliations published between 2005-2016 and relevant to aviation modeled healthcare delivery were found. The debrief process, incident analysis, and CRM are the primary practices incorporated into UK healthcare, with success dependent on cultural acceptance and mindful application. CRM training has gained significant acceptance in UK healthcare environments. Aviation modeled incident analysis, debrief, safety brief, and CRM training are increasingly undertaken within the UK healthcare system. Nuanced application, in which the unique aspects of the healthcare setting are addressed as part of a comprehensive safety approach, shows promise for long-term success. The patient safety brief and aviation modeled incident analysis are in earlier phases of implementation, and warrant further analysis.Powell-Dunford N, Brennan PA, Peerally MF, Kapur N, Hynes JM, Hodkinson PD. Mindful application of aviation practices in healthcare. Aerosp Med Hum Perform. 2017; 88(12):1107-1116.

Factors affecting Japanese retirees' healthcare service utilisation in Malaysia: a qualitative study.

Science.gov (United States)

Kohno, Ayako; Nik Farid, Nik Daliana; Musa, Ghazali; Abdul Aziz, Norlaili; Nakayama, Takeo; Dahlui, Maznah

2016-03-22

While living overseas in another culture, retirees need to adapt to a new environment but often this causes difficulties, particularly among those elderly who require healthcare services. This study examines factors affecting healthcare service utilisation among Japanese retirees in Malaysia. We conducted 6 focus group discussions with Japanese retirees and interviewed 8 relevant medical services providers in-depth. Guided by the Andersen Healthcare Utilisation Model, we managed and analysed the data, using QSR NVivo 10 software and the directed content analysis method. We interviewed participants at Japan Clubs and their offices. 30 Japanese retirees who live in Kuala Lumpur and Ipoh, and 8 medical services providers. We identified health beliefs, medical symptoms and health insurance as the 3 most important themes, respectively, representing the 3 dimensions within the Andersen Healthcare Utilisation Model. Additionally, language barriers, voluntary health repatriation to Japan and psychological support were unique themes that influence healthcare service utilisation among Japanese retirees. The healthcare service utilisation among Japanese retirees in Malaysia could be partially explained by the Andersen Healthcare Utilisation Model, together with some factors that were unique findings to this study. Healthcare service utilisation among Japanese retirees in Malaysia could be improved by alleviating negative health beliefs through awareness programmes for Japanese retirees about the healthcare systems and cultural aspects of medical care in Malaysia. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

The intersection of culture in the provision of dementia care: A systematic review.

Science.gov (United States)

Brooke, Joanne; Cronin, Camille; Stiell, Marlon; Ojo, Omorogieva

2017-08-09

To understand the intersection of healthcare professionals' and care workers' culture and their provision of person-centred care for people with dementia. Due to the nature of global immigration and recruitment strategies, health care is provided by a culturally diverse workforce. Consequently, there is a need to understand healthcare professionals' and care workers' cultural values of illness, disease and dementia. Cultural values and beliefs regarding dementia and care of the older person differ, and currently, there is a lack of clarity regarding the intersection of culture in the provision of person-centred dementia care. A search of the following databases was completed: Medline, CINAHL, Psychology and Behavioural Sciences, PsycINFO and PubMed for papers published from 1st January 2006 to 31st July 2016. A total of seven qualitative studies met the inclusion and exclusion criteria, all explored the impact of healthcare professionals' and care workers' culture in relation to their provision of person-centred dementia care. A meta-synthesis of the data from these studies identified four themes: cultural perceptions of dementia, illness and older people; impact of cultural perceptions on service use; acculturation of the workforce; and cross-cultural communication. Limited evidence was found on the impact of healthcare professionals' and care workers' culture on their provision of person-centred dementia care. The intersection of culture and dementia included the understanding of dementia, care and family roles. Acculturation of migrant healthcare workers to the culture of the host country, workplace, and support with the communication was identified as necessary for the provision of person-centred dementia care. Open access education and training to support communication is required, alongside the development of robust interventions to support the process of acculturation of migrant healthcare professionals and care workers to provide culturally competent person

Radiation sensitivity of poliovirus, a model for norovirus, inoculated in oyster (Crassostrea gigas) and culture broth under different conditions

Energy Technology Data Exchange (ETDEWEB)

Jung, Pil-Mun [Advanced Radiation Technology Institute, Korea Atomic Energy Research Institute, Jeongeup 580-185 (Korea, Republic of); Park, Jae Seok [Korea Food and Drug Administration, Seoul 122-704 (Korea, Republic of); Park, Jin-Gyu; Park, Jae-Nam; Han, In-Jun; Song, Beom-Seok; Choi, Jong-il; Kim, Jae-Hun; Byun, Myung-Woo [Advanced Radiation Technology Institute, Korea Atomic Energy Research Institute, Jeongeup 580-185 (Korea, Republic of); Baek, Min [Atomic Energy Policy Division, Ministry of Education, Science and Technology, Gwacheon 427-715 (Korea, Republic of); Chung, Young-Jin [Department of Food and Nutrition, Chungnam National University, Daejeon 305-764 (Korea, Republic of); Lee, Ju-Woon [Advanced Radiation Technology Institute, Korea Atomic Energy Research Institute, Jeongeup 580-185 (Korea, Republic of)], E-mail: sjwlee@kaeri.re.kr

2009-07-15

Poliovirus is a recognized surrogate for norovirus, pathogen in water and food, due to the structural and genetic similarity. Although radiation sensitivity of poliovirus in water or media had been reported, there has been no research in food model such as shellfish. In this study, oyster (Crassostrea gigas) was incubated in artificial seawater contaminated with poliovirus, and thus radiation sensitivity of poliovirus was determined in inoculated oyster. The effects of ionizing radiation on the sensitivity of poliovirus were also evaluated under different conditions such as pH (4-7) and salt concentration (1-15%) in culture broth, and temperature during irradiation. The D{sub 10} value of poliovirus in PBS buffer, virus culture broth and oyster was determined to 0.46, 2.84 and 2.94 kGy, respectively. The initial plaque forming unit (PFU) of poliovirus in culture broth was slightly decreased as the decrease of pH and the increase of salt concentration, but radiation sensitivity was not affected by pH and salt contents. However, radiation resistance of poliovirus was increased at frozen state. These results provide the basic information for the inactivation of pathogenic virus in foods by using irradiation.

Radiation sensitivity of poliovirus, a model for norovirus, inoculated in oyster (Crassostrea gigas) and culture broth under different conditions

International Nuclear Information System (INIS)

Jung, Pil-Mun; Park, Jae Seok; Park, Jin-Gyu; Park, Jae-Nam; Han, In-Jun; Song, Beom-Seok; Choi, Jong-il; Kim, Jae-Hun; Byun, Myung-Woo; Baek, Min; Chung, Young-Jin; Lee, Ju-Woon

2009-01-01

Poliovirus is a recognized surrogate for norovirus, pathogen in water and food, due to the structural and genetic similarity. Although radiation sensitivity of poliovirus in water or media had been reported, there has been no research in food model such as shellfish. In this study, oyster (Crassostrea gigas) was incubated in artificial seawater contaminated with poliovirus, and thus radiation sensitivity of poliovirus was determined in inoculated oyster. The effects of ionizing radiation on the sensitivity of poliovirus were also evaluated under different conditions such as pH (4-7) and salt concentration (1-15%) in culture broth, and temperature during irradiation. The D 10 value of poliovirus in PBS buffer, virus culture broth and oyster was determined to 0.46, 2.84 and 2.94 kGy, respectively. The initial plaque forming unit (PFU) of poliovirus in culture broth was slightly decreased as the decrease of pH and the increase of salt concentration, but radiation sensitivity was not affected by pH and salt contents. However, radiation resistance of poliovirus was increased at frozen state. These results provide the basic information for the inactivation of pathogenic virus in foods by using irradiation.

Radiation sensitivity of poliovirus, a model for norovirus, inoculated in oyster ( Crassostrea gigas) and culture broth under different conditions

Science.gov (United States)

Jung, Pil-Mun; Park, Jae Seok; Park, Jin-Gyu; Park, Jae-Nam; Han, In-Jun; Song, Beom-Seok; Choi, Jong-il; Kim, Jae-Hun; Byun, Myung-Woo; Baek, Min; Chung, Young-Jin; Lee, Ju-Woon

2009-07-01

Poliovirus is a recognized surrogate for norovirus, pathogen in water and food, due to the structural and genetic similarity. Although radiation sensitivity of poliovirus in water or media had been reported, there has been no research in food model such as shellfish. In this study, oyster ( Crassostrea gigas) was incubated in artificial seawater contaminated with poliovirus, and thus radiation sensitivity of poliovirus was determined in inoculated oyster. The effects of ionizing radiation on the sensitivity of poliovirus were also evaluated under different conditions such as pH (4-7) and salt concentration (1-15%) in culture broth, and temperature during irradiation. The D10 value of poliovirus in PBS buffer, virus culture broth and oyster was determined to 0.46, 2.84 and 2.94 kGy, respectively. The initial plaque forming unit (PFU) of poliovirus in culture broth was slightly decreased as the decrease of pH and the increase of salt concentration, but radiation sensitivity was not affected by pH and salt contents. However, radiation resistance of poliovirus was increased at frozen state. These results provide the basic information for the inactivation of pathogenic virus in foods by using irradiation.

Cultural diversity and the case against ethical relativism.

Science.gov (United States)

Brannigan, M

2000-01-01

The movement to respect cultural diversity, known as multiculturalism, poses a daunting challenge to healthcare ethics. Can we construct a defensible passage from the fact of cultural differences to any claims regarding morality? Or does multiculturalism lead to ethical relativism? Macklin argues that, in view of a leading distinction between universalism in ethics and moral absolutism, the only reasonable passage avoids both absolutism and relativism. She presents a strong case against ethical relativism and its pernicious consequences for cross-cultural issues in healthcare. She also provides sound criteria for the assessment of a culture's moral progress.

Patient's safety culture among Tunisian healthcare workers: results ...

African Journals Online (AJOL)

Conclusion: our study has allowed us to conclude that all dimensions of patients' safety culture need to be improved among our establishment's professionals. Therefore, more efforts are necessary in order to develop a security culture based on confidence, learning, communication and team work and rejecting sanction, ...

Prenatal expectations in Mexican American women: development of a culturally sensitive measure.

Science.gov (United States)

Gress-Smith, Jenna L; Roubinov, Danielle S; Tanaka, Rika; Cmic, Keith; Cirnic, Keith; Gonzales, Nancy; Enders, Craig; Luecken, Linda J

2013-08-01

Prenatal expectations describe various domains a woman envisions in preparation for her role as a new mother and influence how women transition into the maternal role. Although the maternal role is strongly influenced by the prevailing familial and sociocultural context, research characterizing prenatal expectations in ethnic minority and low-income women is lacking. As part of the largest growing minority group in the USA, Latina mothers represent an important group to study. Two hundred and ten low-income Mexican American women were administered the Prenatal Experiences Scale for Mexican Americans (PESMA) that was adapted to capture specific cultural aspects of prenatal expectations. Measures of current support, prenatal depressive symptoms, and other sociodemographic characteristics were also completed to assess validity. Exploratory factor analysis identified three underlying factors of prenatal expectations: paternal support, family support, and maternal role fulfillment. Associations among these subscales and demographic and cultural variables were conducted to characterize women who reported higher and lower levels of expectations. The PESMA demonstrated good concurrent validity when compared to measures of social support, prenatal depressive symptoms, and other sociodemographic constructs. A culturally sensitive measure of prenatal expectations is an important step towards a better understanding of how Mexican American women transition to the maternal role and identify culturally specific targets for interventions to promote maternal health.

Downsides of an overly context-sensitive self: implications from the culture and subjective well-being research.

Science.gov (United States)

Suh, Eunkook M

2007-12-01

The self becomes context sensitive in service of the need to belong. When it comes to achieving personal happiness, an identity system that derives its worth and meaning excessively from its social context puts itself in a significantly disadvantageous position. This article integrates empirical findings and ideas from the self, subjective well-being, and cross-cultural literature and tries to offer insights to why East Asian cultural members report surprisingly low levels of happiness. The various cognitive, motivational, behavioral, and affective characteristics of the overly relation-oriented self are discussed as potential explanations. Implications for the study of self and culture are offered.

Healthcare robots: ethics, design and implementation

NARCIS (Netherlands)

van Wynsberghe, Amy Louise

2015-01-01

This study deals with an underexplored area of the emerging technologies debate: robotics in the healthcare setting. The author explores the role of care and develops a value-sensitive ethical framework for the eventual employment of care robots. Highlighting the range of positive and negative

Data Hemorrhages in the Health-Care Sector

Science.gov (United States)

Johnson, M. Eric

Confidential data hemorrhaging from health-care providers pose financial risks to firms and medical risks to patients. We examine the consequences of data hemorrhages including privacy violations, medical fraud, financial identity theft, and medical identity theft. We also examine the types and sources of data hemorrhages, focusing on inadvertent disclosures. Through an analysis of leaked files, we examine data hemorrhages stemming from inadvertent disclosures on internet-based file sharing networks. We characterize the security risk for a group of health-care organizations using a direct analysis of leaked files. These files contained highly sensitive medical and personal information that could be maliciously exploited by criminals seeking to commit medical and financial identity theft. We also present evidence of the threat by examining user-issued searches. Our analysis demonstrates both the substantial threat and vulnerability for the health-care sector and the unique complexity exhibited by the US health-care system.

Context Sensitive Health Informatics

DEFF Research Database (Denmark)

involves careful consideration of both human and organizational factors. This book presents the proceedings of the Context Sensitive Health Informatics (CSHI) conference, held in Copenhagen, Denmark, in August 2013. The theme of this year’s conference is human and sociotechnical approaches. The Human...... different healthcare contexts. Healthcare organizations, health policy makers and regulatory bodies globally are starting to acknowledge this essential role of human and organizational factors for safe and effective health information technology. This book will be of interest to all those involved......Healthcare information technologies are now routinely deployed in a variety of healthcare contexts. These contexts differ widely, but the smooth integration of IT systems is crucial, so the design, implementation, and evaluation of safe, effective, efficient and easy to adopt health informatics...

Women in healthcare: barriers and enablers from a developing country perspective.

Science.gov (United States)

Tlaiss, Hayfaa A

2013-06-01

As the under-representation of women in management positions continues to persist globally, little is known about the experiences of women in the healthcare sector in the context of the developing Middle Eastern nations. In an attempt to address this knowledge gap, the current study explores some of the barriers that hinder and the enablers that foster women's career advancement in the healthcare sector. To meet its objectives, the current study uses a relational approach that integrates the macro socio-cultural, meso-organisational, and micro-individual levels of analysis. Guided by institutional theory as a theoretical framework and social constructionism as a philosophical stance, the current study adopts a qualitative research methodology. It capitalizes on in-depth, semi-structured, face-to-face interviews with women managers in different occupational fields, across the managerial hierarchy in the healthcare sector in Lebanon. Snowballing and purposeful sampling procedures were used, and the interviews were analysed using thematic analysis, focusing on identifying new, emerging themes. The results of the study confirm the salience of discriminatory cultural values, gendered social roles and expectations in Middle Eastern societies, and illustrate their role as barriers hindering women's career advancement. The results also portray the spillover effect of societal expectations and cultural gender stereotypes into the organisational realm, resulting in widely experienced attitudinal and structural organisational barriers. This study also illustrates how the enablers that facilitate and promote women's career progression unfold amidst the interplay between the macro and meso factors, lending credence to the role of women's agency at the individual micro level. Amongst the toll of barriers, Middle Eastern women navigate the patriarchy of their cultures and the discrimination inherent in their organisations by using their agency and persistence as they construct

Applying importance-performance analysis to patient safety culture.

Science.gov (United States)

Lee, Yii-Ching; Wu, Hsin-Hung; Hsieh, Wan-Lin; Weng, Shao-Jen; Hsieh, Liang-Po; Huang, Chih-Hsuan

2015-01-01

The Sexton et al.'s (2006) safety attitudes questionnaire (SAQ) has been widely used to assess staff's attitudes towards patient safety in healthcare organizations. However, to date there have been few studies that discuss the perceptions of patient safety both from hospital staff and upper management. The purpose of this paper is to improve and to develop better strategies regarding patient safety in healthcare organizations. The Chinese version of SAQ based on the Taiwan Joint Commission on Hospital Accreditation is used to evaluate the perceptions of hospital staff. The current study then lies in applying importance-performance analysis technique to identify the major strengths and weaknesses of the safety culture. The results show that teamwork climate, safety climate, job satisfaction, stress recognition and working conditions are major strengths and should be maintained in order to provide a better patient safety culture. On the contrary, perceptions of management and hospital handoffs and transitions are important weaknesses and should be improved immediately. Research limitations/implications - The research is restricted in generalizability. The assessment of hospital staff in patient safety culture is physicians and registered nurses. It would be interesting to further evaluate other staff's (e.g. technicians, pharmacists and others) opinions regarding patient safety culture in the hospital. Few studies have clearly evaluated the perceptions of healthcare organization management regarding patient safety culture. Healthcare managers enable to take more effective actions to improve the level of patient safety by investigating key characteristics (either strengths or weaknesses) that healthcare organizations should focus on.

78 FR 9054 - National Institute for Occupational Safety and Health Respiratory Protection for Healthcare...

Science.gov (United States)

2013-02-07

... Healthcare Workers'', and ``Advances toward Improved Respirators for Healthcare Workers''. Status: The... research to design and promote the appropriate use of PPE. Compliance with appropriate respirator use.... Poor compliance has been linked to safety culture, workload issues, time constraints, risk perception...

Decision making and coping in healthcare: The Coping in Deliberation (CODE) framework.

NARCIS (Netherlands)

Witt, J.; Elwyn, G.; Wood, F.; Brain, K.

