Alias, Siti Noormi; Ismail, Maimunah
Purpose: This paper aims to propose a conceptual model of philanthropic behavior of volunteers in the health care sector. Design/methodology/approach: This study is based on an extensive review of past research on philanthropic behavior. To conduct the literature review, keywords such as philanthropy, philanthropic behavior, giving, donating,…
McCall, Daniel; Iltis, Ana S
The popularity and availability of global health experiences has increased, with organizations helping groups plan service trips and companies specializing in "voluntourism," health care professionals volunteering their services through different organizations, and medical students participating in global health electives. Much has been written about global health experiences in resource poor settings, but the literature focuses primarily on the work of health care professionals and medical students. This paper focuses on undergraduate student involvement in short term medical volunteer work in resource poor countries, a practice that has become popular among pre-health professions students. We argue that the participation of undergraduate students in global health experiences raises many of the ethical concerns associated with voluntourism and global health experiences for medical students. Some of these may be exacerbated by or emerge in unique ways when undergraduates volunteer. Guidelines and curricula for medical student engagement in global health experiences have been developed. Guidelines specific to undergraduate involvement in such trips and pre-departure curricula to prepare students should be developed and such training should be required of volunteers. We propose a framework for such guidelines and curricula, argue that universities should be the primary point of delivery even when universities are not organizing the trips, and recommend that curricula should be developed in light of additional data.
Kim, Eric S; Konrath, Sara H
Although observational and experimental studies have shown that volunteering is linked with better mental health, physical health, and health behaviors, no studies have examined whether volunteering is associated with patterns of health care use. The purpose of this study was to prospectively examine whether volunteering was associated with a greater use of preventive health care services, but fewer doctor visits and nights spent in the hospital. Participants (n = 7168) were drawn from the 2006 wave of the Health and Retirement Study, a nationally representative panel study of American adults over the age of 51, and tracked for one wave (2 years). Logistic regression and generalized linear models were used for analyses. In analyses that adjusted for sociodemographic factors and baseline health, volunteers were 30% more likely to receive flu shots (OR = 1.30, 95% CI = 1.16-1.47), 47% more likely to receive cholesterol tests (OR = 1.47, 95% CI = 1.24-1.74); female volunteers were 53% more likely to receive mammograms/x-rays (OR = 1.53, 95% CI = 1.28-1.83) and 21% more likely to receive Pap smears (OR = 1.21, 95% CI = 1.03-1.41); male volunteers were 59% more likely to receive prostate exams (OR = 1.59, 95% CI = 1.29-1.95). In a model that adjusted for sociodemographic factors, volunteers spent 38% fewer nights in the hospital (RR = 0.62, 95% CI = 0.52-0.76), however volunteering was not associated with frequency of doctor visits (RR = 0.94, 95% CI = 0.87-1.02). The association between volunteering and number of nights spent in the hospital was minimally affected after adjusting for potential confounding (baseline health) and explanatory variables (health behaviors, social integration, stress, positive psychological factors, personality). This is the first known study to examine the association between volunteering and health care use. If future studies replicate these findings, the results may be used to inform the development of new
Volunteers are provided with an intervention manual and picture book. Resource inputs are low and include training allowances and equipment for counselors and supervisors, and a salary, equipment and materials for a coordinator. It is hypothesized that the counselors will encourage informational and attitudinal change ...
Detollenaere, Jens; Willems, Sara; Baert, Stijn
Separate literatures have related volunteering to health gains and income gains. We study the association between volunteering, income and health within one statistical framework. A state-of-the-art mediation analysis is conducted on data concerning the health, volunteering and sociodemographic characteristics of 42926 individuals within 29 European countries. We find that volunteering is positively associated to self-rated health. This association is partially mediated by household income.
Background Electronic cigarettes (e-cigarette) are new phenomenon that has been widely accepted. E- Cigarettes are more popular that has become one of the preferable rout of smoking cessation in patients. Further researches are required for future advice on e-cigarette use.To determine Health Care Professional and Cigarette Cessation Volunteers Knowledge, Attitude and Practice on e-Cigarettes Methods In a cross-sectional description study, 147 medical professional ...
Kamaludin, Kauthar Mohamad; Muhammad, Mazanah; Wahat, Nor Wahiza Abdul; Ibrahim, Rahimah
The involvement of non-government organizations (NGOs) and support groups has helped strengthen public health services in addressing cancer care burden. Owing to the contribution of volunteers in cancer care, this article documents a qualitative study that examined challenges in attracting and retaining cancer care volunteers as part of the effort to develop a volunteer recruitment model. Data were collected through three focus group discussions involving 19 cancer support group members in Malaysia. Findings of the study revealed that mobility and locality appeared to be significant in Malaysian context, while the need for financial support and time flexibility are challenges faced by cancer support groups to attract and retain volunteers. The findings imply that cancer care initiatives can benefit from more local volunteers but at the same time these volunteers require flexibility and financial support to sustain their engagement.
Sohn, Heeju; Timmermans, Stefan
Do public health policy interventions result in pro-social behaviors? The Affordable Care Act (ACA)’s Medicaid expansions were responsible for the largest gains in public insurance coverage since its inception in 1965. These gains were concentrated in states that opted to expand Medicaid eligibility and provide a unique opportunity to study not just medical but also social consequences of increased public health coverage. This article examines the association between Medicaid and volunteer work. Volunteerism is implicated in individuals’ health and well-being yet it is highly correlated with a person’s existing socioeconomic resources. Medicaid expansions improved financial security and a sense of health—two factors that predict volunteer work—for a socioeconomic group that has had low levels of volunteerism. Difference-in-difference analyses of the Volunteer Supplement of the Current Population Survey (2010–2015) find increased reports of formal volunteering for organizations as well as informal helping behaviors between neighbors for low-income non-elderly adults who would have likely benefited from expansions. Furthermore, increased volunteer work associated with Medicaid was greater among minority groups and narrowed existing ethnic differences in volunteerism in states that expanded Medicaid eligibility. PMID:29142907
This article informs about recent research findings on voluntary and mutual aid in the Czech Republic with a special attention paid to formal volunteering in health and social care. The data suggest that public involvement is comparable to middle-frequency experienced in European countries. In this respect, volunteering is higher in the Czech Republic than in other former Eastern European countries and is an evidence of a successful and rapid restoration of the civic sector. New patterns of volunteering featured by planning, coordination, and contracting have spread out being strongly supported by national and EU policy measures. Managerial patterns of volunteering are dominating in health and social care institutions. Volunteering in health and social care is firmly motivated by emotional altruism; however, reciprocal (instrumental) and normative motivations are also present, though to a lesser extent compared to other sectors of volunteer activities. In the managerial pattern of volunteering altruism is balanced with personal gains and benefits for those who volunteer. Volunteering is deeply embedded in a civic, humanitarian paradigm instead of a religious faith and duty.
Full Text Available Preconception care identifies and modifies the risk factors for pregnancy and childbirth. The present study aimed to determine the effects a preconception care education program, which was based on the Health Belief Model (HBM and implemented by health volunteers, on knowledge and attitudes of women. A semi-experimental study was conducted using 22 health volunteers and 110 women aged 15-49 years selected from two comprehensive health centers of Mashhad, Iran, in 2016. The convenience sampling method was employed for selecting the volunteers and the regular random sampling method for choosing the women. For data collection, we applied a researcher-made tool with verified validity and reliability. HBM-based education was implemented by the volunteers during three sessions. Data analysis was performed in SPSS using Mann-Whitney test, Friedman, and Spearman's rank correlation coefficient; repeated measures data analysis was carried out at the significance level of 0.05. The mean age of the women was 30.6±6.6 years in the intervention group and 31.6±6.5 years in the control group. The mean levels of knowledge and attitude increased significantly after the intervention (P
Liabsuetrakul, Tippawan; Oumudee, Nurlisa; Armeeroh, Masuenah; Nima, Niamina; Duerahing, Nurosanah
Although antenatal care (ANC) coverage has been increasing in low- and middle-income countries, the adherence to the ANC initiation standards at gestational age ANC initiation by training the existing local health volunteers (LHVs) in 3 southernmost provinces of Thailand. A clustered nonrandomized intervention study was conducted from November 2012 to February 2014. One district of each province was selected to be the study intervention districts for that province. A total of 124 LHVs in the intervention districts participated in the knowledge-counseling intervention. It was organized as half-day workshop using 2 training modules each comprising a 30-minute lecture followed by counseling practice in pairs for 1 hour. Outcome was the rate of early ANC initiation among women giving birth, and its association with intervention, meeting an LHV, and months after training was analyzed. Of 6677 women, 3178 and 3499 women were in the control and intervention groups, respectively. Rates of early ANC were significantly improved after the intervention (adjusted odds ratio [OR]: 1.29, 95% confidence interval [CI]: 1.17-1.43, P ANC. Training LHVs in communities by knowledge-counseling intervention significantly improved early ANC initiation, but the magnitude of change was still limited.
Schmitz, Susan; Radcliff, Tiffany A; Chu, Karen; Smith, Robert E; Dobalian, Aram
The US Veterans Health Administration's Disaster Emergency Medical Personnel System (DEMPS) is a team of employee disaster response volunteers who provide clinical and non-clinical staffing assistance when local systems are overwhelmed. This study evaluated attitudes and recommendations of the DEMPS program to understand the impact of multi-modal training on volunteer perceptions. DEMPS volunteers completed an electronic survey in 2012 (n=2120). Three training modes were evaluated: online, field exercise, and face-to-face. Measures included: "Training Satisfaction," "Attitudes about Training," "Continued Engagement in DEMPS." Data were analyzed using χ2 and logistic regression. Open-ended questions were evaluated in a manner consistent with grounded theory methodology. Most respondents participated in DEMPS training (80%). Volunteers with multi-modal training who completed all 3 modes (14%) were significantly more likely to have positive attitudes about training, plan to continue as volunteers, and would recommend DEMPS to others (P-valuevolunteer engagement. A blended learning environment using multi-modal training methods, could enhance satisfaction and attitudes and possibly encourage continued engagement in DEMPS or similar programs. DEMPS training program modifications in 2015 expanded this blended learning approach through new interactive online learning opportunities. (Disaster Med Public Health Preparedness. 2018; page 1 of 8).
Full Text Available Primary care providers are critical in providing and optimizing health care to an aging population. This paper describes the volunteer component of a program (Health TAPESTRY which aims to encourage the delivery of effective primary health care in novel and proactive ways. As part of the program, volunteers visited older adults in their homes and entered information regarding health risks, needs, and goals into an electronic application on a tablet computer. A total of 657 home visits were conducted by 98 volunteers, with 22.45% of volunteers completing at least 20 home visits over the course of the program. Information was summarized in a report and electronically sent to the health care team via clients’ electronic medical records. The report was reviewed by the interprofessional team who then plan ongoing care. Volunteer recruitment, screening, training, retention, and roles are described. This paper highlights the potential role of a volunteer in a unique connection between primary care providers and older adult patients in their homes.
The participants discussed recruitment, training, rewards, retention, and roles of village health volunteers. This paper presents background data on village health volunteers in Malawi and elsewhere and reviews the key issues facing health care providers in working with village health volunteers. A copy of the workshop ...
Rosato, Mikey; Lewycka, Sonia; Mwansambo, Charles; Kazembe, Peter; Phiri, Tambosi; Chapota, Hilda; Vergnano, Stefania; Newell, Marie-Louise; Osrin, David; Costello, Anthony
The aim of this report is to describe a health education intervention involving volunteer infant feeding and care counselors being implemented in Mchinji district, Malawi. The intervention was established in January 2004 and involves 72 volunteer infant feeding and care counselors, supervised by 24 government Health Surveillance Assistants, covering 355 villages in Mchinji district. It aims to change the knowledge, attitudes and behaviour of women to promote exclusive breastfeeding and other infant care practices. The main target population are women of child bearing age who are visited at five key points during pregnancy and after birth. Where possible, their partners are also involved. The visits cover exclusive breastfeeding and other important neonatal and infant care practices. Volunteers are provided with an intervention manual and picture book. Resource inputs are low and include training allowances and equipment for counselors and supervisors, and a salary, equipment and materials for a coordinator. It is hypothesized that the counselors will encourage informational and attitudinal change to enhance motivation and risk reduction skills and self-efficacy to promote exclusive breastfeeding and other infant care practices and reduce infant mortality. The impact is being evaluated through a cluster randomised controlled trial and results will be reported in 2012.
Martiniuk, Alexandra L C; Adunuri, Nikesh; Negin, Joel; Tracey, Patti; Fontecha, Claudio; Caldwell, Paul
The weak health system in Honduras contributes to poor health indicators. To improve population health, a number of volunteer medical brigades from developed countries provide health services in Honduras. To date, there is little information on the brigades' activities and impact. The primary objective of this article is to increase understanding of the type of health care provided by voluntary medical brigades by evaluating and presenting data on patients' presenting symptoms, diagnoses, and care outcomes. The article focuses on an ongoing medical brigade organized by Canadian health professionals in conjunction with Honduras' largest national non-governmental organization. This is a descriptive study of data that are routinely collected by volunteer Canadian health care professionals. Data on all patients presenting to temporary primary health care facilities across Honduras between 2006 and 2009 were analyzed. The data were used to analyze patient demographics, presenting symptoms, diagnoses, and treatments. We found that the brigades provide additional human resources to the relatively weak Honduran health care system. However, while brigades may increase solidarity between Hondurans and Canadians, concerns persist regarding cost-effectiveness and continuity of care for conditions treated by short-term brigade volunteers. Greater scrutiny is needed to increase brigades' effectiveness and ensure they are supportive of domestic health systems.
Neupane, Dinesh; McLachlan, Craig S; Mishra, Shiva Raj
). In the intervention group, 43 FCHVs provided home visits every 4 months for lifestyle counselling and blood pressure monitoring. Eligible participants had been involved in a previous population-based survey, were aged 25–65 years, did not have plans to migrate outside the study area, and were not severely ill......-income population. Methods We did a community-based, open-label, two-group, cluster-randomised controlled trial in Nepal. Using computer-generated codes, we randomly assigned (1:1) 14 clusters to a lifestyle intervention led by female community health volunteers (FCHVs) or usual care (control group...... participants (939 assigned to intervention; 699 assigned to control). At 1 year, 855 participants remained in the intervention group (425 were normotensive, 175 were prehypertensive, and 255 had hypertension) and 613 remained in the control group (305 were normotensive, 128 were prehypertensive, and 180 had...
Kastner, Monika; Sayal, Radha; Oliver, Doug; Straus, Sharon E; Dolovich, Lisa
Chronic diseases are a significant public health concern, particularly in older adults. To address the delivery of health care services to optimally meet the needs of older adults with multiple chronic diseases, Health TAPESTRY (Teams Advancing Patient Experience: Strengthening Quality) uses a novel approach that involves patient home visits by trained volunteers to collect and transmit relevant health information using e-health technology to inform appropriate care from an inter-professional healthcare team. Health TAPESTRY was implemented, pilot tested, and evaluated in a randomized controlled trial (analysis underway). Knowledge translation (KT) interventions such as Health TAPESTRY should involve an investigation of their sustainability and scalability determinants to inform further implementation. However, this is seldom considered in research or considered early enough, so the objectives of this study were to assess the sustainability and scalability potential of Health TAPESTRY from the perspective of the team who developed and pilot-tested it. Our objectives were addressed using a sequential mixed-methods approach involving the administration of a validated, sustainability survey developed by the National Health Service (NHS) to all members of the Health TAPESTRY team who were actively involved in the development, implementation and pilot evaluation of the intervention (Phase 1: n = 38). Mean sustainability scores were calculated to identify the best potential for improvement across sustainability factors. Phase 2 was a qualitative study of interviews with purposively selected Health TAPESTRY team members to gain a more in-depth understanding of the factors that influence the sustainability and scalability Health TAPESTRY. Two independent reviewers coded transcribed interviews and completed a multi-step thematic analysis. Outcomes were participant perceptions of the determinants influencing the sustainability and scalability of Health TAPESTRY. Twenty
Whittall, Dawn; Lee, Susan; O'Connor, Margaret
To review factors shaping volunteering in palliative care in Australian rural communities using Australian and International literature. Identify gaps in the palliative care literature and make recommendations for future research. A comprehensive literature search was conducted using Proquest, Scopus, Sage Premier, Wiley online, Ovid, Cochran, Google Scholar, CINAHL and Informit Health Collection. The literature was synthesised and presented in an integrated thematic narrative. Australian Rural communities. While Australia, Canada, the United States (US) and the United Kingdom (UK) are leaders in palliative care volunteer research, limited research specifically focuses on volunteers in rural communities with the least occurring in Australia. Several interrelated factors influence rural palliative care provision, in particular an increasingly ageing population which includes an ageing volunteer and health professional workforce. Also current and models of palliative care practice fail to recognise the innumerable variables between and within rural communities such as distance, isolation, lack of privacy, limited health care services and infrastructure, and workforce shortages. These issues impact palliative care provision and are significant for health professionals, volunteers, patients and caregivers. The three key themes of this integrated review include: (i) Geography, ageing rural populations in palliative care practice, (ii) Psychosocial impact of end-end-of life care in rural communities and (iii) Palliative care models of practice and volunteering in rural communities. The invisibility of volunteers in rural palliative care research is a concern in understanding the issues affecting the sustainability of quality palliative care provision in rural communities. Recommendations for future Australian research includes examination of the suitability of current models of palliative care practice in addressing the needs of rural communities; the recruitment
Young people are often denied volunteering experiences with vulnerable dying people as this is considered to be 'too distressing'. This project challenged this paternalistic attitude and trained young people to volunteer in the hospice, and other organisations to enhance the delivery of compassionate care. To promote dignity in care, for older people, people with dementia, those at end of life and those with learning disabilities. To reduce social isolation and the stigma associated with dying and being old. To create new volunteering opportunities for young people to raise their awareness of the needs of the dying and the frail elderly. Develop a model of best practice - that could be replicated in other parts of the country. A health promotion approach was used combining education and a community development, partnership approach. Results 120 Volunteers delivered over 3,650 hrs of volunteering activities, supporting individuals to engage in social activities. The project broke myths about having 16-18 year olds volunteering. The relationship between the hospice and the local community has strengthened and the employability skills for the young people taking part have increased. 16% of those who responded to an exit survey had gained full time employment, 9% had gained university places. The personalisation of care for the frail elderly and those at end of life has increased by the use of volunteers. Young volunteers need mentoring. Staff needs support to feel confident to utilise the volunteers and let go of myths about risks. © 2015, 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.
The personal value of being part of a Tropical Health Education Trust (THET) links programme to develop a palliative care degree programme in Sub Saharan Africa: a descriptive study of the views of volunteer UK health care professionals.
Jack, B A; Kirton, J A; Downing, J; Frame, K
There is a global need to expand palliative care services to reach the increasing number requiring end of life care. In developing countries where the incidences of cancer are rising there is an urgent need to develop the palliative care workforce. This paper reports on a UK Department for international development (DFID) initiative funded through the Tropical Health Education Trust (THET) where palliative care staff, both clinical and academic, volunteered to help to develop, support and deliver a degree in palliative care in sub-Saharan Africa. The objective of the study was to explore the personal impact on the health care professionals of being part of this initiative. An evaluation approach using a confidential electronic survey containing quantitative and qualitative questions was distributed to all 17 volunteers on the programme, three months after completion of the first cohort. Data were analysed using descriptive statistics and content thematic analysis. Ethical review deemed the study to be service evaluation. 82 % (14) responded and several themes emerged from the data including the positive impact on teaching and educational skills; clinical practice and finally personal development. Using a score of 1-10 (1-no impact, 10 maximum impact) 'Lifestyle choices - life work balance' (rating 7.83) had the most impact. This approach to supporting the development of palliative care in Sub-Saharan Africa through skill sharing in supporting the delivery of a degree programme in palliative care was successful in terms of delivery of the degree programme, material development and mentorship of local staff. Additionally, this study shows it provided a range of positive impacts on the volunteer health care professionals from the UK. Professional impacts including increased management skills, and being better prepared to undertake a senior role. However it is the personal impact including lifestyle choices which the volunteers reported as the highest impact
Perry, Henry; Morrow, Melanie; Davis, Thomas; Borger, Sarah; Weiss, Jennifer; DeCoster, Mary; Ricca, Jim; Ernst, Pieter
The Care Group approach, described in detail in a companion paper in this journal, uses volunteers to convey health promotion messages to their neighbors. This article summarizes the available evidence on the effectiveness of the Care Group approach, drawing on articles published in the peer-reviewed literature as well as data from unpublished but publicly available project evaluations and summary analyses of these evaluations. When implemented by strong international NGOs with adequate fundi...
Argentero, P; Bonfiglio, N S; Pasero, R
While diverse studies carried out in nursing and medical personnel have demonstrated that health workers can be subject to burnout, little effort has been focused on investigating burnout in volunteer hospital workers. The aim of the present study was to verify if burnout exists with volunteer auxiliary personnel and investigate what organizational conditions may favour it. The study was carried out on 80 volunteer workers of the Red Cross of Mortara (PV), subdivided into two categories: those performing emergency interventions and those performing routine services. For the evaluation of burnout, the Italian version of the Maslach Burnout Inventory was used, together with a qualitative type of methodology. A 5-factor multivariate analysis (sex x shift x team x seniority x role), having as dependent variables the three scales of the MBI, showed that the highest values of depersonalization and fulfillment are found in the emergency team, and that subjects with least seniority are those who are least satisfied or fulfilled. The category of team-leader resulted as that with the highest values of emotional burnout, while sex- and shift-based differences were restricted to routine service workers. Despite these differences, findings showed that subjects are minimally affected by problems linked to burnout, although some relational and organizational difficulties emerged with the medical staff that underlie a certain degree of professional dissatisfaction.
Full Text Available Ulrika Söderhamn1, Bjørg Landmark2,3, Live Aasgaard2, Hilde Eide3, Olle Söderhamn11Center for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway; 2Institute of Research and Development for Nursing and Care Services, Municipality of Drammen, Drammen, Norway; 3Faculty of Health Sciences, Buskerud University College, Drammen, NorwayIntroduction: The number of people suffering from dementia will increase dramatically in the future, and this will be a great challenge and concern for health care services. It is assumed that volunteers will strengthen community health care services more in the future than they do today.Aim: The aim of this study was to elucidate lived experiences of working as a volunteer in an activity center with adapted activities for home-dwelling people with early stage dementia.Methods: Qualitative interviews were implemented in a group of nine female volunteers from an activity center in southern Norway. The interviews were recorded, transcribed verbatim, and analyzed with a descriptive phenomenological method. Results: Volunteering in an activity center for home-dwelling people with early stage dementia was reported to provide experiences of being useful and feeling satisfied with performing a good job. It was an advantage for the volunteers to have had experiences from life in general, but also as a health professional or as being the next of kin of a dementia sufferer. It was important for the volunteers to focus on the dementia sufferer and show caring behavior, and interaction with and the appreciation of the health care professionals were also important. The volunteers were motivated by being able to have influence and participate in the planning of the work, to be a part of the social setting, and to learn. However, for some volunteers it was difficult to adjust to an appropriate role.Conclusion: In order to promote volunteering in a caring context, mutual
Woitha, Kathrin; Hasselaar, Jeroen; van Beek, Karen; Radbruch, Lukas; Jaspers, Birgit; Engels, Yvonne; Vissers, Kris
In Europe, volunteers have an important role in the delivery of palliative care. As part of the EU co-funded Europall project, 4 aspects of volunteering in palliative care were studied for 7 European countries (Belgium, England, France, Germany, the Netherlands, Poland, and Spain). These included (1) involvement of volunteers in palliative care, (2) organization of palliative care volunteering, (3) legal regulations concerning volunteering, and (4) education and training of palliative care volunteering. A literature search combined with an interview study. Information from the scientific literature, and country-specific policy documents were obtained and completed, along with data of consecutive semi-structured interviews with experts in the field of palliative care in the participating countries. In all countries, volunteers appeared to be involved in palliative care, yet their involvement across health care settings differed per country. England, for example, has the highest number of volunteers whereas Spain has the lowest number. Volunteering is embedded in law and regulations in all participating countries except for England and the Netherlands. In all participating countries, training programs are available and volunteers are organized, both on a national and a regional level. This study provides a descriptive overview of volunteer work in palliative care in 7 European countries, with a focus on the organizational aspects. Further research should concentrate on the roles and responsibilities of volunteers in the care for the terminally ill in different European health systems. © 2014 World Institute of Pain.
Shen, Huei-Wern; Khosla, Nidhi
Advance care planning (ACP) increases the likelihood patients will receive end-of-life care that is congruent with their preferences and lowers stress among both patients and caregivers. Previous efforts to increase ACP have mainly focused on information provision in the very late stage of life. This study examines whether a relationship exists between volunteering and ACP, and whether this relationship is associated with social support. The sample comprises 877 individuals who were aged 55+ in 2008, and were deceased before 2010. The sample is derived from seven waves (1998-2010) of data from the Health and Retirement Study. Logistic regression results showed that overall ACP and durable power of attorney for health care (DPAHC) were both higher (OR = 1.61 and 1.71, respectively) for older adults with volunteering experience in the past 10 years than those without such experience. Available social support (relatives and friends living nearby) was not associated with the relationship between volunteering and ACP. Other factors related to ACP included poorer health, death being expected, death due to cancer, older age, and being a racial minority. Involving older people in volunteer work may help to increase ACP. Future research is encouraged to identify reasons for the association between volunteering and ACP.
... very important for healthy people to help," says Melanie Modlin about clinical trials. "We have a role ... that can save lives." Photo: Fran Sandridge For Melanie Modlin, volunteering to take part in a clinical ...
Jenkinson, Caroline E; Dickens, Andy P; Jones, Kerry; Thompson-Coon, Jo; Taylor, Rod S; Rogers, Morwenna; Bambra, Clare L; Lang, Iain; Richards, Suzanne H
Volunteering has been advocated by the United Nations, and American and European governments as a way to engage people in their local communities and improve social capital, with the potential for public health benefits such as improving wellbeing and decreasing health inequalities. Furthermore, the US Corporation for National and Community Service Strategic Plan for 2011-2015 focused on increasing the impact of national service on community needs, supporting volunteers' wellbeing, and prioritising recruitment and engagement of underrepresented populations. The aims of this review were to examine the effect of formal volunteering on volunteers' physical and mental health and survival, and to explore the influence of volunteering type and intensity on health outcomes. Experimental and cohort studies comparing the physical and mental health outcomes and mortality of a volunteering group to a non-volunteering group were identified from twelve electronic databases (Cochrane Library, Medline, Embase, PsychINFO, CINAHL, ERIC, HMIC, SSCI, ASSIA, Social Care Online, Social Policy and Practice) and citation tracking in January 2013. No language, country or date restrictions were applied. Data synthesis was based on vote counting and random effects meta-analysis of mortality risk ratios. Forty papers were selected: five randomised controlled trials (RCTs, seven papers); four non-RCTs; and 17 cohort studies (29 papers). Cohort studies showed volunteering had favourable effects on depression, life satisfaction, wellbeing but not on physical health. These findings were not confirmed by experimental studies. Meta-analysis of five cohort studies found volunteers to be at lower risk of mortality (risk ratio: 0.78; 95% CI: 0.66, 0.90). There was insufficient evidence to demonstrate a consistent influence of volunteering type or intensity on outcomes. Observational evidence suggested that volunteering may benefit mental health and survival although the causal mechanisms remain
Jack, Barbara A; Kirton, Jennifer A; Birakurataki, Jerith; Merriman, Anne
Volunteers in palliative care play a key role, particularly in the hospice setting. The expansion of palliative care into developing countries has been accompanied by the emergence of volunteer workers, who are providing a main source of support and care for patients, many of whom never see a health professional. The aim of this study was to evaluate the motivation for becoming a volunteer and the personal impact of being a palliative care Community Volunteer Worker in Uganda. A qualitative methodology using semi-structured individual and group digitally recorded interviews was adopted for the study. Data were analysed for emerging themes using thematic analysis. Forty-three interviews were undertaken, 32 with Community Volunteer Workers and 11 with the Hospice clinical teams, using semi-structured digitally recorded individual, group and focus group interviews at the Hospice Africa sites in Uganda. The results identified the cultural wish to help people as a key motivator in becoming a volunteer. Additionally, the volunteers reported having a sense of pride in their volunteering role, and this role had a positive impact on their perceived status in their local community. This model of volunteering is clearly having an impact on the volunteers, both personally and also in terms of how they are treated in their communities. Further research to explore the long-term personal benefits of being a palliative care volunteer is recommended.
Claxton-Oldfield, Stephen; Jones, Richard
In all, 119 hospice palliative care volunteers from 3 community-based hospice programs completed the Volunteer Retention Questionnaire (VRQ), a 33-item survey designed for this study. The VRQ asks volunteers to rate the importance of each item to their decision to continue volunteering. The items that received the highest mean importance ratings included enjoying the work they do, feeling adequately prepared/trained to perform their role, and learning from their patients' experiences/listening to their patients' life stories. Being recognized (eg, pins for years of service or being profiled in the hospice newsletter), receiving phone calls/cards from their volunteer coordinator on special occasions, and being reimbursed for out-of-pocket expenses were among the items that received the lowest mean importance ratings. Suggestions for improving volunteer retention are provided.
Hallett, Claudia; Klug, Günter; Lauber, Christoph; Priebe, Stefan
Much of the literature to date concerning public attitudes towards people with severe mental illness (SMI) has focused on negative stereotypes and discriminatory behaviour. However, there also exists a tradition of volunteering with these people, implying a more positive attitude. Groups with positive attitudes and behaviours towards people with SMI have received relatively little attention in research. They merit further attention, as evidence on characteristics and experiences of volunteers may help to promote volunteering. The present paper aims to systematically review the literature reporting characteristics, motivations, experiences, and benefits of volunteers in the care of people with SMI. In November 2010, a systematic electronic search was carried out in BNI, CINAHL, Embase, Medline, PsycINFO, Cochrane Registers and Web of Science databases, using a combination of 'volunteer', 'mental health' and 'outcome' search terms. A secondary hand search was performed in relevant psychiatric journals, grey literature and references. 14 papers met the inclusion criteria for the review, with data on a total of 540 volunteers. The results suggest that volunteers are a mostly female, but otherwise heterogeneous group. Motivations for volunteering are a combination of what they can 'give' to others and what they can 'get' for themselves. Overall volunteers report positive experiences. The main benefit to persons with a psychiatric illness is the gaining of a companion, who is non-stigmatizing and proactive in increasing their social-community involvement. The evidence base for volunteers in care of people with SMI is small and inconsistent. However there are potential implications for both current and future volunteering programmes from the data. As the data suggests that there is no 'typical' volunteer, volunteering programmes should recruit individuals from a variety of backgrounds. The act of volunteering can not only benefit people with SMI, but also the volunteers
Full Text Available Objects: To study the demand of the aged community residents for college volunteers in home nursing care service and its influence factors. Methods: Questionnaires on the aged residents’ expectation and requirements for college volunteers in home nursing care was prepared on basis of studies of reference books, study materials and pre-investigation, and then the questionnaires was completed by means of convenient sampling of 200 aged residents. Results The demand and expectation of the elderly for college volunteers in health care and spiritual comfort was strong. The old people who have more children, living alone and often feel lonely are more likely to need college volunteers. Conclusions: Volunteers should be arranged reasonably according to the needs of the aged people, and priority should be given to those who have more children, living alone and often feel lonely.
This case study examines the current state of cultural competence in hospice and palliative care in the Greater Toronto Area (GTA). Because of changing demographic trends and ethnic minorities underutilizing hospice palliative care services, this research examined the current state of culturally competent care in a hospice setting, and the challenges to providing culturally competent care in a hospice in the GTA. A case study was conducted with a hospice and included in-depth interviews with 14 hospice volunteers. The findings reveal that volunteers encountered cultural clashes when their level of cultural competency was weak. Second, volunteers revealed there was a lack of adequate cultural competency training with their hospice, and finally, there was a lack of ethnic, cultural, and linguistic diversity among the hospice volunteers.
Priest, Kelsey C; Lobingier, Hannah; McCully, Nancy; Lombard, Jackie; Hansen, Mark; Uchiyama, Makoto; Hagg, Daniel S
Health care delivery systems are challenged to support the increasing demands for improving patient safety, satisfaction, and outcomes. Limited resources and staffing are common barriers for making significant and sustained improvements. At Oregon Health & Science University, the medical intensive care unit (MICU) leadership team faced internal capacity limitations for conducting continuous quality improvement, specifically for the implementation and evaluation of the mobility portion of an evidence-based care bundle. The MICU team successfully addressed this capacity challenge using the person power of prehealth volunteers. In the first year of the project, 52 trained volunteers executed an evidence-based mobility intervention for 305 critically ill patients, conducting more than 200 000 exercise repetitions. The volunteers contributed to real-time evaluation of the project, with the collection of approximately 26 950 process measure data points. Prehealth volunteers are an untapped resource for effectively expanding internal continuous quality improvement capacity in the MICU and beyond.
Lough, Benjamin J; Tiessen, Rebecca; Lasker, Judith N
The demand for international volunteer experiences to promote global health and nutrition is increasing and numerous studies have documented the experiences of the international volunteers who travel abroad; however, little is known about effective practices from the perspective of partner organizations. This study aims to understand how variables such as the skill-level of volunteers, the duration of service, cultural and language training, and other key variables affect partner organizations' perceptions of volunteer effectiveness at promoting healthcare and nutrition. This study used a cross-sectional design to survey a convenience sample of 288 volunteer partner organizations located in 68 countries. Principle components analyses and manual coding of cases resulted in a categorization of five generalized types of international volunteering. Differences among these types were compared by the duration of service, skill-level of volunteers, and the volunteers' perceived fit with organizational needs. In addition, a multivariate ordinary least square regression tested associations between nine different characteristics/activities and the volunteers' perceived effectiveness at promoting healthcare and nutrition. Partner organizations viewed highly-skilled volunteers serving for a short-term abroad as the most effective at promoting healthcare and nutrition in their organizations, followed by slightly less-skilled long-term volunteers. The greatest amount of variance in perceived effectiveness was volunteers' ability to speak the local language, followed by their skill level and the duration of service abroad. In addition, volunteer training in community development principles and practices was significantly related to perceived effectiveness. The perceptions of effective healthcare promotion identified by partner organizations suggest that program and volunteer characteristics need to be carefully considered when deciding on methods of volunteer preparation and
Putri, S. T.; Andriyani, S.
Posbindu is a form of public participation to conduct early detection and monitoring of risk factors for non-communicable diseases(NCD), and where it was carried out in as an integrated manner, routine and periodic event. This paper aims to investigates the needs and problems on Posbindu Program based on community health volunteers(CHVs) perspective. This study used descriptive qualitative method by open ended questions. Content analysis using to explicating the result. There are 3 theme finding about elderly needs in Posbindu; medical care, support group community, and health education. We found four theme problems which in Posbindu program: low motivation from elderly, Inadequate of facilities, physical disability, failed communication. To be effective in Posbindu program, all the stakeholders have reached consensus on the Posbindu program as elderly need. CHVs need given wide knowledge about early detection, daily care, control disease continuously so that the elderly keep feeling the advantages of coming to the Posbindu.
Akintola, Olagoke; Hlengwa, Wellington Mthokozisi; Dageid, Wenche
To conduct a quantitative investigation of stress and the relationship with burnout among AIDS care volunteers. Volunteer caregivers experience stress that could lead to burnout. Yet, very few studies quantify stress and its relationship with burnout among AIDS care volunteers. This study uses a cross-sectional, exploratory survey design. Face-to-face interviews were conducted with 126 volunteer caregivers working in 13 semi-rural communities (townships) in Durban, South Africa in April 2009. All participants were women, Christian and with low levels of education. A 22-item instrument was drawn from Pearlin et al.'s role overload and role captivity scales, Van Dyk's stress factor scale and the Maslach Burnout Inventory. Most of the volunteers had moderate-to-high levels of stress. 'Role/work overload' 'lack of support' and 'overwhelming nature of the disease' explained most of the variance in stress. Volunteers' age and number of patients in their care were predictors of stress. Caring for only AIDS patients, lack of support, stress emanating from perceived stigma and lack of training; and the overwhelming nature of AIDS were predictors of burnout. High levels of stress could negatively impact volunteers' health and well-being and on-the-job performance. Policy makers must develop and fund home-based care models that take into account the stressors associated with AIDS care, by reducing the work load, providing ongoing psychosocial support and recruiting nurses to assist volunteers. The small non-probability sample used in this study highlights the need to treat the findings with caution. © 2013 John Wiley & Sons Ltd.
Parkinson, Lynne; Warburton, Jeni; Sibbritt, David; Byles, Julie
As populations age, there will be a need for more volunteers in social welfare, and consequently a need to better understand potential effects of volunteering for older people. Whilst there is a body of international literature exploring health benefits of volunteering in later life, there are currently no longitudinal studies of Australian populations. Internationally, there is a lack of studies focusing on older women, who comprise the majority of the ageing population. The aim of this article was to explore the relationship between volunteering and psychosocial and health factors for a cohort of older Australian women over time. Data for this study were from the oldest cohort of Australian Longitudinal Study on Women's Health, a 20-year longitudinal survey of Australian women aged 70-75 years in 1996. Volunteering status was the factor of interest and study factors included a broad range of demographic, health and social factors. A longitudinal model was developed for mediators of volunteering over time. Of 7088 women in 2005, 24.5% reported actively volunteering, 15.5% were continuing, 7.5% were new, 15.3% were intermittent and 34.7% had never been volunteers. Volunteering was associated with increased quality of life and social support. Women were more likely to continue volunteering over time if they lived in a rural area, had higher socioeconomic indicators, and better levels of physical and mental health. This study contributes to the literature on the relationship between volunteering and health for older women. Understanding the potential health implications of volunteering is a critical issue in current policy debates.
King, Hannah R; Jackson, Joshua J; Morrow-Howell, Nancy; Oltmanns, Thomas F
Existing literature has shown that volunteering is related to better physical and mental health outcomes. The purpose of this study is to examine whether personality traits and volunteering are independent predictors of physical and mental health. The current study utilizes data from the St. Louis Personality and Aging Network (SPAN), a representative sample of community-based adults between the ages of 55 and 64. Using hierarchical linear regressions, we test whether volunteering is a significant predictor of both physical and mental health while controlling for personality traits. We find that volunteering is not significantly related to either physical or mental health while controlling for personality traits. We also find that lower neuroticism is related to better physical functioning and mental health, whereas higher extraversion is related to better mental health. These results indicate that volunteering may be related to health outcomes because of the personality characteristics of volunteers, not the volunteering experience in and of itself. Future longitudinal studies are needed to further explore the relationship between personality, volunteering, and health. © The Author 2014. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Aim: The aim of the study was to describe the characteristics of volunteers who remained active in the home-based care project located in Tzaneen (Limpopo Province) and thereby assist the project leaders to improve the recruitment and quality of the service in the future. Methodology: Structured questionnaires were ...
Ford-Jones, Polly; Daly, Tamara
Volunteers and voluntary organizations can connect preventative health care programs to communities and may play an important role in addressing the health needs of older adults. Despite this, tensions may exist in the structures that drive volunteers and voluntary organizations representing immigrant communities to provide unpaid labour to augment and supplement health care services. Furthermore, organizational challenges may exist for community agencies relying on volunteers to sustain a health screening and education program. The intervention program was led by one voluntary agency specifically for South Asian communities in partnership with the university and five local organizations. This paper draws on volunteer surveys (n = 22) and key informant interviews (n = 12) to detail volunteer experiences providing this intervention. Volunteers were university students and other community volunteers. A total of 810 adults participated in the intervention within the Greater Toronto Area, Ontario, Canada between October 2014 and June 2016. We found that volunteers often used their experience as a 'stepping stone' position to other education or work. They also gained from the knowledge and used it to educate themselves and their family members and friends. This paper provides a critical reflection on the role of volunteers in a preventative and educational healthcare intervention program for older adults from the South Asian community. Tensions exist when relying on volunteer labour for the implementation of preventative community health care programming and must be explored to ensure program sustainability as well as equity within the health care system.
Initiating a community eye health programme in an unfamiliar culture and language can be a daunting task. This report focuses on an underutilised resource for community eye health: American Peace Corps volunteers.
Volunteering in the hospice movement has had a profound impact on generating awareness of hospice work and palliative care in the context of supporting dying persons and their relatives as well as on integrating respective services in the existing health care system. This paper focuses on two specific questions: First, it asks how society is changing with respect to dealing with dying and death, and more precisely with dying persons, which is recognizable by the integration of hospice work and palliative care in the healthcare system and related to the relevance of volunteering in the sense of a citizens' movement. Second, this paper asks what the specific roles of volunteers are as well as the possibilities and limits of voluntary practice in end-of-life care and accompaniment. To answer these questions, the pivotal objectives of the hospice movement - the transformation of the social awareness regarding dying and death, as well as the reorganization of "institutions of dying" - will first be outlined by reference to the concept of "good dying", a specific hospice attitude together with hospice culture and palliative competence. In a second step, the relevance of volunteering and the specific role of volunteers in the actual practice of hospice work and palliative care will be outlined alongside current indicators and recognizable alteration tendencies, before concluding with a discussion of the perspectives of hospices as a citizens' movement.
Health research mainly relies on volunteers to generate data. Volunteer participants not only help provide necessary information to solve problems but also contribute to free participation which in turn helps the research wheel to continue. People mainly contribute to different nonprofit organizations by giving money for ...
Gratz, Margit; Paal, Piret; Emmelmann, Moritz; Roser, Traugott
Hospice volunteers often encounter questions related to spirituality. It is unknown whether spiritual care receives a corresponding level of attention in their training. Our survey investigated the current practice of spiritual care training in Germany. An online survey sent to 1,332 hospice homecare services for adults in Germany was conducted during the summer of 2012. We employed the SPSS 21 software package for statistical evaluation. All training programs included self-reflection on personal spirituality as obligatory. The definitions of spirituality used in programs differ considerably. The task of defining training objectives is randomly delegated to a supervisor, a trainer, or to the governing organization. More than half the institutions work in conjunction with an external trainer. These external trainers frequently have professional backgrounds in pastoral care/theology and/or in hospice/palliative care. While spiritual care receives great attention, the specific tasks it entails are rarely discussed. The response rate for our study was 25.0% (n = 332). A need exists to develop training concepts that outline distinct contents, methods, and objectives. A prospective curriculum would have to provide assistance in the development of training programs. Moreover, it would need to be adaptable to the various concepts of spiritual care employed by the respective institutions and their hospice volunteers.
Guinevere M. Lourens
Full Text Available Background: A volunteer programme with 50 registered volunteers was established in 2007 at a secondary-level public, semi-rural regional hospital in the Cape Winelands, South Africa. This was a rapid response to the extensive renovations and system changes brought about by the hospital revitalisation initiated in 2006 and the resultant expanded services, which required additional human resources. This study describes the hospital volunteer programme and provides hospital administrators with practical planning guidance for hospital volunteer programme implementation. Purpose: The purpose of this study is to (1 describe the outcomes of the hospital volunteer programme implementation intervention and (2 to make sound recommendations for volunteer programme implementation. Methodology and approach: A qualitative case-study methodology was employed using purposive sampling as a technique. Participants were recruited from a public hospital in the Western Cape. A case-study design was applied to explore the hospital volunteer programme implementation. In-depth interviews and a focus group discussion with thematic content analysis of transcripts as well as document reviews were conducted to conclude the study during 2015. The key participants were individually interviewed and included two members of the hospital management, two volunteers and one volunteer coordinator. A focus group discussion consisting of three volunteers was also conducted. Findings: The findings of this study indicate that a volunteer programme can meet needs and be a motivational force for both the individual volunteer and the organisation. However, it requires co-ordination and some secure funding to remain sustainable. Such a programme holds huge benefits in terms of human resource supplementation, organisational development, as well as the possibility of gainful employment for the previously unemployed. Practical implications: In practice, a health service contemplating a
Ahn, SangNam; Phillips, Karon L; Smith, Matthew Lee; Ory, Marcia G
This study aimed to identify participant characteristics associated with volunteering among older adults. Based on data from the 2008 Aging Texas Well (ATW) Indicators Survey, we examined the degree to which demographic factors, health status, spiritual participation, and community involvement are associated with volunteering among adults aged 60 years or older (n = 525). Rates of volunteering varied by race/ethnicity: non-Hispanic Whites (56.4%), African Americans (51.1%), and Hispanics (43.2%). Bivariate analyses showed that non-Hispanic White older adults were more likely to participate in formal volunteering activities, while their African American and Hispanic counterparts tended to participate in informal volunteering activities. Logistic regression analyses revealed that volunteering was less observed among Hispanics (OR = 0.48, 95% CI 0.29-0.78). Volunteering was more observed among those who reported providing informal care (OR=1.93, 95% CI 1.14-3.28), having very good or excellent mental health (OR = 1.90 and 2.07, 95% CI 1.09-3.32 and 1.20-3.55, respectively), having weekly or daily spiritual participation (OR = 2.15 and 2.35, 95% CI 1.28-3.63 and 1.29-4.28, respectively), perceiving community involvement very important (OR = 2.37, 95% CI 1.55-3.62), and being very satisfied with the community interaction (OR = 1.81, 95% CI 1.15-2.85). Given the positive associations of mental health, spirituality, and social engagement with volunteering among older adults, system-level efforts to increase the sense of community among older adults and recognize their roles as volunteers will be helpful in recruiting and retaining older volunteers. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Ørtenblad, Lisbeth; Væggemose, Ulla; Gissel, Lene; Nissen, Nina Konstantin
Challenges in recruiting volunteers encountered by psychiatric services are barely elucidated despite a general societal increase in volunteering. The aim of the study was to explore the significance of professional and private life experiences in willingness to volunteer to care for people with severe mental illness. Focus group interviews with volunteers in the Community Family Programme was conducted, followed by thematic analysis. All interviewees had professional and/or private experience of SMI, which had a major influence on their initial willingness to volunteer. Volunteering was an opportunity to pass on their experiences and to care for SMI people in ways that were not possible in their professions. The interviewees did not distinguish between the influences of professional and/or private life experiences on their willingness to volunteer. The study demonstrates the importance of professional and/or private life experiences in initial considerations about volunteering for mental health care. The consequences for recruitment practices are discussed.
the key issues facing health care providers in ... gral part of community-based health programmes ... health care services more accessible to everyone s. , .... health; villagers are often more willing to help meet the costs of services they value. 2.
Fegan, Colette; Cook, Sarah
The aim of the study was to investigate how people with serious mental illness perceived the experience of volunteering for the health care organisation in which they had received a service. The study took a qualitative approach and in phase one, eleven service user volunteers were purposefully sampled and interviewed. In depth interviews were analysed using grounded theory. This paper describes the findings from phase one, and highlights the following themes to represent the volunteering experience: 1) rehearsing for a new direction; 2) treading carefully at first; 3) discovering my new self; and, 4) using my experience and extending relationships. These themes further support a tentative theoretical framework that considers supported volunteering to enhance recovery because it fosters positive risk taking and gives individuals a valued identity that integrates their mental health experience. In phase two, this framework will be tested with service users in more diverse volunteer positions. The findings of my study suggest that mental health services are in a unique position to build partnerships with service users to support their recovery and journeys toward employment by providing opportunities for volunteering.
Barron, Jeremy S; Tan, Erwin J; Yu, Qilu; Song, Meilin; McGill, Sylvia; Fried, Linda P
Volunteer service opportunities for older adults may soon be expanded. Although volunteering is thought to provide health benefits for healthier older adults, it is not known whether older adults in less than very good health are suitable candidates for high-intensity volunteering and can derive health benefits. This manuscript presents a prospective analysis of 174 older adult volunteers serving in Experience Corps Baltimore, a high-intensity senior volunteer program in Baltimore, Maryland. Volunteers served > or =15 h per week, for a full school year, in elementary schools helping children with reading and other skills between 1999 and 2002. Volunteers were assessed with standardized questionnaires and performance-based testing including grip strength, walking speed, chair stand speed, and stair-climbing speed prior to school volunteering and at the end of the school year. Results were stratified by health status. Among 174 volunteers, 55% initially reported "good" and 12% "fair" or "poor" health status. At baseline, those in fair health reported higher frequencies of disease and disability than volunteers in excellent or very good health. After volunteering, a majority of volunteers in every baseline health status category described increased strength and energy. Those in fair health were significantly more likely to display improved stair-climbing speed than those in good or excellent/very good health (100.0% vs. 53.4% vs. 37.5%, p = 0.05), and many showed clinically significant increases in walking speed of >0.5 m/s. Satisfaction and retention rates were high for all health status groups. Clinicians should consider whether their patients in fair or good health, as well as those in better health, might benefit from high-intensity volunteer programs. Productive activity such as volunteering may be an effective community-based approach to health promotion for older adults.
Roche, Adeline; Ogden, Jane
Samaritan listening volunteers provide emotional support to people in distress or suicidal. Samaritans' has high volunteer turnover, which may be due to burnout. This study evaluated the role of demographic and psychosocial factors in predicting Samaritans listening volunteers' burnout and health status. Samaritans' listening volunteers (n = 216) from seven branches across UK completed an online survey to assess their levels of burnout (emotional exhaustion, depersonalisation, personal accomplishment), subjective health status, coping, empathy and social support. Overall, listeners showed low levels of burnout and good health. Regression analysis revealed that higher emotional exhaustion was predicted by younger age and avoidant coping style; higher depersonalisation was predicted by lower empathy fantasy and higher avoidant coping style; lower personal accomplishment scores were predicted by higher empathy personal distress and worse health status was predicted by more hours per week spent on listening duties, lower social support and higher avoidant coping style. Overall, different factors influenced different facets of burnout. However, higher use of avoidant coping style consistently predicted higher burnout and worse health status, suggesting avoidant coping is an important target for intervention.
Neupane, Dinesh; Dawson, Penny; Houston, Robin
and in many other developing countries. This is a cohort study to evaluate the risk of deaths among LBW infants who received FCHV follow up visit for home-based care compared to those who did not receive in Rural Nepal. Methods A cohort study design was used with data from the Morang Innovative Neonatal...
Burbeck, Rachel; Low, Joe; Sampson, Elizabeth L.; Bravery, Ruth; Hill, Matthew; Morris, Sara; Ockenden, Nick; Payne, Sheila
Abstract Background: Worldwide, the demand for specialist palliative care is increasing but funding is limited. The role of volunteers is underresearched, although their contribution reduces costs significantly. Understanding what volunteers do is vital to ensure services develop appropriately to meet the challenges faced by providers of palliative care. Objective: The study's objective is to describe current involvement of volunteers with direct patient/family contact in U.K. specialist palliative care. Design: An online survey was sent to 290 U.K. adult hospices and specialist palliative care services involving volunteers covering service characteristics, involvement and numbers of volunteers, settings in which they are involved, extent of involvement in care services, specific activities undertaken in each setting, and use of professional skills. Results: The survey had a 67% response rate. Volunteers were most commonly involved in day care and bereavement services. They entirely ran some complementary therapy, beauty therapy/hairdressing, and pastoral/faith-based care services, and were involved in a wide range of activities, including sitting with dying patients. Conclusions: This comprehensive survey of volunteer activity in U.K. specialist palliative care provides an up-to-date picture of volunteer involvement in direct contact with patients and their families, such as providing emotional care, and the extent of their involvement in day and bereavement services. Further research could focus on exploring their involvement in bereavement care. PMID:24475743
Jennifer L Brenner
Full Text Available BACKGROUND: The potential for community health workers to improve child health in sub-Saharan Africa is not well understood. Healthy Child Uganda implemented a volunteer community health worker child health promotion model in rural Uganda. An impact evaluation was conducted to assess volunteer community health workers' effect on child morbidity, mortality and to calculate volunteer retention. METHODOLOGY/PRINCIPAL FINDINGS: Two volunteer community health workers were selected, trained and promoted child health in each of 116 villages (population ∼61,000 during 2006-2009. Evaluation included a household survey of mothers at baseline and post-intervention in intervention/control areas, retrospective reviews of community health worker birth/child death reports and post-intervention focus group discussions. Retention was calculated from administrative records. Main outcomes were prevalence of recent child illness/underweight status, community health worker reports of child deaths, focus group perception of effect, and community health worker retention. After 18-36 months, 86% of trained volunteers remained active. Post-intervention surveys in intervention households revealed absolute reductions of 10.2% [95%CI (-17.7%, -2.6%] in diarrhea prevalence and 5.8% [95%CI (-11.5%, -0.003%] in fever/malaria; comparative decreases in control households were not statistically significant. Underweight prevalence was reduced by 5.1% [95%CI (-10.7%, 0.4%] in intervention households. Community health worker monthly reports revealed a relative decline of 53% in child deaths (<5 years old, during the first 18 months of intervention. Focus groups credited community health workers with decreasing child deaths, improved care-seeking practices, and new income-generating opportunities. CONCLUSIONS/SIGNIFICANCE: A low-cost child health promotion model using volunteer community health workers demonstrated decreased child morbidity, dramatic mortality trend declines and
Pillemer, Karl; Fuller-Rowell, Thomas E.; Reid, M. C.; Wells, Nancy M.
Purpose: This study tested the hypothesis that volunteering in environmental organizations in midlife is associated with greater physical activity and improved mental and physical health over a 20-year period. Design and Methods: The study used data from two waves (1974 and 1994) of the Alameda County Study, a longitudinal study of health and mortality that has followed a cohort of 6,928 adults since 1965. Using logistic and multiple regression models, we examined the prospective association between environmental and other volunteerism and three outcomes (physical activity, self-reported health, and depression), with 1974 volunteerism predicting 1994 outcomes, controlling for a number of relevant covariates. Results: Midlife environmental volunteering was significantly associated with physical activity, self-reported health, and depressive symptoms. Implications: This population-based study offers the first epidemiological evidence for a significant positive relationship between environmental volunteering and health and well-being outcomes. Further research, including intervention studies, is needed to confirm and shed additional light on these initial findings. PMID:20172902
Claxton-Oldfield, Stephen; Bhatt, Anamika
A survey was conducted to examine the frequency, acceptability, and functions of humor between hospice palliative care volunteers and their patients, from the volunteers' perspective. Thirty-two volunteers completed the survey, which was developed for this study. The results revealed that most patients and volunteers initiated humor either "often" or "sometimes" in their interactions. Over half of the volunteers considered humor to be either "very important" or "extremely important" in their interactions with patients (42% and 13%, respectively), with the patient being the determining factor as to whether and when it is appropriate or not (ie, volunteers take their lead from their patients). Volunteers mentioned a number of functions that humor serves within their patient interactions (eg, to relieve tension, to foster relationships/connections, and to distract). Laughter and humor fulfills one of the main goals of hospice palliative care, namely, improving patients' overall quality of life.
Claxton-Oldfield, Stephen; Gosselin, Natasha; Schmidt-Chamberlain, Kirsten; Claxton-Oldfield, Jane
A total of 22 family members, whose deceased loved ones had used the services of a hospice palliative care volunteer, responded to a brief survey designed to assess the importance of the different kinds of support offered to them (family members) by the volunteer, their impressions of the volunteers' personal qualities/characteristics, their general experiences with the volunteer, and their overall satisfaction with the volunteer services. The kind of support that received the highest importance rating from family members was the opportunity to take a much-needed break from the demands of caring for their loved one, closely followed by emotional support, the volunteer spending time with them, and the volunteer providing them with information. Family members rated volunteers highly on a list of qualities/characteristics that exemplify individuals who are effective in this role. In all, 85% of the family members felt that their volunteer was well trained and 95% did not feel that their or their loved one's privacy had been invaded by having a volunteer. Overall, family members were very satisfied with the volunteer support they received. Some limitations of the study are discussed.
Böddeker, Andrea; Smeding, Ruthmarijke; Voltz, Raymond
To relate personal experience and reflections on the tasks and role of a volunteer in an academic palliative care unit into the context of the English publications of 2009. We took a snapshot of the most recent publications as a way of placing the rather unique experiences of this German volunteer in an international context. Five recent studies were found discussing the importance of volunteers in an interdisciplinary context, but mainly focusing on the volunteer's role in the community, interacting with terminally ill patients and their caregivers. Furthermore, aspects of ethical issues, reasons for starting and continuing to volunteer for hospice and the role of male volunteers were evaluated in these studies. The studies feature on the one hand the positive recognition of volunteers, for example, two studies revealed a significant interest by the respondents of having volunteers if they were dying. Also, these articles focused on family carers, who voted for the service of hospice/palliative care volunteers; on the other hand, efforts have to be made to improve the recruitment of volunteers especially if it comes to male support. A further study, reporting on ethical issues, indicates that little is known about these issues when it comes to a volunteer's interaction with a patient in difficult situations, how these are to be managed. These studies give us valuable clues on how and where to make continuous improvements.
This paper explores the manner in which two hospices--one located in Denmark and one in Australia--negotiate and determine the boundaries of volunteer workers vis-à-vis paid staff. A comparative case study approach was used to juxtapose organisations with similar activity fields located in different welfare state systems, i.e. a social democratic welfare state and a liberal welfare state. This study involved non-participant observation of volunteers at work and unstructured interviews with volunteers, staff and management in the hospices (n = 41). Data were collected between August 2012 and February 2013. Data were managed using NVivo and analysed thematically. A key finding is that volunteers in the Danish hospice were excluded from all direct care work due to the effective monopoly of the professional care providers, whereas the Australian volunteers participated in the provision of care to the extent that risk could be eliminated or mitigated to an acceptable level. The findings suggest two different models of the roles of volunteers in tension with professional care providers. Both models recognise that volunteers add to the level of care delivered by the organisations and allow for a discussion that moves away from the normative discussions of 'not taking somebody's job', while also recognising that volunteers must be more than just the 'nice extra' if they are to be of any real value to the organisation and to care receivers. © 2014 John Wiley & Sons Ltd.
Cloyes, Kristin G.; Rosenkranz, Susan J.; Supiano, Katherine P.; Berry, Patricia H.; Routt, Meghan; Llanque, Sarah M.; Shannon-Dorcy, Kathleen
The increasing numbers of aging and chronically ill prisoners incarcerated in Western nations is well documented, as is the growing need for prison-based palliative and end-of-life care. Less often discussed is specifically how end-of-life care can and should be provided, by whom, and with what resources. One strategy incorporates prisoner volunteers into end-of-life services within a peer care program. This article reports on one such program based on focused ethnographic study including in-depth interviews with inmate hospice volunteers, nursing staff, and corrections officers working in the hospice program. We describe how inmate volunteers learn hospice care through formal education and training, supervised practice, guidance from more experienced inmates, and support from correctional staff. We discuss how emergent values of mentorship and stewardship are seen by volunteers and staff as integral to prison hospice sustainability and discuss implications of this volunteer-centric model for response-ability for the end-of-life care of prisoners. PMID:28100141
Klepczyńska-Nyström, Anna; Larsson, Britt-Marie; Grunewald, Johan; Pousette, Charlotte; Lundin, Anders; Eklund, Anders; Svartengren, Magnus
Particle exposure is known to have negative health effects. In Stockholm the environment in the subway has been reported to have higher particle exposure levels, measured as PM(2.5) and PM(10), than roads with intense traffic in the inner city area. We have recently shown that healthy volunteers exposed to subway environment had statistically significant increase of fibrinogen and CD4 cells expressing regulatory T-cell marker CD25(bright)/FOXP3 in blood. The aim of the present study was to find out whether a more vulnerable population, asthmatics, would demonstrate similar or other changes in the lungs or in the peripheral blood. Sixteen mild asthmatics were exposed to a subway and a control environment for 2 h while being monitored by measurements of lung function, and inflammatory response in the lower airways evaluated by bronchoscopy and in peripheral blood. An attempt to standardize the exposures was done, by letting the volunteers alternate 15 min intervals of moderate exercise on a bicycle ergometer with 15 min of rest. We found a statistically significant increased frequency of CD4 cells expressing T-cell activation marker CD25 in bronchoalveolar lavage fluid, but no significant increase of regulatory T-cells in blood as was found in healthy volunteers. Our study shows that airway inflammatory responses after exposure in subway environment differ between asthmatic and healthy humans. Copyright © 2011 Elsevier Ltd. All rights reserved.
care policy which was intended to make health care which of the two alternative methods of health care available to individuals and families in the financing options of free health or DRF was community at very little or no cost at all. However, preferred by the community members within most health facilities would appear to ...
Beasley, Elizabeth; Brooker, Joanne; Warren, Narelle; Fletcher, Jane; Boyle, Christopher; Ventura, Adriana; Burney, Susan
Many patients approaching death experience hopelessness, helplessness, and a depressed mood, and these factors can contribute to a difficult end-of-life (EoL) period. Biography services may assist patients in finding meaning and purpose at this time. The aim of our study was to investigate the lived experience of volunteers involved in a biography service in Melbourne, Australia, using a qualitative methodology. The participants were 10 volunteers who had participated in a biography service within a private palliative care service. Each volunteer was interviewed separately using a study-specific semistructured interview guide. The transcripts of these interviews were then subjected to thematic analysis. Analysis yielded the following themes: motivations for volunteering; dealing with death, dying, and existential issues; psychosocial benefits of volunteering; and benefits and challenges of working with patients and their families. Our results indicated that volunteering gave the volunteers a deeper appreciation of existential issues, and helped them to be more appreciative of their own lives and gain a deeper awareness of the struggles other people experience. They also suggested that volunteers felt that their involvement contributed to their own personal development, and was personally rewarding. Furthermore, the results highlighted that volunteers found that encounters with family members were sometimes challenging. While some were appreciative, others imposed time limits, became overly reliant on the volunteers, and were sometimes offended, hurt, and angered by what was included in the final biography. It is hoped that the findings of the current study will provide direction for improvements in the biography services that will benefit patients, family members, and volunteers. In particular, our findings highlight the need to provide ongoing support for volunteers to assist them in handling the challenges of volunteering in a palliative care setting.
Pesut, Barbara; Duggleby, Wendy; Warner, Grace; Fassbender, Konrad; Antifeau, Elisabeth; Hooper, Brenda; Greig, Madeleine; Sullivan, Kelli
A compassionate community approach to palliative care provides important rationale for building community-based hospice volunteer capacity. In this project, we piloted one such capacity-building model in which volunteers and a nurse partnered to provide navigation support beginning in the early palliative phase for adults living in community. The goal was to improve quality of life by developing independence, engagement, and community connections. Volunteers received navigation training through a three-day workshop and then conducted in-home visits with clients living with advanced chronic illness over one year. A nurse navigator provided education and mentorship. Mixed method evaluation data was collected from clients, volunteer navigators, the nurse navigator, and other stakeholders. Seven volunteers were partnered with 18 clients. Over the one-year pilot, the volunteer navigators conducted visits in home or by phone every two to three weeks. Volunteers were skilled and resourceful in building connections and facilitating engagement. Although it took time to learn the navigator role, volunteers felt well-prepared and found the role satisfying and meaningful. Clients and family rated the service as highly important to their care because of how the volunteer helped to make the difficult experiences of aging and advanced chronic illness more livable. Significant benefits cited by clients were making good decisions for both now and in the future; having a surrogate social safety net; supporting engagement with life; and ultimately, transforming the experience of living with illness. Overall the program was perceived to be well-designed by stakeholders and meeting an important need in the community. Sustainability, however, was a concern expressed by both clients and volunteers. Volunteers providing supportive navigation services during the early phase of palliative care is a feasible way to foster a compassionate community approach to care for an aging population
Ramos Romualdo; Brauchli Rebecca; Bauer Georg; Wehner Theo; Hämmig Oliver
OBJECTIVE To understand the relationship between volunteering and health in the overlooked yet highly engaged working population, adopting a contextualizing balance approach. We hypothesize that volunteering may function as a psychosocial resource, contributing to work-life balance and, ultimately, health. METHODS A total of 746 Swiss workers participated in an online survey; 35% (N = 264) were additionally volunteers in a nonprofit organization. We assessed volunteering, work-life balance...
Ramos, Romualdo; Brauchli, Rebecca; Bauer, Georg; Wehner, Theo; Hämmig, Oliver
To understand the relationship between volunteering and health in the overlooked yet highly engaged working population, adopting a contextualizing balance approach. We hypothesize that volunteering may function as a psychosocial resource, contributing to work-life balance and, ultimately, health. A total of 746 Swiss workers participated in an online survey; 35% (N = 264) were additionally volunteers in a nonprofit organization. We assessed volunteering, work-life balance perceptions, paid job demands, and resources and health outcomes. After controlling for job characteristics, volunteering was associated with less work-life conflict, burnout and stress, and better positive mental health. Results further revealed that balance perceptions partly explained the relationship between volunteering and health. Volunteering, albeit energy and time-consuming, may contribute to a greater sense of balance for people in the workforce, which might, in turn, positively influence health.
Wang, Chi-Jane; Fetzer, Susan J; Yang, Yi-Ching; Wang, Jing-Jy
It is a challenge for rural health professionals to promote medication safety among older adults taking multiple medications. A volunteer coaching program to promote medication safety among rural elders with chronic illnesses was designed and evaluated. A community-based interventional study randomly assigned 62 rural elders with at least two chronic illnesses to routine care plus volunteer coaching or routine care alone. The volunteer coaching group received a medication safety program, including a coach and reminders by well-trained volunteers, as well as three home visits and five telephone calls over a two-month period. All the subjects received routine medication safety instructions for their chronic illnesses. The program was evaluated using pre- and post-tests of knowledge, attitude and behaviors with regard to medication safety. Results show the volunteer coaching group improved their knowledge of medication safety, but there was no change in attitude after the two-month study period. Moreover, the group demonstrated three improved medication safety behaviors compared to the routine care group. The volunteer coaching program and instructions with pictorial aids can provide a reference for community health professionals who wish to improve the medication safety of chronically ill elders. Copyright © 2013 Mosby, Inc. All rights reserved.
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Principi, Andrea; Galenkamp, Henrike; Papa, Roberta; Socci, Marco; Suanet, Bianca; Schmidt, Andrea; Schulmann, Katharine; Golinowska, Stella; Sowa, Agnieszka; Moreira, Amilcar; Deeg, Dorly J H
It has been widely recognised that poor health is one of the main barriers to participation in volunteer activities in older age. Therefore, it is crucial to examine the participation of older people in volunteering, especially those in poor health. Based on the resource theory of volunteering, the aim of this study is to better understand the correlates of volunteering among older people with different health statuses, namely those without health problems (neither multimorbidity nor disability), those with mild health problems (multimorbidity or disability), and those with severe health problems (multimorbidity and disability). Data were drawn from the fourth wave (2011-2012, release 1.1.1) of the Survey of Health, Ageing and Retirement in Europe, which includes European people aged 50 years or older. The results showed that variables linked to volunteering were generally similar regardless of health status, but some differences were nevertheless identified. For older people with mild or severe health problems, for instance, depressive symptoms were negatively associated with their involvement in volunteer activities. We found a positive association of being widowed (rather than married) with volunteering in older people with particularly poor health, whereas high income was associated with volunteering in the case of mild health problems only. These results demonstrate that variables associated with volunteer participation partially differ between older people depending on their health status. These differences should be considered by policy makers in their attempts to promote volunteering in older people, as a means of preventing their social exclusion.
Black, Heather L; Priolo, Chantel; Gonzalez, Rodalyn; Geer, Sabrina; Adam, Bariituu; Apter, Andrea J
To describe and categorize contextual information relevant to patients' medical care unexpectedly volunteered to research personnel as part of a patient advocate (PA) intervention to facilitate access health care, communication with medical personnel, and self-management of a chronic disease such as asthma. We adapted a patient navigator intervention, to overcome barriers to access and communication for adults with moderate or severe asthma. Informed by focus groups of patients and providers, our PAs facilitated preparation for a visit with an asthma provider, attended the visit, confirmed understanding, and assisted with post-visit activities. During meetings with researchers, either for PA activities or for data collection, participants frequently volunteered personal and medical information relevant for achieving successful self-management that was not routinely shared with medical personnel. For this project, researchers journaled information not captured by the structured questionnaires and protocol. Using a qualitative analysis, we describe (1) researchers' journals of these unique communications; (2) their relevance for accomplishing self-management; (3) PAs' formal activities including teach-back, advocacy, and facilitating appointment making; and (4) observations of patients' interactions with the clinical practices. In 83 journals, patients' social support (83%), health (68%), and deportment (69%) were described. PA assistance with navigating the medical system (59%), teach-back (46%), and observed interactions with patient and medical staff (76%) were also journaled. Implicit were ways patients and practices could overcome barriers to access and communication. These journals describe the importance of seeking contextual and medically relevant information from all patients and, especially, those with significant morbidities, prompting patients for barriers to access to health care, and confirming understanding of medical information.
Muckaden, M A; Pandya, Sachi Sanjay
Volunteers are an integral part of the palliative care services in the Tata Memorial Hospital, Mumbai, Maharashtra, India. These volunteers are an important resource for the department. Thus, it is necessary for the department to determine what motivates these volunteers to continue to work in the setting, acknowledge them and direct efforts toward retaining them and giving them opportunities to serve to the best of their desire and abilities. The current study aimed at understanding the motivation of volunteers to work in palliative care, to identify the challenges they face and also the effect of their work on their self and relationships. In-depth interviews were conducted using semistructured interview guide to study above mentioned aspects. Themes were identified and coding was used to analyze the data. The results suggested that the basic motivation for all the volunteers to work in a palliative care setting is an inherent urge, a feeling of need to give back to the society by serving the sick and the suffering. Other motivating factors identified were team spirit, comfort shared, warm and respectful treatment by the team, satisfying nature of work, experience of cancer in the family, and aligned values and beliefs. Some intrinsic rewards mentioned by volunteers were joy of giving, personal growth, enriching experiences, and meaningful nature of work. The study attempted to improve opportunities of working for these volunteers. Although limited in scope, it offers insight for future research in the area of volunteerism in palliative care setup.
M A Muckaden
Full Text Available Background: Volunteers are an integral part of the palliative care services in the Tata Memorial Hospital, Mumbai, Maharashtra, India. These volunteers are an important resource for the department. Thus, it is necessary for the department to determine what motivates these volunteers to continue to work in the setting, acknowledge them and direct efforts toward retaining them and giving them opportunities to serve to the best of their desire and abilities. Aims: The current study aimed at understanding the motivation of volunteers to work in palliative care, to identify the challenges they face and also the effect of their work on their self and relationships. Methodology: In-depth interviews were conducted using semistructured interview guide to study above mentioned aspects. Themes were identified and coding was used to analyze the data. Results: The results suggested that the basic motivation for all the volunteers to work in a palliative care setting is an inherent urge, a feeling of need to give back to the society by serving the sick and the suffering. Other motivating factors identified were team spirit, comfort shared, warm and respectful treatment by the team, satisfying nature of work, experience of cancer in the family, and aligned values and beliefs. Some intrinsic rewards mentioned by volunteers were joy of giving, personal growth, enriching experiences, and meaningful nature of work. Conclusion: The study attempted to improve opportunities of working for these volunteers. Although limited in scope, it offers insight for future research in the area of volunteerism in palliative care setup.
Full Text Available ABSTRACT Objective To report on how brigadistas (“health brigadiers” in Nicaragua volunteer their time before the introduction of expanded responsibilities (beyond the scope of integrated community case management (iCCM for sick children 2–59 months old. Methods Three complete teams of brigadistas (n = 12 brigadistas total were selected from remote communities in the department of Matagalpa. Each respondent brigadista was interviewed privately regarding the frequency and duration (i.e., preparation, round-trip travel, and implementation time of 13 separate activities. The correlation between their overall estimates and summed times of individual activities were measured. Results Brigadista mean density was 1 per 156 total population (range: 120–217. Each team had one encargado/a (“manager” with an iCCM drug box plus two to four asistentes (“assistants”. All resided in the community they served. Eight reported competing time demands during one to nine months of the year. Brigadistas volunteered an average of 75 hours per month (range: 35–131. Encargados were busier than asistentes (98 versus 68 hours per month. Three activities accounted for 70% of their time: 1 iCCM (30%: treatment (11%, follow-up (19%; 2 receiving training (21%; and 3 promoting birth planning (19%. Brigadistas’ time was divided among preparation (12%, travel (27%, and implementation (61%. Overall estimates were highly correlated (+0.70 with summed implementation time. Conclusions Brigadistas from these remote Nicaraguan communities were busy with different activities, levels of effort, and patterns of task-sharing. These findings, plus an ongoing job satisfaction survey and a follow-on time study after the introduction of the new interventions, will inform policy for this valuable volunteer cadre.
Carter, M.W.; Hans, Elias W.; Kolisch, R.
Health care operations management has become a major topic for health care service providers and society. Operations research already has and further will make considerable contributions for the effective and efficient delivery of health care services. This special issue collects seven carefully
Lederer, Alyssa M; Autry, Dana M; Day, Carol R T; Oswalt, Sara B
To examine the impact of work and volunteer hours on 4 health issues among undergraduate college students. Full-time undergraduate students (N = 70,068) enrolled at 129 institutions who participated in the Spring 2011 American College Health Association-National College Health Assessment II survey. Multiple linear regression and binary logistic regression were used to examine work and volunteer hour impact on depression, feelings of being overwhelmed, sleep, and physical activity. The impact of work and volunteer hours was inconsistent among the health outcomes. Increased work hours tended to negatively affect sleep and increase feelings of being overwhelmed. Students who volunteered were more likely to meet physical activity guidelines, and those who volunteered 1 to 9 hours per week reported less depression. College health professionals should consider integrating discussion of students' employment and volunteering and their intersection with health outcomes into clinical visits, programming, and other services.
Full Text Available To explore the association between health literacy and levels of three types of core activities among health promotion volunteers (developing a healthy lifestyle, outreach to family, and outreach to community members.A cross-sectional, anonymous, self-administered postal survey of registered health promotion volunteers in the Konan area in Shiga Prefecture in Japan, conducted in January 2010. The study sample was 575 registered health promotion volunteers.The survey collected data on health literacy, gender, age, education, self-rated health, perceptions about the volunteer organization, and perceptions of recognition in the community. The level of engagement in health promotion activities was measured by the extent to which the participants engaged in seven healthy behaviors and promoted them to family members and the community. The authors compared the health literacy level and other characteristics of the participants by core health promotion activities, using a chi-squared test, to examine the associations between demographic and other variables and the three core activities (healthy lifestyle, outreach to family, and outreach to community.Logistic regression analysis was conducted to examine the association between the degree to which the volunteers engaged in core activities ("healthy lifestyle," "outreach to family," "outreach to community" and the levels of health literacy (low, medium, high among health promotion volunteers, controlling for the effects of age, gender, health condition, education which may also have an impact on volunteers' outreach activities.Four hundred and fifty-four questionnaires were returned, a 79.0% response rate. Excluding 16 cases with missing values on health literacy or the degree of health promotion activities, 438 research subjects were included in the analysis (valid response rate: 76.2%. Health literacy and a few demographic and other characteristics of the volunteers were associated with the three core
Klepczyńska Nyström, A; Svartengren, M; Grunewald, J; Pousette, C; Rödin, I; Lundin, A; Sköld, C M; Eklund, A; Larsson, B-M
Environmental particle exposure, often estimated as the particulate mass of particles with a diameter subway environment. 20 healthy volunteers were exposed to a subway and a control environment for 2 h, followed by measurements of lung function and the inflammatory response in the lower airways (bronchoscopy) and in the peripheral blood. No cellular response was found in the airways after exposure to the subway environment. In the blood, we found a statistically significant increase in fibrinogen and regulatory T-cells expressing CD4/CD25/FOXP3. Subway and road tunnel environments have similar levels of PM(10) and PM(2.5), whilst the concentrations of ultrafine particles, nitrogen monoxide and dioxide are lower in the subway. Although no cellular response was detected, the findings indicate a biological response to the subway environment. Our studies show that using gravimetric estimates of ambient particulate air pollution alone may have clear limitations in health-risk assessment.
Ludwick, Teralynn; Brenner, Jennifer L; Kyomuhangi, Teddy; Wotton, Kathryn A; Kabakyenga, Jerome Kahuma
Globally, health worker shortages continue to plague developing countries. Community health workers are increasingly being promoted to extend primary health care to underserved populations. Since 2004, Healthy Child Uganda (HCU) has trained volunteer community health workers in child health promotion in rural southwest Uganda. This study analyses the retention and motivation of volunteer community health workers trained by HCU. It presents retention rates over a 5-year period and provides insight into volunteer motivation. The findings are based on a 2010 retrospective review of the community health worker registry and the results of a survey on selection and motivation. The survey was comprised of qualitative and quantitative questions and verbally administered to a convenience sample of project participants. Between February 2004 and July 2009, HCU trained 404 community health workers (69% female) in 175 villages. Volunteers had an average age of 36.7 years, 4.9 children and some primary school education. Ninety-six per cent of volunteer community health workers were retained after 1 year (389/404), 91% after 2 years (386/404) and 86% after 5 years (101/117). Of the 54 'dropouts', main reasons cited for discontinuation included 'too busy' (12), moved (11), business/employment (8), death (6) and separation/divorce (6). Of 58 questionnaire respondents, most (87%) reported having been selected at an inclusive community meeting. Pair-wise ranking was used to assess the importance of seven 'motivational factors' among respondents. Those highest ranked were 'improved child health', 'education/training' and 'being asked for advice/assistance by peers', while the modest 'transport allowance' ranked lowest. Our findings suggest that in our rural, African setting, volunteer community health workers can be retained over the medium term. Community health worker programmes should invest in community involvement in selection, quality training, supportive supervision and
Taguchi, Atsuko; Murayama, Hiroshi; Murashima, Sachiyo
To explore the association between health literacy and levels of three types of core activities among health promotion volunteers (developing a healthy lifestyle, outreach to family, and outreach to community members). A cross-sectional, anonymous, self-administered postal survey of registered health promotion volunteers in the Konan area in Shiga Prefecture in Japan, conducted in January 2010. The study sample was 575 registered health promotion volunteers. The survey collected data on health literacy, gender, age, education, self-rated health, perceptions about the volunteer organization, and perceptions of recognition in the community. The level of engagement in health promotion activities was measured by the extent to which the participants engaged in seven healthy behaviors and promoted them to family members and the community. The authors compared the health literacy level and other characteristics of the participants by core health promotion activities, using a chi-squared test, to examine the associations between demographic and other variables and the three core activities (healthy lifestyle, outreach to family, and outreach to community).Logistic regression analysis was conducted to examine the association between the degree to which the volunteers engaged in core activities ("healthy lifestyle," "outreach to family," "outreach to community") and the levels of health literacy (low, medium, high) among health promotion volunteers, controlling for the effects of age, gender, health condition, education which may also have an impact on volunteers' outreach activities. Four hundred and fifty-four questionnaires were returned, a 79.0% response rate. Excluding 16 cases with missing values on health literacy or the degree of health promotion activities, 438 research subjects were included in the analysis (valid response rate: 76.2%). Health literacy and a few demographic and other characteristics of the volunteers were associated with the three core health
Consumer driven health care (CDHC) is a potential solution to two perplexing problems: (1) How to choose between health care and other uses of money, and (2) how to allocate resources in an industry where normal market forces have been systemically suppressed. In the consumer-driven model, consumers occupy the primary decision-making role regarding the health care that they receive. From an employee benefits perspective, consumer driven health care in the broadest sense may refer to limited e...
Yeung, Jerf W K; Zhang, Zhuoni; Kim, Tae Yeun
Although the health benefits of volunteering have been well documented, no research has examined its cumulative effects according to other-oriented and self-oriented volunteering on multiple health outcomes in the general adult public. This study examined other-oriented and self-oriented volunteering in cumulative contribution to health outcomes (mental and physical health, life satisfaction, social well-being and depression). Data were drawn from the Survey of Texas Adults 2004, which contains a statewide population-based sample of adults (n = 1504). Multivariate linear regression and Wald test of parameters equivalence constraint were used to test the relationships. Both forms of volunteering were significantly related to better health outcomes (odds ratios = 3.66% to 11.11%), except the effect of self-oriented volunteering on depression. Other-oriented volunteering was found to have better health benefits than did self-volunteering. Volunteering should be promoted by public health, education and policy practitioners as a kind of healthy lifestyle, especially for the social subgroups of elders, ethnic minorities, those with little education, single people, and unemployed people, who generally have poorer health and less participation in volunteering.