2012-01-01

OBJECTIVE: To develop a framework of decision making and coping in healthcare that describes the twin processes of appraisal and coping faced by patients making preference-sensitive healthcare decisions. METHODS: We briefly review the literature for decision making theories and coping theories

Analysis of sensitive questions across cultures : An application of multigroup item randomized response theory to sexual attitudes and behavior

NARCIS (Netherlands)

de Jong, M.G.; Pieters, R.; Stremersch, S.

2012-01-01

Answers to sensitive questions are prone to social desirability bias. If not properly addressed, the validity of the research can be suspect. This article presents multigroup item randomized response theory (MIRRT) to measure self-reported sensitive topics across cultures. The method was

Evaluation of Patient Safety Culture and Organizational Culture as a Step in Patient Safety Improvement in a Hospital in Jakarta, Indonesia

Directory of Open Access Journals (Sweden)

Afrisya Iriviranty

2016-07-01

Full Text Available Introduction: Establishment of patient safety culture is the first step in the improvement of patient safety. As such, assessment of patient safety culture in hospitals is of paramount importance. Patient safety culture is an inherent component of organizational culture, so that the study of organizational culture is required in developing patient safety. This study aimed to evaluate patient safety culture among the clinical staff of a hospital in Jakarta, Indonesia and identify organizational culture profile. Materials and Methods: This cross-sectional, descriptive, qualitative study was conducted in a hospital in Jakarta, Indonesia in 2014. Sample population consisted of nurses, midwives, physicians, pediatricians, obstetrics and gynecology specialists, laboratory personnel, and pharmacy staff (n=152. Data were collected using the Hospital Survey on Patient Safety Culture developed by the Agency for Healthcare Research and Quality (AHRQ and Organizational Culture Assessment Instrument (OCAI. Results: Teamwork within units” was the strongest dimension of patient safety culture (91.7%, while “staffing” and “non-punitive response to error” were the weakest dimensions (22.7%. Moreover, clan culture was the most dominant type of organizational culture in the studied hospital. This culture serves as a guide for the changes in the healthcare organization, especially in the development of patient safety culture. Conclusion: According to the results of this study, healthcare providers were positively inclined toward the patient safety culture within the organization. As such, the action plan was designed through consensus decision-making and deemed effective in articulating patient safety in the vision and mission of the organization.

LGBT healthcare disparities: What progress have we made?

Science.gov (United States)

Bonvicini, Kathleen A

2017-12-01

Nearly fifteen years have passed since this author's publication which examined the depth of education and training for medical students and practicing physicians specific to clinical competence in the care of lesbian and gay patients in the United States. Since then, there has been an explosion of research gains which have shed a steady light on the needs and disparities of lesbian and gay healthcare. This rich literature base has expanded to include bisexual and transgender (LGBT) healthcare in peer-reviewed journals. Despite these research gains underscoring a call for action, there continues to be a dearth of cultural competency education and training for healthcare professionals focused on clinical assessment and treatment of LGBT patients. This article will focus exclusively on the current status of medical and nursing education and training specific to clinical competence for LGBT healthcare. We are long overdue in closing the clinical competency gap in medical and nursing education to reduce the healthcare disparities within the LGBT community. Copyright © 2017 Elsevier B.V. All rights reserved.

Healthcare leadership's diversity paradox.

Science.gov (United States)

Silver, Reginald

2017-02-06

Purpose The purpose of this research study was to obtain healthcare executives' perspectives on diversity in executive healthcare leadership. The study focused on identifying perspectives about diversity and its potential impact on the access of healthcare services by people of color. The study also identified perspectives about factors that influence the attainment of executive healthcare roles by people of color. Design/methodology/approach A convenience sample of healthcare executives was obtained. The executives identified themselves as belonging to one of two subgroups, White healthcare executives or executives of color. Participants were interviewed telephonically in a semi-structured format. The interviews were transcribed and entered into a qualitative software application. The data were codified and important themes were identified. Findings The majority of the study participants perceive that diversity of the executive healthcare leadership team is important. There were differences in perspective among the subgroups as it relates to solutions to improve access to healthcare by people of color. There were also differences in perspective among the subgroups, as it relates to explaining the underrepresentation of people of color in executive healthcare leadership roles. Research limitations/implications This research effort benefited from the subject matter expertise of 24 healthcare executives from two states. Expansion of the number of survey participants and broadening the geographical spread of where participants were located may have yielded more convergence and/or more divergence in perspectives about key topics. Practical implications The findings from this research study serve to add to the existing body of literature on diversity in executive healthcare leadership. The findings expand on the importance of key elements in contemporary literature such as diversity, cultural competency and perspectives about the need for representation of people of

Healthcare organizational performance: why changing the culture really matters. Commentary.

Science.gov (United States)

Azzolini, Elena; Ricciardi, Walter; Gray, Muir

2018-01-01

An organization may be considered as having three components: a structure, systems and culture. Culture is the most difficult part of the organization to affect. After all, culture has the key role in impacting and improving organizational performance. The leadership of an organization and its key operations are paramount in shaping the culture. Leadership and organizational culture are inextricably intertwined. They are two sides of the same coin. Culture is a medium through which leadership travels and impacts organizational performance. If leaders are to fulfil the challenges of the 21st century, they must first understand the dynamics of culture and their role as sculptors through behavioural and cognitive ways.

Healthcare Workers and Workplace Violence

Directory of Open Access Journals (Sweden)

Tevfik Pinar

2013-06-01

Full Text Available Workplace violence is a threatening worldwide public health problem. Healthcare workers have under particular risk of workplace violence, and they are being exposed to violence 4-16 times more than other service workers. The frequency of violence in the health sector in the world has indicated in different range of results since there is no consistent definition of workplace violence and differences in research methodology (any type of violence: 22,0% - 60,0%; physical violence: 2,6% - 57,0%; verbal violence: 24,3% - 82,0%; sexual harassment: %1,9 - 10,5%. All healthcare workers have right to work in a safe working place. The safety of healthcare workers should deserve the same priority as patient safety. Various risk factors including social, cultural, environmental, organizational and personal elements play a role in the formation of workplace violence that is very important for our country. Considering all those factors, the workplace violence in health sector should be seriously handled and the strategies and policies must be developed for prevention. [TAF Prev Med Bull 2013; 12(3.000: 315-326

How 'healthy' are healthcare organizations? Exploring employee healthcare utilization rates among Dutch healthcare organizations.

Science.gov (United States)

Bronkhorst, Babette

2017-08-01

Occupational health and safety research rarely makes use of data on employee healthcare utilization to gain insight into the physical and mental health of healthcare staff. This paper aims to fill this gap by examining the prevalence of two relevant types of healthcare utilization among staff working in healthcare organizations: physical therapy and mental healthcare utilization. The paper furthermore explores what role employee and organizational characteristics play in explaining differences in healthcare utilization between organizations. A Dutch healthcare insurance company provided healthcare utilization records for a sample of 417 organizations employing 136,804 healthcare workers in the Netherlands. The results showed that there are large differences between and within healthcare industries when it comes to employee healthcare utilization. Multivariate regression analyses revealed that employee characteristics such as age and gender distributions, and healthcare industry, explain some of the variance between healthcare organizations. Nevertheless, the results of the analyses showed that for all healthcare utilization indicators there is still a large amount of unexplained variance. Further research into the subject of organizational differences in employee healthcare utilization is needed, as finding possibilities to influence employee health and subsequent healthcare utilization is beneficial to employees, employers and society as a whole.

A survey of cultural competence of critical care nurses in KwaZuluNatal

Directory of Open Access Journals (Sweden)

Jennifer de Beer

2014-11-01

Full Text Available Background. Nurses are primary caregivers and have a key role in providing care in a culturally diverse healthcare system, such as in South Africa (SA. Nurses need cultural competence in the management of patients within this cultural context. A healthcare system staffed by a culturally competent workforce can provide high-quality care to diverse population groups, contributing to the elimination of health disparities.Objective. To describe the self-rated levels of cultural competence of nurses working in critical care settings in a selected public hospital in SA.Methods. A quantitative descriptive survey was conducted with nurses from eight critical care units in a selected public hospital in KwaZulu-Natal, using the Inventory to Access the Process of Cultural Competency - Revised (IAPCC-R cultural competence questionnaire. Results. The overall cultural competence score for the respondents was 70.2 (standard deviation 7.2 out of a possible 100, with 77 (74% of the respondents scoring in the awareness range, 26 (25% in the competent range, and only 1 in the proficient range. Nurses from non-English-speaking backgrounds scored significantly higher in cultural competence than English-speaking nurses.Conclusion. In addressing the many faces of cultural diversity, healthcare professionals must realise that these faces share a common vision: to obtain quality healthcare services that are culturally responsive and culturally relevant to the specific cultural group.

Synthesis strategy: building a culturally sensitive mid-range theory of risk perception using literary, quantitative, and qualitative methods.

Science.gov (United States)

Siaki, Leilani A; Loescher, Lois J; Trego, Lori L

2013-03-01

This article presents a discussion of development of a mid-range theory of risk perception. Unhealthy behaviours contribute to the development of health inequalities worldwide. The link between perceived risk and successful health behaviour change is inconclusive, particularly in vulnerable populations. This may be attributed to inattention to culture. The synthesis strategy of theory building guided the process using three methods: (1) a systematic review of literature published between 2000-2011 targeting perceived risk in vulnerable populations; (2) qualitative and (3) quantitative data from a study of Samoan Pacific Islanders at high risk of cardiovascular disease and diabetes. Main concepts of this theory include risk attention, appraisal processes, cognition, and affect. Overarching these concepts is health-world view: cultural ways of knowing, beliefs, values, images, and ideas. This theory proposes the following: (1) risk attention varies based on knowledge of the health risk in the context of health-world views; (2) risk appraisals are influenced by affect, health-world views, cultural customs, and protocols that intersect with the health risk; (3) strength of cultural beliefs, values, and images (cultural identity) mediate risk attention and risk appraisal influencing the likelihood that persons will engage in health-promoting behaviours that may contradict cultural customs/protocols. Interventions guided by a culturally sensitive mid-range theory may improve behaviour-related health inequalities in vulnerable populations. The synthesis strategy is an intensive process for developing a culturally sensitive mid-range theory. Testing of the theory will ascertain its usefulness for reducing health inequalities in vulnerable groups. © 2012 Blackwell Publishing Ltd.

Exploring the Health Needs of Aging LGBT Adults in the Cape Fear Region of North Carolina.

Science.gov (United States)

Rowan, Noell L; Beyer, Kelsey

2017-01-01

This study explored issues of culturally sensitive healthcare practice and needs among lesbian, gay, bisexual and transgender aging adults in coastal North Carolina. Survey data results indicated the largest problem was a history of verbally harassment and need for culturally sensitive healthcare. In conclusion, culturally sensitive interventions are needed to address the health disparities and unique needs of LGBT aging adults. Cultural sensitivity training for service providers is suggested as a vital step in addressing health disparities of aging LGBT adults. Implications for research include further exploration of health related needs of these often hidden and underserved population groups.

Globalization of healthcare: case management in a 21st-century world.

Science.gov (United States)

Craig, Kathy; Beichl, Lisa

2009-01-01

This article explains the current state of the global healthcare market with respect to international medical travel (medical tourism) and worldwide provider sourcing. Emphasis is placed on the traditional twin pillars of oversight: program accreditation and branding affiliation. These are discussed for their main strength, which is their ability to operate at a system-strata level. This strength also represents a primary weakness from the international patient's perspective, which is the functional gap between systemic oversight and bedside surveillance. International case management (ICM) is identified as the right conduit of patient-level service delivery that fills the gap between system and bedside. The ICM professional is introduced and defined as the provider of patient-centered quality and safety improvements, who coordinates and collaborates using international network connections and culture-sensitive in-country communication skills. The article's information is useful for healthcare practitioners who want to learn about the global medical marketplace. Practitioners who are preparing to or who already have business enterprises associated with the global healthcare market will also find the information helpful. Explanations and content are useful to case management generalists, specialists, and business developers. The content is intended for uptake by interested parties within and outside the healthcare practice arena. All research and syntheses were executed by the authors. Sources included business correspondences, medical tourism literature, corporate Internet profiles, news releases, and healthcare industry investigative and monitoring agencies. Clinical competencies stem from the international practice experiences of one author (K. Craig). International health insurance, economics, and financing expertise stems from other author (L. Beichl). This article launches the platform for development of checklists, tools, and guidelines for international case

Healthcare at the Crossroads: The Need to Shape an Organizational Culture of Humanistic Teaching and Practice.

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Rider, Elizabeth A; Gilligan, MaryAnn C; Osterberg, Lars G; Litzelman, Debra K; Plews-Ogan, Margaret; Weil, Amy B; Dunne, Dana W; Hafler, Janet P; May, Natalie B; Derse, Arthur R; Frankel, Richard M; Branch, William T

2018-05-08

Changes in the organization of medical practice have impeded humanistic practice and resulted in widespread physician burnout and dissatisfaction. To identify organizational factors that promote or inhibit humanistic practice of medicine by faculty physicians. From January 1, 2015, through December 31, 2016, faculty from eight US medical schools were asked to write reflectively on two open-ended questions regarding institutional-level motivators and impediments to humanistic practice and teaching within their organizations. Sixty eight of the 92 (74%) study participants who received the survey provided written responses. All subjects who were sent the survey had participated in a year-long small-group faculty development program to enhance humanistic practice and teaching. As humanistic leaders, subjects should have insights into motivating and inhibiting factors. Participants' responses were analyzed using the constant comparative method. Motivators included an organizational culture that enhances humanism, which we judged to be the overarching theme. Related themes included leadership supportive of humanistic practice, responsibility to role model humanism, organized activities that promote humanism, and practice structures that facilitate humanism. Impediments included top down organizational culture that inhibits humanism, along with related themes of non-supportive leadership, time and bureaucratic pressures, and non-facilitative practice structures. While healthcare has evolved rapidly, efforts to counteract the negative effects of changes in organizational and practice environments have largely focused on cultivating humanistic attributes in individuals. Our findings suggest that change at the organizational level is at least equally important. Physicians in our study described the characteristics of an organizational culture that supports and embraces humanism. We offer suggestions for organizational change that keep humanistic and compassionate patient

Prenatal expectations in Mexican American women: Development of a culturally-sensitive measure

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Gress-Smith, Jenna L.; Roubinov, Danielle S.; Tanaka, Rika; Crnic, Keith; Gonzales, Nancy; Enders, Craig; Luecken, Linda J.

2013-01-01

Purpose Prenatal expectations describe various domains a woman envisions in preparation for her role as a new mother and influence how women transition into the maternal role. Although the maternal role is strongly influenced by the prevailing familial and sociocultural context, research characterizing prenatal expectations in ethnic minority and low-income women is lacking. As part of the largest growing minority group in the U.S., Latina mothers represent an important group to study. Methods Two hundred and ten low-income Mexican American women were administered the Prenatal Experiences Scale for Mexican Americans (PESMA) that was adapted to capture specific cultural aspects of prenatal expectations. Measures of current support, prenatal depressive symptoms, and other sociodemographic characteristics were also completed to assess validity. Results Exploratory factor analysis identified three underlying factors of prenatal expectations: Paternal Support, Family Support, and Maternal Role Fulfillment. Associations among these subscales, and demographics and cultural variables were conducted to characterize women who reported higher and lower levels of expectations. The PESMA demonstrated good concurrent validity when compared to measures of social support, prenatal depressive symptoms, and other sociodemographic constructs. Conclusions A culturally sensitive measure of prenatal expectations is an important step towards a better understanding of how Mexican American women transition to the maternal role and identify culturally specific targets for interventions to promote maternal health. PMID:23592028

Perception of primary health professionals about Female Genital Mutilation: from healthcare to intercultural competence

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Fàbregas Ma Jose

2009-01-01

Full Text Available Abstract Background The practice of Female Genital Mutilation (FGM, a deeply-rooted tradition in 28 countries in Sub-Saharan Africa, carries important negative consequences for the health and quality of life of women and children. Migratory movements have brought this harmful traditional practice to our medical offices, with the subsequent conflicts related to how to approach this healthcare problem, involving not only a purely healthcare-related event but also questions of an ethical, cultural identity and human rights nature. Methods The aim of this study was to analyse the perceptions, degree of knowledge, attitudes and practices of the primary healthcare professionals in relation to FGM. A transversal, descriptive study was performed with a self-administered questionnaire to family physicians, paediatricians, nurses, midwives and gynaecologists. Trends towards changes in the two periods studied (2001 and 2004 were analysed. Results A total of 225 (80% professionals answered the questionnaire in 2001 and 184 (62% in 2004. Sixteen percent declared detection of some case in 2004, rising three-fold from the number reported in 2001. Eighteen percent stated that they had no interest in FGM. Less than 40% correctly identified the typology, while less than 30% knew the countries in which the practice is carried out and 82% normally attended patients from these countries. Conclusion Female genital mutilations are present in primary healthcare medical offices with paediatricians and gynaecologists having the closest contact with the problem. Preventive measures should be designed as should sensitization to promote stands against these practices.

Cross-Cultural Adaptation and Validation of the Attitudes Toward Suicide Questionnaire Among Healthcare personnel in Malaysia.

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Siau, Ching Sin; Wee, Lei-Hum; Ibrahim, Norhayati; Visvalingam, Uma; Wahab, Suzaily

2017-01-01

Understanding attitudes toward suicide, especially among healthcare personnel, is an important step in both suicide prevention and treatment. We document the adaptation process and establish the validity and reliability of the Attitudes Toward Suicide (ATTS) questionnaire among 262 healthcare personnel in 2 major public hospitals in the Klang Valley, Malaysia. The findings indicate that healthcare personnel in Malaysia have unique constructs on suicide attitude, compared with the original study on a Western European sample. The adapted Malay ATTS questionnaire demonstrates adequate reliability and validity for use among healthcare personnel in Malaysia.

Work motivation among healthcare professionals.

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Kjellström, Sofia; Avby, Gunilla; Areskoug-Josefsson, Kristina; Andersson Gäre, Boel; Andersson Bäck, Monica

2017-06-19

Purpose The purpose of this paper is to explore work motivation among professionals at well-functioning primary healthcare centers subject to a national healthcare reform which include financial incentives. Design/methodology/approach Five primary healthcare centers in Sweden were purposively selected for being well-operated and representing public/private and small/large units. In total, 43 interviews were completed with different medical professions and qualitative deductive content analysis was conducted. Findings Work motivation exists for professionals when their individual goals are aligned with the organizational goals and the design of the reform. The centers' positive management was due to a unique combination of factors, such as clear direction of goals, a culture of non-hierarchical collaboration, and systematic quality improvement work. The financial incentives need to be translated in terms of quality patient care to provide clear direction for the professionals. Social processes where professionals work together as cohesive groups, and provided space for quality improvement work is pivotal in addressing how alignment is created. Practical implications Leaders need to consistently translate and integrate reforms with the professionals' drives and values. This is done by encouraging participation through teamwork, time for structured reflection, and quality improvement work. Social implications The design of the reforms and leadership are essential preconditions for work motivation. Originality/value The study offers a more complete picture of how reforms are managed at primary healthcare centers, as different medical professionals are included. The value also consists of showing how a range of aspects combine for primary healthcare professionals to successfully manage external reforms.

Perceptions of healthcare professionals regarding their own body ...

African Journals Online (AJOL)

reported that older people tend to misperceive their body weight ... To determine healthcare professionals' perceptions of their own body .... 60 years) than younger participants (20 - 30 years) being obese .... Some cultural attitudes lead to women .... risk, nutritional status and refugee children from sub-Saharan Africa.

Board Governance: Transformational Approaches Under Healthcare Reform.

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Zastocki, Deborah K

2015-01-01

Previous successes of healthcare organizations and effective governance practices in the pre-reform environment are not predictive of future success. Healthcare has been through numerous phases of growth and development using tried-and-true strategies. The challenge is that our toolbox does not contain what is needed to build the future healthcare delivery systems required in the post-reform world. Healthcare has had a parochial focus at the local level, with some broadening of horizons at the state and national levels. But healthcare delivery is now a global issue that requires a totally different perspective, and many countries are confronting similar issues. US healthcare reform initiatives have far-reaching implications. Compounding the reform dynamics are the simultaneously occurring, gamechanging accelerants such as enabling information technologies and mobile health, new providers of healthcare, increased consumer demands, and limited healthcare dollars, to name a few. Operating in this turbulent environment requires transformational board, executive, and physician leadership because traditional ways of planning for incremental change and attempting to time those adjustments can prove disastrous. Creating the legacy healthcare system for tomorrow requires governing boards and executive leadership to act today as they would in the desired future system. Boards need to create a culture that fosters.innovation with a tolerance for risk and some failure. To provide effective governance, boards must essentially develop new skills, expertise, and ways of thinking. The rapid rate of change requires board members to possess certain capabilities, including the ability to deal with ambiguity and uncertainty while demonstrating flexibility and adaptability, all with a driving commitment to metrics and results. This requires development plans for both individual members and the overall board. In short, the board needs to function differently, particularly regarding the

Depression and diabetes: Treatment and health-care delivery

DEFF Research Database (Denmark)

Petrak, Frank; Baumeister, Harald; Skinner, Timothy C.

2015-01-01

© 2015 Elsevier Ltd. Despite research efforts in the past 20 years, scientific evidence about screening and treatment for depression in diabetes remains incomplete and is mostly focused on North American and European health-care systems. Validated instruments to detect depression in diabetes......, which are often implemented through collaborative care and stepped-care approaches. The evidence for improved glycaemic control in the treatment of depression by use of selective serotonin reuptake inhibitors or psychological approaches is conflicting; only some analyses show small to moderate...... improvements in glycaemic control. More research is needed to evaluate treatment of different depression subtypes in people with diabetes, the cost-effectiveness of treatments, the use of health-care resources, the need to account for cultural differences and different health-care systems, and new treatment...

Globalization of healthcare.

Science.gov (United States)

2012-05-01

Globalization-the increasing transnational circulation of money, goods, people, ideas, and information worldwide-is generally recognized as one of the most powerful forces shaping our current and future history. How is it affecting healthcare, and in that context, what is the purpose and significance of Global Advances in Health and Medicine (GAHM), publisher of this journal? Our goal is not homogenization but rather to provide an opportunity for integration, convergence, and collaboration across cultures. By respecting and conserving the richness and diversity of each new medicine, we embrace globalization. Globalization is of course not new; it began in the Renaissance and particularly with the 15th- and 16th-century voyages of exploration by Columbus, Magellan, and others. Since the beginning of time, there have been interactions and exchanges among different peoples and cultures. However, the current magnitude of globalization is unprecedented and yet still expanding rapidly.

Globalization of Healthcare

Science.gov (United States)

2012-01-01

Globalization—the increasing transnational circulation of money, goods, people, ideas, and information worldwide—is generally recognized as one of the most powerful forces shaping our current and future history. How is it affecting healthcare, and in that context, what is the purpose and significance of Global Advances in Health and Medicine (GAHM), publisher of this journal? Our goal is not homogenization but rather to provide an opportunity for integration, convergence, and collaboration across cultures. By respecting and conserving the richness and diversity of each new medicine, we embrace globalization. Globalization is of course not new; it began in the Renaissance and particularly with the 15th- and 16th-century voyages of exploration by Columbus, Magellan, and others. Since the beginning of time, there have been interactions and exchanges among different peoples and cultures. However, the current magnitude of globalization is unprecedented and yet still expanding rapidly. PMID:24278809

Implications of climate change (global warming) for the healthcare system.

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Raffa, R B; Eltoukhy, N S; Raffa, K F

2012-10-01

Temperature-sensitive pathogenic species and their vectors and hosts are emerging in previously colder regions as a consequence of several factors, including global warming. As a result, an increasing number of people will be exposed to pathogens against which they have not previously needed defences. We illustrate this with a specific example of recent emergence of Cryptococcus gattii infections in more temperate climates. The outbreaks in more temperate climates of the highly virulent--but usually tropically restricted--C. gattii is illustrative of an anticipated growing challenge for the healthcare system. There is a need for preparedness by healthcare professionals in anticipation and for management of such outbreaks, including other infections whose recent increased prevalence in temperate climates can be at least partly associated with global warming. (Re)emergence of temperature-sensitive pathogenic species in more temperate climates will present new challenges for healthcare systems. Preparation for outbreaks should precede their occurrence. © 2012 Blackwell Publishing Ltd.

Maternal Sensitivity and Child Secure Base Use in Early Childhood: Studies in Different Cultural Contexts

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Posada, German; Trumbell, Jill; Noblega, Magaly; Plata, Sandra; Peña, Paola; Carbonell, Olga A.; Lu, Ting

2016-01-01

This study tested whether maternal sensitivity and child security are related during early childhood and whether such an association is found in different cultural and social contexts. Mother-child dyads (N = 237) from four different countries (Colombia, Mexico, Peru, and the United States) were observed in naturalistic settings when children were…

Women in Healthcare: Barriers and Enablers from a Developing Country Perspective

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Tlaiss, Hayfaa A.

2013-01-01

Background: As the under-representation of women in management positions continues to persist globally, little is known about the experiences of women in the healthcare sector in the context of the developing Middle Eastern nations. In an attempt to address this knowledge gap, the current study explores some of the barriers that hinder and the enablers that foster women’s career advancement in the healthcare sector. To meet its objectives, the current study uses a relational approach that integrates the macro socio-cultural, meso-organisational, and micro-individual levels of analysis. Methods: Guided by institutional theory as a theoretical framework and social constructionism as a philosophical stance, the current study adopts a qualitative research methodology. It capitalizes on in-depth, semi-structured, face-to-face interviews with women managers in different occupational fields, across the managerial hierarchy in the healthcare sector in Lebanon. Snowballing and purposeful sampling procedures were used, and the interviews were analysed using thematic analysis, focusing on identifying new, emerging themes. Results: The results of the study confirm the salience of discriminatory cultural values, gendered social roles and expectations in Middle Eastern societies, and illustrate their role as barriers hindering women’s career advancement. The results also portray the spillover effect of societal expectations and cultural gender stereotypes into the organisational realm, resulting in widely experienced attitudinal and structural organisational barriers. This study also illustrates how the enablers that facilitate and promote women’s career progression unfold amidst the interplay between the macro and meso factors, lending credence to the role of women’s agency at the individual micro level. Amongst the toll of barriers, Middle Eastern women navigate the patriarchy of their cultures and the discrimination inherent in their organisations by using their

Women in Healthcare: Barriers and Enablers from a Developing Country Perspective

Directory of Open Access Journals (Sweden)

Hayfaa A. Tlaiss

2013-05-01

Full Text Available Background: As the under-representation of women in management positions continues to persist globally, little is known about the experiences of women in the healthcare sector in the context of the developing Middle Eastern nations. In an attempt to address this knowledge gap, the current study explores some of the barriers that hinder and the enablers that foster women’s career advancement in the healthcare sector. To meet its objectives, the current study uses a relational approach that integrates the macro socio-cultural, meso-organisational, and micro-individual levels of analysis.Methods: Guided by institutional theory as a theoretical framework and social constructionism as a philosophical stance, the current study adopts a qualitative research methodology. It capitalizes on in-depth, semi-structured, face-to-face interviews with women managers in different occupational fields, across the managerial hierarchy in the healthcare sector in Lebanon. Snowballing and purposeful sampling procedures were used, and the interviews were analysed using thematic analysis, focusing on identifying new, emerging themes.Results: The results of the study confirm the salience of discriminatory cultural values, gendered social roles and expectations in Middle Eastern societies, and illustrate their role as barriers hindering women’s career advancement. The results also portray the spillover effect of societal expectations and cultural gender stereotypes into the organisational realm, resulting in widely experienced attitudinal and structural organisational barriers. This study also illustrates how the enablers that facilitate and promote women’s career progression unfold amidst the interplay between the macro and meso factors, lending credence to the role of women’s agency at the individual micro level. Amongst the toll of barriers, Middle Eastern women navigate the patriarchy of their cultures and the discrimination inherent in their organisations by

Knowledge, Beliefs, and Communication Behavior of Oncology Health-care Providers (HCPs) regarding Lesbian, Gay, Bisexual, and Transgender (LGBT) Patient Health care.

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Banerjee, Smita C; Walters, Chasity B; Staley, Jessica M; Alexander, Koshy; Parker, Patricia A

2018-01-01

Delivery of culturally competent care toward lesbian, gay, bisexual, and transgender (LGBT) patients depends on how health-care providers (HCPs) communicate with them; however, research about knowledge, attitude, and behavior of HCPs toward LGBT patients is scant. The objectives of our study were to describe oncology HCPs' knowledge and examine if beliefs about LGB and transgender patients mediate the effects of LGBT health-care knowledge on open communication behaviors with LGB and transgender patients, respectively. A total of 1253 HCPs (187 physicians, 153 advance practice professionals (APPs), 828 nurses, and 41 others) at a Comprehensive Cancer Center completed an online survey that included the following measures: LGBT health-care knowledge, beliefs, communication behaviors, willingness to treat LGBT patients, encouraging LGBT disclosure, and perceived importance of LGBT sensitivity training. Only 50 participants (5%) correctly answered all 7 knowledge items, and about half the respondents answered 3 (out of 7) items correctly. Favorable beliefs about LGBT health care mediated the effect of higher LGBT health-care knowledge on open communication behaviors with transgender patients, controlling for effects of type of profession, religious orientation, gender identity, sexual orientation, and having LGBT friends/family. The results of this study demonstrated an overall lack of medical knowledge and the need for more education about LGBT health care among oncology HCPs.

Assessment of Patient Safety Culture in a Selected Number of Pharmacies Affiliated to Mashhad University of Medical Sciences Using the Pharmacy Survey on Patient Safety Culture (SOPS

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Sara Jamili

2016-07-01

Conclusion: According to the results of this study, commitment of healthcare authorities to patient safety culture is the most important factor in the promotion of organizational patient safety. Considering that the lowest score of patient safety culture belonged to the dimension of “overall perceptions of patient safety”,it is recommended that related training interventions be implemented for healthcare staff in order to establish and promote the patient safety culture in pharmacies.

Healthcare professionals' perceptions of the value and impact of the arts in healthcare settings: A critical review of the literature.

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Wilson, Ceri; Bungay, Hilary; Munn-Giddings, Carol; Boyce, Melanie

2016-04-01

Internationally there is growing interest in the use of the arts in the healthcare context evidenced by the number of research studies reported in the nursing and medical literature. Establishing successful projects in healthcare environments will to some extent be reliant on the cooperation of staff working in these settings: healthcare professionals and their cultural values will be the lynchpin in the relationship between the artists organising the activities and the patients. This review appraises healthcare professionals' perceptions of the value of the arts in healthcare settings, and the impact of the arts on healthcare professionals. A critical review of the literature between 2004 and 2014 was undertaken. The following databases were searched: MedLine, CINAHL, AMED, Web of Science and ASSIA. Searches included words from three categories: arts activities; healthcare settings, and healthcare providers. Studies were included if they were written in English, explored the attitudes of healthcare professionals on the use of the arts in healthcare settings or the impact of arts activities on healthcare staff. Studies conducted in community venues and/or reporting on arts therapies (art, drama or music) were excluded. An initial 52 studies were identified and following screening for relevance and quality 27 articles were reviewed. Arts interventions were diverse and included music listening, visual arts, reading and creative writing, and dance. Despite some methodological limitations of the reviewed studies it was found that the majority of staff believed that engaging in arts interventions has a positive impact on patients' health and well-being. The findings suggest that arts interventions are perceived to have an impact on patients' stress, mood, pain levels, and sleep. Furthermore, staff believed that the arts can enhance communication between staff and patients, helping to build rapport and strengthen interactions. The majority of reported staff outcomes were

Information and Communication Technologies – and Culturally Sensitive Systems

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Nancy Michail

2006-12-01

Full Text Available This paper discusses the perceptions of Egyptian minority groups in relation to internet information technology with which they feel empowered to protect, affirm and communicate their oppressed existence, on local and global dimensions. The research employs qualitative methods and interpretive analysis, to focus on the use of Internet information technology tools by Egyptian minority groups, in particular, their online platforms and chat rooms, and the related issues associated with these practices and usages. The paper argues that cyberspace is used by specific minority groups in Egypt as a "gateway to freedom" in which it constitutes an ally to establish newly founded cyber identities that aide them to exercise their basic human rights of freedom of thought, speech and expression. The paper thus examines cyberspace a medium or tool for the carrying out of information exchange without the traditional fear of politics and power that is deeply engraved in the roots of the Egyptian culture. In this way, these minority groups are analysed as the newly conceived human information systems (HIS residing on Internet information technology and infrastructure. The paper proposes an adaptive and culturally sensitive model of human information systems as well as human information systems development life cycle (HISDLC to aid in establishing effective processes of information exchange and creation, hence assisting in the emancipation of conflicting parties residing in Egypt, elsewhere in the Middle East and globally.

Occupational Stress Among Home Healthcare Workers: Integrating Worker and Agency-Level Factors.

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Zoeckler, Jeanette M

2018-02-01

Home healthcare work is physically and emotionally exhausting. In addition, home healthcare workers frequently work under precarious work arrangements for low wages and in poor work conditions. Little is known about how sources of job strain for home healthcare workers might be reduced. This research examines the occupational stressors among paid home care workers by analyzing home healthcare agency characteristics and individual home healthcare workers' experiences in upstate New York agencies (n = 9). The study augments existing theoretical models and describes new sources of stress arising from the nature of agency-based caregiving. Results feature the analysis of both agency executives' (n = 20) and home healthcare workers' narratives (n = 25) to make the agency's inner workings more transparent. Agency structures and culture are implicated in the lack of progress to address home care workers' health problems. Policy change should focus on compensation, healthier work conditions, and training requirements.

How commercial and ``violent'' video games can promote culturally sensitive science learning: some questions and challenges

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Kwah, Helen

2012-12-01

In their paper, Muñoz and El-Hani propose to bring video games into science classrooms to promote culturally sensitive ethics and citizenship education. Instead of bringing "educational" games, Muñoz and El-Hani take a more creative route and include games such as Fallout 3® precisely because they are popular and they reproduce ideological and violent representations of gender, race, class, nationality, science and technology. However, there are many questions that arise in bringing these commercial video games into science classrooms, including the questions of how students' capacities for critical reflection can be facilitated, whether traditional science teachers can take on the role of using such games in their classrooms, and which video games would be most appropriate to use. In this response, I raise these questions and consider some of the challenges in order to further the possibility of implementing Muñoz and El-Hani's creative proposal for generating culturally sensitive science classrooms.

Ethical and cultural striving: Lived experiences of minority nurses in dementia care.

Science.gov (United States)

Egede-Nissen, Veslemøy; Sellevold, Gerd Sylvi; Jakobsen, Rita; Sørlie, Venke

2017-09-01

Nursing workforce in Western European health institutions has become more diverse because of immigration and recruitment from Asian, African, and East-European countries. Minority healthcare providers may experience communication problems in interaction with patients and coworkers, and they are likely to experience conflict or uncertainty when confronted with different cultural traditions and values. Persons with dementia are a vulnerable group, and the consequences of their illness challenge the ability to understand and express oneself verbally. The large number of minority healthcare providers in nursing homes underlines the importance to obtain better knowledge about this group's experiences with the care challenges in dementia care units. Can you tell about any challenges in the experiences in the encounter with persons suffering from dementia? Participants and research context: Five minority healthcare providers in a nursing home, in a dementia unit. All guidelines for research ethic were followed. Ethical consideration: The participants were informed that participation was voluntary, and they were guarantied anonymity. We used a qualitative method, conducting individual interviews, using a narrative approach. In the analysis, we applied a phenomenological-hermeneutical method, developed for researching life experiences. One theme and four subthemes: striving to understand the quality of care for persons with dementia. The subthemes: sensitivity to understand the patients' verbal and nonverbal expressions. To understand gratefulness, understand the patient as an adult and autonomous person, and understand the patient as a patient in a nursing home. Challenges comprise both ethical and cultural striving to understand persons with dementia. To care for persons with dementia in an unfamiliar context may be understood as a striving for acting ethically, when at the same time striving to adapt and acculturate to new cultural norms, in order to practice good

Patient safety--worker safety: building a culture of safety to improve healthcare worker and patient well-being.