This article traces how scarcities characteristic of health systems in low-income countries (LICs), and increasing popular interest in Global Health, have inadvertently contributed to the popularisation of a specific Global Health business: international clinical volunteering through private volunteer placement organisations (VPOs). VPOs market neglected health facilities as sites where foreigners can 'make a difference', regardless of their skill set. Drawing on online investigation and ethnographic research in Tanzania over four field seasons from 2011 to 2015, including qualitative interviews with 41 foreign volunteers and 90 Tanzanian health workers, this article offers a postcolonial analysis of VPO marketing and volunteer action in health facilities of LICs. Two prevalent postcolonial racialised tropes inform both VPO marketing and foreign volunteers' discourses and practices in Tanzania. The first trope discounts Tanzanian expertise in order to envision volunteers in expert roles despite lacking training, expertise, or contextual knowledge. The second trope envisions Tanzanian patients as so impoverished that insufficiently trained volunteer help is 'better than nothing at all'. These two postcolonial racialised tropes inform the conceptual work undertaken by VPO marketing schemes and foreign volunteers in order to remake Tanzanian health professionals and patients into appropriate and justifiable sites for foreign volunteer intervention.
In traditional Zulu communities, caregiving is rooted in compassionate and hardworking personal identity precepts and the traditional identity expectations of women. Home-based-care volunteerism in the community represents the performance of this identity. Data from a series of interviews with 15 home-based care ...
Turinawe, E.B.; Rwemisisi, J.T.; Musinguzi, L.K.; de Groot, M.; Muhangi, D.; Mafigiri, D.K.; de Vries, D.H.; Pool, R.
In the debate regarding volunteer Community Health Workers (CHWs) some argue that lack of remuneration is exploitation while others caution that any promise to pay volunteers will decrease the volunteer spirit. In this paper we discuss the possibility of community rewards for CHWs. Ethnographic
Journal of Community Medicine and Primary Health Care. 26 (1) 12-20 .... large proportions of the population work in the poor people use health care services far less than. 19 ... hypertension, cancers and road traffic accidents) below 1 dollar ...
Mutiso, Victoria N.; Musyimi, Christine W.; Nayak, Sameera S.; Musau, Abednego M.; Rebello, Tahilia; Nandoya, Erick; Tele, Albert K.; Pike, Kathleen; Ndetei, David M.
Background: The study was conducted in rural Kenya and assessed stigma in health workers from primary health facilities. Aims: This study compared variations in stigma-related mental health knowledge and attitudes between primary health workers (HWs) and community health volunteers (CHVs). Methods:
The article reviews emerging health care delivery options for handicapped children. Cost structures, quality of care, and future prospects are considered for Health Maintenance Organizations, Preferred Provider Organizations, Tax Supported Direct Service Programs, Hospital-Based Services, and Ambulatory Care Organizations. (Author/DB)
Duggal, Shalu; Farah, Peggy; Straatman, Lynn Patricia; Freeman, Leanne; Dickson, Susan
Canuck Place Children's Hospice (CPCH) is regarded as one of the leading pediatric palliative care systems in the world. Since 1995, it has been providing hospice care free of charge to children and their families living with life-threatening conditions. The pediatric palliative hospice is a relatively new practice in health care, in comparison to the longstanding adult model. As a result, development and implementation of volunteer programs in pediatric hospices is not currently represented in literature. With over 300 volunteers at present, CPCH has built a successful program that can serve as a model in pediatric volunteer services. To present the unique volunteer roles and experience at CPCH, and share ways volunteers work to support the efforts of the clinical team. Strategies to address current challenges in the volunteer program are also addressed. Descriptive design. A current CPCH volunteer discusses the volunteer program. Interviews were conducted with the founding volunteer director of CPCH and current volunteers. The volunteer program at CPCH fully embraces the life of each child and family. Volunteer selection is the groundwork for ensuring a cohesive work force, while training equips volunteers with the knowledge to carry out their role with confidence. Areas of improvement that have been recognized include offering effective feedback to volunteers and delivering adequate level of training for non-direct care roles. The talents of volunteers at CPCH are diverse, and CPCH aims to recognize and thank volunteers for their continuous contributions.
Ouellet, Marie-Christine; Morin, Charles M; Lavoie, André
To compare the long-term psychological functioning of 3 groups of survivors of traumatic brain injury (TBI): (1) those who report being regularly active either by working or studying, (2) those who are not competitively employed but are active volunteers, and (3) those who report neither working, studying, nor volunteering. PARTICIPANTS AND PROCEDURE: Two hundred eight participants aged 16 years and older with minor to severe TBI were classified as (1) Working/Studying (N = 78), (2) Volunteering (N = 54), or (3) Nonactive (N = 76). Measures of psychological distress (anxiety, depression, cognitive disturbance, irritability/anger), fatigue, sleep disturbance, and perception of pain. Survivors of TBI who report being active through work, studies, or volunteering demonstrate a significantly higher level of psychological adjustment than persons who report no activity. Even among participants who are unable to return to work and are declared on long-term disability leave, those who report engaging in volunteer activities present significantly better psychological functioning than participants who are nonactive. Volunteering is associated with enhanced psychological well-being and should be encouraged following TBI.
Stevens, F.; Zee, J. van der
A health care delivery system is the organized response of a society to the health problems of its inhabitants. Societies choose from alternative health care delivery models and, in doing so, they organize and set goals and priorities in such a way that the actions of different actors are effective,
Morris, G. Scott
The Church Health Center (CHC) in Memphis was founded in 1987 to provide quality, affordable health care for working, uninsured people and their families. With numerous, dedicated financial supporters and health care volunteers, CHC has become the largest faith-based health care organization of its type nationally, serving >61,000 patients. CHC embraces a holistic approach to health by promoting wellness in every dimension of life. It offers on-site services including medical care, dentistry,...
Daoud, Nihaya; Shtarkshall, Ronny; Laufer, Neri; Verbov, Gina; Bar-El, Hagar; Abu-Gosh, Nasreen; Mor-Yosef, Shlomo
Ambiguous feelings regarding women engaging in formal volunteering and concerns about their exploitation might explain the dearth of studies regarding the volunteering benefits specifically experienced by low socioeconomic status women. The current study examined benefits of volunteering among women participating in Women for Women's Health (WWH), a lay health volunteers (LHV) programme implemented in Jewish and Arab communities in Israel, and aiming at empowering such women to become active volunteers and promote health activities in their communities. Two years after the introduction of WWH in each community, all 45 Jewish and 25 Arab volunteers were contacted by phone and invited to participate in the focus group discussions. Five focus group discussions were conducted with 25/42 Jewish volunteers in 2003 and four with 20/25 Arab volunteers in 2005. The other volunteers could not attend the scheduled meetings or became inactive for personal reasons. Four benefit categories were identified in both ethnic groups: 1. Personal benefits of having increased knowledge, feeling self-satisfaction, mastering new skills and performing healthy behaviours; 2. Group-social benefits of social support and sense of cohesion; 3. Purposive benefits of achieving the WWH mission and goals; 4. Sociopolitical benefits of learning to accept the other and experiencing increased solidarity. However, the relatively less privileged Arab volunteers enumerated more benefits within the personal and purposive categories. They also identified the unique sociocultural category of improving women's status in the community by creating a legitimate space for women by public sphere involvement, traditionally solely a male domain. We conclude that volunteering in community-based health promotion programmes can be an empowering experience for lay women without being exploitative. Positive volunteering benefits will be even more discernable among underprivileged women who enjoy fewer opportunities in
The United States health care is presently challenged by a significant economic crisis. The purpose of this report is to introduce the readers of Medicinski Pregled to the root causes of this crisis and to explain the steps undertaken to reform health care in order to solve the crisis. It is hoped that the information contained in this report will be of value, if only in small measure, to the shaping of health care in Serbia.
Quarry industry has become a major means of livelihood in Ebonyi state, but insufficient data exists on their operations ... of Dust Mask among Crushers of Selected Quarry (Crushed ... Journal of Community Medicine and Primary Health Care.
2Primary Health Care Department, Ikpoba Okha Local Government Area, Benin City, ... selected from each of the ten wards in the LGA using multistage sampling technique. ..... Knowledge of HIV/AIDS Insurance Companies in Lagos State.
Background: The well-being of women and children is one of the major determinants ... The Sample for the study were women recruited from 11 primary health care ... respondents educational level and knowledge of preconception care (X =24.76, ... single adult or married couple) are in an optimal state .... The major site for.
Leon, Natalie; Sanders, David; Van Damme, Wim; Besada, Donela; Daviaud, Emmanuelle; Oliphant, Nicholas P; Berzal, Rocio; Mason, John; Doherty, Tanya
Community-based research on child survival in sub-Saharan Africa has focussed on the increased provision of curative health services by a formalised cadre of lay community health workers (CHWs), but we have identified a particular configuration, that deserves closer scrutiny. We identified a two-tiered CHW system, with the first tier being the lessor known or 'hidden' community/village level volunteers and the second tier being formal, paid CHWs, in Ethiopia, Mali, and Niger. Whilst the disease-focussed tasks of the formal CHW tier may be more amenable to classic epidemiological surveillance, we postulate that understanding the relationship between formalised CHWs and volunteer cadres, in terms of scope, location of practice and ratio to population, would be important for a comprehensive evaluation of child survival in these countries. We report on the findings from our joint qualitative and quantitative investigations, highlighting the need to recognise the 'hidden' contribution of volunteers. We need to better characterize the volunteers' interaction with community-based and primary care services and to better understand ways to improve the volunteer systems with the right type of investments. This is particularly important for considering the models for scale-up of CHWs in sub-Saharan Africa.
Cocca-Bates, Katherine C; Neal-Boylan, Leslie
A qualitative study was done to explore the perceptions of volunteering among retired registered nurses (RNs) in Kansas. Participants were volunteers in formal nursing roles or were using their nursing knowledge and experience in non-nursing roles, such as church work. Regardless of the type of volunteer position, retired RNs reported that they use what they have learned as nurses when they volunteer. Volunteering benefits include enhanced self-worth, intellectual stimulation, reduced social isolation, and opportunities to help others. Increased paperwork, new technology, difficulty finding nursing-specific volunteer opportunities, resistance from health care organizations, and a lack of respect for what these nurses know are challenges and barriers to volunteering. Retired RNs have accumulated years of clinical nursing experience and can be helpful to employed nurses. Health care organizations should launch targeted efforts to recruit and utilize retired RN volunteers. Health care professionals who care for older adults should recommend volunteering as a healthful endeavor. Copyright © 2011 Mosby, Inc. All rights reserved.
Okun, Morris A.; Rios, Rebeca; Crawford, Aaron V.; Levy, Roy
Previous studies have established a positive association between organizational volunteering and well-being. In the current study, we examined whether the relations between organizational volunteering and positive affect, negative affect, and resilience are modified by respondents' age and number of chronic health conditions. This study used…
enrol in an insurance scheme feeling that they need more information on health insurance and the willingness to enrol in a ... and utilize the benefits of different types of health insurance services. Conclusion: The findings ..... improvements in access and quality of care, and the ... the 'rising tide' of and information technology.
Podlekareva, Daria; Reekie, Joanne; Mocroft, Amanda
ABSTRACT: BACKGROUND: State-of-the-art care involving the utilisation of multiple health care interventions is the basis for an optimal long-term clinical prognosis for HIV-patients. We evaluated health care for HIV-patients based on four key indicators. METHODS: Four indicators of health care we...... document pronounced regional differences in adherence to guidelines and can help to identify gaps and direct target interventions. It may serve as a tool for assessment and benchmarking the clinical management of HIV-patients in any setting worldwide....
Mendes, Eugênio Vilaça
The demographic and epidemiologic transition resulting from aging and the increase of life expectation means an increment related to chronic conditions. The healthcare systems contemporary crisis is characterized by the organization of the focus on fragmented systems turned to the acute conditions care, in spite of the chronic conditions prevalence, and by the hierarchical structure without communication flow among the different health care levels. Brazil health care situation profile is now presenting a triple burden of diseases, due to the concomitant presence of infectious diseases, external causes and chronic diseases. The solution is to restore the consistence between the triple burden of diseases on the health situation and the current system of healthcare practice, with the implantation of health care networks. The conclusion is that there are evidences in the international literature on health care networks that these networks may improve the clinical quality, the sanitation results and the user's satisfaction and the reduction of healthcare systems costs.
Ranapurwala, Shabbar I; Casteel, Carri; Peek-Asa, Corinne
Experiences in adolescence may have a lasting impact on adulthood. The objective of this study is to evaluate the association between adolescent (12-18 years of age) volunteerism with the incidence of illegal behaviors, arrests, and convictions in adulthood (>18 years of age). We conducted a retrospective cohort study using secondary data from the National Longitudinal Study of Adolescent to Adult Health. Students from grades 7-12 were recruited in 1994-1995 (n = 20,745), and then followed in 2001-2002 (n = 14,322) and in 2008-2009 (n = 12,288). In 2000-2001, participants were retrospectively asked about their volunteering experience from 12 to 18 years of age. Consequently, participants were divided into non-volunteers, self-volunteers, adult-required volunteers, and court-ordered volunteers. Groups were compared for rates of illegal behaviors, arrest, and convictions in adulthood (>18 years of age) using weighted generalized linear mixed negative binomial models while accounting for sampling design. Relative to non-volunteers, self-volunteers reported 11 % fewer illegal behaviors (RR: 0.89, 95 % CI: 0.80, 0.99), 31 % fewer arrests (RR: 0.69, 95 %: 0.57, 0.85), and 39 % fewer convictions (RR: 0.61, 95 % CI: 0.47, 0.79) by age 18-28 years, and 28 % fewer illegal behaviors, 53 % fewer arrests, and 36 % fewer convictions by age 24-34. In comparison the adult-required volunteers also reported fewer arrests and convictions; however, they reported more illegal behaviors than the non-volunteers. The court-ordered volunteers reported higher rates of criminal involvement than the non-volunteers, throughout. This study suggests that volunteering in adolescence may reduce crime involvement in adulthood.
Conclusion: The results of this research revealed that to absorb a higher number of volunteers in health and treatment organizations, commitment and purposeful aspects must be emphasized on, as by improving the motivational and satisfaction factors, we can expect that satisfaction and retention level increases in volunteers. Furthermore, by knowing the volunteers’ motivations, the managers of the health and treatment organizations can provide their retention and satisfaction and play a key role in crisis management during disasters by exploiting the volunteer services.
Full Text Available Background and Objective: Health volunteers are the women who do charity work to prevent, protect and promote the health status of the covered neighbors and hereby cooperate with the health centers. The aim of this study was to compare the health volunteer's performance in the covered health centers by Shahid Beheshti University of Medical Sciences.Materials and Methods: This descriptive- analytical study was performed by the participation of 2060 Health volunteers, who were cooperating with 90 covered health centers by Shahid Beheshti University of Medical Sciences. These include Shomal, Shargh, Shemiranat, Pakdasht, Damavand and Firoozkooh. We used census sampling method. Demographic data was gathered through interviews with the health volunteers and their performance evaluated by the supervisor of the volunteers; through the evaluation forms and these data gathered together.Results: The mean (SD of the health volunteers performance was 30.9 (16.4 in all centers. They were 35.1 (22 in Shargh, 34 (14.5 in Shomal, 32 (11.3 in Firoozkooh, 28.3 (14 in Shemiranat, 7.9 (9.2 in Damavand and 23.6 (8.5 in Pakdasht respectively. The mean (SD of the efficacy of health volunteers was 8.6 (9.9 in all centers. They were 11.7 (5.6 in Firoozkooh, 10.7 (15.7 in Shargh, 9.4 (6.8 in Shomal, 7.9 (4.9 in Damavand, 7.9 (6.1 in Shemiranat and 4.6 (4.3 in Pakdasht respectively. Older and married volunteers with more experience performed better. There was no significant relationship between the efficacy of health volunteers with their literacy level, employment status and absorber of them. Conclusion: The health volunteers of Shomal, Shargh and Firoozkooh had the best performances respectively. The performances of those in Shemiranat, Damavand and Pakdasht were less than the overall health centers’ mean score. The efficacy score of Firoozkooh, Shomal and Shargh health centers were above the overall health centers’ mean score respectively
to organize rural health care is more regulatory and distanced in its emphasis on nudging patients and doctors towards the right decisions through economic incentives. This bureaucratic approach to organizing health individually offers a sharp contrast to the religious collectivities that form around health...
Lin, Mei-Chih; Li, I-chuan; Lin, Kuan-chia
The purpose of the study was to understand the relationship between job satisfaction and personal traits in health volunteers in one community in Taiwan. Among different kinds of community resources, the human resource is most essential for the process of developing healthy communities and cities. However, it is not easy to keep voluntary workers as part of health programmes even though they have been trained. Previous research has shown that to increase the job satisfaction of such a person, the volunteer needs to improve effectively his/her need to achieve. The need to achieve is an important part of a person's personal traits. A cross-sectional survey design was used to interview 317 health volunteers in various community health centres in I-lan county, northern Taiwan. The research instruments of this study included the 'locus of control orientation scale' for personality measurement, the 'achievement orientation scale' and the 'job satisfaction scale'. Most of the sample volunteers were female with an average age of 49.55 years; the majority was married and living with their spouses. In terms of the volunteers' personal traits, most of them are internal control orientation. The job satisfaction of the volunteers who took part in this research was extremely high. Significant variables correlating with job satisfaction in this study were gender, educational level, religious preference, participation in training, working to promote community health, the willingness to work, the frequency of participating in job training, and cooperation with other volunteer partners. The explainable variance for the prediction of job satisfaction from a combination of achievement orientation and the frequency of collaboration with other people was 9.1%. The results suggest that there is a need to strengthen cooperative relationships among volunteer by initiating well-planned volunteer training programmes and growth groups with the aim of enhancing their interpersonal
Johnson, Kimberly J; Lee, S Hannah
The present study investigated how volunteering was influenced by individual resources and social capital among four racial/ethnic groups of adults aged 50 and older. The data came from the California Health Interview Survey, a statewide sample that includes non-Hispanic Whites ( n = 18,927), non-Hispanic Asians ( n = 2,428), non-Hispanic Blacks ( n = 1,265), and Hispanics ( n = 3,799). Logistic regression models of volunteering were estimated to explore the effects of human and social capital within and across the racial/ethnic groups. Compared to Whites, racial/ethnic minority adults volunteered less. Although education was a significant predictor of volunteering across all groups, the findings indicated group-specific factors related to human and social capital. Results showed similarities and differences associated with volunteer participation among diverse racial/ethnic groups. The findings underscore the importance of understanding ways of creating inclusive opportunities for civic engagement among an increasingly diverse population.
... MO - St. Louis, Qualifications Required: Bachelor’s degree in business, marketing, health care administration or a related field Current ... Work for AHCA/NCAL News Provider Daily Publications Social Media News Releases LTC Leader Blog Research and Data ...
Hollnagel, E.; Braithwaite, J.; Wears, R. L.
Health care is everywhere under tremendous pressure with regard to efficiency, safety, and economic viability - to say nothing of having to meet various political agendas - and has responded by eagerly adopting techniques that have been useful in other industries, such as quality management, lean...... production, and high reliability. This has on the whole been met with limited success because health care as a non-trivial and multifaceted system differs significantly from most traditional industries. In order to allow health care systems to perform as expected and required, it is necessary to have...... engineering's unique approach emphasises the usefulness of performance variability, and that successes and failures have the same aetiology. This book contains contributions from acknowledged international experts in health care, organisational studies and patient safety, as well as resilience engineering...
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one strategy that could be conducted anywhere, if the health care workers are trained and positively disposed ... places; regulate advertising, manufacturing. 13 .... Gender. Male. 52 (46.0). 61 (54.0). 0.0001. Significant. Female. 82 (73.2).
about teething the world over and especially ... children`s out-patients, dental and the ear, nose and throat clinics of a tertiary hospital in south-west Nigeria. ... parents, health care workers and personal experiences were the sources of beliefs ... None (0%) of the respondents had prior knowledge of proven causes of ear.
VPDs, this represents 17% of global total. 1 ... Knowledge, Attitude and Practice of Childhood Immunization ... Department of Community Health & Primary Care, College of Medicine, University of Lagos, Idi-Araba, P.M.B. 12003, ... include access to services, parental (maternal) ... Calmette Guerin (BCG) vaccine Oral Polio.
May 1, 2012 ... with the quality of care in a tertiary health facility in Delta State, Nigeria ... includes contributions from families, charges have been .... employees at 23.5%, self employed 19.1% of showed that most of the respondents (41.3%).
Misuse and Addiction Prevention Finance & Management Services Health Care Services Juvenile Justice , 2017 Warning - A phone number that was once used for the Denali KidCare program is now being used to ask people for their credit card number in order to win a prize. The phone number related to this
Jarzembski, W B
Today, health care engineering management is merely a concept of dreamers, with most engineering decisions in health care being made by nonengineers. It is the purpose of this paper to present a rationale for an integrated hospital engineering group, and to acquaint the clinical engineer with some of the salient features of management concepts. Included are general management concepts, organization, personnel management, and hospital engineering systems.
The aim of this article is to describe the potential with respect to volunteer work among 55 to 70-year-old persons along with a two-dimensional typology (actual volunteer work and intention of volunteering or expanding actual volunteer work) and to identify the influencing factors. Based on the dataset from the transitions and old age potential (TOP) study, a total of 4421 men and women born between 1942 and 1958 were included. A multinomial regression model showed the predictors for group affiliation along with an engagement-related typology (internal, utilized and external volunteer potential as well as definite non-volunteers). More than a half of the persons in the study sample could be classified as internal or external volunteer potential. Volunteers and potential volunteers revealed more similarities regarding resources and social factors than potential volunteers and definite non-volunteers. Potential volunteers were more active in other informal fields of activity (e.g. nursing or child care) than definite non-volunteers. With respect to volunteer work, definite non-volunteers showed various social disadvantages (in particular with respect to education and health) compared to (potential) volunteers. Other informal activities did not seem to be in major conflict with volunteer activities, e.g. nursing or child care, as long as they were carried out with moderate or low intensity.
Poulin, Michael J
The purpose of these studies was to examine the role of positive views of other people in predicting stress-buffering effects of volunteering on mortality and psychological distress. In Study 1, stressful life events, volunteering, and hostile cynicism assessed in a baseline Detroit-area survey (N = 846) predicted survival over a 5-year period, adjusting for relevant covariates. In Study 2, stressful life events, volunteering, and world benevolence beliefs assessed in a baseline national survey (N = 1,157) predicted psychological distress over a 1-year period, adjusting for distress at baseline. In Study 1, a Cox proportional hazard model indicated that for individuals low in cynicism, stress predicted mortality at low levels of volunteering but not at high levels of volunteering. This effect was not present among those high in cynicism. In Study 2, multiple regression analysis revealed that among individuals high in world benevolence beliefs, stress predicted elevated distress at low levels of volunteering but not at high levels of volunteering. This effect was absent for those lower in world benevolence beliefs. Consistent with prior research on helping behavior, these studies indicate that helping behavior can buffer the effects of stress on health. However, the results of these studies indicate that stress-buffering effects of volunteering are limited to individuals with positive views of other people. Not all individuals may benefit from volunteering, and health-promotion efforts seeking to draw on health benefits of helping behavior may need to target their approach accordingly. PsycINFO Database Record (c) 2014 APA, all rights reserved.
Discusses changing nature of volunteers in Peter Drucker's book "Managing the Nonprofit Corporation." Points out that most volunteers have full-time jobs, families, very little leisure; they are not willing to do such routine work as stuffing envelopes; they want carefully defined projects with beginning and end. Discusses real…
This article examines issues on health care costs and describes measures taken by public districts to reduce spending. As in most companies in America, health plan designs in public districts are being changed to reflect higher out-of-pocket costs, such as higher deductibles on visits to providers, hospital stays, and prescription drugs. District…
Glenton, Claire; Scheel, Inger B; Pradhan, Sabina; Lewin, Simon; Hodgins, Stephen; Shrestha, Vijaya
The Female Community Health Volunteer (FCHV) Programme in Nepal has existed since the late 1980s and includes almost 50,000 volunteers. Although volunteer programmes are widely thought to be characterised by high attrition levels, the FCHV Programme loses fewer than 5% of its volunteers annually. The degree to which decision makers understand community health worker motivations and match these with appropriate incentives is likely to influence programme sustainability. The purpose of this study was to explore the views of stakeholders who have participated in the design and implementation of the Female Community Health Volunteer regarding Volunteer motivation and appropriate incentives, and to compare these views with the views and expectations of Volunteers. Semi-structured interviews were carried out in 2009 with 19 purposively selected non-Volunteer stakeholders, including policy makers and programme managers. Results were compared with data from previous studies of Female Community Health Volunteers and from interviews with four Volunteers and two Volunteer activists. Stakeholders saw Volunteers as motivated primarily by social respect, religious and moral duty. The freedom to deliver services at their leisure was seen as central to the volunteer concept. While stakeholders also saw the need for extrinsic incentives such as micro-credit, regular wages were regarded not only as financially unfeasible, but as a potential threat to the Volunteers' social respect, and thereby to their motivation. These views were reflected in interviews with and previous studies of Female Community Health Volunteers, and appear to be influenced by a tradition of volunteering as moral behaviour, a lack of respect for paid government workers, and the Programme's community embeddedness. Our study suggests that it may not be useful to promote a generic range of incentives, such as wages, to improve community health worker programme sustainability. Instead, programmes should ensure that
Full Text Available Background: Currently, volunteer forces are among the main members of the healthcare services, particularly in the treatment sector, and play a key role in healthcare and treatment services. Since efficient human resources are the greatest and most important assets of all organizations, they constantly work to train, retain, and get the best of these valuable assets. The main objective of this work was to prioritize the motivational factors and satisfaction of the volunteer forces participating in treatment and health programs in the case of emergencies. Materials and Methods: The study population of this research was all volunteers (N=600 in treatment and health programs of Kerman Province. Using the Morgan Table, 360 subjects were selected. The data-gathering instrument was Andam’s questionnaire of motivational factors with reliability of 0.94, and Galindo-Kuhn and Guzley (2001 questionnaire of satisfaction with reliability of 0.92. To determine research data distribution, Kolmogorov-Smirnov test was applied. Moreover, for data analysis inferential statistics tests of Friedman, Mann–Whitney U, and Kruskal–Wallis were used at significance level of P<0.05. Results: The present research revealed that the most and least important motivational factors in volunteers of treatment and health units were purposeful motivation and financial motivation with average rankings of 5.45 and 1.99, respectively. In addition, among the satisfaction factors, the volunteers reported communication with volunteers and organizational communication as the most and least important satisfaction factors, respectively. The results of this research indicated that the female volunteers participated in volunteer activities with greater occupational, support, progress, and social motivations. In addition, single participants had greater occupational, social, and financial motivations towards participation in these activities as compared to married participants
Kumar, Santosh; Calvo, Rocio; Avendano, Mauricio; Sivaramakrishnan, Kavita; Berkman, Lisa F
High levels of social capital and social integration are associated with self-rated health in many developed countries. However, it is not known whether this association extends to non-western and less economically advanced countries. We examine associations between social support, volunteering, and self-rated health in 139 low-, middle- and high-income countries. Data come from the Gallup World Poll, an internationally comparable survey conducted yearly from 2005 to 2009 for those 15 and over. Volunteering was measured by self-reports of volunteering to an organization in the past month. Social support was based on self-reports of access to support from relatives and friends. We started by estimating random coefficient (multi-level) models and then used multivariate logistic regression to model health as a function of social support and volunteering, controlling for age, gender, education, marital status, and religiosity. We found statistically significant evidence of cross-national variation in the association between social capital variables and self-rated health. In the multivariate logistic model, self-rated health were significantly associated with having social support from friends and relatives and volunteering. Results from stratified analyses indicate that these associations are strikingly consistent across countries. Our results indicate that the link between social capital and health is not restricted to high-income countries but extends across many geographical regions regardless of their national-income level. Copyright Â© 2012 Elsevier Ltd. All rights reserved.
Haile, Fisaha; Yemane, Dejen; Gebreslassie, Azeb
Volunteer community health workers (VCHW) are health care providers who are trained but do not have any professional certification. They are intended to fill the gap for unmet curative, preventative, and health promotion health needs of communities. This study aims to investigate the non-financial incentives for VCHWs and factors affecting their motivation. A cross-sectional quantitative study was performed from February to March 2013. A total of 400 randomly selected female VCHWs were included using the district health office registers. Finally, multivariate logistic regression was used to determine the independent predictors of VCHW motivation. Significant numbers (48%) of study participants have mentioned future training as a major non-financial incentive. Age between 20 and 36 years old (adjusted odds ratio (AOR) = 1.45, 95% CI = 1.18, 2.13), married VCHWs (AOR = 3.84, 95% CI = 1.73, 5.02), presence of children under five years old (AOR = 0.2, 95% CI = 0.09, 0.71), allowing volunteer withdrawal (AOR = 1.35, 95% CI = 1.06, 2.47), and establishment of a local endowment fund for community health workers after they left volunteerism (AOR = 1.11, 95% CI = 1.05, 1.91) are all factors associated with VCHW motivation. Future training was mentioned as the prime non-financial incentive. Age, marital status, presence of children under five, allowing volunteer withdrawal, and establishment of a local endowment fund were identified as the independent predictors of motivation. Therefore, considering a non-financial incentive package, including further training and allowing volunteer withdrawal, would be helpful to sustain volunteerism.
Claxton-Oldfield, Stephen; Miller, Kathryn
The purpose of this study was to examine the attitudes of hospice palliative care (HPC) volunteers who provide in-home support (n = 47) and members of the community (n = 58) toward the issue of physician-assisted suicide (PAS). On the first part of the survey, participants responded to 15 items designed to assess their attitudes toward PAS. An examination of individual items revealed differences in opinions among members of both the groups. Responses to additional questions revealed that the majority of volunteers and community members (1) support legalizing PAS; (2) would choose HPC over PAS for themselves if they were terminally ill; and (3) think Canadians should place more priority on developing HPC rather than on legalizing PAS. The implications of these findings are discussed. © The Author(s) 2014.
Jacobsen, Christian Bøtcher; Andersen, Lotte Bøgh; Serritzlew, Søren
An important task in governing health services is to control costs. The literatures on both costcontainment and supplier induced demand focus on the effects of economic incentives on health care costs, but insights from these literatures have never been integrated. This paper asks how economic cost...... containment measures affect the utilization of health services, and how these measures interact with the number of patients per provider. Based on very valid register data, this is investigated for 9.556 Danish physiotherapists between 2001 and 2008. We find that higher (relative) fees for a given service...... make health professionals provide more of this service to each patient, but that lower user payment (unexpectedly) does not necessarily mean higher total cost or a stronger association between the number of patients per supplier and the health care utilization. This implies that incentives...
Weel, C. van; Schers, H.J.; Timmermans, A.
This article analyzes Dutch experiences of health care reform--in particular in primary care--with emphasis on lessons for current United States health care reforms. Recent major innovations were the introduction of private insurance based on the principles of primary care-led health care and
Marušič, Dorjan; Prevolnik Rupel, Valentina
In large systems, such as health care, reforms are underway constantly. The article presents a definition of health care reform and factors that influence its success. The factors being discussed range from knowledgeable personnel, the role of involvement of international experts and all stakeholders in the country, the importance of electoral mandate and governmental support, leadership and clear and transparent communication. The goals set need to be clear, and it is helpful to have good data and analytical support in the process. Despite all debates and experiences, it is impossible to clearly define the best approach to tackle health care reform due to a different configuration of governance structure, political will and state of the economy in a country.
Full Text Available In large systems, such as health care, reforms are underway constantly. The article presents a definition of health care reform and factors that influence its success. The factors being discussed range from knowledgeable personnel, the role of involvement of international experts and all stakeholders in the country, the importance of electoral mandate and governmental support, leadership and clear and transparent communication. The goals set need to be clear, and it is helpful to have good data and analytical support in the process. Despite all debates and experiences, it is impossible to clearly define the best approach to tackle health care reform due to a different configuration of governance structure, political will and state of the economy in a country.
Hasman, Andreas; Hope, Tony; Østerdal, Lars Peter
The argument that scarce health care resources should be distributed so that patients in 'need' are given priority for treatment is rarely contested. In this paper, we argue that if need is to play a significant role in distributive decisions it is crucial that what is meant by need can be precis......The argument that scarce health care resources should be distributed so that patients in 'need' are given priority for treatment is rarely contested. In this paper, we argue that if need is to play a significant role in distributive decisions it is crucial that what is meant by need can...... be precisely articulated. Following a discussion of the general features of health care need, we propose three principal interpretations of need, each of which focuses on separate intuitions. Although this account may not be a completely exhaustive reflection of what people mean when they refer to need...
Singh, Debra; Negin, Joel; Orach, Christopher Garimoi; Cumming, Robert
Community Health Volunteers (CHVs) can be effective in improving pregnancy and newborn outcomes through community education. Inadequate supervision of CHVs, whether due to poor planning, irregular visits, or ineffective supervisory methods, is, however, recognized as a weakness in many programs. There has been little research on best practice supervisory or accompaniment models. From March 2014 to February 2015 a proof of concept study was conducted to compare training alone versus training and supportive supervision by paid CHWs (n = 4) on the effectiveness of CHVs (n = 82) to deliver education about pregnancy, newborn care, family planning and hygiene. The pair-matched cluster randomized trial was conducted in eight villages (four intervention and four control) in Budondo sub-county in Jinja, Uganda. Increases in desired behaviors were seen in both the intervention and control arms over the study period. Both arms showed high retention rates of CHVs (95 %). At 1 year follow-up there was a significantly higher prevalence of installed and functioning tippy taps for hand washing (p services. Supportive supervision involves creating a non-threatening, empowering environment in which both the CHV and the supervising CHW learn together and overcome obstacles that might otherwise demotivate the CHV. While the results seem promising for added value with supportive supervision for CHVs undertaking reproductive health activities, further research on a larger scale will be needed to substantiate the effect.
De Leo, Gianluca; Ponder, Michal; Molet, Tom; Fato, Marco; Thalmann, Daniel; Magnenat-Thalmann, Nadia; Bermano, Francesco; Beltrame, Francesco
In order to guarantee an effective and punctual medical intervention to injured people involved in health emergency situations, where usually both professional and non-professional health operators are involved, a fast and accurate treatment has to be carried out. In case of catastrophic or very critical situations, non-professional operators who did not receive proper training (volunteers are among them) could be affected by psychological inhibitions. Their performances could slow down in such way that would affect the quality of the treatment and increase both direct and indirect costs. Our virtual reality system that is currently in use at the health care emergency center of San Martino Hospital in Genoa, Italy, has been designed and developed to check health emergency operators' capabilities to adopt correct decision-making procedures, to make optimal use of new technological equipment and to overcome psychological barriers. Our system is composed of (1) a high-end simulation PC, whose main functions are execution of the main software module, rendering of 3D scenes in stereo mode, rendering of sound, and control of data transmission from/to VR devices; (2) a low-end control PC, which controls the VR simulation running on the simulation PC, manages medical emergency simulation scenarios, introduces unexpected events to the simulation and controls the simulation difficulty level; (3) a magnetic-based motion tracking device used for head and hand tracking; (4) a wireless pair of shutter glasses together with a cathode ray tube wall projector; and (5) a high-end surround sound system. The expected benefits have been verified through the design and implementation of controlled clinical trials.
Introduction: Integrated community case management (iCCM) involves assessment and treatment of common .... vention units to accommodate budgets, logistics, and su- ... wooden medicine box with a starter supply of pre-pack- ..... chain management and medium-term outcomes. .... Global experience of community health.
Morren, M.; IJzermans, C.J.; Nispen, R.M.A. van; Wevers, S.J.M.
On May 13, 2000, a firework depot exploded in a residential area of the city of Enschede, The Netherlands. Many disaster workers responded, including volunteer firefighters, a group that has received little attention in disaster research. This study examined the presence of health problems in
Thormar, Sigridur Bjork; Gersons, Berthold Paul Rudolf; Juen, Barbara; Marschang, Adelheid; Djakababa, Maria Nelden; Olff, Miranda
This article reviews the literature on mental health of volunteers after working in disasters. When mobilized they often are a community's major source for rescue and recovery. PsychINFO, PubMED, and Web of Science were searched for relevant articles published until October 2009. Of 448 articles
press conference with President Toledo of Peru on March 23, 2002, President Bush proclaimed, “education, jobs, and health care are the greatest...allow patients with chronic illnesses such as diabetes and high blood pressure to “visit” their doctors “on-line” while in the comfort and privacy of...to maintain a healthy lifestyle. As a result, non-communicable disease such as 10 heart disease, stroke, diabetes , and cancer are prevalent throughout
Client Satisfaction with Antenatal Care Services in Primary Health Care. Centres in Sabon ... important information about how well clinicians and the population of women within child bearing. 8 ..... model. Health and Quality of Life outcomes.
Shi, Hong-Zhi; Fan, Quan-Chun; Gao, Jian-Yi; Liu, Jun-Lian; Bai, Gui-E; Mi, Tao; Zhao, Shuang; Liu, Yu; Xu, Dong; Guo, Zhi-Feng; Li, Yong-Zhi
To comprehensively evaluate the health status of 6 volunteers from the Mars 500 Project through analyzing their pulse graphs and determining the changes in cardiovascular function, degree of fatigue and autonomic nervous function. Six volunteers were recruited; all were male aged 26-38 years (average 31.83±4.96 years). Characteristic parameters reflflecting the status of cardiovascular functions were extracted, which included left ventricular contraction, vascular elasticity and peripheral resistance. The degree of fatigue was determined depending on the difference between the calendar age and biological age, which was calculated through the analysis of blood pressure value and characteristic parameters. Based on the values of pulse height variation and pulse time variation on a 30-s pulse graph, autonomic nervous function was evaluated. All parameters examined were marked on an equilateral polygon to form an irregular polygon of the actual fifigure, then health status was evaluated based on the coverage area of the actual fifigure. The results demonstrated: (1) volunteers developed weakened pulse power, increased vascular tension and peripheral resistance, and slight decreased ventricular systolic function; (2) the degree of fatigue was basically mild or moderate; and (3) autonomic nervous function was excited but generally balanced. These volunteers were in the state of sub-health. According to Chinese medicine theories, such symptoms are mainly caused by the weakening of healthy qi, Gan (Liver) failing in free coursing, and disharmony between Gan and Wei (Stomach), which manifests as a weak and string-like pulse.
Kaveh, Mohammad Hossein; Rokhbin, Moslem; Mani, Arash; Maghsoudi, Ahmad
Introduction: Psychological distress is among physical and mental health threats, and health volunteers can play a critical role in empowerment of women. However, evidence has revealed a decline in health volunteers’ activities. Therefore, the present study aimed to investigate the challenges faced by health volunteers in empowerment of women. Methods: The participants’ knowledge level was assessed using a written test. Their perceived skills were also measured using Coping Inventory for Stressful Situations by Endler and Parker and Chesney’s Coping Self-efficacy Scale, respectively. The study data were entered into the SPSS statistical software, version 11.5 and were analyzed using chi-square, sample t-test, and Pearson’s correlation coefficient. Results: The results showed a considerable increase in the intervention group health volunteers’ knowledge about stress, as well as their self-efficacy. Besides, a significant correlation was observed between self-efficacy and task-oriented strategy scores. However, no significant increase was found in this group’s coping strategies. The results also indicated a significant increase in the intervention group women’s knowledge about stress, but no significant change was observed in other constructs. Some challenging factors, such as managerial, personal, and interpersonal factors, were also detected that might have affected the results. Discussion: This study caused no considerable change in coping with stress, except for increasing the women’s knowledge in this regard. Considering the challenges identified in this study, programs should be developed for researchers and health center managers to improve this condition in future. Creative Commons Attribution License
Huynh, Jasmine-Yan; Winefield, Anthony H; Xanthopoulou, Despoina; Metzer, Jacques C
This study examined the role of burnout and connectedness in the job demands-resources (JD-R) model among palliative care volunteers. It was hypothesized that (a) exhaustion mediates the relationship between demands and depression, and between demands and retention; (b) cynicism mediates the relationship between resources and retention; and (c) connectedness mediates the relationship between resources and retention. Hypotheses were tested in 2 separate analyses: structural equation modeling (SEM) and path analyses. The first was based on volunteer self-reports (N = 204), while the second analysis concerned matched data from volunteers and their family members (N = 99). While strong support was found for cynicism and connectedness as mediators in both types of analyses, this was not altogether the case for exhaustion. Implications of these findings for the JD-R model and volunteer organizations are discussed.