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Yassi, Annalee; Hancock, Tina

2005-01-01

Patient safety within the Canadian healthcare system is currently a high national priority, which merits a comprehensive understanding of the underlying causes of adverse events. Not least among these is worker health and safety, which is linked to patient outcomes. Healthcare workers have a high risk of workplace injuries and more mental health problems than most other occupational groups. Many healthcare professionals feel fatigued, stressed, in pain, or at risk of illness or injury-factors they feel impede their ability to provide consistent quality care. With this background, the Occupational Health and Safety Agency for Healthcare (OHSAH) in British Columbia, jointly governed by healthcare unions and healthcare employers, launched several major initiatives to improve the healthcare workplace. These included the promotion of safe patient handling, adaptive clothing, scheduled toileting, stroke management training, measures to improve management of aggressive behaviour and, of course, infection control-all intended to improve the safety of workers, but also to improve patient safety and quality of care. Other projects also explicitly promoting physical and mental health at work, as well as patient safety are also underway. Results of the projects are at various stages of completion, but ample evidence has already been obtained to indicate that looking after the well-being of healthcare workers results in safer and better quality patient care. While more research is needed, our work to date suggests that a comprehensive systems approach to promoting a climate of safety, which includes taking into account workplace organizational factors and physical and psychological hazards for workers, is the best way to improve the healthcare workplace and thereby patient safety.

Culture matters: indigenizing patient safety in Bhutan.

Science.gov (United States)

Pelzang, Rinchen; Johnstone, Megan-Jane; Hutchinson, Alison M

2017-09-01

Studies show that if quality of healthcare in a country is to be achieved, due consideration must be given to the importance of the core cultural values as a critical factor in improving patient safety outcomes. The influence of Bhutan's traditional (core) cultural values on the attitudes and behaviours of healthcare professionals regarding patient care are not known. This study aimed to explore the possible influence of Bhutan's traditional cultural values on staff attitudes towards patient safety and quality care. Undertaken as a qualitative exploratory descriptive inquiry, a purposeful sample of 94 healthcare professionals and managers were recruited from three levels of hospitals, a training institute and the Ministry of Health. Interviews were transcribed verbatim and analysed using thematic analysis strategies. The findings of the study suggest that Bhutanese traditional cultural values have both productive and counterproductive influences on staff attitudes towards healthcare delivery and the processes that need to be in place to ensure patient safety. Productive influences encompassed: karmic incentives to avoid preventable harm and promote safe patient care; and the prospective adoption of the 'four harmonious friends' as a culturally meaningful frame for improving understanding of the role and importance of teamwork in enhancing patient safety. Counterproductive influences included: the adoption of hierarchical and authoritative styles of management; unilateral decision-making; the legitimization of karmic beliefs; differential treatment of patients; and preferences for traditional healing practices and rituals. Although problematic in some areas, Bhutan's traditional cultural values could be used positively to inform and frame an effective model for improving patient safety in Bhutan's hospitals. Such a model must entail the institution of an 'indigenized' patient safety program, with patient safety research and reporting systems framed around local

Identifying risk factors for healthcare-associated infections from electronic medical record home address data

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Rosenman Marc B

2010-09-01

Full Text Available Abstract Background Residential address is a common element in patient electronic medical records. Guidelines from the U.S. Centers for Disease Control and Prevention specify that residence in a nursing home, skilled nursing facility, or hospice within a year prior to a positive culture date is among the criteria for differentiating healthcare-acquired from community-acquired methicillin-resistant Staphylococcus aureus (MRSA infections. Residential addresses may be useful for identifying patients residing in healthcare-associated settings, but methods for categorizing residence type based on electronic medical records have not been widely documented. The aim of this study was to develop a process to assist in differentiating healthcare-associated from community-associated MRSA infections by analyzing patient addresses to determine if residence reported at the time of positive culture was associated with a healthcare facility or other institutional location. Results We identified 1,232 of the patients (8.24% of the sample with positive cultures as probable cases of healthcare-associated MRSA based on residential addresses contained in electronic medical records. Combining manual review with linking to institutional address databases improved geocoding rates from 11,870 records (79.37% to 12,549 records (83.91%. Standardization of patient home address through geocoding increased the number of matches to institutional facilities from 545 (3.64% to 1,379 (9.22%. Conclusions Linking patient home address data from electronic medical records to institutional residential databases provides useful information for epidemiologic researchers, infection control practitioners, and clinicians. This information, coupled with other clinical and laboratory data, can be used to inform differentiation of healthcare-acquired from community-acquired infections. The process presented should be extensible with little or no added data costs.

Developing graduate student competency in providing culturally sensitive end of life care in critical care environments - a pilot study of a teaching innovation.

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Northam, Holly L; Hercelinskyj, Gylo; Grealish, Laurie; Mak, Anita S

2015-11-01

Australia's immigration policy has generated a rich diverse cultural community of staff and patients in critical care environments. Many different cultural perspectives inform individual actions in the context of critical care, including the highly sensitive area of end of life care, with nurses feeling poorly prepared to provide culturally sensitive end of life care. This article describes and evaluates the effectiveness of an educational innovation designed to develop graduate-level critical care nurses' capacity for effective interpersonal communication, as members of a multi-disciplinary team in providing culturally sensitive end-of-life care. A mixed method pilot study was conducted using a curriculum innovation intervention informed by The Excellence in Cultural Experiential Learning and Leadership Program (EXCELL),(1) which is a higher education intervention which was applied to develop the nurses' intercultural communication skills. 12 graduate nursing students studying critical care nursing participated in the study. 42% (n=5) of the participants were from an international background. Information about students' cultural learning was recorded before and after the intervention, using a cultural learning development scale. Student discussions of end of life care were recorded at Week 2 and 14 of the curriculum. The quantitative data was analysed using descriptive statistical analysis and qualitative data was thematically analysed. Students demonstrated an increase in cultural learning in a range of areas in the pre-post surveys including understandings of cultural diversity, interpersonal skills, cross cultural interactions and participating in multicultural groups. Thematic analysis of the end of life discussions revealed an increase in the levels of nurse confidence in approaching end of life care in critical care environments. The EXCELL program provides an effective and supportive educational framework to increase graduate nurses' cultural learning

Ensuring cultural sensitivity for Muslim patients in the Australian ICU: considerations for care.

Science.gov (United States)

Bloomer, Melissa J; Al-Mutair, Abbas

2013-11-01

Australia is a diverse and multicultural nation, made up of a population with a predominant Christian faith. Islam, the second largest religion in the world, has demonstrated significant growth in Australia in the last decade. Coming from various countries of origin and cultural backgrounds, Muslim beliefs can range from what is considered 'traditional' to very 'liberal'. It is neither possible nor practical for every intensive care clinician to have an intimate understanding of Islam and Muslim practices, and cultural variations amongst Muslims will mean that not all beliefs/practices will be applicable to all Muslims. However, being open and flexible in the way that care is provided and respectful of the needs of Muslim patients and their families is essential to providing culturally sensitive care. This discussion paper aims to describe the Islamic faith in terms of Islamic teachings, beliefs and common practices, considering how this impacts upon the perception of illness, the family unit and how it functions, decision-making and care preferences, particularly at the end of life in the intensive care unit. Copyright © 2013 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.

Assessment of Patient Safety Culture in an Adult Oncology Department in Saudi Arabia

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Waleed Alharbi

2018-05-01

Full Text Available Objectives: We sought to evaluate patient safety culture across different healthcare professionals from different countries of origin working in an adult oncology department in a medical facility in Saudi Arabia. Methods: This cross-sectional survey of 130 healthcare staff (doctors, pharmacists, nurses was conducted in February 2017. We used the Hospital Survey of Patient Safety Culture (HSOPSC to examine healthcare staff perceptions of safety culture. Results: A total of 127 questionnaires were returned, yielding a response rate of 97.7%. Eight out of 12 HSOPSC composites were considered areas for improvement (percent positivity < 50.0%. Significantly different mean scores were observed across the three professional groups in all 12 HSOPSC composites. Doctors tended to rate patient safety culture significantly more positively than nurses or pharmacists. Nurses scored significantly lower than pharmacists in the majority of HSOPSC composites. No significant differences in patient safety culture composite scores were observed between Saudi/Gulf Cooperation Council (GCC and non-Saudi/GCC groups. Regression analysis showed that the frequency of reported events is predicted by feedback and communication about errors, and teamwork across units. Perception of patient safety is associated with respondents’ profession and teamwork across units. Conclusions: This study brings to the fore the assumption that all healthcare professionals have a shared understanding of patient safety. We urge healthcare leaders and policy makers to look at patient safety culture at this granular level in their contexts and use this information to develop strategies and training to improve patient safety culture.

Systematic review on embracing cultural diversity for developing and sustaining a healthy work environment in healthcare.

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Pearson, Alan; Srivastava, Rani; Craig, Dianna; Tucker, Donna; Grinspun, Doris; Bajnok, Irmajean; Griffin, Pat; Long, Leslye; Porritt, Kylie; Han, Thuzar; Gi, Aye A

2007-03-01

Objectives  The objective of this review was to evaluate evidence on the structures and processes that support development of effective culturally competent practices and a healthy work environment. Culturally competent practices are a congruent set of workforce behaviours, management practices and institutional policies within a practice setting resulting in an organisational environment that is inclusive of cultural and other forms of diversity. Inclusion criteria  This review included quantitative and qualitative evidence, with a particular emphasis on identifying systematic reviews and randomised controlled trials. For quantitative evidence, other controlled, and descriptive designs were also included. For qualitative evidence, all methodologies were considered. Participants were staff, patients, and systems or policies that were involved or affected by concepts of cultural competence in the nursing workforce in a healthcare environment. Types of interventions included any strategy that had a cultural competence component, which influenced the work environment, and/or patient and nursing staff in the environment. The types of outcomes of interest to this review included nursing staff outcomes, patient outcomes, organisational outcomes and systems level outcomes. Search strategy  The search sought both published and unpublished literature written in the English language. A comprehensive three-step search strategy was used, first to identify appropriate key words, second to combine all optimal key words into a comprehensive search strategy for each database and finally to review the reference lists of all included reviews and research reports. The databases searched were CINAHL, Medline, Current Contents, the Database of Abstracts of Reviews of Effectiveness, The Cochrane Library, PsycINFO, Embase, Sociological Abstracts, Econ lit, ABI/Inform, ERIC and PubMed. The search for unpublished literature used Dissertation Abstracts International. Methodological

Importance of quality aspects of GP care among ethnic minorities: role of cultural attitudes, language and healthcare system of reference.

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Lamkaddem, Majda; Spreeuwenberg, Peter M; Devillé, Walter L; Foets, Marleen M; Groenewegen, Peter P

2012-02-01

This study examines the mechanisms responsible for ethnic differences in perceived quality of care in The Netherlands. The specific role of cultural attitudes, language proficiency, and the health system in the country of origin was examined, taking socio-demographic characteristics into account. Interview data of 1339 respondents of Moroccan, Turkish, Surinamese and Antillean origin were combined with interview data of Dutch respondents (n = 405) and of Western immigrants (n = 102) in The Netherlands and of a random sample of Dutch privately or publicly insured persons (n = 9675). Data collection took place within the Second Dutch National Survey of General Practice (DNSGP-2, 2001). Items from the QUality Of care Through the patient's Eyes (QUOTE) questionnaire were used to measure expectations, as well as items from the QUOTE-Mi (adapted version for migrant groups). Items on normative orientations were used to measure cultural attitudes. In contrast to our hypothesis, respondents with more egalitarian/modern attitudes attached less importance to quality aspects related to access and quality. Tests on the role of the health system of reference were generally conclusive, showing that respondents accustomed to (parts of) another system have different expectations regarding several aspects of general practitioner healthcare quality, e.g. access to specialist care. Besides socio-demographic characteristics, culture influences patients' expectations regarding general practitioner care quality. However, the role of culture can be more clearly ascribed to the characteristics of the health system which is held as the reference than to the general attitudes on normative orientations.

The role of values-based leadership in sustaining a culture of caring.

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Faith, Karen E

2013-01-01

At the heart of healthcare are fundamental values like caring and compassion as well as the duty shared by healthcare organizations to address the care needs of those in their communities who are vulnerable, injured, or ill. A concern being raised by some political analysts in Canada is that fundamental values are being challenged by current economic and political influences that are reshaping the landscape of healthcare in this country. Influences from industry, technology, and business have significantly shifted healthcare from its moral foundations. A culture of caring is also challenged by the values and behaviours of individuals that negatively impact staff morale and inter-professional collaboration in many work settings. If a "culture of caring" is to survive the canons of cost containment, the impact of recurrent political wrangling, and other substantive influences, then healthcare must be guided by committed values-based leadership. Using case illustrations, this article attempts to explain the characteristics and role of values-based leaders in promoting those values that inspire a culture of caring.

Changes in sensitivity to radiation and to bleomycin occurring during the life history of monolayer cultures of a mouse tumour cell line

International Nuclear Information System (INIS)

Twentyman, P.R.; Bleehen, N.M.

1975-01-01

The response to X-radiation and to bleomycin has been measured at a number of times during the life of monolayer cultures of EMT6 mouse tumour cells. Little change in radiation sensitivity was seen at any time and no loss of the shoulder to the survival curve occurred. Cultures in early plateau phase (where a considerable amount of cell proliferation is balanced by cell loss) showed a reduced sensitivity to bleomycin when compared with cells in exponential growth. However, after a longer period in plateau phase, when proliferation had virtually ceased, the sensitivity became greater than that of exponential phase cells. These findings are discussed with reference to the conflicting results of other workers. (author)

The healthcare experiences of Arab Israeli women in a reformed healthcare system.

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Elnekave, Eldad; Gross, Revital

2004-07-01

Arab Israeli women are subject to unique social stresses deriving from their status as part of an ethno-political minority and from their position as women in a patriarchal community. Collectively, their health profiles rate poorly in comparison to Jewish Israeli women or to women in the vast majority of developed countries. To examine the experiences of Arab Israeli women in the contemporary Israeli healthcare system, following implementation of the National Health Insurance Law (NHIL). The study combined quantitative and qualitative research methodologies. A telephone survey utilizing a structured questionnaire was conducted during August-September 1998 among a random national sample of 849 women, with a response rate of 83%. Between the months of January and July of 2000, qualitative data was attained via participant-observation, long and short semi-structured interviews, and focus groups in one large Muslim Arab Israeli village. Arab Israeli women in the national survey reported poorer self-assessed health, lower rates of care by a woman primary care physician, lower satisfaction ratings for primary care physicians and more frequently foregoing medical care than did native or immigrant Jewish Israeli women. Three major factors contributing to Arab Israeli women's healthcare experiences were elucidated by the qualitative study: (1) the threat of physical and social exposure (2) difficulties in communicating with male physicians and (3) the stifling effect of family politics and surveillance on healthcare. We discuss our findings in relation to structural changes associated with the recent reform of the Israeli health care system. We conclude by suggesting policy measures for better adapting primary care services to the needs of Arab Israeli women, and note the relevance to other systems that aim to provide service to cultural and ethno-political minorities, in which healthcare delivery is shaped by unique local circumstances.

Organizational transformation: a model for joint optimization of culture change and evidence-based design.

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Hamilton, D Kirk; Orr, Robin Diane; Raboin, W Ellen

2008-01-01

Healthcare organizations face continuous and accelerating external change and thus must be prepared to manage their own change initiatives proactively. Given that many believe that the U.S. healthcare system is broken and most healthcare organizations are dealing with pervasive problems, some organizations may choose to seek transformational change to achieve the six aims identified by the Institute of Medicine: healthcare that is safe, effective, patient-centered, timely, efficient, and equitable. Transformational change will almost certainly involve organizational culture. Culture change may be most effective when linked to other organizational change initiatives such as organizational strategy, structure, policies, procedures, and recruiting. Significant organizational change often requires accompanying facility change. There is an interdependent relationship between facility design and organizational culture. They affect each other and both impact organizational performance. Sociotechnical theory promotes joint optimization of the social (culture) and technical (facilities) aspects of an organization to achieve sustained positive change. To achieve organizational transformation and to sustain positive change, organizations must be prepared to adopt collaborative efforts in culture change and facility design. The authors propose a model for accomplishing joint optimization of culture change and evidence-based facility design.

The effect of culture density and proliferation rate on the expression of ouabain-sensitive Na/K ATPase pumps in cultured human retinal pigment epithelium

International Nuclear Information System (INIS)

Burke, J.M.; Jaffe, G.J.; Brzeski, C.M.

1991-01-01

The number and activity of ouabain-sensitive Na/K ATPase pumps expressed by many cell types in vitro, including human retinal pigment epithelial cells (RPE), have been shown to decline with increasing culture density. Cell proliferation also declined as cultures became dense so it was unclear if pump number was modulated by cell proliferation or culture confluency. By exposing RPE cultures to various feeding regimens, using culture medium containing or lacking serum, it was possible to produce RPE cultures with a range of culture densities and growth rates. These were analyzed for proliferative activity by quantifying [ 3 H]thymidine incorporation and for Na/K ATPase pump number by measuring specific [ 3 H]ouabain binding. The results suggest that pump number is modulated by culture density and, further, that the density-dependent regulation of pump number requires serum. Although density-dependent modulation of culture growth is also serum requiring, cell proliferation and pump number did not appear to be related; cultures of similar density which differed significantly in growth rate had similar numbers of pumps. The view that elevated numbers of pumps were not necessarily found in proliferating cells was further supported by qualitative examination of radioautographs of cells dually labeled with [ 3 H]thymidine and [ 3 H]ouabain. Cycling cells which had [ 3 H]thymidine-labeled nuclei did not have notably higher labeling with [ 3 H]ouabain. However, [ 3 H]ouabain labeling, as an indicator of pump site number and distribution, did vary among cells in an RPE population and also within individual cells. This latter observation suggests that unpolarized RPE cells in sparse cultures may have regionally different requirements for ionic regulation

Interpretation of way-finding healthcare symbols by a multicultural population: navigation signage design for global health.

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Hashim, Muhammad Jawad; Alkaabi, Mariam Salem Khamis Matar; Bharwani, Sulaiman

2014-05-01

The interpretation of way-finding symbols for healthcare facilities in a multicultural community was assessed in a cross-sectional study. One hundred participants recruited from Al Ain city in the United Arab Emirates were asked to interpret 28 healthcare symbols developed at Hablamos Juntos (such as vaccinations and laboratory) as well as 18 general-purpose symbols (such as elevators and restrooms). The mean age was 27.6 years (16-55 years) of whom 84 (84%) were females. Healthcare symbols were more difficult to comprehend than general-purpose signs. Symbols referring to abstract concepts were the most misinterpreted including oncology, diabetes education, outpatient clinic, interpretive services, pharmacy, internal medicine, registration, social services, obstetrics and gynecology, pediatrics and infectious diseases. Interpretation rates varied across cultural backgrounds and increased with higher education and younger age. Signage within healthcare facilities should be tested among older persons, those with limited literacy and across a wide range of cultures. Copyright © 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

A study on organizational culture, structure and information technology as three KM enablers: A case study in five Iranian medical and healthcare research centers

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Mahdi Iran-nejad-parizi

2013-01-01

Full Text Available This study investigates organizational structure, culture, and information technology as knowledge management (KM infrastructural capabilities, and compares their significance and status quo in five medical research centers in Tehran, Iran. Objectives of this research were pursued by employing two statistical methods, regression analysis and Friedman test. Included in the study were 135 people (researchers and support staff from five medical and healthcare research centers of Tehran. A survey questionnaire including 23 questions was utilized to examine organizational structure, culture and information technology indicators. And another 12 questions examined KM effectiveness. The Friedman test indicated that in terms of their status quo, the three studied KM enablers are at different conditions, with organizational culture having the best (mean rank=1.79 and IT the worst (mean rank=2.14 status. Moreover, it was revealed by regression analysis that organizational structure is believed to have the most significant impact (Beta= 0.397 on the effectiveness of knowledge management initiatives, while information technology gained the least perceived impact (Beta= 0.176.

Adaptive Failure Identification for Healthcare Risk Analysis and Its Application on E-Healthcare

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Kuo-Chung Chu

2014-01-01

Full Text Available To satisfy the requirement for diverse risk preferences, we propose a generic risk priority number (GRPN function that assigns a risk weight to each parameter such that they represent individual organization/department/process preferences for the parameters. This research applies GRPN function-based model to differentiate the types of risk, and primary data are generated through simulation. We also conduct sensitivity analysis on correlation and regression to compare it with the traditional RPN (TRPN. The proposed model outperforms the TRPN model and provides a practical, effective, and adaptive method for risk evaluation. In particular, the defined GRPN function offers a new method to prioritize failure modes in failure mode and effect analysis (FMEA. The different risk preferences considered in the healthcare example show that the modified FMEA model can take into account the various risk factors and prioritize failure modes more accurately. In addition, the model also can apply to a generic e-healthcare service environment with a hierarchical architecture.

How Commercial and "Violent" Video Games Can Promote Culturally Sensitive Science Learning: Some Questions and Challenges

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Kwah, Helen

2012-01-01

In their paper, Munoz and El-Hani propose to bring video games into science classrooms to promote culturally sensitive ethics and citizenship education. Instead of bringing "educational" games, Munoz and El-Hani take a more creative route and include games such as Fallout 3[R] precisely because they are popular and they reproduce ideological and…

Assessment of patient safety culture in private and public hospitals in Peru.

Science.gov (United States)

Arrieta, Alejandro; Suárez, Gabriela; Hakim, Galed

2018-04-01

To assess the patient safety culture in Peruvian hospitals from the perspective of healthcare professionals, and to test for differences between the private and public healthcare sectors. Patient safety is defined as the avoidance and prevention of patient injuries or adverse events resulting from the processes of healthcare delivery. A non-random cross-sectional study conducted online. An online survey was administered from July to August 2016, in Peru. This study reports results from Lima and Callao, which are the capital and the port region of Peru. A total of 1679 healthcare professionals completed the survey. Participants were physicians, medical residents and nurses working in healthcare facilities from the private sector and public sector. Assessment of the degree of patient safety and 12 dimensions of patient safety culture in hospital units as perceived by healthcare professionals. Only 18% of healthcare professionals assess the degree of patient safety in their unit of work as excellent or very good. Significant differences are observed between the patient safety grades in the private sector (37%) compared to the public sub-sectors (13-15%). Moreover, in all patient safety culture dimensions, healthcare professionals from the private sector give more favorable responses for patient safety, than those from the public sub-systems. The most significant difference in support comes from patient safety administrators through communication and information about errors. Overall, the degree of patient safety in Peru is low, with significant gaps that exist between the private and the public sectors.

The representation of healthcare end users' perspectives by surrogates in healthcare decisions: a literature review.

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Shah, Syed Ghulam Sarwar; Farrow, Alexandra; Robinson, Ian

2009-12-01

The representation of end users' perspectives in healthcare decisions requires involvement of their surrogates when the end users, i.e. certain patients, elderly people, children and people with disabilities, are unable to present their views. To review critical issues, and the advantages and disadvantages of involving surrogates in representing end users' perspectives in healthcare decisions. A systematic review of literature published in peer-reviewed journals from 1990 to 2005. Findings show that surrogates are used widely in health care and that they are necessary to represent end users' perspectives in healthcare decisions when the latter are unable to do so themselves. Critical issues in using surrogates include key ethical, social, cultural, legal and medico-technological factors; ascertaining the best interest of end users; potential conflict of interest; possible biased decisions and the burden on surrogates. The key advantage of surrogate involvement in healthcare decisions is their ability to represent end users' needs, values and wishes. The main disadvantages include potential discrepancies between the decisions and conclusions of surrogates and end users; the failure of surrogates to predict end users' preferences accurately and the lack of certainty that useful information will be obtained through the surrogacy process. This systematic review has revealed that the involvement of surrogates is an additional vital way to represent end users' perspectives in healthcare decisions where for a range of reasons their opinions are unable to be effectively ascertained. However, because of the heterogeneity of surrogates and end users, the selection of appropriate surrogates and deploying surrogate decisions require particularly careful consideration of their value in individual cases; thus, subsequent decision-making must be reviewed on a case-to-case basis to seek to ensure that the best interests, needs and wishes of the end user are fully and accurately

Ages and stages questionnaires: adaptation to an Arabic speaking population and cultural sensitivity.

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Charafeddine, Lama; Sinno, Durriyah; Ammous, Farah; Yassin, Walid; Al-Shaar, Laila; Mikati, Mohamad A

2013-09-01

Early detection of developmental delay is essential to initiate early intervention. The Ages and Stages Questionnaires (ASQ) correlate well with physician's assessment and have high predictive value. No such tool exists in Arabic. Translate and test the applicability and reliability of Arabic translated Ages and Stages Questionnaires (A-ASQ) in an Arabic speaking population. 733 healthy children were assessed. ASQ-II for 10 age groups (4-60 months) were translated to Arabic, back translations and cultural adaptation were performed. Test-retest reliability and internal consistency were evaluated using Pearson Correlation Coefficient (CC) and Cronbach's alpha (Cα). Mean scores per domain were compared to US normative scores using t-test. A-ASQ, after culturally relevant adaptations, was easily administered for 4-36 months age groups but not for 4-5 year old due to numerous cultural differences in the later. For the 4-36 month age groups Pearson CC ranged from 0.345 to 0.833. The internal consistency coefficients Cα scores ranged from 0.111 to 0.816. Significant differences were found in the mean domain scores of all age groups between Lebanese and US normative sample (p-value internal consistency and reliability in the younger age groups. It proved to be culturally sensitive, which should be taken into consideration when adapting such tool to non-western populations. Copyright © 2013 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

A Tamper-Resistant and Portable Healthcare Folder

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Nicolas Anciaux

2008-01-01

Full Text Available Electronic health record (EHR projects have been launched in most developed countries to increase the quality of healthcare while decreasing its cost. The benefits provided by centralizing the healthcare information in database systems are unquestionable in terms of information quality, availability, and protection against failure. Yet, patients are reluctant to give to a distant server the control over highly sensitive data (e.g., data revealing a severe or shameful disease. This paper capitalizes on a new hardware portable device, associating the security of a smart card to the storage capacity of a USB key, to give back to the patient the control over his medical data. This paper shows how this device can complement a traditional EHR server to (1 protect and share highly sensitive data among trusted parties and (2 provide a seamless access to the data even in disconnected mode. The proposed architecture is experimented in the context of a medicosocial network providing medical care and social services at home for elderly people.

Barriers to healthcare for transgender individuals.

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Safer, Joshua D; Coleman, Eli; Feldman, Jamie; Garofalo, Robert; Hembree, Wylie; Radix, Asa; Sevelius, Jae

2016-04-01

Transgender persons suffer significant health disparities and may require medical intervention as part of their care. The purpose of this manuscript is to briefly review the literature characterizing barriers to healthcare for transgender individuals and to propose research priorities to understand mechanisms of those barriers and interventions to overcome them. Current research emphasizes sexual minorities' self-report of barriers, rather than using direct methods. The biggest barrier to healthcare reported by transgender individuals is lack of access because of lack of providers who are sufficiently knowledgeable on the topic. Other barriers include: financial barriers, discrimination, lack of cultural competence by providers, health systems barriers, and socioeconomic barriers. National research priorities should include rigorous determination of the capacity of the US healthcare system to provide adequate care for transgender individuals. Studies should determine knowledge and biases of the medical workforce across the spectrum of medical training with regard to transgender medical care; adequacy of sufficient providers for the care required, larger social structural barriers, and status of a framework to pay for appropriate care. As well, studies should propose and validate potential solutions to address identified gaps.

Patient Experience: A Critical Indicator of Healthcare Performance.

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Guler, Pamela H

2017-01-01

Patient experience has become a critical differentiator for healthcare organizations, and it will only grow in importance as transparency and consumerism dominate the healthcare landscape. Creating and sustaining a consistently exceptional experience that promotes patient engagement and the best outcomes is far more than just "satisfying" patients, going well beyond amenities that may be provided.Perception of care experience is often shaped by methods we use to address the biopsychosocial needs of patients. Building relationships and communicating well with our patients and families are primary approaches. In a complex healthcare situation, patients may not fully understand or remember the highly clinical nature of treatment. However, they always remember how we made them feel, how we communicated with them as a team, and what interactions they experienced while in our care.Patients who are fully informed and feel connected to their caregivers are often less anxious than those who are disengaged. Informed and engaged patients are enabled to participate in their healthcare. Organizations that focus on developing an accountable culture-one that inspires caregivers to communicate in a way that connects to patients' mind, body, and spirit while leveraging standard, evidence-based patient experience practices-find that patients' perception of care, or "the patient experience," is vastly improved.Adventist Health System has embarked on a journey to patient experience excellence with a commitment to whole-person care and standard patient experience practice across the system. Recognized with several national awards, we continue to strengthen our approach toward bringing all of our campuses and patient settings to sustained high-level performance. We have found that a combination of strong, accountable leadership; a focus on employee culture; engagement of physicians; standardized patient experience practices and education; and meaningful use of patient feedback are top

Culture and drug sensitivity testing among patients with pulmonary tuberculosis in Mexico: national data for 2009–2013

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Ivonne Orejel

Full Text Available ABSTRACT This study documented the number and results of mycobacterial culture and drug sensitivity testing (CDST in Mexico from 2009–2013 and assessed whether states with a higher risk of multidrug-resistant tuberculosis (MDR-TB performed more CDST and had more cultures showing MDR-TB. Data for this longitudinal, descriptive, operational research study came from the electronic records of 31 state public health laboratories in Mexico. The total number of CDSTs was 6 470, increasing from 2 143 in the first 2 years to 4 327 in the latter 3 years. There was a significant increase in the proportion of cultures showing sensitivity to all drugs, from 53.1% to 60.9% in 2011–2013 (P < 0.001 and a significant decrease in the proportion showing MDR-TB, from 28.2% in 2009 to 19.8% in 2013 (P < 0.001. Cases of extensively drug resistant tuberculosis were < 1% per year. In the 12 states with higher risk for MDR-TB, significantly more CDSTs (2 382 test were done in 2011–2013 than in the other 19 states (1 945 tests. Also, for each year the proportion of cultures showing MDR-TB was significantly higher in high risk MDR-TB states than in lower risk ones (P < 0.001. During the 5-year study period, CDST was scaled up in Mexico, particularly in high-risk MDR-TB states where a higher proportion of cultures showed MDR-TB. Scale up and wider coverage of CDST should continue.

A qualitative thematic review: emotional labour in healthcare settings.

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Riley, Ruth; Weiss, Marjorie C

2016-01-01

To identify the range of emotional labour employed by healthcare professionals in a healthcare setting and implications of this for staff and organisations. In a healthcare setting, emotional labour is the act or skill involved in the caring role, in recognizing the emotions of others and in managing our own. A thematic synthesis of qualitative studies which included emotion work theory in their design, employed qualitative methods and were situated in a healthcare setting. The reporting of the review was informed by the ENTREQ framework. 6 databases were searched between 1979-2014. Studies were included if they were qualitative, employed emotion work theory and were written in English. Papers were appraised and themes identified. Thirteen papers were included. The reviewed studies identified four key themes: (1) The professionalization of emotion and gendered aspects of emotional labour; (2) Intrapersonal aspects of emotional labour - how healthcare workers manage their own emotions in the workplace; (3) Collegial and organisational sources of emotional labour; (4) Support and training needs of professionals This review identified gendered, personal, organisational, collegial and socio-cultural sources of and barriers to emotional labour in healthcare settings. The review highlights the importance of ensuring emotional labour is recognized and valued, ensuring support and supervision is in place to enable staff to cope with the varied emotional demands of their work. © 2015 John Wiley & Sons Ltd.

The effect of culture density and proliferation rate on the expression of ouabain-sensitive Na/K ATPase pumps in cultured human retinal pigment epithelium

Energy Technology Data Exchange (ETDEWEB)

Burke, J.M.; Jaffe, G.J.; Brzeski, C.M. (Medical College of Wisconsin, Milwaukee (USA))

1991-06-01

The number and activity of ouabain-sensitive Na/K ATPase pumps expressed by many cell types in vitro, including human retinal pigment epithelial cells (RPE), have been shown to decline with increasing culture density. Cell proliferation also declined as cultures became dense so it was unclear if pump number was modulated by cell proliferation or culture confluency. By exposing RPE cultures to various feeding regimens, using culture medium containing or lacking serum, it was possible to produce RPE cultures with a range of culture densities and growth rates. These were analyzed for proliferative activity by quantifying ({sup 3}H)thymidine incorporation and for Na/K ATPase pump number by measuring specific ({sup 3}H)ouabain binding. The results suggest that pump number is modulated by culture density and, further, that the density-dependent regulation of pump number requires serum. Although density-dependent modulation of culture growth is also serum requiring, cell proliferation and pump number did not appear to be related; cultures of similar density which differed significantly in growth rate had similar numbers of pumps. The view that elevated numbers of pumps were not necessarily found in proliferating cells was further supported by qualitative examination of radioautographs of cells dually labeled with ({sup 3}H)thymidine and ({sup 3}H)ouabain. Cycling cells which had ({sup 3}H)thymidine-labeled nuclei did not have notably higher labeling with ({sup 3}H)ouabain. However, ({sup 3}H)ouabain labeling, as an indicator of pump site number and distribution, did vary among cells in an RPE population and also within individual cells. This latter observation suggests that unpolarized RPE cells in sparse cultures may have regionally different requirements for ionic regulation.

Risk of tuberculosis transmission among healthcare workers.

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Diel, Roland; Niemann, Stefan; Nienhaus, Albert

2018-04-01

Data from a prospective molecular-epidemiological study (1997-2015) of patients with culture-confirmed tuberculosis in Hamburg, Germany, were evaluated to assess the occupational risk of Mycobacterium tuberculosis complex transmission in a low-incidence setting. Isolates of M. tuberculosis complex were genotyped using IS6110 restriction fragment length polymorphism analysis. Results of structured questionnaires, geographical mapping and additional patient interviews were used for confirming epidemiological links. Out of the 2393 cases, 918 (38.4%) were classified into 224 clusters comprising 2-70 patients per cluster. Among the 918 cluster members, epidemiological links could be confirmed in 340 (37.0%) patients. In total, 55 (2.3%) patients were healthcare workers; 26 healthcare workers remained unclustered, but 29 healthcare workers belonged to cluster groups. Conventional contact tracing performed before genotyping to identify sources of the reported index cases detected only 73 (3.1%) patients. Logistic regression analysis confirmed work in the healthcare sector as strongest predictor for clustering of patients with verified epidemiological links (odds ratio (OR) 3.1, 95% CI 1.6-5.9), followed by alcoholism (OR 2.3, 95% CI 1.7-3.2) and sputum smear positivity (OR 1.8, 95% CI 1.4-2.3). Immigrants were more likely to be cluster nonmembers (OR 0.3, 95% CI 0.3-0.5). Recent transmission in Hamburg within the 19-year study period was found to be strongly associated with working in a healthcare facility. Although clusters also include many "imported" strains from abroad or regional highly prevalent M. tuberculosis strains with no evident epidemiological connection, routine molecular-epidemiological survey is indispensable to optimising and controlling the effectiveness of TB control strategies in German healthcare settings.