Paul, T; Wong, J
A number of striking parallels between recent developments in health care marketing and changes in the retailing industry exist. The authors have compared retailing paradigms to the area on health care marketing so strategists in hospitals and other health care institutions can gain insight from these parallels. Many of the same economic, demographic, technological and lifestyle forces may be at work in both the health care and retail markets. While the services or products offered in health care are radically different from those of conventional retail markets, the manner in which the products and services are positioned, priced or distributed is surprisingly similar.
Part II of Health Care Engineering begins with statistics on the occurrence of medical errors and adverse events, and includes some technological solutions. A chapter on electronic medical records follows. The knowledge management process divided into four steps is described; this includes a discussion on data acquisition, storage, and retrieval. The next two chapters discuss the other three steps of the knowledge management process (knowledge discovery, knowledge translation, knowledge integration and sharing). The last chapter briefly discusses usability studies and clinical trials.This two-
Pettigrew, Simone; Jongenelis, Michelle; Newton, Robert U; Warburton, Jeni; Jackson, Ben
A growing evidence base demonstrates that interventions that focus on participation in physical and social activities can assist in preventing and treating both physical and mental health problems. In addition, there is some evidence that engaging in volunteering activities can provide beneficial social, physical, psychological, and cognitive outcomes for older people. This study will use a randomized controlled trial approach to investigate the potential for interventions involving volunteer activities to produce positive physical and psychological outcomes for older people, thereby contributing to the limited evidence relating to the potential for volunteering to provide multiple health effects. This randomized controlled trial will involve 400 retired/non-employed individuals in good health aged 60+ years living in the metropolitan area in Perth, Western Australia. Participants will be recruited from the Perth metropolitan area using a variety of recruitment methods to achieve a diverse sample in terms of age, gender, and socioeconomic status. Consenting and eligible participants will be randomly assigned to an intervention (n = 200) or control group (n = 200). Those in the intervention group will be asked to engage in a minimum 60 min of volunteer activities per week for a period of 6 months, while those in the control group will be asked to maintain their existing lifestyle or take on new activities as they see fit. Physical and psychological outcomes will be assessed. Primary physical outcomes will include physical activity and sedentary time (measured using pedometers and Actigraph monitors) and physical health (measured using a battery of physical functioning tests, resting heart rate, blood pressure, BMI, and girth). Primary psychological outcomes will include psychological well-being, depression, self-esteem, and quality of life (measured using the Warwick-Edinburgh Mental Well-Being Scale, Center for Epidemiologic Studies Depression Scale, the
Henderson, M D
Health care operations encompass the totality of those health care functions that allow those who practice health care delivery to do so. As the health care industry undergoes dramatic reform, so will the jobs of those who manage health care delivery systems. Although health care operations managers play one of the most vital and substantial roles in the new delivery system, the criteria for their success (or failure) are being defined now. Yet, the new and vital role of the operations manager has been stunted in its development, which is primarily because of old and outdated antipathy between hospital administrators and physicians. This article defines the skills and characteristics of today's health care operations managers.
Full Text Available Objectives: The education promotion of elderly health is an Important preference of health that should be planned for it. Several problems of elderly are supposed to be due to life style so the community education of healthy life style should be considered. The appropriate approach to achieve those objectives is to use of female health volunteers for transformation of this education to families. Methods & Materials: To determine the level of knowledge of health voluntaries about healthy life style for prevention of problems in elderly period, in Shiraz. Method & Materials: In a cross-sectional study, 320 health voluntaries were selected by randomized method. The sample size was calculated with the results. A pilot study on one hundred with use of a questionnaire contain of 5 demographic questions and 32 questions about life style including nutrition, prevention of disease, oral health's and health advices. They filled the questionaries' and the data were entered in EPI 2002 software and were analyzed by descriptive tests. Results: The mean age all of 320 health were 33.7 years, with standard deviation of 8.6 years. The knowledge level of them in health advices were 15% weak, 66.9% medium and 18.2% well. In oral health 21.6% well, 61.3% medium & 7.2% well. In prevention of disease 37% weak, 62.2% medium and 9% well, in nutrition 24.6% weak, 69.3% medium and 5.9% well. Overall the level of knowledge of health volunteers about life style were 20.9% weak, 65.5% medium and 13.8% well. Conclusion: In the aim achieving to their approaches program of health, volunteers was started by Ministry of Health in 1990. This program was performed by the aim of health promotion in these group with participation of themselves. Till now they have trained in the recognition of health problems and healthy approach to them. So, the volunteers transfer their knowledge to community specially to under their coverage. At present the health problems are not only due to
Colorectal cancer (CRC) is a public health challenge in developed countries and an emerging public health problem in developing ... and public health challenges in their immigrant countries. More so ..... The nutrition transition in Brazil. 46.
Vareilles, Ga?lle; Pommier, Jeanine; Marchal, Bruno; Kane, Sumit
Background The recruitment of community health volunteers (CHVs) to support the delivery of health programmes is an established approach in underserved areas and in particular where there are health inequalities due to the scarcity of trained human resources. However, there is a dearth of evidence about what works to improve CHVs? performance. This review aimed to synthesise existing literature to explain why, how and under which circumstances intervention approaches to improve the performanc...
Elder, J P; Louis, T; Sutisnaputra, O; Sulaeiman, N S; Ware, L; Shaw, W; de Moor, C; Graeff, J
The Indonesian Ministry of Health relies on a network of over a million kader (community health volunteers) to bring primary health care to the village level. In West Java, the Department of Health's Control of Diarrhoeal Disease (CDD) Program recently carried out an extensive research and development effort to produce effective job aids for the kader in CDD and a training programme to teach their use. A set of counselling cards was produced to provide kader with a tool to diagnose and treat diarrhoea and teach the proper use of ORS. Researchers conducted a controlled evaluation in which they measured the cards' effectiveness through observations of kader performance and interviews with mothers they had counselled. In the intervention group, 15 kader underwent two days training in the use of the cards when diagnosing and advising treatment for cases of diarrhoea in their villages. The 16 control kader received comparable CDD training without the cards. Each group provided lists of local mothers they pledged to counsel during the coming weeks. Follow-up interviews were held with these mothers to test their level of knowledge on CDD and to observe their ability to mix ORS properly. Significant performance differences between the intervention kader and mothers, and the control kader and mothers, were demonstrated. The intervention kader were consistently more accurate in their diagnoses and recommendations for treatment with a mean of 83% accuracy vs 68% for the control kader. Mothers counselled by the intervention kader also prepared ORS significantly better than the mothers counselled by the control kader, with 97 vs 74% accuracy.
Jopang, Yupin; Petchmark, Suthep; Jetsrisuparb, Arunee; Sanchaisuriya, Kanokwan; Sanchaisuriya, Pattara; Schelp, Frank Peter
The study was conducted to assess the achievement of a thalassemia screening program at a community level supported by village health volunteers (VHVs) of 2 subdistricts in the northeast of Thailand. One subdistrict served as the intervention and the other as the control area. A training program was organized for the village health volunteers from the intervention area. Essential information about the risk and danger of thalassemia was given to the participants who wanted to have children in the community as well. Of the 206 individuals who wanted to have children living in the intervention area, 190 (92.2%) agreed to undergo screening. Of the 196 individuals within the control area, only 26 (13.3%) voluntarily participated in the screening tests. Attitude toward prevention and knowledge about the disease improved significantly in both areas, but the differences between the scores were statistically significantly higher for individuals living in the intervention area. © 2012 APJPH.
Petrochuk, M A; Javalgi, R G
Health care reform has become the dominant domestic policy issue in the United States. President Clinton, and the Democratic leaders in the House and Senate have all proposed legislation to reform the system. Regardless of the plan which is ultimately enacted, health care delivery will be radically changed. Health care marketers, given their perspective, have a unique opportunity to ensure their own institutions' success. Organizational, managerial, and marketing strategies can be employed to deal with the changes which will occur. Marketers can utilize personal strategies to remain proactive and successful during an era of health care reform. As outlined in this article, responding to the health care reform changes requires strategic urgency and action. However, the strategies proposed are practical regardless of the version of health care reform legislation which is ultimately enacted.
dearth of information on patient satisfaction with HIV/AIDS care. This study sought ... with the doctor. Satisfaction rates were: 94.9% technical quality, ... of the delivery of care into several dimensions of contributed by studies carried out in Western. 14 ... efficiency of services as an index of patient needs of its clients. Secondly ...
Engaging men in health care involves a multifaceted approach that has as its main principle the recognition that men consume health care differently to women. This article identifies barriers to engaging men in health care and offers potential and existing solutions to overcome these barriers in a range of health care settings. The concept of multiple masculinities recognises that not all men can be engaged via a particular technique or strategy. The perception that men are disinterested in their health is challenged and a range of approaches discussed, both in the community and in health care facilities. In the general practice setting opportunities exist for the engagement of men at the reception desk and waiting room, as well as during the consultation. Use of the workplace in engaging men is discussed. Future activities to build the capacity of health care providers to better engage men are identified and the role of policy and program development is addressed.
Learning from developing countries in strengthening health systems: an evaluation of personal and professional impact among global health volunteers at Addis Ababa University's Tikur Anbessa Specialized Hospital (Ethiopia).
Busse, Heidi; Aboneh, Ephrem A; Tefera, Girma
The positive impact of global health activities by volunteers from the United States in low-and middle-income countries has been recognized. Most existing global health partnerships evaluate what knowledge, ideas, and activities the US institution transferred to the low- or middle-income country. However, what this fails to capture are what kinds of change happen to US-based partners due to engagement in global health partnerships, both at the individual and institutional levels. "Reverse innovation" is the term that is used in global health literature to describe this type of impact. The objectives of this study were to identify what kinds of impact global partnerships have on health volunteers from developed countries, advance this emerging body of knowledge, and improve understanding of methods and indicators for assessing reverse innovation. The study population consisted of 80 US, Canada, and South Africa-based health care professionals who volunteered at Tikur Anbessa Specialized Hospital in Ethiopia. Surveys were web-based and included multiple choice and open-ended questions to assess global health competencies. The data were analyzed using IBRM SPSS® version 21 for quantitative analysis; the open-ended responses were coded using constant comparative analysis to identify themes. Of the 80 volunteers, 63 responded (79 percent response rate). Fifty-two percent of the respondents were male, and over 60 percent were 40 years of age and older. Eighty-three percent reported they accomplished their trip objectives, 95 percent would participate in future activities and 96 percent would recommend participation to other colleagues. Eighty-nine percent reported personal impact and 73 percent reported change on their professional development. Previous global health experience, multiple prior trips, and the desire for career advancement were associated with positive impact on professional development. Professionally and personally meaningful learning happens often
Vrangbæk, Karsten; Byrkjeflot, Haldor
The debate on accountability within the public sector has been lively in the past decade. Significant progress has been made in developing conceptual frameworks and typologies for characterizing different features and functions of accountability. However, there is a lack of sector specific...... adjustment of such frameworks. In this article we present a framework for analyzing accountability within health care. The paper makes use of the concept of "accountability regime" to signify the combination of different accountability forms, directions and functions at any given point in time. We show...... that reforms can introduce new forms of accountability, change existing accountability relations or change the relative importance of different accountability forms. They may also change the dominant direction and shift the balance between different functions of accountability. We further suggest...
G. Alan Tarr
Full Text Available President Barack Obama proposed a major overhaul of the American healthsystem, and in 2010 the U.S. Congress enacted his proposal, the PatientProtection and Affordable Care Act. Opponents of the Act challenged itsconstitutionality in federal court, claiming that it exceeds the powers grantedto the federal government under the Commerce Clause and the NecessaryProper Clause of the federal Constitution. Some courts have upheldthe law, but others have agreed with the critics, in particular ruling thatthe provision requiring citizens to buy health insurance is unconstitutional.Eventually the U.S. Supreme Court will rule on the issue. This article tracesthe controversy, surveys the interpretation of pertinent constitutional provisionsin past cases, analyzes the constitutional arguments presented byproponents and opponents of the Act, and concludes that the Act is constitutional.
Health care workers are exposed to many job hazards. These can include Infections Needle injuries Back injuries ... prevention practices. They can reduce your risk of health problems. Use protective equipment, follow infection control guidelines, ...
2Department of Community Health, University of Benin, Benin City, Nigeria. ... Mental morbidity is a public health problem that can lead to a great burden of disability in the community. ..... community study in Sao Paulo, Brazil where.
Hershey, Tina Batra; Van Nostrand, Elizabeth; Sood, Rishi K; Potter, Margaret
During disaster response and recovery, legal issues often arise related to the provision of health care services to affected residents. Superstorm Sandy led to the evacuation of many hospitals and other health care facilities and compromised the ability of health care practitioners to provide necessary primary care. This article highlights the challenges and legal concerns faced by health care practitioners in the aftermath of Sandy, which included limitations in scope of practice, difficulties with credentialing, lack of portability of practitioner licenses, and concerns regarding volunteer immunity and liability. Governmental and nongovernmental entities employed various strategies to address these concerns; however, legal barriers remained that posed challenges throughout the Superstorm Sandy response and recovery period. We suggest future approaches to address these legal considerations, including policies and legislation, additional waivers of law, and planning and coordination among multiple levels of governmental and nongovernmental organizations. (Disaster Med Public Health Preparedness. 2016;10:518-524).
Gill, Stephen D; Dolley, Pamela J; Dunning, Trisha L; Hughes, Andrew J
To determine patient, staff and community volunteer opinions and experiences of point of service feedback (POSF) in an inpatient rehabilitation facility. Participants were recruited by purposeful sampling. Two researchers conducted in-depth semi-scripted interviews with patients, staff or volunteers until no new issues emerged. Manually transcribed interview data underwent thematic analysis that grouped information into categories of related information. Twenty patients, 26 staff from 10 different professional groups, and 2 community volunteers were interviewed. Patient and volunteer data were grouped into five main categories: patients wanted their voice heard and acted on; patients could be positively and negatively affected by POSF; patients could be reluctant to evaluate staff; patients preferred POSF to post-discharge mailed questionnaires; and patients' feedback was influenced by the data collector. Staff wanted: feedback to help them improve the patient experience; and feedback that was trustworthy, usable and used. Staff believed that the feedback-collector influenced patients' feedback and affected how feedback could be used. Patients, staff and community volunteers identified issues that determine the appropriateness and usefulness of POSF. Policy and practise should address the preferences, needs and experiences of health service users and providers so that POSF produces maximum benefits for both patients and health services. Implications for Rehabilitation POSF can enhance patients' experiences of inpatient rehabilitation by providing a mechanism to be heard and communicating that patients are valued; care must be exercised with patients who find giving feedback stressful. Collecting POSF is most beneficial when coupled with methods to efficiently and effectively respond to feedback. POSF requires interpretation in light of its limitations including patients' ability to accurately and unreservedly communicate their experiences. Who collects POSF
Weiss, Jennifer; Makonnen, Raphael; Sula, Delphin
Community-based strategies that foster frequent contact between caregivers of children under five and provide credible sources of health information are essential to improve child survival. Care Groups are a community-based implementation strategy for the delivery of social and behavior change interventions. This study assessed if supervision of Care Group activities by Ministry of Health (MOH) personnel could achieve the same child health outcomes as supervision provided by specialized non-governmental organization (NGO) staff. The study was a pretest-posttest quasi-experimental design implemented in Burundi. A total of 45 MOH-led Care Groups with 478 Care Group Volunteers (CGVs) were established in the intervention area; and 50 NGO-led Care Groups with 509 CGVs were formed in the comparison area. Data were collected from 593 and 700 mothers of children 0-23 months at baseline and endline, respectively. Pearson's chi-squared test and difference-in-difference analysis assessed changes in 40 child health and nutrition outcomes. A qualitative process evaluation was also conducted midway through the study. The MOH-led Care Group model performed at least as well as the NGO-led model in achieving specific child health and nutrition outcomes. Mothers of children 0-23 months in the intervention and comparison sites reported similar levels of knowledge and practices for 38 of 40 dependent variables measured in the study, and these results remained unchanged after accounting for differences in the indicator values at baseline. Process monitoring data confirmed that the MOH-led Care Group model and the NGO-led Care Group model were implemented with similar intervention strength. The study demonstrated that behavior change interventions traditionally led by NGOs can be implemented through the existing MOH systems and achieve similar results, thereby increasing the potential for sustainable child health outcomes. Future research on the MOH-led Care Group model is required to
Kawczynski , Lukasz; Taisch , Marco
International audience; In every society there is a need for an efficient health care system. This paper aims to propose a value definition and a value chain model within the health care. In order to define value patients and experts were surveyed. The proposed definition offers a complex way of looking at the value within the health care sector. The proposal of the value chain model is anticipated with a value stream mapping activities and experts interviews. Proposed model offers consistent...
Tracy, Jane; McDonald, Rachael
Background: Despite awareness of the health inequalities experienced by people with intellectual disability, their health status remains poor. Inequalities in health outcomes are manifest in higher morbidity and rates of premature death. Contributing factors include the barriers encountered in accessing and receiving high-quality health care.…
and pre/ post partum care during delivery. America should select measures that reflect the health-care goals of the nation. As an example, the Healthy...accidents (8) More than 50% of patients with diabetes, hypertension, tobacco addiction, hyperlipidemia, congestive heart failure, asthma, depression ...reflect the cumulative efforts of different types of individual care. For example, infant mortality is a reflection of pre-natal care, post - natal care
Carling, Philip C
This article presents a review and perspectives on aspects of optimizing health care environmental hygiene. The topics covered include the epidemiology of environmental surface contamination, a discussion of cleaning health care patient area surfaces, an overview of disinfecting health care surfaces, an overview of challenges in monitoring cleaning versus cleanliness, a description of an integrated approach to environmental hygiene and hand hygiene as interrelated disciplines, and an overview of the research opportunities and challenges related to health care environmental hygiene. Copyright © 2016 Elsevier Inc. All rights reserved.
Jayita Kedar Deodhar
Full Text Available Context: Training programs for volunteers prior to their working in palliative care are well-established in India. However, few studies report on continuing professional development programs for this group. Aims: To conduct a preliminary assessment of educational needs of volunteers working in palliative care for developing a structured formal continuing professional development program for this group. Settings and Design: Cross-sectional observational study conducted in the Department of Palliative Medicine of a tertiary care cancer institute in India. Materials and Methods: Participant volunteers completed a questionnaire, noting previous training, years of experience, and a comprehensive list of topics for inclusion in this program, rated in order of importance according to them. Statistical Analysis Used: Descriptive statistics for overall data and Chi-square tests for categorical variables for group comparisons were applied using Statistical Package for Social Sciences version 18. Results: Fourteen out of 17 volunteers completed the questionnaire, seven having 5-10-years experience in working in palliative care. A need for continuing professional development program was felt by all participants. Communication skills, more for children and elderly specific issues were given highest priority. Spiritual-existential aspects and self-care were rated lower in importance than psychological, physical, and social aspects in palliative care. More experienced volunteers (>5 years of experience felt the need for self-care as a topic in the program than those with less (<5-years experience ( P < 0.05. Conclusions: Understanding palliative care volunteers′ educational needs is essential for developing a structured formal continuing professional development program and should include self-care as a significant component.
.... Ambulances, Rural Health Centers (RHC) or other remote health location, Ships navigating in wide seas and Airplanes in flight are common examples of possible emergency sites, while critical care telemetry, and telemedicine home follow-ups...
Beer, G.; Slovak, K.
In Slovakia a strange approach to the purchase of health care equipment has not been limited to ophthalmology. Suspicious procurements are symptomatic. This applies also to specialisation where the correct spending of money can make the difference between life and death and can greatly effect the quality of life. More than a year ago, the Ministry of Health started the procurement of linear accelerators for oncology units in three hospitals. This plan placed on the market a potential order worth more than 11 million EUR without VAT. Three companies produce this complex equipment. The US company, Varian, the German company, Siemens, and the Swedish company, Elekta. Three suppliers, three hospitals. What a coincidence that each hospital - in Presov, Banska Bystrica and Bratislava - received only one envelope with an offer. Each from a different supplier. If anyone wanted to prove that the suppliers did not agree on a common approach, he would soon get into trouble. Each tender was organized by Pro-Tender, Kosice. The tender for the purchase of linear accelerators observed all the legal regulations. For each hospital there was only one offer and so it won. No-one complained, because each company got an order. Amedis Piestany will deliver a Varian product to Bystrica. In Narodny onkologicky ustav in Bratislava the winner was Transkontakt with Elekta products. And in Presov it was Ad Rem from Dunajska Streda that succeeded. The small company owned by a local vet joined up with Siemens and is now opening the doors of state-owned and regional hospitals to the company. (authors)
Department of Epidemiology and Community Health, University of Ilorin, Ilorin, Nigeria .... exercise. All pupils in the selected school later done under the light ..... increased the likelihood of intestinal parasitic of Ilechukwu et al in which a ...
Subject and Methods: ... To the best of the authors' knowledge, ... increase in percentage of women visiting health categories were decided on because ..... leadership resulted in an empowering work Significant differences in the proportions of.
Immunization is a proven cost-effective ... immunization programme and control of Vaccine was conducted to assess the ..... HFs where emphasis is on profit maximization revealed that the widespread ... World Health Organization (WHO).
Merlino, James I; Raman, Ananth
The Cleveland Clinic has long had a reputation for medical excellence. But in 2009 the CEO acknowledged that patients did not think much of their experience there and decided to act. Since then the Clinic has leaped to the top tier of patient-satisfaction surveys, and it now draws hospital executives from around the world who want to study its practices. The Clinic's journey also holds Lessons for organizations outside health care that must suddenly compete by creating a superior customer experience. The authors, one of whom was critical to steering the hospital's transformation, detail the processes that allowed the Clinic to excel at patient satisfaction without jeopardizing its traditional strengths. Hospital leaders: Publicized the problem internally. Seeing the hospital's dismal service scores shocked employees into recognizing that serious flaws existed. Worked to understand patients' needs. Management commissioned studies to get at the root causes of dissatisfaction. Made everyone a caregiver. An enterprisewide program trained everyone, from physicians to janitors, to put the patient first. Increased employee engagement. The Clinic instituted a "caregiver celebration" program and redoubled other motivational efforts. Established new processes. For example, any patient, for any reason, can now make a same-day appointment with a single call. Set patients' expectations. Printed and online materials educate patients about their stays--before they're admitted. Operating a truly patient-centered organization, the authors conclude, isn't a program; it's a way of life.
Townsend, Anne; Amarsi, Zubin; Backman, Catherine L; Cox, Susan M; Li, Linda C
While use of the Internet is increasingly widespread in research, little is known about the role of routine electronic mail (email) correspondence during recruitment and early volunteer-researcher interactions. To gain insight into the standpoint of volunteers we analyzed email communications in an early rheumatoid arthritis qualitative interview study. The objectives of our study were (1) to understand the perspectives and motivations of individuals who volunteered for an interview study about the experiences of early rheumatoid arthritis, and (2) to investigate the role of emails in volunteer-researcher interactions during recruitment. Between December 2007 and December 2008 we recruited 38 individuals with early rheumatoid arthritis through rheumatologist and family physician offices, arthritis Internet sites, and the Arthritis Research Centre of Canada for a (face-to-face) qualitative interview study. Interested individuals were invited to contact us via email or telephone. In this paper, we report on email communications from 12 of 29 volunteers who used email as their primary communication mode. Emails offered insights into the perspective of study volunteers. They provided evidence prospectively about recruitment and informed consent in the context of early rheumatoid arthritis. First, some individuals anticipated that participating would have mutual benefits, for themselves and the research, suggesting a reciprocal quality to volunteering. Second, volunteering for the study was strongly motivated by a need to access health services and was both a help-seeking and self-managing strategy. Third, volunteers expressed ambivalence around participation, such as how far participating would benefit them, versus more general benefits for research. Fourth, practical difficulties of negotiating symptom impact, medical appointments, and research tasks were revealed. We also reflect on how emails documented volunteer-researcher interactions, illustrating typically
Wick, Jeannette Y; Zanni, Guido R
When groups of people relocate from their homelands to other nations, especially if the movement is involuntary, minority populations are created in the countries that receive them. The issues related to these diaspora and diasporic communities--any groups that have been dispersed outside their traditional homelands--are financial, social, historical, political, or religious. In health care, issues include heritable diseases, cultural barriers, patients' health care beliefs, and unique disease presentations. In long-term care, many residents and health care providers have relocated to the United States from other countries.
Discusses how entrepreneurs have helped reduce costs in health care and examines the major changes in the health care system that are simultaneously lowering costs and increasing quality. The author then explains how current reform proposals might affect these entrepreneurial innovations. (GLR)
Bjerneld, Magdalena; Lindmark, Gunilla; McSpadden, Lucia Ann; Garrett, Martha J
International nongovernmental organizations (NGOs) involved in humanitarian assistance employ millions of volunteers. One of the major challenges for the organizations is the high turnover rate among their personnel. Another is recruiting the right persons. As part of a series of studies investigating factors that affect the recruitment process and the success of assignment, this qualitative study examined health professionals' motivations for volunteering, their various concerns, and their expectations about themselves and the organizations for which they would work. The findings from focus group interviews with potential humanitarian volunteers were considered within the framework of Hertzberg's theory of motivations and Maslow's hierarchy of needs. The study has significant implications for personnel policy and practice in the humanitarian sector. Recruitment officers should have the self-actualized person, as described by Maslow, in mind when interviewing candidates. This perspective would make it easier for them to understand the candidates' thoughts and concerns and would lead to more effective interventions. Program officers should have satisfiers and dissatisfiers, as identified by Herzberg, in mind when planning programs. The probability that personnel will leave humanitarian work is lower if they perceive working conditions as good.
Palenstein Helderman, W.H. van; Benzian, H.
Dental NGOs and volunteers working in disadvantaged communities around the world do so with the best of intentions and with high motivation. Regrettably, the impact of this engagement on oral health at the population level remains rather low. This is mainly due to the choice of inappropriate
To introduce the articles in this special issue, discussing emotion in the in health-care organisations. Discusses such topics as what makes health care different, editorial perspectives, how health care has explored emotion so far, and the impact of emotion on patients and the consequences for staff. Health care provides a setting that juxtaposes emotion and rationality, the individual and the body corporate, the formal and the deeply personal, the public and the private, all of which must be understood better if changes in expectations and delivery are to remain coherent. The papers indicate a shared international desire to understand meaning in emotion that is now spreading across organizational process and into all professional roles within health care.
compared the perceived availability of essential drugs and patronage of health facilities in a BI and non-BI Local government areas (LGA) of ... 2Medical Directorate, Hospitals Management Board, Uyo, Akwa Ibom State ... majority of the population in Malaysia had access to .... Ethical clearance for this study was obtained.
The level of knowledge of HIV/AIDS among senior secondary school students in Ikpoba Okha LGA was poor. Parents were mainly the first source of information on HCT for the respondents. There is need for more research to update knowledge and information on adolescent health issues and services related to HIV/AIDS.
A nation's disease control effort is often as good as the surveillance and notification system put in place, .... Department. Community Health. 11. 4.9. Dentistry. 28. 12.5. Family Medicine. 14 .... formal training and a posting in the Infection control.
Latin America and Southeast Asia. Cervical ... screening method based on visual Inspection with. 10-13 .... 56(49.6%) had poor knowledge while relating to practice of ... articulated road map and policy frame work to address ... European formal of Public ... Knowledge attitude and Practice ... Tertiary Health Institution. Int J.
the mobile phones of health workers and their role as a source of hospital acquired infection. The study utilised ..... grew organisms which is much lower than may not be as effective as regular hand. 7 .... Akinyemi KO, Atapu AD, Adetona. 2011 ...
Watts, Jacqueline H.
Volunteering is now a regular feature of health and social care service provision with volunteers working in diverse contexts such as day care centres, ‘after school’ clubs, hospitals and hospices. The promotion of the idea of an active civil society by successive UK governments has led to the professionalisation of some voluntary work as the product of a partnership between the voluntary sector, government and business. More standardised working practices and semi-formalised aspects of volun...
Spasojević-Kosić, Ljubica; Savić, Sara
There are two basic aspects of hunting dog’s health care: infectious diseases of hunting dogs and dog’s hunting performance. Concerning infectious diseases of hunting dogs, special attention is paid to public health, preventing possible dangers that could possibly arise. On the other hand, hunting performance of dogs depends on their nutrition. A complete analysis of hunting dogs’ health care in our country requires an assessment of awareness level in hunte...
Kent, Jennifer A; Patel, Vinisha; Varela, Natalie A
The existence of disparities in delivery of health care has been the subject of increased empirical study in recent years. Some studies have suggested that disparities between men and women exist in the diagnoses and treatment of health conditions, and as a result measures have been taken to identify these differences. This article uses several examples to illustrate health care gender bias in medicine. These examples include surgery, peripheral artery disease, cardiovascular disease, critical care, and cardiovascular risk factors. Additionally, we discuss reasons why these issues still occur, trends in health care that may address these issues, and the need for acknowledgement of the current system's inequities in order to provide unbiased care for women in the future. © 2012 Mount Sinai School of Medicine.
Stempsey, William E
Virtually all activities of health care are motivated at some level by hope. Patients hope for a cure; for relief from pain; for a return home. Physicians hope to prevent illness in their patients; to make the correct diagnosis when illness presents itself; that their prescribed treatments will be effective. Researchers hope to learn more about the causes of illness; to discover new and more effective treatments; to understand how treatments work. Ultimately, all who work in health care hope to offer their patients hope. In this paper, I offer a brief analysis of hope, considering the definitions of Hobbes, Locke, Hume and Thomas Aquinas. I then differentiate shallow and deep hope and show how hope in health care can remain shallow. Next, I explore what a philosophy of deep hope in health care might look like, drawing important points from Ernst Bloch and Gabriel Marcel. Finally, I suggest some implications of this philosophy of hope for patients, physicians, and researchers.
Alam, Khurshid; Tasneem, Sakiba; Huq, Molla
BRAC, a large Bangladeshi NGO, recently has been using female volunteer community health workers (CHWs) in Dhaka urban slums to provide maternal and child health services. Due to erratic performance-based income and higher opportunity cost the urban CHWs lose motivation which contributes to high dropout and poor performance. This results challenges for the cost effectiveness and sustainability of the urban health program. CHWs also consider their performance-based income very low compare to their work load. So, CHWs raise their voice for a fixed income. In order to understand this problem we explored fixed income for CHWs and the correlates that influence it. We surveyed a sample of 542 current CHWs. We used bidding game approach to derive the equilibrium reservation wage for CHWs for providing full-time services. Then, we performed ordered logit models with bootstrap simulation to identify the determinants of reservation wage. The average reservation wage of CHWs to continue their work as full-time CHWs rather than volunteer CHWs was US$24.11 which was three times higher than their current performance-based average income of US$ 8.03. Those CHWs received additional health training outside BRAC were 72% and those who joined with an expectation of income were 62% more likely to ask for higher reservation wage. On the contrary, CHWs who were burdened with household loan were 65% and CHWs who had alternative income generating scope were 47% less likely to ask for higher reservation wage. Other important factors we identified were BRAC village organization membership, competition with other health services providers, performance as a CHW, and current and past monthly CHW income. The findings of this study are relevant to certain developing countries such as Bangladesh and Tanzania which commonly use volunteer CHWs, and where poor retention and performance is a common issue due to erratic and performance-based income. So, the study has implications in improving
Du, Xin; Zeng, Weijie; Li, Chengwei; Xue, Junwei; Wu, Xiuyong; Liu, Yinjia; Wan, Yuxin; Zhang, Yiru; Ji, Yurong; Wu, Lei; Yang, Yongzhe; Zhang, Yue; Zhu, Bin; Huang, Yueshan; Wu, Kai
Wearable devices are used in the new design of the maternal health care system to detect electrocardiogram and oxygen saturation signal while smart terminals are used to achieve assessments and input maternal clinical information. All the results combined with biochemical analysis from hospital are uploaded to cloud server by mobile Internet. Machine learning algorithms are used for data mining of all information of subjects. This system can achieve the assessment and care of maternal physical health as well as mental health. Moreover, the system can send the results and health guidance to smart terminals.
Kasteng, Frida; Settumba, Stella; Källander, Karin; Vassall, Anna
Community health worker (CHW) programmes are currently being scaled-up in sub-Saharan Africa to improve access to healthcare. CHWs are often volunteers; from an economic perspective, this raises considerations whether reliance on an unpaid workforce is sustainable and how to appropriately cost and value the work of CHWs. Both these questions can be informed by an understanding of CHWs' workload, their opportunity costs of time and the perceived benefits of being a CHW. However, to date few studies have fully explored the methodological challenges in valuing CHW time. We examined the costs and benefits of volunteering in a sample of 45 CHWs providing integrated community case management of common childhood illnesses in rural Uganda in February 2012 using different methods. We assessed the value of CHW time using the minimum public sector salary rate and a CHW-elicited replacement wage, as well as the opportunity cost of time based on CHW-estimated annual income and alternative work opportunities, respectively. Reported monthly CHW workload, a median of 19.3 h (range 2.5-57), was valued at USD 6.9 (range 0.9-20.4) per month from the perspective of the healthcare system (applicable replacement wage) and at a median of USD 4.1 (range 0.4-169) from the perspective of the CHWs (individual opportunity cost of time). In a discrete choice experiment on preferred work characteristics, remuneration and community appreciation dominated. We find that volunteering CHWs value the opportunity to make a social contribution, but the decision to volunteer is also influenced by anticipated future rewards. Care must be taken by those costing and designing CHW programmes to acknowledge the opportunity cost of CHWs at the margin and over the long term. Failure to properly consider these issues may lead to cost estimations below the amount necessary to scale up and sustain programmes. © The Author 2015. Published by Oxford University Press in association with The London School of
U.S. Department of Health & Human Services — A list of all Home Health Agencies that have been registered with Medicare. The list includes addresses, phone numbers, and quality measure ratings for each agency.
Full Text Available The paper deals with conscientious objection in health care, addressing the problems of scope, verification and limitation of such refusal, paying attention to ideological agendas hidden behind the right of conscience where the claimed refusal can cause harm or where such a claim is an attempt to impose certain moral values on society or an excuse for not providing health care. The nature of conscientious objection will be investigated and an ethical analysis of conscientious objection will be conducted. Finally some suggestions for health care policy will be proposed.
Full Text Available Abstract Background The model of volunteer community health workers (CHWs is a common approach to serving the poor communities in developing countries. BRAC, a large NGO in Bangladesh, is a pioneer in this area, has been using female CHWs as core workers in its community-based health programs since 1977. After 25 years of implementing of the CHW model in rural areas, BRAC has begun using female CHWs in urban slums through a community-based maternal health intervention. However, BRAC experiences high dropout rates among CHWs suggesting a need to better understand the impact of their dropout which would help to reduce dropout and increase program sustainability. The main objective of the study was to estimate impact of dropout of volunteer CHWs from both BRAC and community perspectives. Also, we estimated cost of possible strategies to reduce dropout and compared whether these costs were more or less than the costs borne by BRAC and the community. Methods We used the ‘ingredient approach’ to estimate the cost of recruiting and training of CHWs and the so-called ‘friction cost approach’ to estimate the cost of replacement of CHWs after adapting. Finally, we estimated forgone services in the community due to CHW dropout applying the concept of the friction period. Results In 2009, average cost per regular CHW was US$ 59.28 which was US$ 60.04 for an ad-hoc CHW if a CHW participated a three-week basic training, a one-day refresher training, one incentive day and worked for a month in the community after recruitment. One month absence of a CHW with standard performance in the community meant substantial forgone health services like health education, antenatal visits, deliveries, referrals of complicated cases, and distribution of drugs and health commodities. However, with an additional investment of US$ 121 yearly per CHW BRAC could save another US$ 60 invested an ad-hoc CHW plus forgone services in the community. Conclusion Although CHWs
Full Text Available Aurel O Iuga,1,2 Maura J McGuire3,4 1Johns Hopkins Bloomberg School of Public Health, 2Johns Hopkins University, 3Johns Hopkins Community Physicians, 4Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: Medication nonadherence is an important public health consideration, affecting health outcomes and overall health care costs. This review considers the most recent developments in adherence research with a focus on the impact of medication adherence on health care costs in the US health system. We describe the magnitude of the nonadherence problem and related costs, with an extensive discussion of the mechanisms underlying the impact of nonadherence on costs. Specifically, we summarize the impact of nonadherence on health care costs in several chronic diseases, such as diabetes and asthma. A brief analysis of existing research study designs, along with suggestions for future research focus, is provided. Finally, given the ongoing changes in the US health care system, we also address some of the most relevant and current trends in health care, including pharmacist-led medication therapy management and electronic (e-prescribing. Keywords: patient, medication, adherence, compliance, nonadherence, noncompliance, cost
Full Text Available Health care organizations have to develop a sustainable path for creating public value by seeking legitimacy for building and maintaining public trust with patients as social and economic institutions creating value and sustaining both health and wealth for people and communities within society. Health care organizations having at disposal decreasing resources and meeting increasing demands of citizens are following an unsustainable path. Designing sustainable health care systems and organizations is emerging as a strategic goal for developing the wealth of people and communities over time. Building sustainable organizations relies on valuing human resources, designing efficient and effective processes, using technology for better managing the relationships within and outside organizations. Sustainable health care organizations tend to rediscover the importance of human resource management and policies for effectively improving communication with patients and building trust-based relationships. While processes of accreditation contribute to legitimizing effectiveness and quality of health care services and efficient processes, introducing and using new information and communication technologies (ICTs and informatics helps communication leading to restore trust-based relationships between health care institutions and patients for value creation within society.
... ency/patientinstructions/000878.htm Understanding your health care costs To use the sharing features on this page, ... on out-of-pocket costs. Out-of-Pocket Costs The good news is there is a limit ...
Journal of Community Medicine and Primary Health Care. ... Ladoke Akintola University of Technology, PMB 4400, Osogbo, Osun State. ... weak management and poor adherence to the basic infrastructure e.g. primary, secondary and tertiary.
3Department of Community and Primary Health Care, College of Medicine, University of Lagos, Idiaraba, ... Some of the participants (45.3%) carry out physical exercises such as walking ..... hypertension, continuous effective management of.
%) was the least common. On bivariate analysis ... the power to determine what their wives do or fail to ... pregnancy care while joint decision-making ... Other maternal health services rendered This data collection was done by a team of trained.
Raffel, M W; Raffel, N K
Before World War II, Czechoslovakia was among the most developed European countries with an excellent health care system. After the Communist coup d'etat in 1948, the country was forced to adapt its existing health care system to the Soviet model. It was planned and managed by the government, financed by general tax money, operated in a highly centralized, bureaucratic fashion, and provided service at no direct charge at the time of service. In recent years, the health care system had been deteriorating as the health of the people had also been declining. Life expectancy, infant mortality rates, and diseases of the circulatory system are higher than in Western European countries. In 1989, political changes occurred in Czechoslovakia that made health care reform possible. Now health services are being decentralized, and the ownership of hospitals is expected to be transferred to communities, municipalities, churches, charitable groups, or private entities. Almost all health leaders, including hospital directors and hospital department heads, have been replaced. Physicians will be paid according to the type and amount of work performed. Perhaps the most important reform is the establishment of an independent General Health Care Insurance Office financed directly by compulsory contributions from workers, employers, and government that will be able to negotiate with hospitals and physicians to determine payment for services.
The Effect of Volunteering at a Student-Run Free Healthcare Clinic on Medical Students' Self-Efficacy, Comfortableness, Attitude, and Interest in Working with the Underserved Population and Interest in Primary Care.
Tran, Kelvin; Kovalskiy, Aleksandr; Desai, Anand; Imran, Amna; Ismail, Rahim; Hernandez, Caridad
The number of primary care physicians in the United States continues to lag behind the number of uninsured people. There has been a growing demand for medical students to improve their self-efficacy, comfortableness, attitude, and interest in working with the underserved and in primary care. This study aims to discern whether volunteering at a student-run, free healthcare clinic has a positive impact on these five variables of interest or not. A 95-item survey was distributed through Qualtrics Survey Software (Qualtrics, Provo, UT, USA) to medical students from the Class of 2018 and Class of 2019 at the University of Central Florida College of Medicine. They were recruited via emails, Facebook, and in-classroom announcements. Mean responses on a Likert-like scale to different survey items were collected and compared between two study cohorts: Keeping Neighbors In Good Health Through Service (KNIGHTS) Clinic volunteers and non-volunteers. Results from 128 students showed no significant differences in the means between the two cohorts (p-values were not significant). When volunteers were asked the survey item, "KNIGHTS Clinic positively influenced my attitude towards working with underserved patients," 62% strongly agreed, 26% agreed, 10% were neutral, and 2% disagreed. Based on the results, volunteering at KNIGHTS Clinic may not have a positive impact on the five variables of interest. However, the lack of significance may also be due to certain limitations of this study addressed elsewhere in this paper. With the majority of KNIGHTS Clinic volunteers agreeing that "KNIGHTS Clinic positively influenced […their] attitude towards working with underserved patients," there may be a positive impact of volunteering on volunteers' attitude towards working with the underserved.
Marasović Šušnjara, Ivana
Corruption is a global problem that takes special place in health care system. A large number of participants in the health care system and numerous interactions among them provide an opportunity for various forms of corruption, be it bribery, theft, bureaucratic corruption or incorrect information. Even though it is difficult to measure the amount of corruption in medicine, there are tools that allow forming of the frames for possible interventions.
Connell, Braydon; Warner, Grace; Weeks, Lori E
Background/Question: Volunteers are important in the support of frail older adults requiring palliative care, especially in rural areas. However, there are challenges associated with volunteer supports related to training, management and capacity to work in partnership with healthcare providers (HCP). This review addresses the question: What is the feasibility of a volunteer-HCP partnership to support frail older adults residing in rural areas, as they require palliative care? This integrative review identified ten articles that met the identified search criteria. Articles were appraised using the Critical Appraisal Skills Programme (CASP) checklists, designed for use across a range of quantitative and qualitative studies. Studies were drawn from international sources to understand how volunteer roles vary by culture and organization; the majority of studies were conducted in North America. Studies varied in methodology, including quantitative, qualitative and educational commentary. Identified factors that were crucial to the feasibility of volunteer-HCP partnerships in rural areas included volunteer training dynamics, relationships between volunteers and HCP, and rural environmental factors. Preliminary evidence indicates that a volunteer-HCP palliative partnership is feasible. However, training policies/procedures, volunteer-HCP relationships, and rural specific designs impact the feasibility of this partnership. Additional research is needed to further establish the feasibility of implementing these partnerships in rural settings.
Grazier, Kyle L; Metzler, Bridget
Entrepreneurship is often described as the ability to create new ventures from new or existing concepts, ideas and visions. There has been significant entrepreneurial response to the changes in the scientific and social underpinnings of health care services delivery. However, a growing portion of the economic development driving health care industry expansion is threatened further by longstanding use of financing models that are suboptimal for health care ventures. The delayed pace of entrepreneurial activity in this industry is in part a response to the general economy and markets, but also due to the lack of capital for new health care ventures. The recent dearth of entrepreneurial activities in the health services sector may also due to failure to consider new approaches to partnerships and strategic ventures, despite their mutually beneficial organizational and financing potential. As capital becomes more scarce for innovators, it is imperative that those with new and creative ideas for health and health care improvement consider techniques for capital acquisition that have been successful in other industries and at similar stages of development. The capital and added expertise can allow entrepreneurs to leverage resources, dampen business fluctuations, and strengthen long term prospects.
Henriksen, Lars Skov; Rosdahl, David
volunteering within the three major welfare fields: social service, health, and education. It could be argued that this is a more heterogeneous type of volunteering, because some volunteers work in ‘service organizations' aiming at particular client groups (battered women, homeless, elderly people etc.) while...
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Rose, Kathleen C.; Blout, JoAnn; DiGregorio, Heiddy; Selekman, Janice
It is the position of the National Association of School Nurses (NASN) that quality health care within the school environment can best be attained through the employment of a full-time registered professional school nurse (hereinafter referred to as school nurse) for each school building. The health services needed by students at school continue…
Deodhar, N S
Concurrently with the development of the general health services infrastructure in India, serveral special health programs were instituted at the national level to provide a massive and concentrated assault on the major public health problems of malaria, smallpox, cholera, trachoma, tuberculosis, leprosy, filariasis, and the rapid population growth. These vertical programs were expected to reduce the heavy morbidity and mortality within the shortest possible time to where they were no longer major public health problems. The impact was variable. Major steps toward providing integrated health care were taken during the first 5-year plan. Emphasis was on the provision of a packet of inttegrated health, family planning, and nutrition services to the vulnerable groups, i.e., children, pregnant women, and nursing mothers. To rectify past shortcomings ssuch as the failures of the national health programs, ineffective coordination in the nutrition programs, and slow rate of development as a result of interdependence of different sectors, it was necessary to improve the health infrastructure and to launch a frontal attack on poverty. The Multipurpose Health Workers Scheme was planned to rationalize the organization and use of available manpower to reduce the area and population covered by each of the field staff in order to reduce travel time and to make services more effective and more satisfactory. Each multipurpose health worker was entrusted with the task of providing comprehensive health care to about 5000 people. Communicable diseases were the main public health problems, and many specific control/eradication programs were launched. the immunization programs against common childhood diseases have not taken deep roots and coverage continues to be poor. The adoption of the Western model of medical services has resulted in emphasis on "cure" rather than on "care". Another problem is maldistribution of the facilities. Overemphasis on medical education has resulted in the
This master thesis is trying to describe the situation of private sector in public health care systems. As a private sector we understand patients, private health insurance companies and private health care providers. The focus is placed on private health care providers, especially in ambulatory treatment. At first there is a definition of health as a main determinant of a health care systems, definition of public and private sectors in health care systems and the difficulties at the market o...
A booklet on health care for limited English speakers provides information on choosing the right doctor, buying medicine, paying the bill, and the individual's role in maintaining his or her health. Cartoons, questions and puzzles concerning the message in cartoons and narrative passages, checklists about an individual's personal habits related to…
Paper discuss an introduction to importance's as well as challenges facing health care sector in many countries. Particular attention is devoted to the preconditions and/or basic requirements have to be developed in order to make health sector to functioned. Focusing to end users as well as employing marketing tools ought to be right orientation.
This podcast will educate health care providers on diagnosing babesiosis and providing patients at risk with tick bite prevention messages. Created: 4/25/2012 by Center for Global Health, Division of Parasitic Diseases and Malaria. Date Released: 4/25/2012.
... Experience in a primary health care facility in Rivers State, South-South Nigeria. ... health center increased by 3.09% (p-value > 0.05); the patients that had their babies in the facility were ... 100, 000 live births, based on historical studies and.
Nath, L M
In India, although the health care system infrastructure is extensive, the people often regard government facilities as family planning (FP) centers instead of primary health care centers. This problem has been compounded by the separation of health care and FP at all stages, even down to the storage of the same medication in two different locations depending upon whether it is to be used for "health" or for "FP." In rural areas where the government centers are particularly desolate, the community has chosen to erect its own health care system of private practitioners of all sorts and qualifications. Even in rural areas where a comprehensive health service is provided, with each household visited regularly by health workers, and where this service has resulted in a lowering of the crude death rate from 14.6 to 7 and the maternal mortality rate from 4.7 to 0.5/1000, people depend upon practitioners of various types. Upon analysis, it was discovered that the reason for using this multiplicity of practitioners had nothing to do with the level of satisfaction with the government service or with the accessibility of the services. Rather, when ill, the people make a diagnosis and then go to the proper place for treatment. If, for instance, they believe their malady was caused by the evil eye, they consult a magico-religious practitioner. These various types of practitioners flourish in areas with the best primary health care because they fulfill a need not met by the primary health care staff. If government agencies work with the local practitioners and afford them the proper respect, their skills can be upgraded in selected areas and the whole community will benefit.
Skar, Pål; Young, Lynne; Gordon, Carol
reducing cardiovascular disease in specific hard-to-reach populations. Several systematic reviews have been conducted to assess different models for delivering services to people living with high blood pressure to assess community-based programs with a focus on cardiovascular disease, and to assess effectiveness of community health workers (CHW) in a variety of settings. These systematic reviews point to the importance of distinguishing between different categories of health care providers, their training and their roles in program delivery when assessing studies for possible inclusion in a systematic review.In a systematic review of studies from the US by Brownstein et al. focusing on the effectiveness of community health workers (CHWs) in the care of people with hypertension, this category of health care providers went under many different names. Community health workers in this review were defined as "any health workers who carried out functions related to health care deliver, were trained as part of an intervention, had no formal paraprofessional or professional designation, and had a relationship with the community being served". One of the findings from this review was the wide variety of formal training of the CHWs. In other parts of the world, a CHW might be defined differently. In their review of CHW-based programs focusing on children's health, Bhattacharyya, Winch, LeBan and Tien found that "in general CHWs are not paid salaries because the MOH (Ministry of Health) or donors do not consider salaries to be sustainable. Yet CHWs are often held accountable and supervised as if they were employees. Community health worker programs must recognize that CHWs are volunteers (emphasis in original), even if they receive small monetary or nonmonetary incentives. They are volunteering their time to serve the community". One Canadian model for delivering a cardiovascular awareness program designed to reach older adults through their primary care provider is based on
Fernando, Neil; Suveendran, Thirupathy; de Silva, Chithramalee
In the past, mental health services in Sri Lanka were limited to tertiary-care institutions, resulting in a large treatment gap. Starting in 2000, significant efforts have been made to reconfigure service provision and to integrate mental health services with primary health care. This approach was supported by significant political commitment to establishing island-wide decentralized mental health care in the wake of the 2004 tsunami. Various initiatives were consolidated in The mental health policy of Sri Lanka 2005-2015, which called for implementation of a comprehensive community-based, decentralized service structure. The main objectives of the policy were to provide mental health services of good quality at primary, secondary and tertiary levels; to ensure the active involvement of communities, families and service users; to make mental health services culturally appropriate and evidence based; and to protect the human rights and dignity of all people with mental health disorders. Significant improvements have been made and new cadres of mental health workers have been introduced. Trained medical officers (mental health) now provide outpatient care, domiciliary care, mental health promotion in schools, and community mental health education. Community psychiatric nurses have also been trained and deployed to supervise treatment adherence in the home and provide mental health education to patients, their family members and the wider community. A total of 4367 mental health volunteers are supporting care and raising mental health literacy in the community. Despite these important achievements, more improvements are needed to provide more timely intervention, combat myths and stigma, and further decentralize care provision. These, and other challenges, will be targeted in the new mental health policy for 2017-2026.
Full Text Available Background. It is possible to evaluate quality characteristics of different aspects of health care by many different measures. For these purposes, in various countries all over the world authorised institutions and/or agencies developed number of methodological accessories, criteria and tools for selection of more or less appropriately and optimally defined criteria and indicators of quality clinical performance.Conclusions. Recently we have started with activities for gradual introduction of systematic monitoring, assessment and improvement of quality of health care in Slovenia as well. One of the key prerequisites for selection of valid, practicable, efficient and reliable quality indicators is the establishment of continuous and methodologically appropriate system of development and implementation of evidence-based clinical practice guidelines. We started this process within the framework of national Health Sector Management Project, where all potential key stakeholders from health care sector participated. Also the project on Quality in Health Care in Slovenia, started, leaded and performed by the Medical Chamber of Slovenia, represents one of the important parallel starting steps towards assurance of reliable data on development/establishment of appropriate set of quality indicators and standards of health care in our country.
Brighton, Lisa Jane; Koffman, Jonathan; Robinson, Vicky; Khan, Shaheen A; George, Rob; Burman, Rachel; Selman, Lucy Ellen
Over half of all deaths in Europe occur in hospital, a location associated with many complaints. Initiatives to improve inpatient end-of-life care are therefore a priority. In England, over 78,000 volunteers provide a potentially cost-effective resource to hospitals. Many work with people who are dying and their families, yet little is known about their training in end-of-life care. To explore hospital volunteers' end-of-life care training needs and learning preferences, and the acceptability of training evaluation methods. Qualitative focus groups. Volunteers from a large teaching hospital were purposively sampled. Five focus groups were conducted with 25 hospital volunteers (aged 19-80 years). Four themes emerged as follows: preparation for the volunteering role, training needs, training preferences and evaluation preferences. Many described encounters with patients with life-threatening illness and their families. Perceived training needs in end-of-life care included communication skills, grief and bereavement, spiritual diversity, common symptoms, and self-care. Volunteers valued learning from peers and end-of-life care specialists using interactive teaching methods including real-case examples and role plays. A chance to 'refresh' training at a later date was suggested to enhance learning. Evaluation through self-reports or observations were acceptable, but ratings by patients, families and staff were thought to be pragmatically unsuitable owing to sporadic contact with each. Gaps in end-of-life care training for hospital volunteers indicate scope to maximise on this resource. This evidence will inform development of training and evaluations which could better enable volunteers to make positive, cost-effective contributions to end-of-life care in hospitals.
Svendsen, Gunnar Lind Haase; Jensen, Marit Vatn
This literature study focuses on possible links between access to health services and migration in rural areas. Why do people move to or from rural areas or why do they stay? What determines where people settle? And, in this context, do local health care services play an important or minor role......, or no role at all? First, the paper reports on key findings from rural migration studies, in order to shed light on two migration trends: urbanization and counter-urbanization. Then we take a closer look on settlement preferences in rural areas, including the impact of health care facilities. Finally, we end...... up with a more deepgoing review of the relatively small number of studies, which explicitly deal with settlement preferences related to access to health care....
Norris, M J; Harris, J C
A very basic part of marketing success is determining areas of your business in which you have a competitive advantage. In drafting a marketing plan for the Denver Clinic, the competitive advantages group practices have in the area of occupational health were quickly realized. This competitive edge is presented along with the Denver Clinic's marketing strategies and plans to capitalize on occupational healthcare advantages.
This podcast is based on the November, 2010 CDC Vital Signs report which indicates that more than one in four adults 18-64 years old (about 50 million) report being uninsured for at least part of the past 12 months, and focuses on the growing number of middle-income adults and those with a chronic illness or disability who have no health insurance.
Full Text Available Introduction: Food borne illnesses are usually infectious or toxic in nature and caused by bacteria, viruses, parasites or chemical substances entering the body through contaminated food or water. Unsafe food causes more than 200 diseases - ranging from diarrhea to cancers. Food safety is a public health priority. The aim of present study was determine level of health communicators' knowledge about food safety in Damavand city that was performed according to the World Health Organization guide. Methods: This study is a descriptive analysis of the target a group of health Volunteers in Damavand depended to Shahid Beheshti University of Medical Sciences. 109 persons were enrolled with s awareness, scarification and consent of the census. Tools for data collection was a questionnaire consisting of 13 questions on demographic characteristics and 24 questions about food safety according to WHO’s guide. Data was analyzed with SPSS-18 software and statistical analysis includes one-way ANOVA, t-test and spearman correlation. Results: The mean age of participant was 44.75 ± 9.98 years. Average score of awareness of food safety was 35.87 ±6.22 and for awareness was 77 (71%. No significant relationships was observed between of awareness and marital status, age, education, occupation and education of wife was not significant relationships (p>0/05. Conclusion: In some safety food items the level of knowledge in some safety food items was good, in other one, such as food storage, transmission of microbes, cooking temperature for meat there was low awareness. In this respect, information, education programs to raise awareness of the health status for health volunteers is recommended
Abarca, Esmeralda; Campos, Solange; Herskovic, Valeria; Fuentes, Carolina
Informal caregivers of bedridden elders need a respite. One form of obtaining a respite is through volunteers who are contacted by means of information and communication technology (ICT). A qualitative study was carried out in a low-income district in Santiago, Chile, to learn about how caregivers of bedridden elders perceive the possibility of using ICT to access this respite. In-depth interviews were carried out and transcribed verbatim, then analysed using open coding. Results: The results reveal that caregivers are willing to receive a volunteer in their home and use ICT to communicate with them, although a discrepancy exists between the use of devices connected to the Internet and feature phones. Conclusion: This study concludes that informal caregivers of bedridden elders have a favourable disposition towards accessing a respite system by means of ICT based on a peer-to-peer economy.
Abarca, Esmeralda; Campos, Solange; Herskovic, Valeria; Fuentes, Carolina
ABSTRACT Purpose: Informal caregivers of bedridden elders need a respite. One form of obtaining a respite is through volunteers who are contacted by means of information and communication technology (ICT). Method: A qualitative study was carried out in a low-income district in Santiago, Chile, to learn about how caregivers of bedridden elders perceive the possibility of using ICT to access this respite. In-depth interviews were carried out and transcribed verbatim, then analysed using open coding. Results: The results reveal that caregivers are willing to receive a volunteer in their home and use ICT to communicate with them, although a discrepancy exists between the use of devices connected to the Internet and feature phones. Conclusion: This study concludes that informal caregivers of bedridden elders have a favourable disposition towards accessing a respite system by means of ICT based on a peer-to-peer economy. PMID:29336722
Sahoo, Sanjeeb K
Nanomedicine: Emerging Field of Nanotechnology to Human HealthNanomedicines: Impacts in Ocular Delivery and TargetingImmuno-Nanosystems to CNS Pathologies: State of the Art PEGylated Zinc Protoporphyrin: A Micelle-Forming Polymeric Drug for Cancer TherapyORMOSIL Nanoparticles: Nanomedicine Approach for Drug/Gene Delivery to the BrainMagnetic Nanoparticles: A Versatile System for Therapeutic and Imaging SystemNanobiotechnology: A New Generation of Biomedicine Application of Nanotechnology-Based Drug Delivery and Targeting to LungsAptamers and Nanomedicine in C
This podcast is based on the November, 2010 CDC Vital Signs report which indicates that more than one in four adults 18-64 years old (about 50 million) report being uninsured for at least part of the past 12 months, and focuses on the growing number of middle-income adults and those with a chronic illness or disability who have no health insurance. Created: 11/9/2010 by Centers for Disease Control and Prevention (CDC). Date Released: 11/9/2010.
Scherwitz, Larry; Pullman, Marcie; McHenry, Pamela; Gao, Billy; Ostaseski, Frank
Inspired by a 2,500-year-old Buddhist tradition, the Zen Hospice Project (ZHP) provides residential hospice care, volunteer programs, and educational efforts that cultivate wisdom and compassion in service. The present study was designed to understand how being with dying hospice residents affects hospice volunteers well-being and the role of spiritual practice in ameliorating the fear of death. A one-year longitudinal study of two volunteer cohorts (N = 24 and N = 22) with repeated measures of spiritual practice, well-being, and hospice performance during one-year service as volunteers. The Zen Hospice Guest House and Laguna Honda Residential Hospital of San Francisco, CA. All 46 individuals who became ZHP volunteers during two years. A 40-hour training program for beginning hospice volunteers stressing compassion, equanimity, mindfulness, and practical bedside care; a one-year caregiver assignment five hours per week; and monthly group meeting. Self-report FACIT spiritual well-being, general well-being, self-transcendence scale, and a volunteer coordinator-rated ZHP performance scale. The volunteers had a high level of self-care and well-being at baseline and maintained both throughout the year; they increased compassion and decreased fear of death. Those (n = 20) practicing yoga were found to have consistently lower fear of death than the group average (P = .04, P = .008, respectively). All rated the training and program highly, and 63% continued to volunteer after the first year's commitment. The results suggest that this approach to training and supporting hospice volunteers fosters emotional well-being and spiritual growth.
Bhupendra Kumar Basnet
Full Text Available Introduction:Transient elastography is a very promising non invasive procedure to determine liver stiffness for diagnosis of fibrosis in various chronic liver diseases. However, studies on normal values of liver stiffness in apparently healthy subjects are still few. We aimed to determine liver stiffness values in healthy Nepalese volunteers. Methods:Transient elastography (FibroScanR, Echosens, Paris, France was performed to find out liver stiffness values in 45 apparently healthy volunteers after explaining study protocol. Complete medical examination with routine laboratory tests was performed. Subjects with normal liver biochemistries and normal liver ultrasonography were taken for analysis. Results:Mean liver stiffness value of study subjects was 4.24±0.70 kPa. Liver stiffness value was found higher in males than in females (4.32±0.74 vs 4.07±0.61 kPa, respectively, P=0.26 but not statistically significant. Similarly, comparison between age and liver stiffness also showed positive correlation (r=0.211 but not statistically significant (P=0.164 Conclusions: Our study showed that the mean liver stiffness value was 4.24±0.70 kPa in our population and influence of age, gender and body mass index were not significant. Keywords: chronic liver disease; FibroScanR; healthy volunteers; liver stiffness valve; transient elastography.
Antonio, Gisele Damian; Tesser, Charles Dalcanale; Moretti-Pires, Rodrigo Otavio
OBJECTIVE To characterize the integration of phytotherapy in primary health care in Brazil. METHODS Journal articles and theses and dissertations were searched for in the following databases: SciELO, Lilacs, PubMed, Scopus, Web of Science and Theses Portal Capes, between January 1988 and March 2013. We analyzed 53 original studies on actions, programs, acceptance and use of phytotherapy and medicinal plants in the Brazilian Unified Health System. Bibliometric data, characteristics of the actions/programs, places and subjects involved and type and focus of the selected studies were analyzed. RESULTS Between 2003 and 2013, there was an increase in publications in different areas of knowledge, compared with the 1990-2002 period. The objectives and actions of programs involving the integration of phytotherapy into primary health care varied: including other treatment options, reduce costs, reviving traditional knowledge, preserving biodiversity, promoting social development and stimulating inter-sectorial actions. CONCLUSIONS Over the past 25 years, there was a small increase in scientific production on actions/programs developed in primary care. Including phytotherapy in primary care services encourages interaction between health care users and professionals. It also contributes to the socialization of scientific research and the development of a critical vision about the use of phytotherapy and plant medicine, not only on the part of professionals but also of the population. PMID:25119949
Vizeshfar, Fatemeh; Momennasab, Marzieh; Yektatalab, Shahrzad; Iman, Mohamad Taghi
Objective: This study aimed to evaluate the effectiveness of a health volunteers' complementary training programme on first aid. Design: Quasi-experimental study. Setting: A comprehensive health centre in the southwest of Iran. Method: The study was conducted in the second half of 2015 with all 25 health volunteers in the Qamar Bani Hashem…
Sharan, Alok D; Schroeder, Gregory D; West, Michael E; Vaccaro, Alexander R
As reimbursement transitions from a volume-based to a value-based system, innovation in health care delivery will be needed. The process of innovation begins with framing the problem that needs to be solved along with the strategic vision that has to be achieved. Similar to scientific testing, a hypothesis is generated for a new solution to a problem. Innovation requires conducting a disciplined form of experimentation and then learning from the process. This manuscript will discuss the different types of innovation, and the key steps necessary for successful innovation in the health care field.
Full Text Available Our health care system has faced many challenges over the past 40 plus years. Now these challenges have forced us into a complicated situation that makes it confusing on how best to proceed. Today third party insurance payers make most health care payments. Our premiums are paid into a risk pool-on medical services for other people. Consumers are disconnected from knowing the cost of goods or services that they are receiving. This commentary reviews the current situation and provides a few common sense approaches for pursuing the best potential policies.
Mawn, Barbara; Siqueira, Eduardo; Koren, Ainat; Slatin, Craig; Devereaux Melillo, Karen; Pearce, Carole; Hoff, Lee Ann
In this article we describe the process of an interdisciplinary case study that examined the social contexts of occupational and general health disparities among health care workers in two sets of New England hospitals and nursing homes. A political economy of the work environment framework guided the study, which incorporated dimensions related to market dynamics, technology, and political and economic power. The purpose of this article is to relate the challenges encountered in occupational health care settings and how these could have impacted the study results. An innovative data collection matrix that guided small-group analysis provided a firm foundation from which to make design modifications to address these challenges. Implications for policy and research include the use of a political and economic framework from which to frame future studies, and the need to maintain rigor while allowing flexibility in design to adapt to challenges in the field.
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Laberge, Maude; Wodchis, Walter P; Barnsley, Jan; Laporte, Audrey
The purpose of this study is to analyze the relationship between newly introduced primary care models in Ontario, Canada, and patients' primary care and total health care costs. A specific focus is on the payment mechanisms for primary care physicians, i.e. fee-for-service (FFS), enhanced-FFS, and blended capitation, and whether providers practiced as part of a multidisciplinary team. Utilization data for a one year period was measured using administrative databases for a 10% sample selected at random from the Ontario adult population. Primary care and total health care costs were calculated at the individual level and included costs from physician services, hospital visits and admissions, long term care, drugs, home care, lab tests, and visits to non-medical health care providers. Generalized linear model regressions were conducted to assess the differences in costs between primary care models. Patients not enrolled with a primary care physicians were younger, more likely to be males and of lower socio-economic status. Patients in blended capitation models were healthier and wealthier than FFS and enhanced-FFS patients. Primary care and total health care costs were significantly different across Ontario primary care models. Using the traditional FFS as the reference, we found that patients in the enhanced-FFS models had the lowest total health care costs, and also the lowest primary care costs. Patients in the blended capitation models had higher primary care costs but lower total health care costs. Patients that were in multidisciplinary teams (FHT), where physicians are also paid on a blended capitation basis, had higher total health care costs than non-FHT patients but still lower than the FFS reference group. Primary care and total health care costs increased with patients' age, morbidity, and lower income quintile across all primary care payment types. The new primary care models were associated with lower total health care costs for patients compared to the
Presents an overview of Islamic health care beliefs and practices, noting health-related social and spiritual issues, fundamental beliefs and themes in Islam, health care beliefs and practices common among Muslims, and health-affecting social roles among Muslims. Cultural, religious, and social barriers to health care and ways to reduce them are…
Vareilles, Gaëlle; Marchal, Bruno; Kane, Sumit; Petrič, Taja; Pictet, Gabriel; Pommier, Jeanine
Objectives This paper presents the results of a realist evaluation that aimed to understand how, why and under what circumstances a Red Cross (RC) capacity-building intervention influences the motivation and the performance of RC community health volunteers involved in the delivery of an immunisation programme in Kampala, Uganda. Method Given the complexity of the intervention, we adopted realist evaluation as our methodological approach and the case study as our study design. Data collection included document review, participant observation and interviews. The constant comparative method was used for the analysis. Two contrasted cases were selected within the five Kampala districts. Each case covers the management of the immunisation programme implemented at a RC branch. In each case, a programme manager and 15 RC volunteers were interviewed. The selection of the volunteers was purposive. Results We found that a capacity-building programme including supervision supportive of autonomy, skills and knowledge enhancement, and adapted to the different subgroups of volunteers, leads to satisfaction of the three key drivers of volunteer motivation: feelings of autonomy, competence and connectedness. This contributes to higher retention, and better task performance and well-being among the volunteers. Enabling contextual conditions include the responsiveness of the Uganda Red Cross Society (URCS) to community needs, and recognition of the work of the volunteers, from the URCS and the community. Conclusions A management approach that caters for the different motivational states and changing needs of the volunteers will lead to better performance. The findings will inform not only the management of community health volunteers, but also the management of all kinds of health workers. PMID:26525721
Greer, Scott L; Jacobson, Peter D
Health policy debates are replete with discussions of federalism, most often when advocates of reform put their hopes in states. But health policy literature is remarkably silent on the question of allocation of authority, rarely asking which levels of government ought to lead. We draw on the larger literatures about federalism, found mostly in political science and law, to develop a set of criteria for allocating health policy authority between states and the federal government. They are social justice, procedural democracy, compatibility with value pluralism, institutional capability, and economic sustainability. Of them, only procedural democracy and compatibility with value pluralism point to state leadership. In examining these criteria, we conclude that American policy debates often get federalism backward, putting the burden of health care coverage policy on states that cannot enact or sustain it, while increasing the federal role in issues where the arguments for state leadership are compelling. We suggest that the federal government should lead present and future financing of health care coverage, since it would require major changes in American intergovernmental relations to make innovative state health care financing sustainable outside a strong federal framework.
Many young people look forward to volunteering abroad and overlook the ample volunteer opportunities at home. There are several advantages to volunteering at home: you help people in your own community; you can make a long-term commitment; and you have continuity of care for your patients. There are >1200 free clinics in the United States whose main goal is to provide care to the indigent population. These free clinics are always looking for volunteers with specialized medical training. This article reviews the medically related and unrelated volunteer opportunities available in the United States. Volunteering at home is a worthwhile experience, and I encourage the otolaryngology community to explore these opportunities. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.
Hougaard, Jens Leth; Østerdal, Lars Peter; Yu, Yi
In the present paper we describe the structure of the Chinese health care system and sketch its future development. We analyse issues of provider incentives and the actual burden sharing between government, enterprises and people. We further aim to identify a number of current problems and link...
Wagner, H C; Fleming, D; Mangold, W G; LaForge, R W
Building relationships with patients is critical to the success of many health care organizations. The authors profile the relationship marketing program for a hospital's cardiac center and discuss the key strategic aspects that account for its success: a focus on a specific hospital service, an integrated marketing communication strategy, a specially designed database, and the continuous tracking of results.
Connor, L R
Health care executives across the country, faced with intense competition, are being forced to consider drastic cost cutting measures as a matter of survival. The entire health care industry is under siege from boards of directors, management and others who encourage health care systems to take actions ranging from strategic acquisitions and mergers to simple "downsizing" or "rightsizing," to improve their perceived competitive positions in terms of costs, revenues and market share. In some cases, management is poorly prepared to work within this new competitive paradigm and turns to consultants who promise that following their methodologies can result in competitive advantage. One favored methodology is reengineering. Frequently, cost cutting attention is focused on the materials management budget because it is relatively large and is viewed as being comprised mostly of controllable expenses. Also, materials management is seldom considered a core competency for the health care system and the organization performing these activities does not occupy a strongly defensible position. This paper focuses on the application of a reengineering methodology to healthcare materials management.
Artiklen har fokus på undervisning, planlægning, udvikling og evaluering af et internationalt tværfagligt valgfag Intercultural Health Care and Welfare, der udbydes på Det Sundhedsfaglige og Teknologiske Fakultet på Professionshøjskolen Metropol. Ifølge den tysk-amerikanske professor Iris Varner og...
Handelsman, L; Speiser, M; Maltz, A; Kirpalani, S
Bankruptcy is an event that is often considered a business' worst nightmare. Debt, lawyers, and the U.S. government can lead to the eventual destruction of a business. This article shows how declaring bankruptcy can be a helpful instrument in continuing a successful venture in the health care marketplace.
Hackney, J D; Linn, W S; Avol, E L
Observations of high acidity (pH as low as 1.7) in fogwater collected in polluted areas have provoked concern for public health. Effects of exposure to acidic pollutants have not been studied under foggy conditions; thus there is no directly relevant information from which to estimate the health risk. Indirectly relevant information is available from numerous studies of volunteers exposed to "acid fog precursors" under controlled conditions at less than 100% relative humidity. The effect of fog in modifying responses to inhaled acidic pollutants is difficult to predict: depending on circumstances, fog droplets might either increase or decrease the effective dose of pollutants to the lower respiratory tract. Fog inhalation per se may have unfavorable effects in some individuals. Sulfur dioxide is known to exacerbate airway constriction in exercising asthmatics, at exposure concentrations attainable in ambient air. Nitrogen dioxide has shown little untoward respiratory effect at ambient concentrations in most studies, although it has been suggested to increase bronchial reactivity. Sulfuric acid aerosol has shown no clear effects at concentrations within the ambient range. At somewhat higher levels, increased bronchial reactivity and change in mucociliary clearance have been suggested. Almost no information is available concerning nitric acid.
Oliffe, John L; Bottorff, Joan L; McKenzie, Michael M; Hislop, T Gregory; Gerbrandt, Julieta S; Oglov, Valerie
In this article we describe the connections between prostate cancer support groups (PCSGs) and men's health literacy and consumer orientation to health care services. The study findings are drawn from participant observations conducted at 16 PCSGs in British Columbia, Canada and 54 individual interviews that focused on men's experiences of attending group meetings. Men's communication and interactions at PCSGs provide important insights for how men talk about and conceptualize health and illness. For example, biomedical language often predominated at group meetings, and men used numbers and measures to engage with risk discourses in linking prostate cancer markers to various treatment options and morbidity and mortality rates. Many groups afforded opportunities for men to interact with health care providers as a means to better understand the language and logic of prostate cancer management. The health literacy skills fostered at PCSGs along with specific group-informed strategies could be mobilized in the men's subsequent clinical consultations. Consumer discourses and strategies to contest power relations with health care professionals underpinned many men's search for prostate cancer information and their commitment to assisting other men. Key were patients' rights, and perhaps responsibility, to compare diverse health products and services in making decisions across the entire trajectory of their prostate cancer. Overall, the study findings reveal PCSGs as having the capacity to contest as well as align with medical expertise and services facilitating men's transition from patient to informed health care consumers. The processes through which this occurs may direct the design of older men's health promotion programs.
U.S. Department of Health & Human Services — The Affordable Care Act includes tools to improve the quality of health care that can also lower costs for taxpayers and patients. This means avoiding costly...
Roberts, Helen C
This review will describe the evidence for changing the hospital environment to improve nutrition of older people, with particular emphasis on the role of additional mealtime assistance. Poor nutrition among older people in hospital is well recognised in many countries and is associated with poor outcomes of hospital care including increased mortality and longer lengths of stay. Factors recognised to contribute to poor dietary intake include acute illness, co-morbidities, cognitive impairment, low mood and medication. The hospital environment has also been scrutinised with reports from many countries of food being placed out of reach or going cold because time-pressured ward and catering staff often struggle to help an increasingly dependent group of patients at mealtimes. Routine screening in hospital for people at risk of under nutrition is recommended. Coloured trays and protected mealtimes are widespread although there is relatively little evidence for their impact on dietary intake. Volunteers can be trained to sfely give additional mealtime assistance including feeding to older patients on acute medical wards. They can improve the quality of mealtime care for patients and nursing staff although the evidence for improved dietary intake is mixed. In conclusion, improving the nutrition of older patients in hospital is challenging. Initiatives such as routine screening, the use of coloured trays, protected mealtimes and additional mealtime assistance can work together synergistically. Volunteers are likely to be increasingly important in an era when healthcare systems are generally limited in both financial resources and the ability to recruit sufficient nursing staff.
Robinson, James C
The future of market-oriented health policy and practice lies in "managed consumerism," a blend of the patient-centric focus of consumer-driven health care and the provider-centric focus of managed competition. The optimal locus of incentives will vary among health services according to the nature of the illness, the clinical technology, and the extent of discretion in utilization. A competitive market will manifest a variety of comprehensive and limited benefit designs, broad and narrow contractual networks, and single-and multispecialty provider organizations.
Emanuel, E J; Emanuel, L L
There are two prominent trends in health care today: first, increasing demands for accountabilty, and second, increasing provision of care through managed care organizations. These trends promote the question: What form of account-ability is appropriate to managed care plans? Accountability is the process by which a party justifies its actions and policies. Components of accountability include parties that can be held or hold others accountable, domains and content areas being assessed, and procedures of assessment. Traditionally, the professional model of accountability has operated in medical care. In this model, physicians establish the standards of accountability and hold each other accountable through professional organizations. This form of accountability seems outdated and inapplicable to managed care plans. The alternatives are the economic and the political models of accountability. In the economic model, medicine becomes more like a commodity, and "exit" (consumers changing providers for reasons of cost and quality) is the dominant procedure of accountability. In the political model, medicine becomes more like a community good, and "voice" (citizens communicating their views in public forums or on policy committees, or in elections for representatives) is the dominant procedure of accountability. The economic model's advantages affirm American individualism, make minimal demands on consumers, and use a powerful incentive, money. Its disadvantages undermine health care as a nonmarket good, undermine individual autonomy, undermine good medical practice, impose significant demands on consumers to be informed, sustain differentials of power, and use indirect procedures of accountability. The political model's advantages affirm health care as a matter of justice, permit selecting domains other than price and quality for accountability, reinforce good medical practice, and equalize power between patients and physicians. Its disadvantages include inefficiency in
Full Text Available Introduction: The text message can be presented as a way to change patterns of behavior-based prevention programs, such as the theory of planned behavior and health belief model to be used., And as an alternative approach to the individual and group training programs should be considered. The present study examined the effectiveness of this new method in promoting food handling behavior of a team of health volunteers on health belief model was based. Methods: This study was an evaluation of an intervention in which 16 health centers, 200 health volunteers who were actively involved Yazd city who were randomly divided into two groups. After the initial test, chi-square test, t test were analyzed. The intervention group received an educational package on the SMS regarding food handling behavior on health Belief Model was designed for codification; wantonly within a month and a half a day and after 8 weeks of the last SMS sent from any intervention and control groups was performed in a secondary assessment. Tool for data gathering questionnaire consisting of structures of health belief model including demographic variables, respectively. Data were using 18spss and employing applied, statistical tests of non-parametric Wilcoxon, Mann-Whitney and Kruskal-Wallis, Chi-square and correlation coefficient the analysis was. Results: The overall food handling behavior, after training significantly increased in the intervention group (p =0/01, while the control group was not significant (p=0/21. Cooling behavior after training in the experimental group and the control group was significantly increased (p =0/00. Cooking behavior, after training in the intervention group (p =0/11 and control group( p =0/17 was not significantly increased. Individual health behavior, after training in the intervention group (p =0/13 and control group (p =0/07 was not significantly increased. Separation behavior after training has not significantly increased in the
Health care technology has become an increasingly visible issue in many countries, primarily because of the rising costs of health care. In addition, many questions concerning quality of care are being raised. Health care technology assessment has been seen as an aid in addressing questions
M de Wet
Full Text Available One of the challenges facing primary health care in South Africa is the delivery of quality eye care to all South Africans. In this regard the role of the primary health care worker, as the first point of contact, is crucial. This paper reports on the problems primary health care workers experience in providing quality eye care in Region B of the Free State. Problems identified by those involved in the study include the cumbersome referral system, the unavailability of appropriate medicine at clinics, the insufficient knowledge of primary health care workers regarding eye conditions and the lack of communication between the various eye care service providers. Suggestions to address the problems identified included more in-service training of primary health care workers regarding eye conditions, liaison with NGO’s providing eye care, decentralisation of services and the establishment of an eye care committee in the region.
Blue, Christine; Riggs, Sheila
The accountable care organization (ACO) provides an opportunity to strategically design a comprehensive health system in which oral health works within primary care. A dental hygienist/therapist within the ACO represents value-based health care in action. Inspired by health care reform efforts in Minnesota, a vision of an accountable care organization that integrates oral health into primary health care was developed. Dental hygienists and dental therapists can help accelerate the integration of oral health into primary care, particularly in light of the compelling evidence confirming the cost-effectiveness of care delivered by an allied workforce. A dental insurance Chief Operating Officer and a dental hygiene educator used their unique perspectives and experience to describe the potential of an interdisciplinary team-based approach to individual and population health, including oral health, via an accountable care community. The principles of the patient-centered medical home and the vision for accountable care communities present a paradigm shift from a curative system of care to a prevention-based system that encompasses the behavioral, social, nutritional, economic, and environmental factors that impact health and well-being. Oral health measures embedded in the spectrum of general health care have the potential to ensure a truly comprehensive healthcare system. Published by Elsevier Inc.
Godbout, Elisabeth; Filiatrault, Johanne; Plante, Michelle
Volunteer work can be a very significant form of social participation for seniors. It can also provide seniors with important physical and psychological health benefits. This explains why occupational therapists and other health care professionals, as well as community workers who are concerned with healthy aging, appeal to seniors to volunteer in health promotion and community support However, the recruitment and ongoing involvement of seniors as volunteers is often challenging. A systematic review of the literature was undertaken to enlighten practitioners working in this domain. The objective was to identify factors that influence seniors' participation in volunteer work. Six bibliographic databases were searched using key words. A total of 27 relevant papers were retrieved and allowed an identification of a series of factors that could influence seniors' participation in volunteer work, namely personal factors, environmental factors, and occupational factors. This analysis leads to practical guidelines for facilitating the recruitment and maintenance of seniors' engagement in volunteer work.