The national response for preventing healthcare-associated infections: infrastructure development.

Science.gov (United States)

Mendel, Peter; Siegel, Sari; Leuschner, Kristin J; Gall, Elizabeth M; Weinberg, Daniel A; Kahn, Katherine L

2014-02-01

In 2009, the US Department of Health and Human Services (HHS) launched the Action Plan to Prevent Healthcare-associated Infections (HAIs). The Action Plan adopted national targets for reduction of specific infections, making HHS accountable for change across the healthcare system over which federal agencies have limited control. This article examines the unique infrastructure developed through the Action Plan to support adoption of HAI prevention practices. Interviews of federal (n=32) and other stakeholders (n=38), reviews of agency documents and journal articles (n=260), and observations of interagency meetings (n=17) and multistakeholder conferences (n=17) over a 3-year evaluation period. We extract key progress and challenges in the development of national HAI prevention infrastructure--1 of the 4 system functions in our evaluation framework encompassing regulation, payment systems, safety culture, and dissemination and technical assistance. We then identify system properties--for example, coordination and alignment, accountability and incentives, etc.--that enabled or hindered progress within each key development. The Action Plan has developed a model of interagency coordination (including a dedicated "home" and culture of cooperation) at the federal level and infrastructure for stimulating change through the wider healthcare system (including transparency and financial incentives, support of state and regional HAI prevention capacity, changes in safety culture, and mechanisms for stakeholder engagement). Significant challenges to infrastructure development included many related to the same areas of progress. The Action Plan has built a foundation of infrastructure to expand prevention of HAIs and presents useful lessons for other large-scale improvement initiatives.

Predictors of Healthcare Service Utilization for Mental Health Reasons

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Marie-Josée Fleury

2014-10-01

Full Text Available This study was designed to identify: (1 predictors of 12-month healthcare service utilization for mental health reasons, framed by the Andersen model, among a population cohort in an epidemiological catchment area; and (2 correlates associated with healthcare service utilization for mental health reasons among individuals with and without mental disorders respectively. Analyses comprised univariate, bivariate, and multiple regression analyses. Being male, having poor quality of life, possessing better self-perception of physical health, and suffering from major depressive episodes, panic disorder, social phobia, and emotional problems predicted healthcare service utilization for mental health reasons. Among individuals with mental disorders, needs factors (psychological distress, impulsiveness, emotional problems, victim of violence, and aggressive behavior and visits to healthcare professionals were associated with healthcare service utilization for mental health reasons. Among individuals without mental disorders, healthcare service utilization for mental health reasons is strongly associated with enabling factors such as social support, income, environmental variables, and self-perception of the neighborhood. Interventions facilitating social cohesion and social solidarity in neighborhood settings may reduce the need to seek help among individuals without mental disorders. Furthermore, in their capacity as frontline professionals, general practitioners should be more sensitive in preventing, detecting, and treating mental disorders in routine primary care.

Innovations in healthcare finance lessons from the 401(k) model.

Science.gov (United States)

Myers, Chris; Lineen, Jason

2008-10-01

*Escalating health benefit expenses are leading employers to shift more of the costs to their employees. *Global financial services companies and startup entrepreneurs are competing to develop private-sector solutions to capitalize on the ailing and mis-aligned healthcare financing system. *Emerging innovations are targeting insured individuals who are facing increasing responsibility for first-dollar coverage. *Healthcare providers should view patients as individual "price-sensitive payers" as new tools enable them to shop around for services based on cost and quality.

Cultural identity and patient trust among older American Indians.

Science.gov (United States)

Simonds, Vanessa W; Goins, R Turner; Krantz, Elizabeth M; Garroutte, Eva Marie

2014-03-01

Patients' trust in healthcare providers and institutions has been identified as a likely contributor to racial-ethnic health disparities. The likely influence of patients' cultural characteristics on trust is widely acknowledged but inadequately explored. To compare levels of patients' trust in primary care provider (interpersonal trust) with trust in healthcare organizations (institutional trust) among older American Indians (AIs), and determine associations with cultural identity. Patient survey administered following primary care visits. Two-hundred and nineteen American Indian patients ≥ 50 years receiving care for a non-acute condition at two clinics operated by the Cherokee Nation in northeastern Oklahoma. Self-reported sociodemographic and cultural characteristics. Trust was measured using three questions about interpersonal trust and one measure of institutional trust; responses ranged from strongly agree to strongly disagree. Finding substantial variation only in institutional trust, we used logistic generalized estimating equations to examine relationships of patient cultural identity with institutional trust. Ninety-five percent of patients reported trusting their individual provider, while only 46 % reported trusting their healthcare institution. Patients who strongly self-identified with an AI cultural identity had significantly lower institutional trust compared to those self-identifying less strongly (OR: 0.6, 95 % CI: 0.4, 0.9). Interpersonal and institutional trust represent distinct dimensions of patients' experience of care that may show important relationships to patients' cultural characteristics. Strategies for addressing low institutional trust may have special relevance for patients who identify strongly with AI culture.

Assessing the relationship between patient safety culture and EHR strategy.

Science.gov (United States)

Ford, Eric W; Silvera, Geoffrey A; Kazley, Abby S; Diana, Mark L; Huerta, Timothy R

2016-07-11

Purpose - The purpose of this paper is to explore the relationship between hospitals' electronic health record (EHR) adoption characteristics and their patient safety cultures. The "Meaningful Use" (MU) program is designed to increase hospitals' adoption of EHR, which will lead to better care quality, reduce medical errors, avoid unnecessary cost, and promote a patient safety culture. To reduce medical errors, hospital leaders have been encouraged to promote safety cultures common to high-reliability organizations. Expecting a positive relationship between EHR adoption and improved patient safety cultures appears sound in theory, but it has yet to be empirically demonstrated. Design/methodology/approach - Providers' perceptions of patient safety culture and counts of patient safety incidents are explored in relationship to hospital EHR adoption patterns. Multi-level modeling is employed to data drawn from the Agency for Healthcare Research and Quality's surveys on patient safety culture (level 1) and the American Hospital Association's survey and healthcare information technology supplement (level 2). Findings - The findings suggest that the early adoption of EHR capabilities hold a negative association to the number of patient safety events reported. However, this relationship was not present in providers' perceptions of overall patient safety cultures. These mixed results suggest that the understanding of the EHR-patient safety culture relationship needs further research. Originality/value - Relating EHR MU and providers' care quality attitudes is an important leading indicator for improved patient safety cultures. For healthcare facility managers and providers, the ability to effectively quantify the impact of new technologies on efforts to change organizational cultures is important for pinpointing clinical areas for process improvements.

Thinking Differently: Catalyzing Innovation in Healthcare and Beyond.

Science.gov (United States)

Samet, Kenneth A; Smith, Mark S

2016-01-01

Convenience, value, access, and choice have become the new expectations of consumers seeking care. Incorporating these imperatives and navigating an expanded competitive landscape are necessary for the success of healthcare organizations-today and in the future-and require thinking differently than in the past.Innovation must be a central strategy for clinical and business operations to be successful. However, the currently popular concept of innovation is at risk of losing its power and meaning unless deliberate and focused action is taken to define it, adopt it, embrace it, and embed it in an organization's culture. This article details MedStar Health's blueprint for establishing the MedStar Institute for Innovation (MI2), which involved recognizing the sharpened need for innovation, creating a single specific entity to catalyze innovation across the healthcare organization and community, discovering the untapped innovation energy already residing in its employee base, and moving nimbly into the white space of possibility.Drawing on MedStar's experience with MI2, we offer suggestions in the following areas for implementing an innovation institute in a large healthcare system:We offer healthcare and business leaders a playbook for identifying and unleashing innovation in their organizations, at a time when innovation is at an increased risk of being misunderstood or misdirected but remains absolutely necessary for healthcare systems and organizations to flourish in the future.

Assessing organisational culture for quality and safety improvement: a national survey of tools and tool use.

Science.gov (United States)

Mannion, R; Konteh, F H; Davies, H T O

2009-04-01

There is growing international interest in managing organisational culture as a lever for healthcare improvement. This has prompted a practical need to understand what instruments and tools exist for assessing cultures in healthcare contexts. The present study was undertaken to determine the culture assessment tools being used in the English NHS and assess their fitness for purpose. Postal questionnaire survey of clinical governance leads in 275 English NHS organisations, with a response rate of 77%. A third of the organisations were currently using a culture assessment instrument to support their clinical governance activity. Although we found a high degree of satisfaction with existing instruments, in terms of ease of use and relevance, there is an immediate practical need to develop new and better bespoke culture assessment tools to bridge the gap between the cultural domains covered by extant instruments and the broader range of concerns of clinical governance managers. There is growing interest in understanding and shaping local cultures in healthcare, which is not yet matched by widespread use of available instruments. Even though extant tools cover many of the most important cultural attributes identified by clinical governance managers, the over-riding focus of tools in use is on safety rather than a holistic assessment of the dimensions of healthcare quality and performance.

Cultural context and school counseling: Cultural sensitivity to advocate for social justice

Directory of Open Access Journals (Sweden)

Moshé Tatar

2008-06-01

Full Text Available In this paper the relevance of understanding the different meanings of culture in the counseling profession is presented. Two approaches to the concept of culture as they relate to counseling are suggested: the first approach stresses the organisational culture of the institution where the counselor works; the second —the multicultural approach— calls for the complex recognition of the variety of ethnic cultural backgrounds of those involved in the counseling situation. Professional practices are analysed as means for the reinforcement of present conditions or as ways for changing them. The concepts of empowerment of and advocacy for our clients are put forward as main components in the challenging new roles of the counseling profession. Implications for counselors are suggested.

Density gradient localization of vanadate- and NO-3-sensitive ATPase from sterile cultures of Spirodela polyrrhiza (L. Schleiden

Directory of Open Access Journals (Sweden)

Józef Buczek

2014-01-01

Full Text Available The present work deals with the separation and some characteristics of ATPase activities bound with plant membanes prepared from sterile cultures of Spirodela polyrrhiza. The membrane-bound ATPases were separated on sucrose gradients and distinguished by membrane density and sensitivity to several inhibitors. The results showed that N0-3-sensitive ATPase activity associated with the tonoplast was localized at a sucrose density between 1.095-1.117 g•cm-3. The vanadate-sensitive ATPase activity bound with the plasma membrane showed a density between 1.127-1.151 g•cm-3. Both ATPases were insensitive to azide and oligomycin and were separable from markers for mitochondria.

A framework for luck egalitarianism in health and healthcare.

Science.gov (United States)

Albertsen, Andreas; Knight, Carl

2015-02-01

Several attempts have been made to apply the choice-sensitive theory of distributive justice, luck egalitarianism, in the context of health and healthcare. This article presents a framework for this discussion by highlighting different normative decisions to be made in such an application, some of the objections to which luck egalitarians must provide answers and some of the practical implications associated with applying such an approach in the real world. It is argued that luck egalitarians should address distributions of health rather than healthcare, endorse an integrationist theory that combines health concerns with general distributive concerns and be pluralist in their approach. It further suggests that choice-sensitive policies need not be the result of applying luck egalitarianism in this context. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Healthcare and healthcare systems: inspiring progress and future prospects.

Science.gov (United States)

Durrani, Hammad

2016-01-01

growth will occur in the urban areas of poor countries. The rapid, unplanned and unsustainable style of urban development will make developing countries cities the key focal points for emerging environmental and health hazards. Changes will be seen in design, culture and practices of hospitals to better meet the needs of patients, families and providers. Top driving factors of global healthcare system for next 30 years will be leading causes of mortalities, non-health factors (impact of nutrition, sanitation and women's empowerment), investment in health workforce and growth of medical tourism in future healthcare scenario. Evaluating the patterns of previous 30 years and predicting the progress and challenges of future health system are no rocket science. Medical care will be more self-directed in a more tech-savvy population as information will be more accessible and user friendly with higher quality. Health driving factors such as clean water, sanitation and food will take the center stage in humanities struggle and even increase population size.

A rapid and sensitive method for measuring N-acetylglucosaminidase activity in cultured cells.

Directory of Open Access Journals (Sweden)

Victor Mauri

Full Text Available A rapid and sensitive method to quantitatively assess N-acetylglucosaminidase (NAG activity in cultured cells is highly desirable for both basic research and clinical studies. NAG activity is deficient in cells from patients with Mucopolysaccharidosis type IIIB (MPS IIIB due to mutations in NAGLU, the gene that encodes NAG. Currently available techniques for measuring NAG activity in patient-derived cell lines include chromogenic and fluorogenic assays and provide a biochemical method for the diagnosis of MPS IIIB. However, standard protocols require large amounts of cells, cell disruption by sonication or freeze-thawing, and normalization to the cellular protein content, resulting in an error-prone procedure that is material- and time-consuming and that produces highly variable results. Here we report a new procedure for measuring NAG activity in cultured cells. This procedure is based on the use of the fluorogenic NAG substrate, 4-Methylumbelliferyl-2-acetamido-2-deoxy-alpha-D-glucopyranoside (MUG, in a one-step cell assay that does not require cell disruption or post-assay normalization and that employs a low number of cells in 96-well plate format. We show that the NAG one-step cell assay greatly discriminates between wild-type and MPS IIIB patient-derived fibroblasts, thus providing a rapid method for the detection of deficiencies in NAG activity. We also show that the assay is sensitive to changes in NAG activity due to increases in NAGLU expression achieved by either overexpressing the transcription factor EB (TFEB, a master regulator of lysosomal function, or by inducing TFEB activation chemically. Because of its small format, rapidity, sensitivity and reproducibility, the NAG one-step cell assay is suitable for multiple procedures, including the high-throughput screening of chemical libraries to identify modulators of NAG expression, folding and activity, and the investigation of candidate molecules and constructs for applications in

Health equity monitoring for healthcare quality assurance.

Science.gov (United States)

Cookson, R; Asaria, M; Ali, S; Shaw, R; Doran, T; Goldblatt, P

2018-02-01

Population-wide health equity monitoring remains isolated from mainstream healthcare quality assurance. As a result, healthcare organizations remain ill-informed about the health equity impacts of their decisions - despite becoming increasingly well-informed about quality of care for the average patient. We present a new and improved analytical approach to integrating health equity into mainstream healthcare quality assurance, illustrate how this approach has been applied in the English National Health Service, and discuss how it could be applied in other countries. We illustrate the approach using a key quality indicator that is widely used to assess how well healthcare is co-ordinated between primary, community and acute settings: emergency inpatient hospital admissions for ambulatory care sensitive chronic conditions ("potentially avoidable emergency admissions", for short). Whole-population data for 2015 on potentially avoidable emergency admissions in England were linked with neighborhood deprivation indices. Inequality within the populations served by 209 clinical commissioning groups (CCGs: care purchasing organizations with mean population 272,000) was compared against two benchmarks - national inequality and inequality within ten similar populations - using neighborhood-level models to simulate the gap in indirectly standardized admissions between most and least deprived neighborhoods. The modelled inequality gap for England was 927 potentially avoidable emergency admissions per 100,000 people, implying 263,894 excess hospitalizations associated with inequality. Against this national benchmark, 17% of CCGs had significantly worse-than-benchmark equity, and 23% significantly better. The corresponding figures were 11% and 12% respectively against the similar populations benchmark. Deprivation-related inequality in potentially avoidable emergency admissions varies substantially between English CCGs serving similar populations, beyond expected statistical

The Decent Care Movement: Subsidiarity, Pragmatic Solidarity, and Cross-Cultural Resonance.

Science.gov (United States)

Niforatos, Joshua D

2016-02-01

Decent Care is the World Health Organization and The Ford Foundation's joint effort to articulate a healthcare paradigm that makes a patient's voice equal to the voice of the healthcare provider. In this article, the six tenants of Decent Care are outlined with particular emphasis on subsidiarity. Liberation theology's preferential option for the poor maxim is presented and compared with other major world religions to demonstrate the cross-cultural focus of "decency." The power of this paradigm is in its emphasis and proclamation of human flourishing in a healthcare setting, generally speaking, and more specifically, human flourishing in the presence of affliction from chronic disease or dying cross-culturally.

Patient Safety Culture and the Second Victim Phenomenon: Connecting Culture to Staff Distress in Nurses

Science.gov (United States)

Quillivan, Rebecca R.; Burlison, Jonathan D.; Browne, Emily K.; Scott, Susan D.; Hoffman, James M.

2017-01-01

Background Second victim experiences can affect the well-being of healthcare providers and compromise patient safety. Many factors associated with improved coping afer patient safety event involvement are also components of a strong patient safety culture, so that supportive patient safety cultures may reduce second victim–related trauma. A cross-sectional survey study was conducted to assess the influence of patient safety culture on second victim–related distress, in which associations among patient safety culture dimensions, organizational support, and second victim distress were investigated. Methods The Agency for Healthcare Research and Quality (AHRQ) Hospital Survey on Patient Safety Culture (HSOPSC) and the Second Victim Experience and Support Tool (SVEST), which was developed to assess organizational support and personal and professional distress after involvement in a patient safety event, were administered to nurses involved in direct patient care. Results Of 358 nurses, 155 (41%) responded, of whom 144 completed both surveys. Hierarchical linear regression demonstrated that the patient safety culture survey dimension nonpunitive response to errors was significantly associated with reductions in the second victim survey dimensions psychological, physical, and professional distress (p patient safety event by encouraging supportive interactions. Also, perceptions of second victim–related distress may be less severe when hospital cultures are characterized by nonpunitive response to errors. Reducing punitive response to error and encouraging supportive coworker, supervisor, and institutional interactions may be useful strategies to manage the severity of second victim experiences. PMID:27456420

Healthcare for migrants, participatory health research and implementation science--better health policy and practice through inclusion. The RESTORE project.