Robinson, J C
Internet-related health care firms have accelerated through the life cycle of capital finance and organizational destiny, including venture capital funding, public stock offerings, and consolidation, in the wake of heightened competition and earnings disappointments. Venture capital flooded into the e-health sector, rising from $3 million in the first quarter of 1998 to $335 million two years later. Twenty-six e-health firms went public in eighteen months, raising $1.53 billion at initial public offering (IPO) and with post-IPO share price appreciation greater than 100 percent for eighteen firms. The technology-sector crash hit the e-health sector especially hard, driving share prices down by more than 80 percent for twenty-one firms. The industry now faces an extended period of consolidation between e-health and conventional firms.
Hahn, Julie; Reilly, Patricia M; Buchanan, Teresa M
Creating a healing and healthy environment for patients, families, and staff is an ongoing challenge. As part of our hospital's Integrative Care Program, a Reiki Volunteer Program has helped to foster a caring and healing environment, providing a means for patients, family, and staff to reduce pain and anxiety and improve their ability to relax and be present. Because direct care providers manage multiple and competing needs at any given time, they may not be available to provide Reiki when it is needed. This program demonstrates that a volunteer-based program can successfully support nurses in meeting patient, family, and staff demand for Reiki services.
This study assesses the impact of the NHIS scheme in promoting access to health care. It identifies a need for all stakeholders to engage in the active promotion of awareness on health insurance as option of health care provisioning. It argues that health insurance can make health care more accessible to a wider segment ...
Wentzer, Helle; Bygholm, Ann
Introduction: Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods: Against a background of theor......Introduction: Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods: Against a background...
France, K R; Grover, R
Because of the current competitive environment, health care providers (hospitals, HMOs, physicians, and others) are constantly searching for better products and better means for delivering them. The health care product is often loosely defined as a service. The authors develop a more precise definition of the health care product, product line, and product mix. A bundle-of-elements concept is presented for the health care product. These conceptualizations help to address how health care providers can segment their market and position, promote, and price their products. Though the authors focus on hospitals, the concepts and procedures developed are applicable to other health care organizations.
The purpose of the study was to enhance contraceptive acceptance among currently-married women of reproductive age (CMWRA) through empowerment training of female community health volunteers (FCHVs). Seventeen FCHVs, who were working in Kakani Village Development Committee in the hills of central Nepal, attended an empowerment training that used participatory action research and reinforcement mechanisms. Following the training, the FCHVs were expected to empower the CMWRA to increase their contraceptive use. The impact of the intervention was assessed in a sample of 241 CMWRA, who were neither pregnant nor using contraceptives at the time of selection, by interviewing them before and six months after the intervention. The implementation of the intervention significantly increased the proportion of CMWRA knowing at least one contraceptive method (chi2(ldr)=71 .7, p=0.001). The use of modern contraceptives among the CMWRA from none before the intervention increased to 52.3% six months following the intervention. Satisfaction of the CMWRA with services provided by the FCHVs also significantly increased. The study concludes that empowerment training of FCHVs using participatory action research and peer reinforcement help increase the acceptance of contraceptives among CMWRA.
Melvin Hsien Liang Chung
Full Text Available The objective of this study was to assess the role performance among KOSPEN community health volunteer in Kuching district and its associated factors. This was a cross-sectional study, conducted in 21 localities in Kuching with a total of 210 respondents. Data were collected using validated interviewer-administered questionnaires and analyzed using SPSS version 22.0. The respondents comprised 55.2% females, 81.9% married, and 41.4% aged above 45 and above and 72.4% completed their education up to secondary school. The result revealed that 59.0% of the respondents agreed and understood their role performances. Multiple Logistics analysis revealed that factors associated with role performance were age group (p=0.003, education level (p<0.001, marital status (p=0.025, prestige and respect (p=0.012, being seen as “doctor” in community (p=0.003, job aids (p=0.009, training location (p=0.001, and supervision by community (p<0.001. To increase and maintain the work performance of CHVs, commitment from the government, policy makers, stakeholders, and the communities is required.
Chung, Melvin Hsien Liang; Hazmi, Helmy
The objective of this study was to assess the role performance among KOSPEN community health volunteer in Kuching district and its associated factors. This was a cross-sectional study, conducted in 21 localities in Kuching with a total of 210 respondents. Data were collected using validated interviewer-administered questionnaires and analyzed using SPSS version 22.0. The respondents comprised 55.2% females, 81.9% married, and 41.4% aged above 45 and above and 72.4% completed their education up to secondary school. The result revealed that 59.0% of the respondents agreed and understood their role performances. Multiple Logistics analysis revealed that factors associated with role performance were age group (p = 0.003), education level (p < 0.001), marital status (p = 0.025), prestige and respect (p = 0.012), being seen as “doctor” in community (p = 0.003), job aids (p = 0.009), training location (p = 0.001), and supervision by community (p < 0.001). To increase and maintain the work performance of CHVs, commitment from the government, policy makers, stakeholders, and the communities is required. PMID:28286530
The Trump Administration's recent attempts to repeal the Affordable Care Act have reignited long-running debates surrounding the nature of justice in health care provision, the extent of our obligations to others, and the most effective ways of funding and delivering quality health care. In this article, I respond to arguments that individualist systems of health care provision deliver higher-quality health care and promote liberty more effectively than the cooperative, solidaristic approaches that characterize health care provision in most wealthy countries apart from the United States. I argue that these claims are mistaken and suggest one way of rejecting the implied criticisms of solidaristic practices in health care provision they represent. This defence of solidarity is phrased in terms of the advantages solidaristic approaches to health care provision have over individualist alternatives in promoting certain important personal liberties, and delivering high-quality, affordable health care. © 2018 John Wiley & Sons Ltd.
Chen, P C
The definition of primary health care is basically the same, but the wide variety of concepts as to the form and type of worker required is largely due to variations in economic, demographic, socio-cultural and political factors. Whatever form it takes, in many parts of the developing world, it is increasingly clear that primary health care must be provided by non-physicians. The reasons for this trend are compelling, yet it is surprisingly opposed by the medical profession in many a developing country. Nonetheless, numerous field trials are being conducted in a variety of situations in several countries around the world. Non-physician primary health care workers vary from medical assistants and nurse practitioners to aide-level workers called village mobilizers, village volunteers, village aides and a variety of other names. The functions, limitations and training of such workers will need to be defined, so that an optimal combination of skills, knowledge and attitudes best suited to produce the desired effect on local health problems may be attained. The supervision of such workers by the physician and other health professionals will need to be developed in the spirit of the health team. An example of the use of non-physicians in providing primary health care in Sarawak is outlined.
Zvárová, Jana; Hanzlíček, Petr
Roč. 13, č. 5 (2005), s. 451-452 ISSN 0928-7329. [MedNet 2005. World Congress on the Internet in Medicine /10./. 04.12.2005-07.12.2005, Prague] R&D Projects: GA AV ČR 1ET200300413 Institutional research plan: CEZ:AV0Z10300504 Keywords : Internet * health care * technology Subject RIV: BD - Theory of Information
Mendoza del Pino, Mario Valentín
The book O ncology in the primary health care , constitutes an important contribution to the prevention and treatment of cancer, from a very comprehensive assessment. It's a disease that is the second leading cause of death in our country, to much pain and suffering is for the patient and their family. The book has a very useful for basic health equipment approach, since it emphasizes that cancer can be prevented if achieved in the population changes in lifestyle. The book is valued not correct food as responsible for one third of all cancers. Currently important research being developed in relation to psiconeuroinmuno-Endocrinology, who is studying the association between psychological factors and the development of cancer valuing that kept stress and depression reduces the antitumor activity of the immune system; that made programs with encouraging results where the treatment of cancer has joined elements of psychotherapy, immunotherapy and the use of the biotherapy. The focus of the book fills an important place in the primary health care and is an indispensable guide for professionals at this level of care (author)
Dickson, Murray; Dickson, Geraldine Gerri
Volunteering internationally appeals to health care professionals and students for a variety of reasons and serves a number of purposes. If international voluntarism is to be mutually advantageous, however, host countries, volunteers and project sponsors need to understand how best they can work together and what can be achieved by volunteers for the greatest benefit of all concerned. This paper is intended to contribute to the growing dialogue on international voluntarism and offers suggestions to strengthen its value, from the perspectives of health workers in a developing country and the authors" experiences over the past 30 years. The paper also identifies undesirable side effects and disabling interventions of international initiatives and examines the notions of aid and assistance. One strategy to prepare volunteers for upcoming international efforts as well as to address inequities at home is involvement with underserved populations in our own country.
Tillson, Esther; van Wees, Sibylle Herzig; McGowan, Charlotte; Franklin, Hannah; Jones, Helena; Bogue, Patrick; Aliabadi, Shirin; Baraitser, Paula
Capacity building partnerships between healthcare institutions have the potential to benefit both partners particularly in staff development. Previous research suggests that volunteering can contribute to professional development but there is little evidence on how learning is acquired, the barriers and facilitators to learning in this context or the process of translation of learning to the home environment. Volunteers from a healthcare partnership between the UK and Somaliland reported learning in communication, interdisciplinary working, teaching, management, leadership and service development. This learning came from observing familiar practices in unfamiliar environments; alternative solutions to familiar problems; learning about Somali culture; opportunities to assume higher levels of responsibility and new professional relationships. There was variability in the extent of translation to NHS practice. Time and support available for reflection and mentoring were important facilitators of this process. The professional development outcomes documented in this study came directly from the experience of volunteering. Experiential learning theory suggests that this requires a complex process of critical reflection and new knowledge generation, testing and translation for use in new contexts. This process benefits from identification of learning as an important element of volunteering and support for reflection and the translation translation of learning to UK contexts. We suggest that missed opportunities for volunteer learning will remain until the volunteering process is overtly framed as part of continuing professional development.
Women health workers have made great contributions to the health of their community for many years. In India, women physicians have established some hospitals, e.g., Christian Medical Colleges in Ludhiana and Vellore. Some such hospitals operate in remote areas to serve the poor and the suffering. Women health workers of Jamkhed, Deen Bandhu of Pachod, have proved that village women can improve the health status of their community, particularly that of women and children, if they receive encouragement to learn health care skills In India, community health care lies mainly with women (e.g., nursing personnel and in rural areas). Yet, despite their competence and experience, few become physicians, health project directors, and administrators because the society continues to be patriarchal and discriminates against females. Women need to become empowered to ensure equal opportunities for training and promotion and equal wages for equal work. In Bangladesh, use of bicycles to visit houses allows women paramedical workers from Gonasasthya Kendra, Sawar, freedom and imparts confidence. People must identify customs, practices, laws, attitudes, religious misrepresentations, and policies that discriminate against women and then oppose them. They should set these changes in motion at home, in villages, and from district to national, and even global levels. In India, society blames the mother for having a girl, but the man donates the chromosome determining sex. In Gandhigram, a woman physician and her peers have effected an apparent change in attitude toward the birth of a girl. Now the people confer equal happiness to her birth as they do to a boy's birth. Yet, female infanticides still occur in some villages of Salem District of Tamil Nadu. Sex determination tests often lead to abortion of female fetuses. Once a woman marries she has no right to her maternal home and often suffers from domestic violence. Many people resist legislation to grant women more rights, e
Dwinnells, Ronald; Misik, Lauren
Efficient and effective integration of behavioral health programs in a community health care practice emphasizes patient-centered medical home principles to improve quality of care. A prospective, 3-period, interrupted time series study was used to explore which of 3 different integrative behavioral health care screening and management processes were the most efficient and effective in prompting behavioral health screening, identification, interventions, and referrals in a community health practice. A total of 99.5% ( P < .001) of medical patients completed behavioral health screenings; brief intervention rates nearly doubled to 83% ( P < .001) and 100% ( P < .001) of identified at-risk patients had referrals made using a combination of electronic tablets, electronic medical record, and behavioral health care coordination.
Gould, Stephen J.
Questionnaires returned by 343 out of 350 subjects measured health attitudes and health status. Results suggest that some consumers take a more scientific approach to health care and prevention. Demographic factors, health status, and health consciousness are partial predictors of consumer attitudes and approach to health care. (SK)
Corder, K T; Phoon, J; Barter, M
Health care reform is a complex issue involving many key sectors including providers, consumers, insurers, employers, and the government. System changes must involve all sectors for reform to be effective. Each sector has a responsibility to understand not only its own role in the health care system, but the roles of others as well. The role of business employers is often not apparent to health care providers, especially nurses. Understanding the influence employers have on the health care system is vital if providers want to be proactive change agents ensuring quality care.
Morris, G Scott
The Church Health Center (CHC) in Memphis was founded in 1987 to provide quality, affordable health care for working, uninsured people and their families. With numerous, dedicated financial supporters and health care volunteers, CHC has become the largest faith-based health care organization of its type nationally, serving >61,000 patients. CHC embraces a holistic approach to health by promoting wellness in every dimension of life. It offers on-site services including medical care, dentistry, optometry, counseling, social work, and nutrition and fitness education, to promote wellness in every dimension of life. A 2012 economic analysis estimated that a $1 contribution to the CHC provided roughly $8 in health services. The CHC has trained >1200 Congregational Health Promoters to be health leaders and is conducting research on the effectiveness of faith community nurses partnering with congregations to assist in home care for patients recently discharged from Memphis hospitals. The MEMPHIS Plan, CHC's employer-sponsored health care plan for small business and the self-employed, offers uninsured people in lower-wage jobs access to quality, affordable health care. The CHC also conducts replications workshops several times a year to share their model with leaders in other communities. The Institute for Healthcare Improvement (IHI) recently completed a case study that concluded: "The CHC is one of a very few organizations successfully embodying all three components of the IHI Triple Aim by improving population health outcomes, enhancing the individual's health care experience, and controlling costs. All three have been part of the Center's DNA since its inception, and as a transforming force in the community, the model is well worth national attention."
Trafford, Zara; Swartz, Alison; Colvin, Christopher J
In this paper, we explore the increasing activity around labor rights for South African community health workers (CHWs). Contextualizing this activity within broader policy and legal developments, we track the emergence of sporadic mobilizations for decent work (supported by local health activist organizations) and subsequently, the formation of a CHW union. The National Union of Care Workers of South Africa (NUCWOSA) was inaugurated in 2016, hoping to secure formal and secure employment through government and the consequent labor and occupational health protections. Various tensions were observed during fieldwork in the run up to NUCWOSA's formation and raise important questions about representation, legitimacy, and hierarchies of power. We close by offering suggestions for future research in this developing space.
Prætorius, Thim; C. Becker, Markus
Understanding how health care organizations can achieve care coordination internally is essential because it is difficult to achieve, but essential for high quality and efficient health care delivery. This article offers an answer by providing a synthesis of knowledge about coordination from...
Jørgensen, Pelle; Wallin, Michael
In most of the developed countries hospitals are facing a major challenge – they have to provide more health care using the same resources. Due to the demographic trend and the increasing share of the population being in a more health-demanding age, the hospitals will have to deal with more...... patients in the future. It is therefore essential that the hospitals are more efficient in order to meet the requirement of providing more health for the same or less resources. Studies have shown that more than 30% of hospital expenditures are related to various logistics cost, making the logistics...... papers presented at scientific conferences, and three articles submitted to scientific journals. In addition to the results, the thesis presents a detailed description of the scientific approach taken, as well as considerations in relation to the scientific approach and the achieved results....
Cutler, David M.
Health care is one of the economy's biggest industries, so it is natural that the health care industry should play some role in the teaching of introductory economics. There are many ways that health care can appear in such a context: in the teaching of microeconomics, as a macroeconomic issue, to learn about social welfare, and even to learn how…
Brink-Muinen, A. van den
Differences are investigated between female practice populations of female general practitioners providing women's health care and of women and men general practitioners providing regular health care. Women's health care in the Netherlands is provided in the general practice "Aletta" and is based
O'Reilly, Dermot; Rosato, Michael; Ferry, Finola; Moriarty, John; Leavy, Gerard
the health impacts of caregiving and volunteering are rarely studied concurrently, despite the potential for both synergies and conflicts. This population-based study examines the association of these activities on health and subsequent mortality. a census-based record-linkage study of 244,429 people aged 65 and over, with cohort characteristics, caregiving and volunteering status, and presence of chronic health conditions derived from the Census returns. Mortality risk was assessed over the following 45 months with adjustment for baseline characteristics. caregivers and volunteers were individually more mobile than those undertaking neither activity; caregivers who also volunteered were more mobile than those who did not volunteer, but no less likely to suffer from poor mental health. Both caregiving and volunteering were separately associated with reduced mortality risk (HR = 0.74: 95% confidence intervals (CIs) = 0.71, 0.77 and HR = 0.76: 0.73, 0.81, respectively); the lowest mortality was found amongst light caregivers who also volunteered (HR = 0.53: 95% CIs = 0.45, 0.62), compared to those engaged in neither. There was no evidence of a multiplicative effect of caregiving and volunteering at more intense levels of caregiving. there is a large overlap in caregiving and volunteering activities with complex associations with health status. There is some evidence that combining caregiving and volunteering activities, for those involved in less intense levels of caregiving, maybe associated with lower mortality risk than associated with either activity alone. Further research is needed to understand which aspects of caregiving and volunteering are best and for whom and in which circumstances. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: email@example.com
K I Mathai
Full Text Available An overview of health care delivery in India is essential, if we are to plan and to improve health care delivery and the indices of health in the coming decades. The health sector in India is a mix of private and government services. While some health care indices appear dismal, several others, including life expectancy are heartening. A balance between regulation and free enterprise is possibly the best option. In this paper we provide a glimpse of health and health related statistics & a n overview of the public health care delivery systems. In the end, we offer suggestion on rationalisation of health care delivery to provide maximum services for the majority of our population within the budget of an optimal health care system outlay
Newbould, Louise; Mountain, Gail; Hawley, Mark; Ariss, Steve
A survey was developed to map provision, knowledge, attitudes and views towards videoconferencing in care homes in Yorkshire and The Humber. The survey was sent to 859 care homes, with a 14% response rate. Twelve homes reported using videoconferencing. Non-users appeared skeptical, managers using the system reported improvements in outcomes.
Wesolowski, C E
Organizations that clearly demonstrate they care about their people reap the benefits of a positive self-image, higher productivity and financial gains. Consider the effects that a demoralized, unappreciated staff have on productivity, recruitment and retention, public relations, marketing, customer satisfaction and the resulting financial repercussions. Can we afford not to care?
What makes a successful volunteer Expert Patients Programme tutor? Factors predicting satisfaction, productivity and intention to continue tutoring of a new public health workforce in the United Kingdom.
Macdonald, Wendy; Kontopantelis, Evangelos; Bower, Peter; Kennedy, Anne; Rogers, Anne; Reeves, David
Better management of chronic conditions is a challenge for public health policy. The Expert Patients Programme was introduced into the United Kingdom to improve self-care in people with long-term conditions. To deliver self-care courses, the programme relies on the recruitment and continued commitment to delivering the courses of volunteer lay tutors who have long-term conditions. Ensuring the tutor workforce is productive, satisfied in their role and retained long-term is central to the viability of the programme. This exploratory study aimed to determine what factors predict productivity, intention to continue tutoring, and satisfaction in a sample of volunteer tutors from the Expert Patients Programme. A cross-sectional survey of 895 tutors was carried out and 518 (58%) responded. The questionnaire was designed to describe the characteristics, productivity, intention to continue tutoring, and satisfaction of tutors. Multiple linear regression analyses were used to examine the determinants of productivity, intention to continue tutoring, and satisfaction, such as patient demographics, attitudes, physical and mental health, mastery and self-esteem. Attitudes relating to personal goals, and better health were significant predictors of satisfaction with the tutor role. Only a small proportion of the variance in productivity was accounted for, and tutors were more likely to be productive when they were single, homeowners, car owners, and had lower scores on the depression scale. Overall satisfaction and personal goals were predictors of intention to continue tutoring. Demographic factors, health measures and attitudes each predicted different aspects of the experience of work conducted by the volunteer tutors. The results should prove useful for planning interventions to enhance the success of this new workforce initiative. Attempts to increase participation in courses by people from deprived backgrounds are likely to be enhanced if tutors come from similar
van der Horst, Mariska; Vickerstaff, Sarah; Lain, David; Clark, Charlotte; Baumberg Geiger, Ben
It is well established that what happens to older people in one domain (like paid work) is likely to be related to what happens in another domain (like family caring or voluntary work). There is, however, limited research on the interplay between multiple activity domains in later careers. Research
These guidelines have been drown up to assist all those involved in the management and maintenance of hospitals and health care establishments. Compliance with this guidance should minimise the risk of pollution occurring. The guidelines are jointly produced by the Environment Agency for England and Wales, the Scottish Environment Protection Agency and the Environment and Heritage Service for Northern Ireland, referred to as the Agency or Agencies. It includes guidelines on site drainage, sewage and waste water disposal, treatment of surface water drainage and waste management
... my condition? Has it been rated by state, consumer, or other groups for its quality of care? ... be both rewarding and demanding. It can change relationships and require families to cope with all aspects ...
Jensen, Olaf Chresten
exposures during life at sea and work place health promotion. SEAHEALTH and some of the shipping companies have already added workplace health promotion to occupational health care programs. The purpose of this article is to reinforce this trend by adding some international perspectives and by providing......Workplace Health Promotion is the combined efforts of employers, employees and society to improve the health and well-being of people at work. Integrated maritime health care can be defined as the total maritime health care function that includes the prevention of health risks from harmful...
Tomkins, Andrew; Duff, Jean; Fitzgibbon, Atallah; Karam, Azza; Mills, Edward J; Munnings, Keith; Smith, Sally; Seshadri, Shreelata Rao; Steinberg, Avraham; Vitillo, Robert; Yugi, Philemon
Differences in religious faith-based viewpoints (controversies) on the sanctity of human life, acceptable behaviour, health-care technologies and health-care services contribute to the widespread variations in health care worldwide. Faith-linked controversies include family planning, child protection (especially child marriage, female genital mutilation, and immunisation), stigma and harm reduction, violence against women, sexual and reproductive health and HIV, gender, end-of-life issues, and faith activities including prayer. Buddhism, Christianity, Hinduism, Islam, Judaism, and traditional beliefs have similarities and differences in their viewpoints. Improved understanding by health-care providers of the heterogeneity of viewpoints, both within and between faiths, and their effect on health care is important for clinical medicine, public-health programmes, and health-care policy. Increased appreciation in faith leaders of the effect of their teachings on health care is also crucial. This Series paper outlines some faith-related controversies, describes how they influence health-care provision and uptake, and identifies opportunities for research and increased interaction between faith leaders and health-care providers to improve health care. Copyright © 2015 Elsevier Ltd. All rights reserved.
Background: data from different studies showed health care behaviour and estimated per capita health care expenditure for the general population, but the specific data for infants at different levels of care are lacking. The objectives of this study were to describe mothers' health service utilization during pregnancy and ...
Sorrell, Jeanne M
Health care was an important issue for both the Obama and McCain election campaigns. Now that Barack Obama is poised to serve as the 44th President of the United States, many health care providers are focused on what Obama's administration will mean for new health care initiatives. This article focuses specifically on aspects of the Obama and Biden health care plan that affects mental health care for older adults.
Bystedt, Maria; Eriksson, Maria; Wilde-Larsson, Bodil
To describe how registered nurses (RNs) perceive delegation to unlicensed personnel (UP) in a municipal healthcare context in Sweden. Within municipal health care RNs often delegate tasks to UP. The latter have practical training, but lack formal competence. Twelve RNs were interviewed and the material was analysed using a phenomenographic approach. Owing to a shortage of RNs, delegation is seen as a prerequisite for a functioning organization. This necessity also involves a number of perceived contradictions in three areas: (1) the work situation of RNs - facilitation and relief vs. lack of control, powerlessness, vagueness regarding responsibility, and resignation; (2) the relationship with unlicensed personnel - stimulation, possibility for mentoring, use of UP competence and the creation of fairness vs. questioning UP competence; and (3) The patients - increase in continuity, quicker treatment, and increased security vs. insecurity (with respect to, for example, the handling of medicine). Registered nurses perceptions of delegation within municipal healthcare involve their own work situation, the UP and the patients. Registered nurses who delegate to UP must be given time for mentoring such that the nursing care is safe care of high quality. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.
U.S. Department of Health & Human Services — The data was derived from the Health Care Information System (HCIS), which contains Medicare Part A (Inpatient, Skilled Nursing Facility, Home Health Agency (Part A...
Császi, L; Kullberg, P
Over the past two decades Hungary has initiated a series of social and economic reforms which have emphasized decentralization of control and the reintroduction of market mechanisms into the socialized economy. These reforms both reflect and reinforce a changing social structure, in particular the growing influence of upper class special interest groups. Market reforms are an expression of concurrent ideological shifts in Hungarian society. We examined the political significance of three recent proposals to reform health services against the backdrop of broader social and economic changes taking place. The first proposes a bureaucratic reorganization, the second, patient co-payments, and the third, a voucher system. The problems each proposal identifies, as well as the constituency each represents, reveal a trend toward consolidation of class structure in Hungary. Only one of these proposals has any potential to democratize the control and management of the heath care system. Moreover, despite a governmental push toward decentralization, two of these proposals would actually increase centralized bureaucratic control. Two of the reforms incorporate market logic into their arguments, an indication that the philosophical premises of capitalism are re-emerging as an important component of the Hungarian world-view. In Hungary, as well as in other countries, social analysis of proposed health care reforms can effectively illuminate the social and political dynamics of the larger society.
Lousson, J P
EDI is the technique the most frequently used by Chemists to relay their daily orders to their suppliers. Three out of four Chemists in France are computerised using various forms of computer hardware and software. The Health Care organisations propose that Chemists use the EDI to relay to the CETELIC all the items of information concerning their invoicing. This means handing over administrative information identifying the patient, the doctor ... as well as financial and confidential data such as the CIP code of the prescribed and delivered medicine. The law of the 4th January 1993 was instigated to control the rising expenses of the Health Care organisations and it mandates the Caisse Primaire d'Assurance Maladie (the French social security organisations) to retrieve and analyse the information thus gathered from all of the medical professionals involved. However, the accumulation of all these items of computerised information constitutes in effect a confidential medical file on each patient. This raises the following issues: Who does this confidential data belong to? Who should the Chemists give it to? What is to be done with it? Who will be responsible for its analysis in respect of the confidentiality problem? (Another medical professional bound by oath?) And how can we insure against subsequent abuse of this material?
Full Text Available The increasing use of natural rubber latex medical gloves in the last three decades has caused an increase in latex allergy. The majority of risk groups for allergy development include health care workers, workers in the rubber industry, atopic individuals and children with congenital malformations. Three types of pathological reactions can occur in people using latex medical gloves: irritant contact dermatitis, allergic contact dermatitis and immediate hypersensitivity. The latex allergy is caused by constituent components of latex gloves and added powders; there are also numerous latex allergens involved in cross-reactivity between latex and fruits and vegetables, the so-called latex-fruit syndrome. The diagnosis is based on an accurate history of exposure, clinical presentation and confirmatory in vivo and in vitro tests. Prevention is the easiest, most effective and least expensive way to avoid latex allergy. Powder-free latex gloves with reduced levels of proteins and chemicals, and synthetic gloves for allergic workers must be provided in the work environment. There are already many health care institutions around the world where all latex products have been replaced by synthetic material products.
Chenu, Olivier; Vuillerme, Nicolas; Bucki, Marek; Diot, Bruno; Cannard, Francis; Payan, Yohan
This paper introduces the recently developed TexiCare device that aims at preventing pressure ulcers for people with spinal cord injury. This embedded device is aimed to be mounted on the user wheelchair. Its sensor is 100% textile and allows the measurement of pressures at the interface between the cushion and the buttocks. It is comfortable, washable and low cost. It is connected to a cigarette-box sized unit that (i) measures the pressures in real time, (ii) estimates the risk for internal over-strains, and (iii) alerts the wheelchair user whenever necessary. The alert method has been defined as a result of a utility/usability/acceptability study conducted with representative end users. It is based on a tactile-visual feedback (via a watch or a smartphone for example): the tactile modality is used to discreetly alarm the person while the visual modality conveys an informative message. In order to evaluate the usability of the TexiCare device, a paraplegic volunteer equipped his wheelchair at home during a six months period. Interestingly, the first results revealed bad habits such as an inadequate posture when watching TV, rare relief maneuvers, and the occurrence of abnormal high pressures. Copyright © 2013 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.
Ngunyulu, R N; Peu, M D; Mulaudzi, F M; Mataboge, M L S; Phiri, S S
Collaborative HIV care between the nurses and traditional health practitioners is an important strategy to improve health care of people living with HIV. To explore and describe the views of nurses regarding collaborative HIV care in primary healthcare services in the City of Tshwane, South Africa. A qualitative, descriptive design was used to explore and describe the views of nurses who met the study's inclusion criteria. In-depth individual interviews were conducted to collect data from purposively selected nurses. Content analysis was used to analyse data. Two main categories were developed during the data analysis stage. The views of nurses and health system challenges regarding collaborative HIV care. The study findings revealed that there was inadequate collaborative HIV care between the nurses and the traditional health practitioners. It is evident that there is inadequate policy implementation, monitoring and evaluation regarding collaboration in HIV care. The study findings might influence policymakers to consider the importance of collaborative HIV care, and improve the quality of care by strengthening the referral system and follow-up of people living with HIV and AIDS, as a result the health outcomes as implied in the Sustainable Development Goals 2030 might be improved. Training and involvement of traditional health practitioners in the nursing and health policy should be considered to enhance and build a trustworthy working relationship between the nurses and the traditional health practitioners in HIV care. © 2017 International Council of Nurses.
Widmer, Geraldine; And Others
Findings from a study of home care services in one New York district document the value and relatively modest costs of home health care for the chronically ill and dependent elderly. Professional nurses coordinated the care, but most of the direct services were provided by home health aides and housekeepers. (MF)
Full Text Available
Background: oral health is an important aspect of well-being. In Italy immigrants can have different access to health care services, and can opt for the national Health Service (nHS and/ or private non- profit health care organizations. The purpose of this study was to develop an instrument to evaluate oral health in the immigrant population of rome and to investigate the differences between two different types of ser- vices: the First observation unit at the department of oral and Maxillo Facial Sciences, at the "Sapienza" university of rome (a nHS affiliate, and a charitable organization, the caritas dental center (cdc.
Methods: a multiple-choice questionnaire was administered between the last trimester of 2006 and the first trimester of 2007. a chi square analysis was performed and the level of significance was set at p<0.05. reSulTS: The sample was composed of 250 people, of which 100 were patients of the cdc and 150 were patients of the nHS. The percentage of non-Italians was 80% (n=80 in the cdc sample, and only 16% (n=25 in the nHS sample. In the cdc, definitive resolving therapies, such as tooth extractions, prevailed (60% v’s 47% nHS; p=0.033. In addition, the frequency of consumption of sugary foods and drinks was significantly higher among cdc patients (31% reported to consume these over 9 times a day compared to nHS patients (11% reporting this consumption.
Discussion: the study shows a substantial under using of the national Health Service for oral health care needs by the immigrant population. The particular composition of the sample, with a high prevalence being of romanian nationality, might reflect specific conditions of this nationality. The results showed that immigrants were satisfied with the health care even though they encountered difficulties in terms of level of communication.
Dulin, Patrick L; Gavala, Jhanitra; Stephens, Christine; Kostick, Marylynne; McDonald, Jennifer
This study sought to understand the relationship between volunteer activity and happiness among a sample of older adult New Zealanders. It specifically sought to determine if ethnicity (Māori vs. non-Māori) and economic living standards (ELS) functioned as moderators of the relationship between volunteering and happiness. Data were garnered from the 2008 administration of the New Zealand Health, Work, and Retirement Longitudinal Study. Correlational and multiple regression procedures were employed to examine study hypotheses. Results from multiple regression analyses showed that the amount of volunteering per week was a unique predictor of the overall level of happiness. Moderation analyses indicated that ethnicity did not function as a moderator of the relationship between volunteering and happiness, but ELS did. Those with low ELS evidenced a stronger relationship between volunteering and happiness than those with high ELS. Results also indicated that Maori and those with low ELS volunteered more frequently than non-Māori and those with high ELS. This study provides evidence that volunteering is related to increased happiness, irrespective of ethnicity. It also provides further evidence that the relationship between volunteering and happiness is moderated by economic resources. Older individuals at the low end of the economic spectrum are likely to benefit more from volunteering than those at the high end.
Full Text Available The incentives of health care expenditure (HCE have been a topic of discussion in the USA (Obama reforms and in Europe (adjustment to debt crisis. There are competing views of institutional versus GDP (unit income elasticity and productivity related factors of growth of expenditure. However ageing of populations, technology change and economic incentives related to institutions are also key drivers of growth according to the OECD and EU’s AWG committee. Simulation models have been developed to forecast the growth of social expenditure (including HCEs to 2050. In this article we take a historical perspective to look at the institutional structures and their relationship to HCE growth. When controlling for age structure, price developments, doctor density and in-patient and public shares of expenditures, we find that fee-for-service in primary care, is according to the results, in at least 20 percent more costly than capitation or salary remuneration. Capitation and salary (or wage remuneration are at same cost levels in primary care. However we did not find the cost lowering effect for gatekeeping which could have been expected based on previous literature. Global budgeting 30 (partly DRG based percent less costly in specialized care than other reimbursement schemes like open contracting or volume based reimbursement. However the public integration of purchaser and provider cost seems to result to about 20 higher than public reimbursement or public contracting. Increasing the number of doctors or public financing share results in increased HCEs. Therefore expanding public reimbursement share of health services seems to lead to higher HCE. On the contrary, the in-patient share reduced expenditures. Compared to the previous literature, the finding on institutional dummies is in line with similar modeling papers. However the results for public expansion of services is a contrary one to previous works on the subject. The median lag length of
Trajkovski, Suza; Schmied, Virginia; Vickers, Margaret; Jackson, Debra
Amid tremendous changes in contemporary health care stimulated by shifts in social, economic and political environments, health care managers are challenged to provide new structures and processes to continually improve health service delivery. The general public and the media are becoming less tolerant of poor levels of health care, and health care professionals need to be involved and supported to bring about positive change in health care. Appreciative inquiry (AI) is a philosophy and method for promoting transformational change, shifting from a traditional problem-based orientation to a more strength-based approach to change, that focuses on affirmation, appreciation and positive dialog. This paper discusses how an innovative participatory approach such as AI may be used to promote workforce engagement and organizational learning, and facilitate positive organizational change in a health care context.
Vareilles, Gaëlle; Pommier, Jeanine; Kane, Sumit; Pictet, Gabriel; Marchal, Bruno
Introduction The recruitment of community health volunteers to support the delivery of health programmes is a well-established approach in many countries, particularly where health services are not readily available. However, studies on management of volunteers are scarce and current research on human resource management of volunteers faces methodological challenges. This paper presents the protocol of a realist evaluation that aims at identifying the factors influencing the performance of community health volunteers involved in the delivery of a Red Cross immunisation programme in Kampala (Uganda) with a specific focus on motivation. Methods and analysis The realist evaluation cycle structures the protocol. To develop the theoretical basis for the evaluation, the authors conducted interviews and reviewed the literature on community health volunteers’ performance, management and organisational behaviour. This led to the formulation of the initial programme theory, which links the intervention inputs (capacity-building strategies) to the expected outcomes (positive work behaviour) with mechanisms that point in the direction of drivers of motivation. The contextual elements include components such as organisational culture, resource availability, etc. A case study design will be adopted. We define a case as a Red Cross branch, run by a programme manager, and will select two cases at the district level in Kampala. Mixed methods will be used in data collection, including individual interviews of volunteers, participant observation and document review. The thematic analysis will be based on the initial programme theory and will seek for context-mechanism-outcome configurations. Findings from the two cases will be compared. Discussion We discuss the scope for applying realist evaluation and the methodological challenges we encountered in developing this protocol. Ethics and dissemination The study was approved by the Ethical Committee at Rennes University Hospital
Stöver, Heino; Wolff, Hans
Despite the dissemination of principles of medical ethics in prisons, formulated and advocated by numerous international organizations, health care professionals in prisons all over the world continue to infringe these principles because of perceived or real dual loyalty to patients and prison authorities. Health care professionals and nonmedical prison staff need greater awareness of and training in medical ethics and prisoner human rights. All parties should accept integration of prison health services with public health services. Health care workers in prison should act exclusively as caregivers, and medical tasks required by the prosecution, court, or security system should be carried out by medical professionals not involved in the care of prisoners. PMID:22390510
Gawaine Powell Davies
Full Text Available Introduction: To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Description of policy: Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Discussion: Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.
Davies, Gawaine Powell; Perkins, David; McDonald, Julie; Williams, Anna
To fulfil its role of coordinating health care, primary health care needs to be well integrated, internally and with other health and related services. In Australia, primary health care services are divided between public and private sectors, are responsible to different levels of government and work under a variety of funding arrangements, with no overarching policy to provide a common frame of reference for their activities. Over the past decade, coordination of service provision has been improved by changes to the funding of private medical and allied health services for chronic conditions, by the development in some states of voluntary networks of services and by local initiatives, although these have had little impact on coordination of planning. Integrated primary health care centres are being established nationally and in some states, but these are too recent for their impact to be assessed. Reforms being considered by the federal government include bringing primary health care under one level of government with a national primary health care policy, establishing regional organisations to coordinate health planning, trialling voluntary registration of patients with general practices and reforming funding systems. If adopted, these could greatly improve integration within primary health care. Careful change management and realistic expectations will be needed. Also other challenges remain, in particular the need for developing a more population and community oriented primary health care.
Youth transitioning out of foster care face significant medical and mental health care needs. Unfortunately, these youth rarely receive the services they need because of lack of health insurance. Through many policies and programs, the federal government has taken steps to support older youth in foster care and those aging out. The Fostering Connections to Success and Increasing Adoptions Act of 2008 (Pub L No. 110-354) requires states to work with youth to develop a transition plan that addresses issues such as health insurance. In addition, beginning in 2014, the Patient Protection and Affordable Care Act of 2010 (Pub L No. 111-148) makes youth aging out of foster care eligible for Medicaid coverage until age 26 years, regardless of income. Pediatricians can support youth aging out of foster care by working collaboratively with the child welfare agency in their state to ensure that the ongoing health needs of transitioning youth are met.
.... The purpose of this study was to assess the imposed inspiratory work of breathing and breathing comfort of nonintubated healthy volunteers breathing spontaneously through three portable ventilators...
Günzel-Jensen, Franziska; Jain, Ajay K.; Kjeldsen, Anne Mette
Management and health care literature is increasingly preoccupied with leadership as a collective social process, and related leadership concepts such as distributed leadership have therefore recently gained momentum. This paper investigates how formal, i.e. transformational, transactional...... and empowering, leadership styles affect employees’ perceived agency in distributed leadership, and whether these associations are mediated by employees’ perceived organizational efficacy. Based on large-scale survey data from a study at one of Scandinavia’s largest public hospitals (N = 1,147), our results show...... that all leadership styles had a significant positive impact on employees’ perceived agency in distributed leadership. Further, organizational efficacy related negatively to employees’ perceived agency in distributed leadership; however a mediatory impact of this on the formal leadership styles...
Ainul Hayati Daud; Hazmimi Kasim
The medical and health care sector in general supplies products and provides services that can be categorized as diagnostic radiology, therapeutic application and nuclear medicine (both, diagnostic and/ or therapeutic). The institutions offer different categories of services. Some provide only one category of service, for example, diagnostic radiology. Others may provide more than one categories, for example, diagnostic nuclear medicine and therapeutic nuclear medicine services. A total of 90 entities comprising 65 public agencies and 34 private companies were selected in this study for this sector. The majority of the entities, 75.6 %, operate in Peninsular Malaysia. The remainders operate in Sabah and Sarawak. The findings of the study on both public agencies and private companies are presented in subsequent sections of this chapter. (author)
... care include strep throat, bladder infection, or a dog bite. You will save both time and money ... health services. www.healthcare.gov/coverage/preventive-care-benefits . Accessed October 18, 2016. U.S. Preventive Services Taskforce ...
Nov 19, 2009 ... Background: The Phelophepa Health Care Train is the only primary healthcare train in the world. Phelophepa is an ... history of caring.3. The Phelophepa .... Skin conditions were, according to the pharmacists, common in the ...
Purpose: To evaluate the impact of educational intervention by health care providers on clinical outcomes in type 2 diabetes patients in a Yemeni health facility. Methods: A prospective, one-group and pre- and post-test design to assess the effects of health care providers' education on clinical patient outcomes was ...
Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes
Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in…
Vingilis, Evelyn; Wade, Terrance; Seeley, Jane
This study, using Andersen's health care utilization model, examined how predisposing characteristics, enabling resources, need, personal health practices, and psychological factors influence health care utilization using a nationally representative, longitudinal sample of Canadian adolescents. Second, this study examined whether this process…
F.T. Schut (Erik)
textabstractFor more than two decades, Dutch health policy has been marked by a search for a suitable market order in health care. Suitable in the sense of maintaining universal access, containing the growth of health care expenditure and improving the technical and allocative efficiency of
Hall, Mark A
National Federation of Independent Business v. Sebelius, the Supreme Court's ruling on the Patient Protection and Affordable Care Act, is a landmark decision - both for constitutional law and for health care law and policy. Others will study its implications for constitutional limits on a range of federal powers beyond health care. This article considers to what extent the decision is also about health care law, properly conceived. Under one view, health care law is the subdiscipline that inquires how courts and government actors take account of the special features of medicine that make legal or policy issues especially problematic - rather than regarding health care delivery and finance more generically, like most any other economic or social enterprise. Viewed this way, the opinions from the Court's conservative justices are mainly about general constitutional law principles. In contrast, Justice Ruth Bader Ginsburg's dissenting opinion for the four more liberal justices is just as much about health care law as it is about constitutional law. Her opinion gives detailed attention to the unique features of health care finance and delivery in order to inform her analysis of constitutional precedents and principles. Thus, the Court's multiple opinions give a vivid depiction of the compelling contrasts between communal versus individualistic conceptions of caring for those in need, and between health care and health insurance as ordinary commodities versus ones that merit special economic, social, and legal status.
Rich, Preston B; Adams, Sasha D
National health care expenditures constitute a continuously expanding component of the US economy. Health care resources are distributed unequally among the population, and geriatric patients are disproportionately represented. Characterizing this group of individuals that accounts for the largest percentage of US health spending may facilitate the introduction of targeted interventions in key high-impact areas. Changing demographics, an increasing incidence of chronic disease and progressive disability, rapid technological advances, and systemic market failures in the health care sector combine to drive cost. A multidisciplinary approach will become increasingly necessary to balance the delicate relationship between our constrained supply and increasing demand. Copyright © 2015 Elsevier Inc. All rights reserved.
Laberge, Maude; Wodchis, Walter P; Barnsley, Jan; Laporte, Audrey
Background The purpose of this study is to analyze the relationship between newly introduced primary care models in Ontario, Canada, and patients? primary care and total health care costs. A specific focus is on the payment mechanisms for primary care physicians, i.e. fee-for-service (FFS), enhanced-FFS, and blended capitation, and whether providers practiced as part of a multidisciplinary team. Methods Utilization data for a one year period was measured using administrative databases for a 1...
Belgrave, L L
Growing awareness of apparent gaps in health care received by women and men raises concern over possible discrimination. This literature review examines this issue for elderly women, whose health care is obtained in a system that also may be permeated with age discrimination. Physicians tend to spend more time with women and older patients, suggesting that discrimination may not be an issue in the physician-patient relationship or may work in favor of older women. However, this may simply reflect elderly women's poorer health. Gender and age disparities in medical treatments received provide a more compelling argument that the health care system is a source of discrimination against older women, who are less likely than others to receive available treatments for cardiac, renal, and other conditions. The history of medical treatment of menopause suggests that stereotypes of older women have been advantageous for segments of the health care system. Finally, in addition to discrimination that has its source within the health care system itself, societal-wide inequities, particularly economic, are extremely detrimental to older women's health care. As we respond to the health care crisis, we must be alert to the potential to rectify those structures and tendencies that can lead to discrimination against women and the aged. Health care reform presents a unique opportunity to ensure health care equity.
Sharan, Alok D; Schroeder, Gregory D; West, Michael E; Vaccaro, Alexander R
As the US health care system transitions toward a value-based system, providers and health care organizations will have to closely scrutinize their current processes of care. To do this, a value chain analysis can be performed to ensure that only the most efficient steps are followed in patient care. Ultimately this will produce a higher quality or equal quality product for less cost by eliminating wasteful steps along the way.
The Vantaa Primary Care Depression Study (PC-VDS) is a naturalistic and prospective cohort study concerning primary care patients with depressive disorders. It forms a collaborative research project between the Department of Mental and Alcohol Research of the National Public Health Institute, and the Primary Health Care Organization of the City of Vantaa. The aim is to obtain a comprehensive view on clinically significant depression in primary care, and to compare depressive patients in prima...
Balarajan, Y; Selvaraj, S; Subramanian, S V
In India, despite improvements in access to health care, inequalities are related to socioeconomic status, geography, and gender, and are compounded by high out-of-pocket expenditures, with more than three-quarters of the increasing financial burden of health care being met by households. Health-care expenditures exacerbate poverty, with about 39 million additional people falling into poverty every year as a result of such expenditures. We identify key challenges for the achievement of equity in service provision, and equity in financing and financial risk protection in India. These challenges include an imbalance in resource allocation, inadequate physical access to high-quality health services and human resources for health, high out-of-pocket health expenditures, inflation in health spending, and behavioural factors that affect the demand for appropriate health care. Use of equity metrics in monitoring, assessment, and strategic planning; investment in development of a rigorous knowledge base of health-systems research; development of a refined equity-focused process of deliberative decision making in health reform; and redefinition of the specific responsibilities and accountabilities of key actors are needed to try to achieve equity in health care in India. The implementation of these principles with strengthened public health and primary-care services will help to ensure a more equitable health care for India's population. Copyright © 2011 Elsevier Ltd. All rights reserved.
Full Text Available Introduction: Western health care is under pressure from growing demands on quality and efficiency. The development and implementation of information technology, IT is a key mean of health care authorities to improve on health care infrastructure. Theory and methods: Against a background of theories on human-computer interaction and IT-mediated communication, different empirical studies of IT implementation in health care are analyzed. The outcome is an analytical discernment between different relations of communication and levels of interaction with IT in health care infrastructure. These relations and levels are synthesized into a framework for identifying tensions and potential problems in the mediation of health care with the IT system. These problems are also known as unexpected adverse consequences, UACs, from IT implementation into clinical health care practices. Results: This paper develops a conceptual framework for addressing transformations of communication and workflow in health care as a result of implementing IT. Conclusion and discussion: The purpose of the conceptual framework is to support the attention to and continuous screening for errors and unintended consequences of IT implementation into health care practices and outcomes.
... Series Urinary Tract Imaging Urodynamic Testing Virtual Colonoscopy Celiac Disease Testing (for Health Care Professionals) Serologic tests for celiac disease provide an effective first step in identifying candidates ...
Vidaeff, Alex C; Kerrigan, Anthony J; Monga, Manju
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.
Thaís Giudice Schultz
Full Text Available Objective: This article describes an experience report that aimed to present perceptions on the care of children with disabilities in the Family Health Strategy (FHS, showing its limits and potentials based on the experience of participation in the program ‘PET-Saúde’. Method: Data were collected from field notes which recorded the monitoring of the care process offered to children with disabilities by the FHS teams. The study was conducted in a health facility in the city of Rio de Janeiro for one year. Results: Content analysis results listed the two main themes that composed the issues of concern for child care in this experience: the coordination of health care and the family and community orientation as the core for child care in the FHS. Conclusion: Despite the weakness in compliance with these categories, which are principles and fundamentals of the FHS, this is a privileged space with regard to care practices for children with disabilities.
Corsello, Giovanni; Ferrara, Pietro; Chiamenti, Gianpietro; Nigri, Luigi; Campanozzi, Angelo; Pettoello-Mantovani, Massimo
Pediatric care in Italy has been based during the last 40 years on the increased awareness of the importance of meeting the psychosocial and developmental needs of children and of the role of families in promoting the health and well-being of their children. The pediatric health care system in Italy is part of the national health system. It is made up of 3 main levels of intervention: first access/primary care, secondary care/hospital care, and tertiary care based on specialty hospital care. This overview will also include a brief report on neonatal care, pediatric preventive health care, health service accreditation programs, and postgraduate training in pediatrics. The quality of the Italian child health care system is now considered to be in serious danger because of the restriction of investments in public health caused both by the 2008 global and national economic crisis and by a reduction of the pediatric workforce as a result of progressively insufficient replacement of specialists in pediatrics. Copyright © 2016 Elsevier Inc. All rights reserved.
Purpose: To evaluate the impact of educational intervention by health care providers on clinical outcomes in type 2 diabetes patients in a Yemeni health facility. Methods: A .... compliance, exercise and diets recommended for diabetes patients.
... for the Obesity Epidemic KENNETH E. WARNER 99 8 Patterns and Causes of Disparities in Health DAVID R. WILLIAMS 115 9 Addressing Racial Inequality in Health Care SARA ROSENBAUM AND JOEL TEITELBAU...
Full Text Available Volunteer workers contribute to many aspects of society. There are volunteer organisations which formally assist in many areas such as health, education, housing, safety and security. Virtual volunteering is less common. Virtual volunteering...
acute care, treatment and rehabilitation as a 72-hour assessment unit in a .... resemble prisons, such as unnecessary bars on windows and one-way glass. ..... model to consider design solutions for other acute mental health care settings.
CARE PRIORITIES - A CASE STUDY. OF NATIONAL ... development of comprehensive primary health care (pHC). The routine ..... on injection safety will be sustainable. On the negative side, ... This is mainly at management level, where time ...
Ossebaard, Hans Cornelis; van Gemert-Pijnen, Julia E.W.C.
The use of information and communication technologies in health and health care could improve healthcare quality in many ways. Today's evidence base demonstrates the (cost-)effectiveness of online education, self-management support and tele-monitoring in several domains of health and care. While new
Landers, Steven; Madigan, Elizabeth; Leff, Bruce; Rosati, Robert J.; McCann, Barbara A.; Hornbake, Rodney; MacMillan, Richard; Jones, Kate; Bowles, Kathryn; Dowding, Dawn; Lee, Teresa; Moorhead, Tracey; Rodriguez, Sally; Breese, Erica
The Future of Home Health project sought to support transformation of home health and home-based care to meet the needs of patients in the evolving U.S. health care system. Interviews with key thought leaders and stakeholders resulted in key themes about the future of home health care. By synthesizing this qualitative research, a literature review, case studies, and the themes from a 2014 Institute of Medicine and National Research Council workshop on “The Future of Home Health Care,” the authors articulate a vision for home-based care and recommend a bold framework for the Medicare-certified home health agency of the future. The authors also identify challenges and recommendations for achievement of this framework. PMID:27746670
Ballou, Kathryn A; Landreneau, Kandace J
The aim of this article is to increase understanding of the mechanisms of the continuation of elite hegemonic control of a highly valued social system--American health care. White, male physicians and administrators achieved control of the health care industry and its workers, including nurses, at the start of the 20th century. Using critical theorists' work on authoritarianism and incorporating gender analysis, the authors describe the health care system from a critical social- psychological perspective. The authors discuss the meaning and presence of authoritarian hierarchy and gender effects in today's health system through a critical analysis of the profession of medicine, the profession of nursing, corporate and bureaucratic health care, and patients or consumers. It is concluded that the social-psychological behavior of the American health care system has profound implications that must be taken into account in any recommendations for change.
Güntert, Bernhard J
The situation in the health care sector is affected by a shortage of public funds on the one hand and, on the other hand, by rapid developments in medicine and nursing with an enormous expansion of both diagnostic and therapeutic possibilities. This and the aging population are generating a steadily increasing demand for health care services. The result is an increased cost consciousness in society calling for more professional management in health care organizations. However, the traditional administration of health care organizations, which is closely aligned with health professionals and production processes, was not able to cope with these dynamics or did so only unsatisfactorily. An improved management would surely lead to an optimization of health care delivery processes and a more effective use of resources. The question, however, is whether the effectiveness of the total system can be improved and whether patients' and society's needs can actually be met by classical management approaches.
Health care organization is not only a technical issue. Ethics gives meaning to the medical profession's declared intent of preserving the health and life of the people while honoring their intelligence, dignity and intimacy. It also induces physicians to apply their knowledge, intellect and skills for the benefit of the patient. In a health care system, it is important that people have insurance coverage for health contingencies and that the quality of the services provided be satisfactory. People tend to judge the medical profession according to the experience they have in their personal encounter with physicians, health care workers, hospitals and clinics. Society and its political leaders must decide upon the particular model that will ensure the right of citizens to a satisfactory health care. Any health care organization not founded on humanitarian and ethical values is doomed tofailure. The strict adherence of physicians to Hippocratic values and to the norms of good clinical practice as well as to an altruistic cooperative attitude will improve the efficiency of the health care sector and reduce its costs. It is incumbent upon society to generate the conditions where by the ethical roots of medical care can be brought to bear upon the workings of the health care system. Every country must strive to provide not only technically efficient medical services, but also the social mechanisms that make possible a humanitarian interaction between professionals and patients where kindness and respect prevail.
, and this is particularly apparent in the South Asian countries, including Nepal. Despite the growing burden and chronic nature of type 2 diabetes, prevention and control of this disease is far from adequate in these settings. One possibility could be through the involvement of community health workers to prevent, diagnose...... and treat type 2 diabetes. We suggest that involving Female Community Health Volunteers (FCHVs) of Nepal offering culturally appropriate health promotion may be the blue print for community-based management programmes tackling type 2 diabetes. We aim to explore the potential role of FCHVs of Nepal...... for diabetes management at community level. It is anticipated that the study can give valuable information regarding effectiveness, acceptability, and feasibility of an innovative way to improve diabetes management in low resource settings....
K. Arrow (Kenneth); A. Auerbach (Alan); J. Bertko (John); L.P. Casalino (Lawrence Peter); F.J. Crosson (Francis); A. Enthoven (Alain); E. Falcone; R.C. Feldman; V.R. Fuchs (Victor); A.M. Garber (Alan); M.R. Gold (Marthe Rachel); D.A. Goldman; G.K. Hadfield (Gillian); M.A. Hall (Mark Ann); R.I. Horwitz (Ralph); M. Hooven; P.D. Jacobson (Peter); T.S. Jost (Timothy Stoltzfus); L.J. Kotlikoff; J. Levin (Jonathan); S. Levine (Sharon); R. Levy; K. Linscott; H.S. Luft; R. Mashal; D. McFadden (Daniel); D. Mechanic (David); D. Meltzer (David); J.P. Newhouse (Joseph); R.G. Noll (Roger); J.B. Pietzsch (Jan Benjamin); P. Pizzo (Philip); R.D. Reischauer (Robert); S. Rosenbaum (Sara); W. Sage (William); L.D. Schaeffer (Leonard Daniel); E. Sheen; B.N. Silber (Bernie Michael); J. Skinner (Jonathan Robert); S.M. Shortell (Stephen); S.O. Thier (Samuel); S. Tunis (Sean); L. Wulsin Jr.; P. Yock (Paul); G.B. Nun; S. Bryan (Stirling); O. Luxenburg (Osnat); W.P.M.M. van de Ven (Wynand); J. Cooper (Jim)
textabstractThe coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a
Dulal, R K
Nepal has entered from its unitary system into a new "Federal Democratic Republic State". The current constitution presents basic health care services as a fundamental right. The Ministry for Health and Population has been providing resources to meet health demands, but managers are wrestling to meet these demands. Persistent disparities between rural and urban and across regions resulted inferior health outcomes, e.g., life expectancy in an urban district like Bhaktapur is 71 years, whereas in the rural district of Mugu it is 44 years. The poor health and poor access to health care in the past systems prompted people to seek a different model. Ultimately, all political parties except one have agreed on federalism. The exact number of federal states that are going to be created is unknown. In federalism, all federated states have to assume certain relationships between the locality, the region, and the nation that apply not only in politics but in health care too. Managing changes in health care organization during the transitional period and after restructuring the unitary Nepal into federal states should be carefully planned. In case, if new system also fails to deliver necessary health care services, the possibility of igniting of dissatisfaction, public unrest and even disintegration cannot be ignored. In order to outline a structure and give life to a health care system under federalism, health care professionals need to engage themselves seriously.
Palley, H A; Feldman, G; Gallner, I; Tysor, M
Because the unemployed and their families are often likely to develop stress-related health problems, ensuring them access to health care is a public health issue. Congressional efforts thus far to legislate health coverage for the unemployed have proposed a system that recognizes people's basic need for coverage but has several limitations.
Ginsburg, Paul B
The U.S. is spending a growing share of the GDP on health care, outpacing other industrialized countries. This synthesis examines why costs are higher in the U.S. and what is driving their growth. Key findings include: health care inefficiency, medical technology and health status (particularly obesity) are the primary drivers of rising U.S. health care costs. Health payer systems that reward inefficiencies and preempt competition have impeded productivity gains in the health care sector. The best evidence indicates medical technology accounts for one-half to two-thirds of spending growth. While medical malpractice insurance and defensive medicine contribute to health costs, they are not large enough factors to significantly contribute to a rise in spending. Research is consistent that demographics will not be a significant factor in driving spending despite the aging baby boomers.
Godderis, Rebecca; Rossiter, Kate
Duty to care has been identified as a pressing ethical issue in contemporary discussions of pandemic preparedness; however, nuanced discussions of this complicated issue are relatively limited. This article presents historical data from the experience of the 1918 influenza pandemic in Brantford, Ontario in Canada, demonstrating that, in the face of an actual pandemic, the particular construction of duty to care as both moral and gendered meant that women were placed at a greater personal risk during this time. Given that women still dominate the front lines of healthcare work, we argue that it is critical for current stakeholders to reflect on how these historical patterns may be replicated in contemporary pandemic planning and response. © 2012 The Authors. Sociology of Health & Illness 2012 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.
Verheij, R.; Barten, D.J.; Hek, K.; Nielen, M.; Prins, M.; Zwaanswijk, M.; Bakker, D. de
Background: As computerisation of primary care facilities is rapidly increasing, a wealth of data is created in routinely recorded electronic health records (EHRs). This data can be used to create a true learning health care system, in which routinely available data are processed and analysed in
Andersen, Kim Normann; Agger Nielsen, Jeppe; Kim, Soonhee
This paper brings forward five propositions on the use of online communication in health care, its potential impacts on efficiency and effectiveness in health care, and which role government should play in moving forward the use of online communication. In the paper, each of the five propositions...
Casparie, A.F.; Sluijs, E.M.; Wagner, C.; Bakker, D.H. de
The implementation of quality systems in Dutch health care was supervised by a national committee during 1990-1995. To monitor the progress of implementation a large survey was conducted in the beginning of 1995. The survey enclosed all subsectors in health care. A postal questionnaire-derived
The past decades have been a time of rapid technological change in health care, but technological change will probably accelerate during the next decade or so. This will bring problems, but it will also present certain opportunities. In particular, the health care system is faced with the need to
Brink-Muinen, A. van den; Bensing, J.M.; Kerssens, J.J.
Objectives: differences were investigated between general practitioners providing women's health care (4 women) and general practitioners providing regular health care (8 women and 8 men). Expectations were formulated on the basis of the principles of women's health care and literature about gender
Karuppan, Corinne M; Karuppan, Muthu
Despite much coverage in the popular press, only anecdotal evidence is available on medical tourists. At first sight, they seemed confined to small and narrowly defined consumer segments: individuals seeking bargains in cosmetic surgery or uninsured and financially distressed individuals in desperate need of medical care. The study reported in this article is the first empirical investigation of the medical tourism consumer market. It provides the demographic profile, motivations, and value perceptions of health care consumers who traveled abroad specifically to receive medical care. The findings suggest a much broader market of educated and savvy health care consumers than previously thought. In the backdrop of the health care reform, the article concludes with implications for health care providers.
Payne, Julianne; Razi, Sima; Emery, Kyle; Quattrone, Westleigh; Tardif-Douglin, Miriam
Health care organizations increasingly employ community health workers (CHWs) to help address growing provider shortages, improve patient outcomes, and increase access to culturally sensitive care among traditionally inaccessible or disenfranchised patient populations. Scholarly interest in CHWs has grown in recent decades, but researchers tend to focus on how CHWs affect patient outcomes rather than whether and how CHWs fit into the existing health care workforce. This paper focuses on the factors that facilitate and impede the integration of the CHWs into health care organizations, and strategies that organizations and their staff develop to overcome barriers to CHW integration. We use qualitative evaluation data from 13 awardees that received Health Care Innovation Awards from the Centers of Medicare and Medicaid Innovation to enhance the quality of health care, improve health outcomes, and reduce the cost of care using programs involving CHWs. We find that organizational capacity, support for CHWs, clarity about health care roles, and clinical workflow drive CHW integration. We conclude with practical recommendations for health care organizations interested in employing CHWs.
Bisantz, Ann M; Fairbanks, Rollin J
Cognitive Engineering for Better Health Care Systems, Ann M. Bisantz, Rollin J. Fairbanks, and Catherine M. BurnsThe Role of Cognitive Engineering in Improving Clinical Decision Support, Anne Miller and Laura MilitelloTeam Cognitive Work Analysis as an Approach for Understanding Teamwork in Health Care, Catherine M. BurnsCognitive Engineering Design of an Emergency Department Information System, Theresa K. Guarrera, Nicolette M. McGeorge, Lindsey N. Clark, David T. LaVergne, Zachary A. Hettinger, Rollin J. Fairbanks, and Ann M. BisantzDisplays for Health Care Teams: A Conceptual Framework and Design Methodology, Avi ParushInformation Modeling for Cognitive Work in a Health Care System, Priyadarshini R. PennathurSupport for ICU Clinician Cognitive Work through CSE, Christopher Nemeth, Shilo Anders, Jeffrey Brown, Anna Grome, Beth Crandall, and Jeremy PamplinMatching Cognitive Aids and the "Real Work" of Health Care in Support of Surgical Microsystem Teamwork, Sarah Henrickson Parker and Shawna J. PerryEngageme...
Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L
Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspectives is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among U.S. Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, they identified several areas for improvement. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. © The Author(s) 2014.
Cloyes, Kristin G; Rosenkranz, Susan J; Wold, Dawn; Berry, Patricia H; Supiano, Katherine P
Some US prisons are meeting the growing need for end-of-life care through inmate volunteer programs, yet knowledge of the motivations of inmate caregivers is underdeveloped. This study explored the motivations of inmate hospice volunteers from across Louisiana State (n = 75) through an open-ended survey, a grounded theory approach to analysis, and comparison of responses by experience level and gender. Participants expressed complex motivations; Inter-related themes on personal growth, social responsibility and ethical service to vulnerable peers suggested that inmate caregivers experience an underlying process of personal and social transformation, from hospice as a source of positive self-identity to peer-caregiving as a foundation for community. Better understanding of inmate caregiver motivations and processes will help prisons devise effective and sustainable end of life peer-care programs. © The Author(s) 2013.
Davis, Alaina M; Brown, Rebekah F; Taylor, Julie Lounds; Epstein, Richard A; McPheeters, Melissa L
Approximately 750,000 children in the United States with special health care needs will transition from pediatric to adult care annually. Fewer than half receive adequate transition care. We had conversations with key informants representing clinicians who provide transition care, pediatric and adult providers of services for individuals with special health care needs, policy experts, and researchers; searched online sources for information about currently available programs and resources; and conducted a literature search to identify research on the effectiveness of transition programs. We identified 25 studies evaluating transition care programs. Most (n = 8) were conducted in populations with diabetes, with a smaller literature (n = 5) on transplant patients. We identified an additional 12 studies on a range of conditions, with no more than 2 studies on the same condition. Common components of care included use of a transition coordinator, a special clinic for young adults in transition, and provision of educational materials. The issue of how to provide transition care for children with special health care needs warrants further attention. Research needs are wide ranging, including both substantive and methodologic concerns. Although there is widespread agreement on the need for adequate transition programs, there is no accepted way to measure transition success. It will be essential to establish consistent goals to build an adequate body of literature to affect practice. Copyright © 2014 by the American Academy of Pediatrics.
Lopes Sauers, Andrea D; Sauers, Eric L; Valier, Alison R Snyder
Quality improvement (QI) is a health care concept that ensures patients receive high-quality (safe, timely, effective, efficient, equitable, patient-centered) and affordable care. Despite its importance, the application of QI in athletic health care has been limited. To describe the need for and define QI in health care, to describe how to measure quality in health care, and to present a QI case in athletic training. As the athletic training profession continues to grow, a widespread engagement in QI efforts is necessary to establish the value of athletic training services for the patients that we serve. A review of the importance of QI in health care, historical perspectives of QI, tools to drive QI efforts, and examples of common QI initiatives is presented to assist clinicians in better understanding the value of QI for advancing athletic health care and the profession. Clinical and Research Advantages: By engaging clinicians in strategies to measure outcomes and improve their patient care services, QI practice can help athletic trainers provide high-quality and affordable care to patients.
Full Text Available At first glance, it doesn't seem as though socialism and health-care reform have a whole lot to do with each other. After all, the most visible "left" position in the current discussion of health-care reform merely advocates for the government to assume the function of national insurer, leaving the delivery of health care - from its often-questionable content to its hierarchical relationships - firmly in place. As such, a single payer, Medicare-for-All insurance program is a modest, even tepid reform. Those of us on the left who have been active in the single payer movement have always seen it as a steppingstone toward health-care justice: until the question of access to care is solved, how do we even begin to address not only health care but also health inequities? How, for example, can working-class Americans, Americans of color, and women demand appropriate, respectful, humane, first-rate care when our ability to access any health-care services at all is so tightly constrained?
Wynia, Matthew K.; Osborn, Chandra Y.
The relationship between limited health literacy and poor health may be due to poor communication quality within health care delivery organizations. We explored the relationship between health literacy status and receiving patient-centered communication in clinics and hospitals serving communication-vulnerable patient populations. Thirteen health care organizations nationwide distributed a survey to 5,929 patients. All patients completed seven items assessing patient-centered communication. One third also completed three items assessing health literacy. The majority of patients had self-reported health literacy challenges, reporting problems learning about their medical condition because of difficulty understanding written information (53%), a lack of confidence in completing medical forms by themselves (61%), and needing someone to help them read hospital/clinic materials (57%). Logistic regression models showed that, after adjustment for patient demographic characteristics and health care organization type, patients with limited health literacy were 28–79% less likely than those with adequate health literacy to report their health care organization “always” provides patient-centered communication across seven communication items. Using a scaled composite of these items, limited health literacy remained associated with lower reported communication quality. These results suggest that improving communication quality in health care organizations might help to address the challenges facing patients with limited health literacy. They also highlight that efforts to address the needs of patients with limited health literacy should be sensitive to the range of communication challenges confronting these patients and their caregivers. PMID:20845197
Full Text Available Education and health care policies in Ghana since independence have been universalist in approach providing free universal health care and free basic and tertiary education until the early 1980s. Precipitated primarily by a severe drought, stagnant economic growth, mismanagement, and political instability, Ghana undertook major economic reforms with prodding from the World Bank and International Monetary Fund in a bid to salvage the economy. These economic measures included cost recovery and cutback spending in education and health sectors. However, in recent years, purposive targeted interventions have been pursued to address inequalities in education and health care. These new programs include the Education Capitation Grant, school feeding program, and the National Health Insurance Scheme (NHIS, which are propelling Ghana toward the achievement of the Millennium Development Goals. The prospects of these programs in addressing disparities in access to education and health care in the country and recommendations for improved delivery are discussed.
Brown, S T
The most common opportunities for nurse anesthetists to be involved in volunteer anesthesia overseas are usually on a surgical team to provide direct care for selected types of patients or to be involved in teaching local anesthesia providers. The challenges are numerous and unique in each setting. Sharing of knowledge, directly as an instructor or indirectly as a provider, provides for a great impact on health care delivery in many emerging nations. The anesthesia provider who is working to deliver care in another country must consider many variables before taking on such a venture. The type of surgical team or teaching assignment one accepts will determine the type of preparation that must be done before departing. In addition to the many organizational items, one should consider some personal issues as well. Lost wages, transportation costs, and lodging expenses are often paid for by the volunteer. Time away from one's family may also be a consideration. Health care, such as updated immunizations, must be attended to before to departure. Volunteers must be able to provide good care in less than ideal situations, and often with much less equipment and medications than are available in the United States. A review of some of the issues that one should consider before deciding to be a volunteer are outlined in this article. The nurse anesthetist who successfully anticipates and deals with the challenges of volunteer anesthesia will be rewarded with an intense degree of personal satisfaction. The ability to give back to the profession and those who would otherwise not have access to one's skills or knowledge produces a sense of accomplishment that is unique.
This study describes health, functioning, and health care service use by medically complex technology-dependent children according to condition severity (moderately disabled, severely disabled, and vegetative state). Data were collected monthly for 5 months using the Pediatric Quality of Life Generic Core Module 4.0 Parent-Proxy Report. Health care service use measured the number of routine and acute care office visits (including primary and specialty physicians), emergency department visits, hospitalizations, nursing health care services, special therapies, medications, medical technology devices (MTDs), and assistive devices. Child physical health was different across the condition severity groups. The average age of the children was 10.1 years (SD, 6.2); the average number of medications used was 5.5 (SD, 3.7); the average number of MTDs used was 4.2 (SD, 2.9); and the average number of assistive devices used was 4.3 (SD, 2.7). Severely disabled and vegetative children were similar in age (older) and had a similar number of medications, MTDs, and assistive devices (greater) than moderately disabled children. The advanced practice nurse care coordinator role is necessary for the health and functioning of medically complex, technology-dependent children. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
An important aspect of allowing patients to take control of their health care is the introduction of new procedures for dealing with complaints. This article examines the concepts that underpin the new Department of Health regulations on complaints management and what they will mean for health and social care professionals. It also explains why these regulations focus on restorative justice rather than blame when adverse events occur.
Despite well-documented links between low health literacy, low rates of health insurance coverage, and poor health outcomes, there has been almost no research on the relationship between low health literacy and self-reported access to care. This study analyzed a large, nationally representative sample of community-dwelling adults ages 50 and older to estimate the relationship between low health literacy and self-reported difficulty obtaining care. We found that individuals with low health literacy were significantly more likely than individuals with adequate health literacy to delay or forego needed care or to report difficulty finding a provider, even after controlling for other factors including health insurance coverage, employment, race/ethnicity, poverty, and general cognitive function. They were also more likely to lack a usual source of care, although this result was only marginally significant after controlling for other factors. The results show that in addition to any obstacles that low health literacy creates within the context of the clinical encounter, low health literacy also reduces the probability that people get in the door of the health care system in a timely way. PMID:27043757
Eriksson, Irene; Lindblad, Monica; Möller, Ulrika; Gillsjö, Catharina
Advanced Practice Nurse (APN) is a fairly new role in the Swedish health care system. To describe patients' experiences of health care provided by an APN in primary health care. An inductive, descriptive qualitative approach with qualitative open-ended interviews was chosen to obtain descriptions from 10 participants regarding their experiences of health care provided by an APN. The data were collected during the spring 2012, and a qualitative approach was used for analyze. The APNs had knowledge and skills to provide safe and secure individual and holistic health care with high quality, and a respectful and flexible approach. The APNs conveyed trust and safety and provided health care that satisfied the patients' needs of accessibility and appropriateness in level of care. The APNs way of providing health care and promoting health seems beneficial in many ways for the patients. The individual and holistic approach that characterizes the health care provided by the APNs is a key aspect in the prevailing change of health care practice. The transfer of care and the increasing number of older adults, often with a variety of complex health problems, call for development of the new role in this context. © 2017 The Authors. International Journal of Nursing Practice Published by John Wiley & Sons Australia, Ltd.
Buerger, Anita M; Clark, Kevin R
To discuss the current and growing use of point-of-care (POC) ultrasound in the management and care of patients. Several electronic research databases were searched to find articles that emphasized the use of POC ultrasound by health care providers who manage and treat critically ill or injured patients. Thirty-five relevant peer-reviewed journal articles were selected for this literature review. Common themes identified in the literature included the use of POC ultrasound in emergency medicine, military medicine, and remote care; comparison of POC ultrasound to other medical imaging modalities; investigation of the education and training required for nonimaging health care professionals who perform POC ultrasound in their practices; and discussion of the financial implications and limitations of POC ultrasound. POC ultrasound provides clinicians with real-time information to better manage and treat critically ill or injured patients in emergency medicine, military medicine, and remote care. In addition to providing immediate bedside diagnostic information, use of POC ultrasound has increased because of concerns regarding radiation protection. Finally, the expansion of POC ultrasound to other specialty areas requires nonimaging health care professionals to perform bedside ultrasound examinations and interpret the resulting images. Because POC ultrasound is user-dependent, adequate training is essential for all who perform and interpret the examinations. Research involving POC ultrasound will continue as innovations and confidence in ultrasound applications advance. Future research should continue to examine the broad use of POC ultrasound in patient care and management. ©2017 American Society of Radiologic Technologists.
Full Text Available The process of collective education in an organization that has the capacity to impact an organization’s operations, performance and outcomes is called organizational learning. In health care organizations, patient care is provided through one or more visible and invisible teams. These teams are composed of experts and novices from diverse backgrounds working together to provide coordinated care. The number of teams involved in providing care and the possibility of breakdowns in communication and coordinated care increases in direct proportion to sophisticated technology and treatment strategies of complex disease processes. Safe patient care is facilitated by individual professional learning; inter-professional team learning and system based organizational learning, which encompass modified context specific learning by multiple teams and team members in a health care organization. Organizational learning in health care systems is central to managing the learning requirements in complex interconnected dynamic systems where all have to know common background knowledge along with shared meta-knowledge of roles and responsibilities to execute their assigned functions, communicate and transfer the flow of pertinent information and collectively provide safe patient care. Organizational learning in health care is not a onetime intervention, but a continuing organizational phenomenon that occurs through formal and informal learning which has reciprocal association with organizational change. As such, organizational changes elicit organizational learning and organizational learning implements new knowledge and practices to create organizational changes.
2Department of Community Medicine & Primary Care, Faculty of Clinical Sciences, ... It may result from road traffic accident, near saving basic principles in emergency care that even drowning, electric ... (4.3%) at place of work, 8 (11.4%) at.
Balarajan, Yarlini; Selvaraj, S; Subramanian, S V
India’s health system faces the ongoing challenge of responding to the needs of the most disadvantaged members of Indian society. Despite progress in improving access to health care, inequalities by socioeconomic status, geography and gender continue to persist. This is compounded by high out-of-pocket expenditures, with the rising financial burden of health care falling overwhelming on private households, which account for more than three-quarter of health spending in India. Health expenditures are responsible for more than half of Indian households falling into poverty; the impact of this has been increasing pushing around 39 million Indians into poverty each year. In this paper, we identify key challenges to equity in service delivery, and equity in financing and financial risk protection in India. These include imbalanced resource allocation, limited physical access to quality health services and inadequate human resources for health; high out-of-pocket health expenditures, health spending inflation, and behavioral factors that affect the demand for appropriate health care. Complementing other paper in this Series, we argue for the application of certain principles in the pursuit of equity in health care in India. These are the adoption of equity metrics in monitoring, evaluation and strategic planning, investment in developing a rigorous knowledge-base of health systems research; development of more equity-focused process of deliberative decision-making in health reform, and redefinition of the specific responsibilities and accountabilities of key actors. The implementation of these principles, together with strengthening of public health and primary care services, provide an approach for ensuring more equitable health care for India’s population. PMID:21227492
Sanders, Scott R; Erickson, Lance D; Call, Vaughn R A; McKnight, Matthew L; Hedges, Dawson W
(1) To assess the prevalence of rural primary care physician (PCP) bypass, a behavior in which residents travel farther than necessary to obtain health care, (2) To examine the role of community and non-health-care-related characteristics on bypass behavior, and (3) To analyze spatial bypass patterns to determine which rural communities are most affected by bypass. Data came from the Montana Health Matters survey, which gathered self-reported information from Montana residents on their health care utilization, satisfaction with health care services, and community and demographic characteristics. Logistic regression and spatial analysis were used to examine the probability and spatial patterns of bypass. Overall, 39% of respondents bypass local health care. Similar to previous studies, dissatisfaction with local health care was found to increase the likelihood of bypass. Dissatisfaction with local shopping also increases the likelihood of bypass, while the number of friends in a community, and commonality with community reduce the likelihood of bypass. Other significant factors associated with bypass include age, income, health, and living in a highly rural community or one with high commuting flows. Our results suggest that outshopping theory, in which patients bundle services and shopping for added convenience, extends to primary health care selection. This implies that rural health care selection is multifaceted, and that in addition to perceived satisfaction with local health care, the quality of local shopping and levels of community attachment also influence bypass behavior. © 2014 National Rural Health Association.
information on mental health care outcome, to do a cost analysis and to establish a quality assurance cycle that may facilitate a cost ... clinical record reviews of mental health service delivery, training ... (d) describe the demographic and clinical profile of HIV positive ..... accommodate the differentiated but integrated care of.
Objective: This is the third of three reports on the follow-up review of mental health care at Helen Joseph Hospital (HJH). The study reviewed existing South African standards for mental health care facilities. Architectural principles and implications for the use of space were deducted from recent legislation. Objectives were to ...
Objective: This is the first of three reports on a follow-up review of mental health care at Helen Joseph Hospital (HJH). In this first part, qualitative and quantitative descriptions were made of the services and of demographic and clinical data on acute mental health care users managed at HJH, in a retrospective review of ...
Segouin, C; Thayer, C
In 1996, the French government introduced a wide-ranging health care reform which aimed to resolve the problems of rising health expenditure and a levelling off in health sector income. Changes in the regulation of the health care system sought to strengthen quality while improving professional practice. At the same time the changes were intended to encourage greater synergy both between professionals and between the different parts of the system, thus promoting greater cost-effectiveness. The tools designed to achieve these results included: the creation of new regional hospital agencies, the introduction of cash-limited budgets at national and regional level, the launching of a contracting procedure between health authorities and hospitals and the setting up of a new health care accreditation agency. With some signs of improvement in the overall health insurance budgetary situation, the Jospin government seems to be supporting the broad lines of the reform introduced by its predecessor.
According to the final consensus of a panel of intense discussions, the health care system should/can not be excluded from the economic laws of efficiency. Appropriate adaptation of various methods and instruments of economics make these tools applicable for use in the health care system. Due to errors in the implementation of economic methods, though, the question arises who is economically responsible in the health care system. The answer is found at three different levels of the health care system. The physician plays a leading role, both personally and professionally, in being primarily responsible for the direct medical treatment of the patient. The physician's dependence, however, on the health care system reduces his independence, which markedly affects his decision-making and treatment. Management of and in health care institutions is largely independent of the profession learned. Managers and physicians acting as managers must be appropriately and duly educated in the necessary specific talents and knowledge. The organisation of a health care system should also be reserved for trained specialists where the physicians as well as other professionals are obliged to acquire the skills necessary.
Tor I. Romøren
Full Text Available Introduction: The Norwegian health care system is well organized within its two main sectors - primary health and long term care on the one hand, and hospitals and specialist services on the other. However, the relation between them lacks mediating structures.Policy practice: Enhancing coordination between primary and secondary health care has been central in Norwegian health care policy the last decade. In 2003 a committee was appointed to identify coordination problems and proposed a lot of practical and organisational recommendations. It relied on an approach challenging primary and secondary health care in shared geographical regions to take action. However, these proposals were not implemented. In 2008 a new Minister of Health and Care worked out plans under the key term "Coordination Reform". These reform plans superseded and expanded the previous policy initiatives concerning cooperation, but represented also a shift in focus to a regulative and centralised strategy, including new health legislation, structural reforms and use of economic incentives that are now about to be implemented.Discussion: The article analyses the perspectives and proposals of the previous and the recent reform initiatives in Norway and discusses them in relation to integrated care measures implemented in Denmark and Sweden.