Science.gov (United States)

MacFarlane, Anne; O'Reilly-de Brún, Mary; de Brún, Tomas; Dowrick, Christopher; O'Donnell, Catherine; Mair, Frances; Spiegel, Wolfgang; van den Muijsenbergh, Maria; van Weel Baumgarten, Evelyn; Lionis, Christos; Clissmann, Ciaran

2014-06-01

This is a time of unprecedented mobility across the globe. Healthcare systems need to adapt to ensure that primary care is culturally and linguistically appropriate for migrants. Evidence-based guidelines and training interventions for cultural competence and the use of professional interpreters are available across European healthcare settings. However, in real-world practice migrants and their healthcare providers 'get by' with a range of informal and inadequate strategies. RESTORE is an EU FP7 funded project, which is designed to address this translational gap. The objective of RESTORE is to investigate and support the implementation of guidelines and training initiatives to support communication in cross-cultural consultations in selected European primary care settings. RESTORE is a qualitative, participatory health project running from 2011-2015. It uses a novel combination of normalization process theory and participatory learning and action research to follow and shape the implementation journeys of relevant guidelines and training initiatives. Research teams in Ireland, England, the Netherlands, Austria and Greece are conducting similar parallel qualitative case study fieldwork, with a complementary health policy analysis led by Scotland. In each setting, key stakeholders, including migrants, are involved in participatory data generation and analysis. RESTORE will provide knowledge about the levers and barriers to the implementation of guidelines and training initiatives in European healthcare settings and about successful, transferrable strategies to overcome identified barriers. RESTORE will elucidate the role of policy in shaping these implementation journeys; generate recommendations for European policy driving the development of culturally and linguistically appropriate healthcare systems.

Sensitivity, specificity and predictive value of blood cultures from cattle clinically suspected of bacterial endocarditis

DEFF Research Database (Denmark)

Houe, Hans; Eriksen, L.; Jungersen, Gregers

1993-01-01

This study investigated the number of blood culture-positive cattle among 215 animals clinically suspected of having bacterial endocarditis. For animals that were necropsied, the sensitivity, specificity and predictive value of the diagnosis of endocarditis were calculated on the basis...... of the isolation of the causative bacteria from blood. Furthermore, it was investigated whether the glutaraldehyde coagulation time, total leucocyte count, per cent neutrophil granulocytes, pulse rate and duration of disease could help to discriminate endocarditis from other diseases. Among 138 animals necropsied...... the sensitivity, specificity and predictive value of blood cultivation were 70.7 per cent, 93.8 per cent and 89.1 per cent, respectively. None of the other measurements could be used to discriminate between endocarditis and non-endocarditis cases....

Familial study of ataxia telangiectasia. Heterozygotes identification on the basis of sensitivity of gamma-irradiated cultures to caffeine post-treatment

International Nuclear Information System (INIS)

Pawlak, A.L.; Kotecki, M.

1994-01-01

The effects of caffeine (CF), γ-irradiation + CF post-treatment on chromosomal aberrations were studied in lymphocyte cultures from a patient with ataxia telangiectasia (AT), his parents and brother. In the studied family both the homozygotes and the obligatory heterozygotes of AT showed increased sensitivity to CF post-treatment. Individual differences in sensitivity to γ-irradiation + CF post-treatment proved to be correlated with the sensitivity of non-irradiated cells to CF treatment, but not to γ-irradiation. (author). 19 refs, 1 fig., 1 tab

Familial study of ataxia telangiectasia. Heterozygotes identification on the basis of sensitivity of gamma-irradiated cultures to caffeine post-treatment

Energy Technology Data Exchange (ETDEWEB)

Pawlak, A.L.; Kotecki, M. [Polska Akademia Nauk, Poznan (Poland). Zaklad Genetyki Czlowieka; Ignatowicz, R. [Centrum Zdrowia Dziecka, Warsaw (Poland)

1994-12-31

The effects of caffeine (CF), {gamma}-irradiation + CF post-treatment on chromosomal aberrations were studied in lymphocyte cultures from a patient with ataxia telangiectasia (AT), his parents and brother. In the studied family both the homozygotes and the obligatory heterozygotes of AT showed increased sensitivity to CF post-treatment. Individual differences in sensitivity to {gamma}-irradiation + CF post-treatment proved to be correlated with the sensitivity of non-irradiated cells to CF treatment, but not to {gamma}-irradiation. (author). 19 refs, 1 fig., 1 tab.

Integrating the 3Ds—Social Determinants, Health Disparities, and Health-Care Workforce Diversity

Science.gov (United States)

Pierre, Geraldine

2014-01-01

The established relationships among social determinants of health (SDH), health disparities, and race/ethnicity highlight the need for health-care professionals to adequately address SDH in their encounters with patients. The ethnic demographic transition slated to occur during the next several decades in the United States will have numerous effects on the health-care sector, particularly as it pertains to the need for a more diverse and culturally aware workforce. In recent years, a substantial body of literature has developed, exploring the extent to which diversity in the health-care workforce may be used as a tool to eliminate racial/ethnic disparities in health and health care in the U.S. We explore existing literature on this topic, propose a conceptual framework, and identify next steps in health-care policy for reducing and eliminating health disparities by addressing SDH and diversification of the health-care workforce. PMID:24385659

Integrating the 3Ds--social determinants, health disparities, and health-care workforce diversity.

Science.gov (United States)

LaVeist, Thomas A; Pierre, Geraldine

2014-01-01

The established relationships among social determinants of health (SDH), health disparities, and race/ethnicity highlight the need for health-care professionals to adequately address SDH in their encounters with patients. The ethnic demographic transition slated to occur during the next several decades in the United States will have numerous effects on the health-care sector, particularly as it pertains to the need for a more diverse and culturally aware workforce. In recent years, a substantial body of literature has developed, exploring the extent to which diversity in the health-care workforce may be used as a tool to eliminate racial/ethnic disparities in health and health care in the U.S. We explore existing literature on this topic, propose a conceptual framework, and identify next steps in health-care policy for reducing and eliminating health disparities by addressing SDH and diversification of the health-care workforce.

Islam and the healthcare environment: designing patient rooms.

Science.gov (United States)

Kopec, D A K; Han, Li

2008-01-01

Islam and the Muslim population are often the source of much misunderstanding and media-influenced misconceptions. Muslim patients who enter the healthcare environment are often weak and likely to experience feelings of vulnerability. Because of the complex and interwoven nature of culture and religion in a person's identity, it is important to consider patient belief systems and values when designing a patient's immediate environment. Through an exploration of literature related to culture and diversity and the beliefs and value system of the Muslim population, the authors were able to identify flexible design initiatives that could accommodate an array of cultural and spiritual practices. Islam and the Muslim population were chosen as the points of reference for this study because of the strong influence of the religion on the culture, and because of the many nuances that differ from the dominant culture within the United States. From these points of reference, a hypothetical design was developed for a patient room that considers differing notions of privacy, alternatives for cultural and religious practices, and ways to include symbolic meaning derived from attributes such as color.

Relationship between sensitivity to ultraviolet light and budding in yeast cells of different culture ages

International Nuclear Information System (INIS)

Atsuta, J.; Okajima, S.

1976-01-01

Subpopulations of yeast cells, consisting of cells of different sizes and different percentages of budding cells, were prepared by centrifugation through sucrose solutions with linear density gradients of cultures at different phases of the growth cycle. Ultraviolet survival of these cells was determined by colony counting, and the survival rate was compared with the cells' respiratory rates. Individual budding cells and interdivisional cells, and also mother cells and daughter cells derived from irradiated budding cells, were isolated by the micromanipulation technique. The number of divisions in each cell was measured during a 21-hr incubation period immediately after irradiation. In the population in the logarithmic phase consisting of homogeneous cells of middle size, no difference in uv sensitivity was observed between mother cells and daughter cells, irrespective of mutual adhesion. Budding cell resistance was observed in the population in the transitional phase; this was due to the lesser uv sensitivity of daughter cells in the fresh medium. In the stationary phase, daughter cells were rather more sensitive than mother cells or interdivisional cells, so there was little difference in uv sensitivity between budding cells and interdivisional cells

Security issues in healthcare applications using wireless medical sensor networks: a survey.

Science.gov (United States)

Kumar, Pardeep; Lee, Hoon-Jae

2012-01-01

Healthcare applications are considered as promising fields for wireless sensor networks, where patients can be monitored using wireless medical sensor networks (WMSNs). Current WMSN healthcare research trends focus on patient reliable communication, patient mobility, and energy-efficient routing, as a few examples. However, deploying new technologies in healthcare applications without considering security makes patient privacy vulnerable. Moreover, the physiological data of an individual are highly sensitive. Therefore, security is a paramount requirement of healthcare applications, especially in the case of patient privacy, if the patient has an embarrassing disease. This paper discusses the security and privacy issues in healthcare application using WMSNs. We highlight some popular healthcare projects using wireless medical sensor networks, and discuss their security. Our aim is to instigate discussion on these critical issues since the success of healthcare application depends directly on patient security and privacy, for ethic as well as legal reasons. In addition, we discuss the issues with existing security mechanisms, and sketch out the important security requirements for such applications. In addition, the paper reviews existing schemes that have been recently proposed to provide security solutions in wireless healthcare scenarios. Finally, the paper ends up with a summary of open security research issues that need to be explored for future healthcare applications using WMSNs.

Security Issues in Healthcare Applications Using Wireless Medical Sensor Networks: A Survey

Directory of Open Access Journals (Sweden)

Hoon-Jae Lee

2011-12-01

Full Text Available Healthcare applications are considered as promising fields for wireless sensor networks, where patients can be monitored using wireless medical sensor networks (WMSNs. Current WMSN healthcare research trends focus on patient reliable communication, patient mobility, and energy-efficient routing, as a few examples. However, deploying new technologies in healthcare applications without considering security makes patient privacy vulnerable. Moreover, the physiological data of an individual are highly sensitive. Therefore, security is a paramount requirement of healthcare applications, especially in the case of patient privacy, if the patient has an embarrassing disease. This paper discusses the security and privacy issues in healthcare application using WMSNs. We highlight some popular healthcare projects using wireless medical sensor networks, and discuss their security. Our aim is to instigate discussion on these critical issues since the success of healthcare application depends directly on patient security and privacy, for ethic as well as legal reasons. In addition, we discuss the issues with existing security mechanisms, and sketch out the important security requirements for such applications. In addition, the paper reviews existing schemes that have been recently proposed to provide security solutions in wireless healthcare scenarios. Finally, the paper ends up with a summary of open security research issues that need to be explored for future healthcare applications using WMSNs.

Development and Validation of Culture-Sensitive Physics Learning Environment Survey (CS-PLES

Directory of Open Access Journals (Sweden)

Marie Paz E. Morales

2014-05-01

Full Text Available The study combined qualitative approaches with quantitative research design to come up with a survey instrument called Culture-Sensitive Physics Learning Environment Survey (CS-PLES.This survey instrument is intended to extract the learners’ beliefs and expectations on the integration of culture and language in the teaching and learning process of physics concepts. Significant contribution of the instrument can be traced to establishing and defining the constructs and categories on how curriculum localization and context-based science learning can be developed aligned with students’ expectations and beliefs. The development process employed non-conventional processes adopted from literature which included pilot study to identify pre-deterministic constructs and specific categories for the items to be included in the survey. Data analysis included descriptive statistics and factor analysis to establish the categories or constructs of the survey instruments. Reliability measures of the instrument and its respective constructs were established for standardization. These categories were intended to aid researchers for an in-depth analysis when the instrument is administered for its purpose. The raw statistical categories were qualitatively paralleled with the pre-deterministic constructs to establish congruence of the survey tool to Instructional Congruence Framework (ICF.

Counseling Spanish-speaking patients: Atlanta pharmacists' cultural sensitivity, use of language-assistance services, and attitudes.

Science.gov (United States)

Muzyk, Andrew J; Muzyk, Tara L; Barnett, Candace W

2004-01-01

To document the types of language-assistance services available in pharmacies and the perceptions of pharmacists regarding the effectiveness of these services, and to measure the attitudes toward counseling Spanish-speaking patients and cultural sensitivity of pharmacists. Cross-sectional assessment. Metropolitan Atlanta, Ga. Registered Georgia pharmacists residing in metropolitan Atlanta. Mailed survey, with repeat mailing 2 weeks later. 38 survey items measuring demographic and practice-site characteristics, types of language-assistance services available with an assessment of the effectiveness of each measured on a nominal scale, and attitudinal items concerning counseling of Spanish-speaking patients and pharmacists' cultural sensitivity using a 5-point Likert-type response scale. Of 1,975 questionnaires mailed, 608 were returned, a 30.8% response rate. Nearly two thirds of the pharmacists had recently counseled a Spanish-speaking patient, but only one fourth of those respondents considered their interactions effective. Nearly all pharmacists, 88.0%, worked in pharmacies with language-assistance services. Of seven types of these services, a mean of 2.19 were available in pharmacies, and the majority of pharmacists (84.4% or more) identifying a service considered it to be effective. The pharmacists were neutral about counseling Spanish-speaking patients (mean = 2.94) and indifferent toward other cultures (mean = 3.28); however, they agreed they had a responsibility to counsel Spanish-speaking patients, and they believed that use of language-assistance services would constitute a reasonable effort to counsel these patients. Pharmacists have an opportunity to address barriers to communication with the Spanish-speaking population through use of language-assistance services and educational measures within the profession.

Nurses' perceptions of patient safety culture in Jordanian hospitals.

Science.gov (United States)

Khater, W A; Akhu-Zaheya, L M; Al-Mahasneh, S I; Khater, R

2015-03-01

Patients' safety culture is a key aspect in determining healthcare organizations' ability to address and reduce risks of patients. Nurses play a major role in patients' safety because they are accountable for direct and continuous patient care. There is little known information about patients' safety culture in Jordanian hospitals, particularly from the perspective of healthcare providers. The study aimed to assess patient safety culture in Jordanian hospitals from nurses' perspective. A cross-sectional, descriptive design was utilized. A total number of 658 nurses participated in the current study. Data were collected using an Arabic version of the hospital survey of patients' safety culture. Teamwork within unit dimensions had a high positive response, and was perceived by nurses to be the only strong suit in Jordanian hospitals. Areas that required improvement, as perceived by nurses, are as follows: communication openness, staffing, handoff and transition, non-punitive responses to errors, and teamwork across units. Regression analysis revealed factors, from nurses' perspectives, that influenced patients' safety culture in Jordanian hospital. Factors included age, total years of experience, working in university hospitals, utilizing evidence-based practice and working in hospitals that consider patient safety to be a priority. Participants in this study were limited to nurses. Therefore, there is a need to assess patient safety culture from other healthcare providers' perspectives. Moreover, the use of a self-reported questionnaire introduced the social desirability biases. The current study provides insight into how nurses perceive patient safety culture. Results of this study have revealed that there is a need to replace the traditional culture of shame/blame with a non-punitive culture. Study results implied that improving patient safety culture requires a fundamental transformation of nurses' work environment. New policies to improve collaboration between

Urine culture

Science.gov (United States)

Culture and sensitivity - urine ... when urinating. You also may have a urine culture after you have been treated for an infection. ... when bacteria or yeast are found in the culture. This likely means that you have a urinary ...

Managing cultural diversity in healthcare partnerships: the case of LIFT.

Science.gov (United States)

Mannion, Russell; Brown, Sally; Beck, Matthias; Lunt, Neil

2011-01-01

The National Health Service (NHS) Local Improvement Finance Trust (LIFT) programme was launched in 2001 as an innovative public-private partnership to address the historical under-investment in local primary care facilities in England. The organisations from the public and private sector that comprise a local LIFT partnership each have their own distinctive norms of behaviour and acceptable working practices - ultimately different organisational cultures. The purpose of this article is to assess the role of organisational culture in facilitating (or impeding) LIFT partnerships and to contribute to an understanding of how cultural diversity in public-private partnerships is managed at the local level. The approach taken was qualitative case studies, with data gathering comprising interviews and a review of background documentation in three LIFT companies purposefully sampled to represent a range of background factors. Elite interviews were also conducted with senior policy makers responsible for implementing LIFT policy at the national level. Interpreting the data against a conceptual framework designed to assess approaches to managing strategic alliances, the authors identified a number of key differences in the values, working practices and cultures in public and private organisations that influenced the quality of joint working. On the whole, however, partners in the three LIFT companies appeared to be working well together, with neither side dominating the development of strategy. Differences in culture were being managed and accommodated as partnerships matured. As LIFT develops and becomes the primary source of investment for managing, developing and channelling funding into regenerating the primary care infrastructure, further longitudinal work might examine how ongoing partnerships are working, and how changes in the cultures of public and private partners impact upon wider relationships within local health economies and shape the delivery of patient care

The cross-cultural importance of satisfying vital needs.

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Alvarez, Allen Andrew A

2009-11-01

Ethical beliefs may vary across cultures but there are things that must be valued as preconditions to any cultural practice. Physical and mental abilities vital to believing, valuing and practising a culture are such preconditions and it is always important to protect them. If one is to practise a distinct culture, she must at least have these basic abilities. Access to basic healthcare is one way to ensure that vital abilities are protected. John Rawls argued that access to all-purpose primary goods must be ensured. Amartya Sen and Martha Nussbaum claim that universal capabilities are what resources are meant to enable. Len Doyal and Ian Gough identify physical health and autonomy as basic needs of every person in every culture. When we disagree on what to prioritize, when resources to satisfy competing demands are scarce, our common needs can provide a point of normative convergence. Need-based rationing, however, has been criticized for being too indeterminate to give guidance for deciding which healthcare services to prioritize and for tending to create a bottomless-pit problem. But there is a difference between needing something (first-order need) and needing to have the ability to need (second-order need). Even if we disagree about which first-order need to prioritize, we must accept the importance of satisfying our second-order need to have the ability to value things. We all have a second-order need for basic healthcare as a means to protect our vital abilities even if we differ in what our cultures consider to be particular first-order needs.

Comparison of communication skills between trained and untrained students using a culturally sensitive nurse-client communication guideline in Indonesia.

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Claramita, Mora; Tuah, Rodianson; Riskione, Patricia; Prabandari, Yayi Suryo; Effendy, Christantie

2016-01-01

A communication guideline that is sensitive to the local culture is influential in the process of nursing care. The Gadjah Mada nurse-client communication guideline, the "Ready-Greet-Invite-Discuss," was meant (1) to strengthen the relationship between the nurse and the client despite of socio-culturally hierarchical gap between health providers and clients in Indonesian context, (2) to provide attention to the unspoken concerns especially in the context of indirect communication which mostly using non-verbal signs and politeness etiquettes, and (3) to initiate dialog in the society which hold a more community-oriented decision making. Our aim is to compare the communication skills of nursing students who had and had not received a training using a culture-sensitive Gadjah Mada nurse-client communication guideline. This was a quasi experimental randomized control study to the fifth semester students of a nursing school at Yogyakarta, Indonesia. The intervention group was trained by the Gadjah Mada nurse-client communication guideline. Both intervention and the control group had learned general nurse-client communication guidelines. The training was 4h with role-plays, supportive information and feedback sessions. An objective-structured clinical examination (OSCE) was conducted 1week after the training, in seven stations, with seven simulated clients. Observers judged the communication skills of the students using a checklist of 5-point Likert scale, whereas simulated clients judged their satisfaction using 4-point Likert scale represented in colorful ribbons. There were significant mean differences in each domain of communication guideline observed between the trained and the control groups as judged by the teachers (p≤0.05) and simulated clients. Training using a culture-sensitive communication skills guideline could improve the communication skills of the nursing students and may increase satisfaction of the clients. Copyright © 2015 Elsevier Ltd. All rights

Use of an Innovative Personality-Mindset Profiling Tool to Guide Culture-Change Strategies among Different Healthcare Worker Groups.

Directory of Open Access Journals (Sweden)

M Lindsay Grayson

Full Text Available Important culture-change initiatives (e.g. improving hand hygiene compliance are frequently associated with variable uptake among different healthcare worker (HCW categories. Inherent personality differences between these groups may explain change uptake and help improve future intervention design.We used an innovative personality-profiling tool (ColourGrid® to assess personality differences among standard HCW categories at five large Australian hospitals using two data sources (HCW participant surveys [PS] and generic institution-wide human resource [HR] data to: a compare the relative accuracy of these two sources; b identify differences between HCW groups and c use the observed profiles to guide design strategies to improve uptake of three clinically-important initiatives (improved hand hygiene, antimicrobial stewardship and isolation procedure adherence.Results from 34,243 HCWs (HR data and 1045 survey participants (PS data suggest that HCWs were different from the general population, displaying more individualism, lower power distance, less uncertainty avoidance and greater cynicism about advertising messages. HR and PS data were highly concordant in identifying differences between the three key HCW categories (doctors, nursing/allied-health, support services and predicting appropriate implementation strategies. Among doctors, the data suggest that key messaging should differ between full-time vs part-time (visiting senior medical officers (SMO, VMO and junior hospital medical officers (HMO, with SMO messaging focused on evidence-based compliance, VMO initiatives emphasising structured mandatory controls and prestige loss for non-adherence, and for HMOs focusing on leadership opportunity and future career risk for non-adherence.Compared to current standardised approaches, targeted interventions based on personality differences between HCW categories should result in improved infection control-related culture-change uptake. Personality

Use of an Innovative Personality-Mindset Profiling Tool to Guide Culture-Change Strategies among Different Healthcare Worker Groups.

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Grayson, M Lindsay; Macesic, Nenad; Huang, G Khai; Bond, Katherine; Fletcher, Jason; Gilbert, Gwendolyn L; Gordon, David L; Hellsten, Jane F; Iredell, Jonathan; Keighley, Caitlin; Stuart, Rhonda L; Xuereb, Charles S; Cruickshank, Marilyn

2015-01-01

Important culture-change initiatives (e.g. improving hand hygiene compliance) are frequently associated with variable uptake among different healthcare worker (HCW) categories. Inherent personality differences between these groups may explain change uptake and help improve future intervention design. We used an innovative personality-profiling tool (ColourGrid®) to assess personality differences among standard HCW categories at five large Australian hospitals using two data sources (HCW participant surveys [PS] and generic institution-wide human resource [HR] data) to: a) compare the relative accuracy of these two sources; b) identify differences between HCW groups and c) use the observed profiles to guide design strategies to improve uptake of three clinically-important initiatives (improved hand hygiene, antimicrobial stewardship and isolation procedure adherence). Results from 34,243 HCWs (HR data) and 1045 survey participants (PS data) suggest that HCWs were different from the general population, displaying more individualism, lower power distance, less uncertainty avoidance and greater cynicism about advertising messages. HR and PS data were highly concordant in identifying differences between the three key HCW categories (doctors, nursing/allied-health, support services) and predicting appropriate implementation strategies. Among doctors, the data suggest that key messaging should differ between full-time vs part-time (visiting) senior medical officers (SMO, VMO) and junior hospital medical officers (HMO), with SMO messaging focused on evidence-based compliance, VMO initiatives emphasising structured mandatory controls and prestige loss for non-adherence, and for HMOs focusing on leadership opportunity and future career risk for non-adherence. Compared to current standardised approaches, targeted interventions based on personality differences between HCW categories should result in improved infection control-related culture-change uptake. Personality

Integration Between Mental Health-Care Providers and Traditional Spiritual Healers: Contextualising Islam in the Twenty-First Century.

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Chowdhury, Nayeefa

2016-10-01

In the United Arab Emirates, neuropsychiatric disorders are estimated to contribute to one-fifth of the global burden of disease. Studies show that the UAE citizens' apathy towards seeking professional mental health services is associated with the 'religious viewpoints' on the issue, societal stigma, lack of awareness of mental health and lack of confidence in mental health-care providers. Mental health expenditures by the UAE government health ministry are not available exclusively. The majority of primary health-care doctors and nurses have not received official in-service training on mental health within the last 5 years. Efforts are to be made at deconstructing the position of mental illness and its treatments in the light of Islamic Jurisprudence; drafting culturally sensitive and relevant models of mental health care for Emirati citizens; liaising between Imams of mosques and professional mental health service providers; launching small-scale pilot programs in collaboration with specialist institutions; facilitating mentoring in line with Science, Technology, Engineering and Math (STEM) outreach programmes for senior school Emirati students concerning mental health; and promoting mental health awareness in the wider community through participation in events open to public.

Nurses' perceptions of workplace culture in primary health care in Finland.

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Hahtela, N; Paavilainen, E; McCormack, B; Helminen, M; Slater, P; Suominen, T

2015-12-01

This study aimed to describe nurses' perceptions of workplace culture, especially in regard to stress levels, job satisfaction and the practice environment in primary health care. Health care is facing many challenges related to its attractiveness as a place of employment and the maintenance of a sufficient workforce supply. Previous studies report increasing rates of nurse job dissatisfaction and intentions to leave their current positions both in Finland and also globally. Improving workplace culture is thus vital in meeting the challenges related to recruitment and retention. A cross-sectional descriptive design was used to describe nurses' perceptions of workplace culture. Data were collected by questionnaire from 22 units in nine primary healthcare organizations in Finland, and analysed using descriptive and inferential statistics. Most of the respondents indicated that they were not certain whether their workplace culture was either positive or negative. Profession, age and work shift characteristics had an effect on the respondents' perceptions of workplace culture. Younger licensed practical and registered nurses assessed their workplace culture more positively, whereas older registered nurses and those working rotating rosters viewed workplace culture more negatively. The findings suggest that both unit and demographic characteristics affect workplace culture. This survey highlights that a positive workplace culture is one of the key factors in retaining and recruiting nurses, and provides an essential evidence that may be considered by other healthcare organizations. Nurse managers and healthcare leaders need to address workload management and take into account the related variables that affect a unit's workplace culture. © 2015 International Council of Nurses.

Conflicts between healthcare professionals and families of a multi-ethnic patient population during critical care: an ethnographic study.

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Van Keer, Rose-Lima; Deschepper, Reginald; Francke, Anneke L; Huyghens, Luc; Bilsen, Johan

2015-12-22

Conflicts during communication in multi-ethnic healthcare settings is an increasing point of concern as a result of societies' increased ethno-cultural diversity. We can expect that conflicts are even more likely to arise in situations where difficult medical decisions have to be made, such as critical medical situations in hospital. However, in-depth research on this topic is rather scarce. During critical care patients are often unable to communicate. We have therefore investigated factors contributing to conflicts between healthcare professionals and family members from ethnic minority groups in critical medical situations in hospital. Ethnographic fieldwork was done in one intensive care unit of a multi-ethnic urban hospital in Belgium over 6 months (January 2014 to June 2014). Data were collected through negotiated interactive observation, in-depth interviews with healthcare professionals, from patients' medical records, and by making notes in a logbook. Data were analysed by using grounded theory procedures. Conflicts were essentially related to differences in participants' views on what constitutes 'good care' based on different care approaches. Healthcare professionals' views on good care were based predominantly on a biomedical care model, whereas families' views on good care were mainly inspired by a holistic lifeworld-oriented approach. Giving good care, from the healthcare professionals' point of view, included great attention to regulations, structured communication, and central decision making. On the other hand, good care from the families' point of view included seeking exhaustive information, and participating in end-of-life decision making. Healthcare professionals' biomedical views on offering good care were strengthened by the features of the critical care context whereas families' holistic views on offering good care were reinforced by the specific characteristics of families' ethno-familial care context, including their different ethno-cultural

Healthcare waste management: current practices in selected healthcare facilities, Botswana.

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Mbongwe, Bontle; Mmereki, Baagi T; Magashula, Andrew

2008-01-01

Healthcare waste management continues to present an array of challenges for developing countries, and Botswana is no exception. The possible impact of healthcare waste on public health and the environment has received a lot of attention such that Waste Management dedicated a special issue to the management of healthcare waste (Healthcare Wastes Management, 2005. Waste Management 25(6) 567-665). As the demand for more healthcare facilities increases, there is also an increase on waste generation from these facilities. This situation requires an organised system of healthcare waste management to curb public health risks as well as occupational hazards among healthcare workers as a result of poor waste management. This paper reviews current waste management practices at the healthcare facility level and proposes possible options for improvement in Botswana.

The Cuban National Healthcare System: Characterization of primary healthcare services.

Directory of Open Access Journals (Sweden)

Keli Regina DAL PRÁ

2015-10-01

Full Text Available This article presents a report on the experience of healthcare professionals in Florianópolis, who took the course La Atención Primaria de Salud y la Medicina Familiar en Cuba [Primary Healthcare and Family Medicine in Cuba], in 2014. The purpose of the study is to characterize the healthcare units and services provided by the Cuban National Healthcare System (SNS and to reflect on this experience/immersion, particularly on Cuba’s Primary Healthcare Service. The results found that in comparison with Brazil’s Single Healthcare System (SUS Cuba’s SNS Family Healthcare (SF service is the central organizing element of the Primary Healthcare Service. The number of SF teams per inhabitant is different than in Brazil; the programs given priority in the APS are similar to those in Brazil and the intersectorial nature and scope of the services prove to be effective in the resolution of healthcare problems.

Abundance and diversity of culturable Pseudomonas constitute sensitive indicators for adverse long-term copper impacts in soil

DEFF Research Database (Denmark)

Thorsen, Maja Kristine; Brandt, Kristian Koefoed; Nybroe, Ole

2013-01-01

heterotrophic bacteria. This indicates that the Pseudomonas population is not resilient towards copper stress and that culturable Pseudomonas spp. comprise sensitive bio-indicators of adverse copper impacts in contaminated soils. Further this study shows that copper exposure decreases bacterial diversity...

Implementing healthcare information security: standards can help.

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Orel, Andrej; Bernik, Igor

2013-01-01

Using widely spread common approaches to systems security in health dedicated controlled environments, a level of awareness, confidence and acceptance of relevant standardisation is evaluated. Patients' information is sensitive, so putting appropriate organisational techniques as well as modern technology in place to secure health information is of paramount importance. Mobile devices are becoming the top priorities in advanced information security planning with healthcare environments being no exception. There are less and less application areas in healthcare without having a need for a mobile functionality which represents an even greater information security challenge. This is also true in emergency treatments, rehabilitation and homecare just to mention a few areas outside hospital controlled environments. Unfortunately quite often traditional unsecured communications principles are still in routine use for communicating sensitive health related information. The security awareness level with users, patients and care professionals is not high enough so potential threats and risks may not be addressed and the respective information security management is therefore weak. Standards like ISO/IEC 27000 ISMS family, the ISO/IEC 27799 information security guidelines in health are often not well known, but together with legislation principles such as HIPAA, they can help.

The Challenge of Four-Status Model of eLearning: Principles Toward a New Understanding for Healthcare Professionals

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Turnbull, Niruwan; Wills, Gary; Gobbi, Mary

2011-01-01

This paper presents the critical reviews of the advantages and disadvantages of eLearning for healthcare professionals. The impact of learning on healthcare professionals is explored; the focus is on healthcare professionals in rural Thailand. Literature suggests that there are four main topics related to the drivers and barriers in eLearning, they are: Infrastructure; Finance; Policies; and Culture (IF-PC). IF-PC model of barriers and drivers of eLearning is being adopted as a template for t...

Design Quality in the Context of Healthcare Environments: A Scoping Review.

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Anåker, Anna; Heylighen, Ann; Nordin, Susanna; Elf, Marie

2017-07-01

We explored the concept of design quality in relation to healthcare environments. In addition, we present a taxonomy that illustrates the wide range of terms used in connection with design quality in healthcare. High-quality physical environments can promote health and well-being. Developments in healthcare technology and methodology put high demands on the design quality of care environments, coupled with increasing expectations and demands from patients and staff that care environments be person centered, welcoming, and accessible while also supporting privacy and security. In addition, there are demands that decisions about the design of healthcare architecture be based on the best available information from credible research and the evaluation of existing building projects. The basic principles of Arksey and O'Malley's model of scoping review design were used. Data were derived from literature searches in scientific databases. A total of 18 articles and books were found that referred to design quality in a healthcare context. Design quality of physical healthcare environments involves three different themes: (i) environmental sustainability and ecological values, (ii) social and cultural interactions and values, and (iii) resilience of the engineering and building construction. Design quality was clarified herein with a definition. Awareness of what is considered design quality in relation to healthcare architecture could help to design healthcare environments based on evidence. To operationalize the concept, its definition must be clear and explicit and able to meet the complex needs of the stakeholders in a healthcare context, including patients, staff, and significant others.

The Impact of International Service-Learning on Nursing Students' Cultural Competency.

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Kohlbry, Pamela Wolfe

2016-05-01

This article reports research findings on the effect of an international immersion service-learning project on the level and components of cultural competence of baccalaureate (BSN) nursing students. A triangulated methodology was used to determine changes in components and level of cultural competence pre- and postexperience. The theoretical model The Process of Cultural Competence in the Delivery of Healthcare Services was used. It identifies five central constructs in the process of becoming culturally competent: cultural awareness, cultural knowledge, cultural skill, cultural encounter, and cultural desire. The sample of 121 BSN nursing students was gathered from three southern California universities. Data were collected from 2009 to 2013. Using the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-Student Version© and Cultural Self-Efficacy Scale, constructs of cultural competency were measured in pre- and posttest participants who participated in international service-learning immersion experiences. A demographic survey and open-ended qualitative questions were completed at the posttrip meeting. Mean, frequencies, and correlations with demographic data and survey data were calculated. Pre- and posttrip means were analyzed. Qualitative analysis from six open-ended questions completed at the posttest were coded and themes emerged. The research findings demonstrated the impact of the international service-learning project on building cultural competency in nursing students. Quantitative findings revealed statistically significant differences between pre- and posttest surveys for two of the five constructs of cultural competence. Qualitative analysis supported the quantitative findings in cultural competency constructs found in the model. The research findings support nursing education program use of international service-learning immersion experiences to foster cultural competence in nursing students. Findings from

A systematic review of asthma and health literacy: a cultural-ethnic perspective in Canada.

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Poureslami, Iraj M; Rootman, Irving; Balka, Ellen; Devarakonda, Rajashree; Hatch, James; Fitzgerald, J Mark

2007-08-21

Asthma is one of the most common inflammatory lung diseases and its prevalence and incidence have increased in many developed and developing countries. Asthma places a heavy burden on healthcare expenditures and productivity, which in turn diminishes the quality of life of the individuals involved as well as their families. The goal of improving a patient's knowledge about asthma management should include the enhancement of the individual's skills with the hopeful outcome of improving how the individual manages the condition. However, when health professionals prepare a training program, they are faced with the challenging cosmopolitan reality of individuals with different ethnic backgrounds. In order to find links between asthma and health literacy in a cultural/ethnicity perspective, we performed a systematic review of all publications on the topic of asthma, health, and literacy among cultural groups from 1980 to 2006 using the Internet and journals: Medline (Ovid), ERIC, EMBASE, PsycINFO, Google, Google Scholar, Sociological Abstracts, and Anthropology Plus. Key words included the following: "asthma," "culture," "ethnicity," "literacy," "health," "health literacy," "health beliefs," "adults," "disease management," "chronic condition," "ethnocultural groups," "minority groups," and "newcomers/immigrants." More than 650 articles were initially identified in our review; 65 met our inclusion criteria. From these, we examined the factors related to asthma and literacy/health literacy with a cultural lens. All of these are categorized and summarized below. We chose what we considered to be the most relevant and important articles/documents in the research literature to date. Because many of the studies were qualitative, a formal meta-analytic review was not undertaken. We found that current asthma management techniques - including patient education - are not culturally sensitive, linguistically sensitive, or relevant, which creates further difficulties for