Yau Zakari Lawal
Full Text Available Qualitative health care is a fundamental right of all citizens of a given country. How this health care is delivered depends significantly on the economy, dedication, and quality of the health-care providers and the political will of the government of the country. Health care may be public run or organized by private health-care providers. We can also have an intercalated program where there is public–private partnership. Whichever way this basic fundamental human right is delivered, sustainability, affordability, and accessibility are vital to its success. The Nigerian health-care delivery can be broadly classified into two; the hitherto existing traditional medicine and the modern orthodox medicine which came to our shores with the arrival of the European colonialists. The traditional system is still patronized by most Nigerians and is known by different linguistic terminologies such as the “Wanzami” or Barber in Hausa and the “Babalawo” in Yoruba language. Traditional birth attendants also exist in all communities in Nigeria complemented by herbalist and spiritualists of different shades and callings. It is our aim to give a brief account of our observations on the Nigerian health-care system with a view to correcting the challenges by the government and the public in general.
The question of corporate moral responsibility--of whether it makes sense to hold an organisation corporately morally responsible for its actions, rather than holding responsible the individuals who contributed to that action--has been debated over a number of years in the business ethics literature. However, it has had little attention in the world of health care ethics. Health care in the United Kingdom (UK) is becoming an increasingly corporate responsibility, so the issue is increasingly relevant in the health care context, and it is worth considering whether the specific nature of health care raises special questions around corporate moral responsibility. For instance, corporate responsibility has usually been considered in the context of private corporations, and the organisations of health care in the UK are mainly state bodies. However, there is enough similarity in relevant respects between state organisations and private corporations, for the question of corporate responsibility to be equally applicable. Also, health care is characterised by professions with their own systems of ethical regulation. However, this feature does not seriously diminish the importance of the corporate responsibility issue, and the importance of the latter is enhanced by recent developments. But there is one major area of difference. Health care, as an activity with an intrinsically moral goal, differs importantly from commercial activities that are essentially amoral, in that it narrows the range of opportunities for corporate wrongdoing, and also makes such organisations more difficult to punish.
Full Text Available RQ: Personal excellence of nursing focusing on self-transcendence and achievements is crucial for achieving excellence in health care. The question is whether there is unequal treatment of patients despite high ethical standards placed in health care.Purpose: Professional nurses code is a guide in assessing their ethical performance. People are different amongst each other, but have the same rights in the health system, which should be provided by health care services. The need to overcome inequalities has become a cornerstone of excellence in health care.Method: A small quantitative survey of nurses was conducted in one of the departments in a Slovenian hospital. To analyse the results, we used frequency statistics, Spearman's rank correlation test and chi-square test. Results: Providers of health care services are aware of the importance of ethics in its formation. Professional Code is relatively well known; 8.4 % of the respondents were not sure if they clearly define the principles of respect for equality. Discrimination, caused by providers of health care, is of a less extent. Ethical awareness among health care providers does not affect identification with the profession. The education level ofnursing personnel and the perception of discrimination based on religious affiliation influenced one another. Education has no influence on the perception of discrimination based on other circumstances.Organization: Health care organizations should integrate hygieneethical thinking among its strategic goals. Quality is not only quantifying the data. Personal excellence of health care providers, which is difficult to measure, is the basic building block of organizational excellence and patient satisfaction.Originality: There are not many research studies on perceptionsof discrimination in health care. The article raises the sensitive issue that we should talk more about.Limitations: The survey was conducted on a small sample size. Further research
Molleman, Eric; Broekhuis, Manda; Stoffels, Renee; Jaspers, Frans
Health professionals increasingly face patients with complex health problems and this pressurizes them to cooperate. The authors have analyzed how the complexity of health care problems relates to two types of cooperation: consultation and multidisciplinary teamwork (MTW). Moreover, they have
Durieux-Paillard, S; Dao, M Dominicé; Perron, N Junod
When consulting with migrant patients, general practitioners should pay special attention to the quality of their communication, because language barriers and cultural differences may arise. They must also be aware that life events experienced in the home country, during transit and in the host country can impact negatively on their patients' health, and thus a detailed history must be carefully obtained. Finally, they must be conscious that the migratory policies of the host country can influence the delivery of health care to migrant patients as well as their health status.
J.E.C.M. Aarts (Jos)
textabstractHealth information technology is widely accepted to increase patient safety and reduce medical errors. The widespread implementation makes evident that health information technology has become of a complex sociotechnical system that is health care. Design and implementation may result in
This podcast features teens who urge US health care professionals to talk to teen patients about pregnancy and contraception. Created: 10/11/2011 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Reproductive Health (DRH). Date Released: 10/11/2011.
Kerbl, Reinhold; Ziniel, Georg; Winkler, Petra; Habl, Claudia; Püspök, Rudolf; Waldhauser, Franz
We describe child health care in Austria, a small country in Central Europe with a population of about 9 million inhabitants of whom approximately 1.7 million are children and adolescents under the age of 20 years. For children and adolescents, few health care indicators are available. Pediatric and adolescent health provision, such as overall health provision, follows a complex system with responsibilities shared by the Ministry of Health, 19 social insurance funds, provinces, and other key players. Several institutions are affiliated with or cooperate with the Ministry of Health to assure quality control. The Austrian public health care system is financed through a combination of income-based social insurance payments and taxes. Pediatric primary health care in Austria involves the services of general pediatricians and general practitioners. Secondary care is mostly provided by the 43 children's hospitals; tertiary care is (particularly) provided in 4 state university hospitals and 1 private university hospital. The training program of residents takes 6 years and is completed by a final examination. Every year, this training program is completed by about 60 residents. Copyright © 2016 Elsevier Inc. All rights reserved.
Management Sciences for Health (MSH) defined ... Poor supply chains, weak stock ... pharmacies and patent medicine stores for their ACT supply. ..... Global Health Observatory (GHO); program. ... logistics of supply and distribution is yet to be.
did not statistically affect it. (p>0.05). Conclusion ... and irritability) with concomitant memory .... associated with other health related effects though believe that it will affect the self- image and ego of .... attitude toward andropause among health.
Work Profile of Community Health Extension Workers in Cross. River State and ... reasons. In some countries they were to meet shortages in health manpower. In other ... Life expectancy is 51 years; maternal mortality and workers were ...
Background: Physical exercise is important for good health. Moderate ... Conclusion: Public education is needed to improve physical activity and curb the menace of health ..... Geriatrics 53(10):46-62. ... Recreation Therapy, 2005; 4(1): 21-30.
Background:Community Based Health Insurance Scheme is a social service organized at community level. It is a mutual health ... As part of her corporate social responsibility. Shell in .... Schmidt J. The benefits and challenges of shows the ...
According to the U.S. Food and Drug Administration 'the broad scope of digital health includes categories such as mobile health (mHealth), health information technology (IT), wearable devices, telehealth and telemedicine, and personalised medicine, and is used by providers and other stakeholders in their efforts to reduce inefficiencies, improve access, reduce costs, increase quality, and make medicine more personalised for patients (FDA 2016). More recently, Paul Sonier, a digital health strategist and founder of the Linkedin digital health group with more than 40,000 members, defined digital health as 'the convergence of the digital and genomic revolutions with health, healthcare, living, and society' (storyofdigitalhealth.com 2016). Copyright the Association for Perioperative Practice.
The objective of this contribution is to characterize the functional and institutional features of the German health-care system. This takes place after a short introduction and examination of the ongoing debate on health care in Germany. External funding describes the form of revenue generation. Regarding external funding of the German health care system, one of the favored alternatives in the current debate is the possibility of introducing per capita payments. After a short introduction to the capitation option, focus is on the so-called health fund that is currently debated on and being made ready for implementation in Germany, actually a mixed system of capitation and contributions based on income. On the other hand, internal funding is the method of how different health-care services are purchased or reimbursed. This becomes a rather hot topic in light of new trends for integrated and networked care to patients and different types of budgeting. Another dominating question in the German health-care system is the liberalization of the contractual law, with its "joint and uniform" regulations that have to be loosened for competition gains. After a discussion of the consequences of diagnosis-related groups (DRGs) in Germany, the article is concluded by a note on the political rationality of the current health-care reform for increased competition within the Statutory Health Insurance and its players as exemplified by the health fund. To sum up, it has to be said that the complexity and specific features of how the German system is financed seem to require ongoing reform considerations even after realization of the currently debated health-care reform law which, unfortunately, is dominated by political rationalities rather than objective thoughts.
light, its chances of influencing those it would like bear down on is bound to be minimal. For a health care program to have an effect it must be able to travel or move between practices. Some health care programs successfully accomplish this task. They come to be widely adopted, apparently having...... global relevance, as for example the Chronic Disease Self-Management Program, which has been adopted by countries as diverse as Japan, Australia and Denmark. But how does this happen and which effects does traveling have on a health care program and its place of arrival? This question is the starting...... point for the following text....
Oborn, Eivor; Barrett, Michael; Darzi, Ara
Robots have long captured our imagination and are being used increasingly in health care. In this paper we summarize, organize and criticize the health care robotics literature and highlight how the social and technical elements of robots iteratively influence and redefine each other. We suggest the need for increased emphasis on sociological dimensions of using robots, recognizing how social and work relations are restructured during changes in practice. Further, we propose the usefulness of a 'service logic' in providing insight as to how robots can influence health care innovation. The Royal Society of Medicine Press Ltd 2011.
Cost Utility Analysis (CUA) and Cost Benefit Analysis (CBA) are methods to evaluate allocations of health care resources. Problems are raised for both methods when income taxes do not meet the first best optimum. This paper explores the implications of three ways that taxes may fall short of this ideal. First, taxes may be distortionary. Second, they may be designed and administered without reference to information that is used by providers of health care. Finally, the share of tax revenue that is devoted to health care may be suboptimal. The two methods are amended to account for these factors.
Kennedy, Michael H
This article addresses the use of simulation software to solve administrative problems faced by health care managers. Spreadsheet add-ins, process simulation software, and discrete event simulation software are available at a range of costs and complexity. All use the Monte Carlo method to realistically integrate probability distributions into models of the health care environment. Problems typically addressed by health care simulation modeling are facility planning, resource allocation, staffing, patient flow and wait time, routing and transportation, supply chain management, and process improvement.
Chow, Clara K; Ariyarathna, Nilshan; Islam, Sheikh Mohammed Shariful; Thiagalingam, Aravinda; Redfern, Julie
Mobile health (mHealth) has been defined as medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices and personal digital assistants. Cardiovascular mHealth is, arguably, leading the mHealth space, through innovation, research and implementation, and especially in the areas of prevention, cardiac rehabilitation and education. mHealth includes simple strategies, such as the use of short message service (SMS) or text messages in successful short-term smoking-cessation, weight loss and diabetes management programs. The recent Australian Tobacco, Exercise and Diet Messages (TEXT ME) randomised clinical trial addressed multiple cardiovascular risk factors. mHealth can also involve more complex strategies, such as smart phone applications (apps), global positioning systems (GPS) and Bluetooth technologies. Although many apps could be considered suitable for primary prevention, they are largely unregulated and most are not evidence-based. Some have been well-developed, such as the Food Switch app and an iPhone electrocardiogram (ECG) system. The "explosion" of apps has driven initiatives such as the Mobile Applications Rating Scale (MARS). More recently, the use of sensors to monitor and provide feedback to patients and healthcare providers is being explored. With almost two billion people currently owning a Smartphone, and 50% of adults (globally) predicted to own one by 2018, mHealth provides the prospect of delivering efficient, affordable healthcare services to widespread populations both locally and globally. In particular, it has the potential to reduce socioeconomic disparity and alleviate the burden of cardiovascular disease. There is now a need to rethink traditional health service structures and bioengineering capacity, to ensure mHealth systems are also safe, secure and robust. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of
Taylor, Anna K; Condry, Hannah; Cahill, David
Lesbian, gay, bisexual and transgender (LGBT) patients represent an important proportion of the population. Despite the health inequalities and barriers to health care noted within this group, there is little evidence of LGBT-focused education within medicine, dentistry or nursing. We introduced and evaluated the effect of a half-day teaching session focused on LGBT health care, delivered to year-2 students. Initial informal discussion with year-2 and year-3 students suggested that the awareness of health inequalities other than sexual health was limited, and that students had little awareness of other issues such as gender dysphoria and heterosexism. We therefore targeted these areas when developing the material. There is little evidence of LGBT-focused education within medicine, dentistry or nursing INNOVATION: The session was divided into two sections: a lecture and a workshop. The lecture provided an introduction to issues around legislation, transgender health and health inequalities, whereas the workshops involved a role-play focused on gender dysphoria, followed by small group discussions on topics such as heterosexism and sexual identity. Volunteer peer facilitators, some of whom identified as LGBT, undertook a 2-hour training session to ensure that they were comfortable with both the material and the group facilitation. Students completed a short questionnaire before and after the session. Feedback was gathered from 350 students between 2012 and 2015. Sixty-nine per cent of students rated their competency level higher after the workshop, suggesting that they felt better prepared to consult with LGBT patients. Written comments suggested that the sessions are useful for students in terms of improving awareness of health inequalities and enabling consultation skills practice in an informal environment. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.
Perry, Henry; Morrow, Melanie; Borger, Sarah; Weiss, Jennifer; DeCoster, Mary; Davis, Thomas; Ernst, Pieter
In view of the slow progress being made in reducing maternal and child mortality in many priority countries, new approaches are urgently needed that can be applied in settings with weak health systems and a scarcity of human resources for health. The Care Group approach uses facilitators, who are a lower-level cadre of paid workers, to work with groups of 12 or so volunteers (the Care Group), and each volunteer is responsible for 10-15 households. The volunteers share messages with the mothers of the households to promote important health behaviors and to use key health services. The Care Groups create a multiplying effect, reaching all households in a community at low cost. This article describes the Care Group approach in more detail, its history, and current NGO experience with implementing the approach across more than 28 countries. A companion article also published in this journal summarizes the evidence on the effectiveness of the Care Group approach. An estimated 1.3 million households—almost entirely in rural areas—have been reached using Care Groups, and at least 106,000 volunteers have been trained. The NGOs with experience implementing Care Groups have achieved high population coverage of key health interventions proven to reduce maternal and child deaths. Some of the essential criteria in applying the Care Group approach include: peer-to-peer health promotion (between mothers), selection of volunteers by mothers, limited workload for the volunteers, limited number of volunteers per Care Group, frequent contact between the volunteers and mothers, use of visual teaching tools and participatory behavior change methods, and regular supervision of volunteers. Incorporating Care Groups into ministries of health would help sustain the approach, which would require creating posts for facilitators as well as supervisors. Although not widely known about outside the NGO child survival and food security networks, the Care Group approach deserves broader
Malik, Arunima; Lenzen, Manfred; McAlister, Scott; McGain, Forbes
Carbon footprints stemming from health care have been found to be variable, from 3% of the total national CO 2 equivalent (CO 2 e) emissions in England to 10% of the national CO 2 e emissions in the USA. We aimed to measure the carbon footprint of Australia's health-care system. We did an observational economic input-output lifecycle assessment of Australia's health-care system. All expenditure data were obtained from the 15 sectors of the Australian Institute of Health and Welfare for the financial year 2014-15. The Australian Industrial Ecology Virtual Laboratory (IELab) data were used to obtain CO 2 e emissions per AUS$ spent on health care. In 2014-15 Australia spent $161·6 billion on health care that led to CO 2 e emissions of about 35 772 (68% CI 25 398-46 146) kilotonnes. Australia's total CO 2 e emissions in 2014-15 were 494 930 kilotonnes, thus health care represented 35 772 (7%) of 494 930 kilotonnes total CO 2 e emissions in Australia. The five most important sectors within health care in decreasing order of total CO 2 e emissions were: public hospitals (12 295 [34%] of 35 772 kilotonnes CO 2 e), private hospitals (3635 kilotonnes [10%]), other medications (3347 kilotonnes [9%]), benefit-paid drugs (3257 kilotonnes [9%]), and capital expenditure for buildings (2776 kilotonnes [8%]). The carbon footprint attributed to health care was 7% of Australia's total; with hospitals and pharmaceuticals the major contributors. We quantified Australian carbon footprint attributed to health care and identified health-care sectors that could be ameliorated. Our results suggest the need for carbon-efficient procedures, including greater public health measures, to lower the impact of health-care services on the environment. None. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.
Consuelo Helena Aires de Freitas
Full Text Available Objective: To discuss the practice of mental health care performed by healthcare professionals from the Family Health Strategy in Fortaleza-CE, Brazil. Methods: This is a critical and reflective study conducted in six Basic Health Units in Fortaleza-Ce. The study subjects were 12 health workers of the following professions: doctor, nurse, community health agents and technical and/or nursing assistant. Semi-structured interviews, systematic observationand questionnaire were used for data collection. The empirical analysis was based on an understanding of the discourses through critical hermeneutics. Results: It was evident that the mental health services are developed by some health workers in the ESF, such as, matrix support, relational technologies, home visits and community group therapy. However, there is still deficiency in training/coaching by most professionals in primary care, due to anenduring model of pathological or curative health care. Conclusion: Mental health care is still occasionally held by some workers in primary care. However, some progresses are already present as matrix support, relational technologies in health care, home visits andcommunity therapy.
Vance, Connie; Larson, Elaine
To summarize research on leadership in the health care and business literature and to identify the outcomes of leadership on individuals, groups, and organizations. A computerized search and review of research studies was conducted in the health care and business literature from 1970-1999. Studies were categorized and analyzed according to participants, design, primary topic area, and effects or outcomes of leadership. Most of the health care and business literature on leadership consisted of anecdotal or theoretical discussion. Only 4.4% (n = 290) of 6,628 articles reviewed were data-based. Further, the largest proportion of the research (120/290, 41.4%) was purely descriptive of the demographic characteristics or personality traits of leaders. Other studies showed the influence of leadership on subordinates (27.9%). Only 15 (5.2%) of 290 research articles include correlations of qualities or styles of leadership with measurable outcomes on the recipients of services or positive changes in organizations. Research on leadership in the health care and business literature to date has been primarily descriptive. Although work in the social sciences indicates that leadership styles can have a major influence on performance and outcomes, minimal transfer of this work to the health care system is evident. Limited research on leadership and health care outcomes exists, such as changes in patient care or improvements in organizational outputs. In this era of evidence-based practice, such research, although difficult to conduct, is urgently needed.
Full Text Available The activities of health promotion for the students in health care specialties is organized and managed by the teacher process. During the training communication skills are acquired. It is the time for preparing students for work in counseling and patient education, collecting and providing health information - promotive function in the process of care (1. We assumed that these opportunities could be used in our work with children deprived of parental care. We set a goal to explore experiences, attitudes and ideas about students’ participation in health care in health promotion in the community of children and individuals. The study found that students are aware of the social importance of the knowledge acquired during the training and are convinced of the need to support adolescents to develop a responsible attitude towards their own health.
M.E. Nieboer; A.M. van Hout; Joost van Hoof; Sil Aarts; Eveline Wouters
Perceptions and values of care professionals are critical in successfully implementing technology in health care. The aim of this study was threefold: (1) to explore the main values of health care professionals, (2) to investigate the perceived influence of the technologies regarding these values,
H. Zhang (Hao)
markdownabstractThis dissertation investigates the challenges faced by China around 2010 in two domains – population health and the health care system. Specifically, chapters 2 and 3 are devoted to health challenges, explaining the female health disadvantage in later life and assessing the effect
Noren, J; Kindig, D; Sprenger, A
Native American health care programs face complex and unprecedented challenges resulting from the increased assumption of clinical operations by tribal authorities, shortfalls in Federal funding, modifications in state and Federal health and welfare programs, and intensifying involvement with managed care organizations. These challenges are further complicated by service populations that are increasing at a faster rate than the growth in funding. The authors conducted onsite surveys of 39 Native American health programs in 10 states in order to assess the organizational and management problems they faced. The trend toward transfer of health programs from the Indian Health Service to tribal operation seems likely to continue and accelerate. The survey results indicate that in order for programs to be effective in the long run, they will need to be guided by skilled managers able to adapt to these powerful changes in the health care environment.
Kaiser, L R
Our primary agenda for the 21st Century is the reinvention of America. We must reinvent democracy, capitalism, entrepreneurism, and community. Indeed, we must recreate all of our major social institutions. This includes health care. A design for a new society requires a new design for health care. In fact, health care enjoys a special privilege in this regard. It is the gateway to total societal redesign. Health is the common denominator in any society. If you loose your health you cannot work, you cannot play, you cannot study; and, if you lose it sufficiently, you cannot even pray. Health and well-being create the foundation for all other constructive human endeavors. Therefore, the design of healthy communities is the necessary first step in the redesign of total human habitats. This massive redesign effort will take a century. However, it will be launched in the next few years.
In different health care systems, there are different schemes of organization and principles of financing activities aimed at ensuring the working population health and safety. Regardless of the scheme and the range of health care provided, economists strive for rationalization of costs (including their reduction). This applies to both employers who include workers' health care costs into indirect costs of the market product manufacture and health care institutions, which provide health care services. In practice, new methods of setting costs of workers' health care facilitate regular cost control, acquisition of detailed information about costs, and better adjustment of information to planning and control needs in individual health care institutions. For economic institutions and institutions specialized in workers' health care, a traditional cost-effect calculation focused on setting costs of individual products (services) is useful only if costs are relatively low and the output of simple products is not very high. But when products form aggregates of numerous actions like those involved in occupational medicine services, the method of activity based costing (ABC), representing the process approach, is much more useful. According to this approach costs are attributed to the product according to resources used during different activities involved in its production. The calculation of costs proceeds through allocation of all direct costs for specific processes in a given institution. Indirect costs are settled on the basis of resources used during the implementation of individual tasks involved in the process of making a new product. In this method, so called map of processes/actions consisted in the manufactured product and their interrelations are of particular importance. Advancements in the cost-effect for the management of health care institutions depend on their managerial needs. Current trends in this regard primarily depend on treating all cost reference
Masud, Abdullah Al; Ahmed, Md. Shahoriar; Sultana, Mst. Rebeka; Alam, S. M. Iftekhar; Kabir, Russell; Arafat, S. M. Yasir; Papadopoulos, Konstantinos
Abstract Background: Rohingya refugees are one of the most vulnerable group due to lack of health care system, personal hygiene, shelter, sanitation and violence. Aim: The present study aims to find out the health problems and health care seeking behavior of rohingya refugee peoples, to identify the socio-demographic information for such exposure group in relation to age, sex, occupation, living areas, to explore the patient's physical, emotional, perceptions, attitudes and environmen...
Bauer, M; Bach, A
Managed care, i.e., the integration of health insurance and delivery of care under the direction of one organization, is gaining importance in the USA health market. The initial effects consisted of a decrease in insurance premiums, a very attractive feature for employers. Managed care promises to contain expenditures for health care. Given the shrinking public resources in Germany, managed care seems attractive for the German health system, too. In this review the development of managed care, the principal elements, forms of organisation and practical tools are outlined. The regulation of the delivery of care by means of controlling and financial incentives threatens the autonomy of physicians: the physician must act as a "double agent", caring for the interest for the individual patient and being restricted by the contract with the managed care organisation. Cost containment by managed care was achieved by reducing the fees for physicians and hospitals (and partly by restricting care for patients). Only a fraction of this cost reduction was handed over to the enrollee or employer, and most of the money was returned with profit to the shareholders of the managed care organisations. The preeminent role of primary care physicians as gatekeepers of the health network led to a reduced demand for specialist services in general and for university hospitals and anesthesiologists in particular. The paradigm of managed care, i.e., to guide the patient and the care giver through the health care system in order to achieve cost-effective and high quality care, seems very attractive. The stress on cost minimization by any means in the daily practice of managed care makes it doubtful if managed care should be an option for the German health system, in particular because there are a number of restrictions on it in German law.
In a rapidly changing world of health care information access and patients’ rights, there is limited conceptual infrastructure available to understand how people approach and engage in treatment of medical conditions. The construct of health care empowerment is defined as the process and state of being engaged, informed, collaborative, committed, and tolerant of uncertainty regarding health care. I present a model in which health care empowerment is influenced by an interplay of cultural, social, and environmental factors; personal resources; and intrapersonal factors. The model offers a framework to understand patient and provider roles in facilitating health care empowerment and presents opportunities for investigation into the role of health care empowerment in multiple outcomes across populations and settings, including inquiries into the sources and consequences of health disparities. PMID:21164096
Bednarz, Daniel; Bae, Jaeyong; Pierce, Jessica
Petroleum is used widely in health care—primarily as a transport fuel and feedstock for pharmaceuticals, plastics, and medical supplies—and few substitutes for it are available. This dependence theoretically makes health care vulnerable to petroleum supply shifts, but this vulnerability has not been empirically assessed. We quantify key aspects of petroleum use in health care and explore historical associations between petroleum supply shocks and health care prices. These analyses confirm that petroleum products are intrinsic to modern health care and that petroleum supply shifts can affect health care prices. In anticipation of future supply contractions lasting longer than previous shifts and potentially disrupting health care delivery, we propose an adaptive management approach and outline its application to the example of emergency medical services. PMID:21778473
Recent times are witnessing methods in the various forms of community care for the mentally ill in India. Non-governmental organizations (NGO) play a pivotal role in filling the gap in the existing mental health services in India and the substantial need for these services. Various strategies that have been employed in community care have attempted to utilize existing community resources for implementation. Informal manpower resources incorporated with specialist psychiatric care and integrated with existing health care facilities have been general strategies. While the feasibility and cost-effectiveness of the NGO operated community outreach programs for the mentally ill have been demonstrated, various factors are seen to influence the planning and execution of such programs. This paper elucidates some critical factors that would need to be considered in community mental health care in India.
Fernandes, Ritabelle; Riklon, Sheldon; Langidrik, Justina R; Williams, Shellie N; Kabua, Neiar
Implementation lessons: (1) The development and testing of a culturally appropriate palliative care navigation curriculum for countries facing high cancer and non-communicable diseases burden requires collaboration with the local Ministry of Health. (2) Lay volunteers from non-governmental and faith-based organizations are potential candidates to provide patient navigation services. Copyright © 2014 Elsevier Inc. All rights reserved.
Deb, Partha; Norton, Edward C
Health care expenditures and use are challenging to model because these dependent variables typically have distributions that are skewed with a large mass at zero. In this article, we describe estimation and interpretation of the effects of a natural experiment using two classes of nonlinear statistical models: one for health care expenditures and the other for counts of health care use. We extend prior analyses to test the effect of the ACA's young adult expansion on three different outcomes: total health care expenditures, office-based visits, and emergency department visits. Modeling the outcomes with a two-part or hurdle model, instead of a single-equation model, reveals that the ACA policy increased the number of office-based visits but decreased emergency department visits and overall spending.
Discussions of the economic aspects of health care often blur the distinction ... occupation with the treatment of economic symptoms rather than causes. ..... New York: Basic Books,. 1974. 14. ... Harvard University Press, 1971. 21. Benatar SR.
... of Page What Can Be Done The Federal government is Implementing activities across all government agencies to ... Making Health Care Safer [PSA – 0:60 seconds] Digital Press Kit: CDC Modeling Predicts Growth of Drug- ...
Board on Health Care Services Staff; Institute of Medicine Staff; Institute of Medicine; National Academy of Sciences
...: Insurance and Health Care , explores the myths and realities of who is uninsured, identifies social, economic, and policy factors that contribute to the situation, and describes the likelihood faced...
Reform In Mexico — Silvia Tamez and Nancy Molina ... This book assesses the health care reforms of the past decade in Argentina, Brazil and Mexico. ...... prevention and control of pulmonary tuberculosis; prevention and control of high blood ...
O'Donnell, Owen; van Doorslaer, Eddy; Rannan-Eliya, Ravi P; Somanathan, Aparnaa; Adhikari, Shiva Raj; Akkazieva, Baktygul; Harbianto, Deni; Garg, Charu C; Hanvoravongchai, Piya; Herrin, Alejandro N; Huq, Mohammed N; Ibragimova, Shamsia; Karan, Anup; Kwon, Soon-man; Leung, Gabriel M; Lu, Jui-fen Rachel; Ohkusa, Yasushi; Pande, Badri Raj; Racelis, Rachel; Tin, Keith; Tisayaticom, Kanjana; Trisnantoro, Laksono; Wan, Quan; Yang, Bong-Min; Zhao, Yuxin
We estimate the distributional incidence of health care financing in 13 Asian territories that account for 55% of the Asian population. In all territories, higher-income households contribute more to the financing of health care. The better-off contribute more as a proportion of ability to pay in most low- and lower-middle-income territories. Health care financing is slightly regressive in three high-income economies with universal social insurance. Direct taxation is the most progressive source of finance and is most so in poorer economies. In universal systems, social insurance is proportional to regressive. In high-income economies, the out-of-pocket (OOP) payments are proportional or regressive while in low-income economies the better-off spend relatively more OOP. But in most low-/middle-income countries, the better-off not only pay more, they also get more health care.
the other to the population as cliemele of that system. Recently the ... divides from which inequalities in this sector emanate are those of .... power for private health care, and fewer srill are insured .... Nurses are mainly employed in public sector.
Sonnenwald, Diane H.; Söderholm, Hanna Maurin; Welch, Gregory F.
reported the technology would require additional training, changes to existing financial models used in emergency health care, and increased access to physicians. Conclusions. Teaching collaboration skills and strategies to physicians and paramedics could benefit their collaboration today, and increase...
This 60 second public service announcement is based on the March 2013 CDC Vital Signs report, which discusses lethal infections from carbapenem-resistant Enterobacteriaceae, or CRE, germs and ways health care providers can help stop CRE infections.
This paper is focusing on the legal aspects of communication in health care, especially on doctor-patient relationship, responsibility for information, communication of adverse events, and legal declarations.
... Healthy Living Healthy Living Healthy Living Nutrition Fitness Sports Oral Health Emotional Wellness Growing Healthy Sleep Safety & Prevention Safety & Prevention Safety and Prevention Immunizations ...
Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre
The purpose of this collaborative summary is to document current chiropractic involvement in the public health movement, reflect on social ecological levels of influence as a profession, and summarize the relationship of chiropractic to the current public health topics of: safety, health issues...... disorders? How can chiropractic use cognitive behavioral therapy to address chronic low back pain as a public health problem? What opportunities exist for doctors of chiropractic to more effectively serve the aging population? What is the role of ethics and the contribution of the chiropractic profession...
Villarosa, Amy R; Clark, Sally; Villarosa, Ariana C; Patterson Norrie, Tiffany; Macdonald, Susan; Anlezark, Jennifer; Srinivas, Ravi; George, Ajesh
This study aimed to look at the practices and perspectives of residential aged care facility (RACF) care staff regarding the provision of oral health care in RACFs. Emphasis has been placed on the provision of adequate oral health care in RACFs through the Better Oral Health in Residential Aged Care programme. Endorsed by the Australian government, this programme provided oral health education and training for aged care staff. However, recent evidence suggests that nearly five years after the implementation of this programme, the provision of oral care in RACFs in NSW remains inadequate. This project utilised an exploratory qualitative design which involved a focus group with 12 RACF care staff. Participants were asked to discuss the current oral health practices in their facility, and their perceived barriers to providing oral health care. The key findings demonstrated current oral health practices and challenges among care staff. Most care staff had received oral health training and demonstrated positive attitudes towards providing dental care. However, some participants identified that ongoing and regular training was necessary to inform practice and raise awareness among residents. Organisational constraints and access to dental services also limited provision of dental care while a lack of standardised guidelines created confusion in defining their role as oral healthcare providers in the RACF. This study highlighted the need for research and strategies that focus on capacity building care staff in oral health care and improving access of aged care residents to dental services. © 2018 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.
address inequalities in health care should commence at the root causes .... sion and disrribution, bear in mind rhat rhere are also rhose mecha- nism and .... gle body is evidem in borh nawmal heallh service syscems and socialised heallh care ...
Phillips, Richard C.
Under new "managed health care systems," the classical functional separation of risk taker, claims payor, and provider are vertically integrated into a common entity. This evolution should produce a competitive environment with medical care rendered to all Americans on a more cost-effective basis. (CJH)
AND+third. 15 Ibid. 16 Ibid. 17 32 C.F.R. §199.17(p)(5)(ii) (2005). 18 See http://mytoc.tma.osd.mil/AccessToCare/ TOC /ATC.htm. 19 File name...responsible sexual behavior; mental health; injury and violence; environmental quality; immunization; and access to care.11 Responsibility The Assistant
... for mental disorders is enormous 4. Primary care for mental health enhances access 5. Primary care for mental health promotes respect of human rights 6. Primary care for mental health is affordab...
Reilly, R F; Rabe, J R
Health care entities (and especially medical practices) are valued for a number of reasons: sale transaction pricing and structuring, merger formation and dissolution, taxation and regulatory compliance, and litigation support and dispute resolution. The identification and quantification of the entity's intangible assets are often the most important aspects of the valuation. This article illustrates the generally accepted methods for valuing health care-related intangible assets.
Glennerster, H; Matsaganis, M
England and Sweden have two of the most advanced systems of universal access to health care in the world. Both have begun major reforms based on similar principles. Universal access and finance from taxation are retained, but a measure of competition between providers of health care is introduced. The reforms therefore show a movement toward the kind of approach advocated by some in the United States. This article traces the origins and early results of the two countries' reform efforts.
DeVries, R A
The number and types of multi-institutional arrangements among health care facilities are on the increase, and the days of the completely autonomous, independent hospital are coming to a close. Although by themselves hospital systems are no panacea in dealing with the challenges facing hospitals today, many such arrangements offer more opportunities than problems in coping with the rapid changes currently facing the health care industry. The pros and cons of seven arrangements are discussed in detail.
Sterns, J B
Access to capital will become more difficult. Capital access is dependent on ability to repay debt, which, in turn, is dependent on internally generated cash flows. Under any health care reform proposal, revenue inflows will be slowed. The use of corporate finance techniques to limit financial risk and lower cost will be a permanent response to fundamental changes to the health care system. These changes will result in greater balance sheet management, centralized capital allocation, and alternative sources of capital.
Horne, L Chad
While citizens in a liberal democracy are generally expected to see to their basic needs out of their own income shares, health care is treated differently. Most rich liberal democracies provide their citizens with health care or health care insurance in kind. Is this "special" treatment justified? The predominant liberal account of justice in health care holds that the moral importance of health justifies treating health care as special in this way. I reject this approach and offer an alternative account. Health needs are not more important than other basic needs, but they are more unpredictable. I argue that citizens are owed access to insurance against health risks to provide stability in their future expectations and thus to protect their capacities for self-determination.
Ködmön, József; Csajbók, Zoltán Ernő
Doctors, nurses and other medical professionals are spending more and more time in front of the computer, using applications developed for general practitioners, specialized care, or perhaps an integrated hospital system. The data they handle during healing and patient care are mostly sensitive data and, therefore, their management is strictly regulated. Finding our way in the jungle of laws, regulations and policies is not simple. Notwithstanding, our lack of information does not waive our responsibility. This study summarizes the most important points of international recommendations, standards and legal regulations of the field, as well as giving practical advices for managing medical and patient data securely and in compliance with the current legal regulations.
Steaban, Robin Lea
This article is meant to spur debate on the role of the professional nurse in care coordination as well as the role of nursing leaders for defining and leading to a future state. This work highlights the opportunity and benefits associated with transformation of professional nursing practice in response to the mandates of the Affordable Care Act of 2010. An understanding of core concepts and the work of care coordination are used to propose a model of care coordination based on the population health pyramid. This maximizes the roles of nurses across the continuum as transformational leaders in the patient/family and nursing relationship. The author explores the role of the nurse in a transactional versus transformational relationship with patients, leading to actualization of the nurse in care coordination. Focusing on the role of the nurse leader, the challenges and necessary actions for optimization of the professional nurse role are explored, using principles of transformational leadership.
Peyton, Margit Malmmose
Many studies have been conducted on the issue of New Public Management (NPM) and health care, not always quoting directly the philosophies of NPM, but using methods deriving from it. This study seeks to explore the development of studies on NPM in health care since the 1970s. The following resear...... construction of the governable person” as a theoretical framework, all academic articles from AA journals on the issues of NPM, health care and/or hospitals are analyzed.......Many studies have been conducted on the issue of New Public Management (NPM) and health care, not always quoting directly the philosophies of NPM, but using methods deriving from it. This study seeks to explore the development of studies on NPM in health care since the 1970s. The following research...... questions will be addressed: What types of studies are conducted on NPM in health care and how do these studies relate to the construction of the governable person? What are the changes in these relations and is the acceptance of this nationally dependent? Using Miller and O’Leary’s (1987), “The...
Poole Wilson, Tiffany; Davis, Kermit G
The aim of this study was to assess the contributions of Thomas Waters's work in the field of health care ergonomics and beyond. Waters's research of safe patient handling with a focus on reducing musculoskeletal disorders (MSDs) in health care workers contributed to current studies and prevention strategies. He worked with several groups to share his research and assist in developing safe patient handling guidelines and curriculum for nursing students and health care workers. The citations of articles that were published by Waters in health care ergonomics were evaluated for quality and themes of conclusions. Quality was assessed using the Mixed Methods Appraisal Tool and centrality to original research rating. Themes were documented by the type of population the citing articles were investigating. In total, 266 articles that referenced the top seven cited articles were evaluated. More than 95% of them were rated either medium or high quality. The important themes of these citing articles were as follows: (a) Safe patient handling is effective in reducing MSDs in health care workers. (b) Shift work has negative impact on nurses. (c) There is no safe way to manually lift a patient. (d) Nurse curriculums should contain safe patient handling. The research of Waters has contributed significantly to the health care ergonomics and beyond. His work, in combination with other pioneers in the field, has generated multiple initiatives, such as a standard safe patient-handling curriculum and safe patient-handling programs. © 2016, Human Factors and Ergonomics Society.
Wald, John T; Lowery-Schrandt, Sherri; Hayes, David L; Kotsenas, Amy L
By leveraging its experience and expertise as a consultative clinical partner, the Mayo Clinic developed an innovative, scalable care model to accomplish several strategic goals: (1) create and sustain high-value relationships that benefit patients and providers, (2) foster relationships with like-minded partners to act as a strategy against the development of narrow health care networks, and (3) increase national and international brand awareness of Mayo Clinic. The result was the Mayo Clinic Care Network. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.
demographic and health indicators.1 The data showed a high growth rate in excess of 3% ... an integrated form with all other health care needs including promotive and ... In 1999 the government of Uganda (Ministry of Health) developed a ten .... The usual drug procurement system was strengthened with a special project.
María L. Vecina
Full Text Available In a sample of volunteers, who work, but not for money, and whose managers expect them to remain with the organization over the long term and to feel well by doing good, this study examines the distinctiveness between three concepts, usually related in the work field: Engagement, organizational commitment, and satisfaction. Based on the existing literature, they are related among them and regarding three relevant outcomes for management: Intention to remain, psychological well-being, and perceived physical health. Three structural equations models make it clear that volunteer engagement does contribute to the explanation of organizational commitment, volunteer satisfaction, and psychological well-being. At the same time, it does not seem to account for levels of intention to remain neither perceived physical health. On the contrary, organizational commitment is the only predictor of intention to remain, and volunteer satisfaction is the only predictor of perceived physical health. This last result was not expected, according to the literature on work, but reinforces the distinctiveness between the concepts and may have a plausible explanation in the volunteering field.
Full Text Available Employees of any organization are the most central part so they need to be influenced and persuaded towards task fulfillment. Examinations connected with medical services were carried out using the Servqual method. It was stated that care of employees and their motivation to work is a very important factor regarding employee engagement but also about the overall success of an organization.
these lines: eating together 261/669 (39%), hugging 149/668 (22%), shaking ... Level of education was associated with positive attitudes towards ocular .... the about 250 ethnic groups of Nigeria. ..... ocular cancer are reflection of challenges ... Care: Focus Groups with Older African ... youths in a Nigerian local population.
Kuenburg, Alexa; Fellinger, Paul; Fellinger, Johannes
Access to health care without barriers is a clearly defined right of people with disabilities as stated by the UN Convention on the Rights of People with Disabilities. The present study reviews literature from 2000 to 2015 on access to health care for deaf people and reveals significant challenges in communication with health providers and gaps in global health knowledge for deaf people including those with even higher risk of marginalization. Examples of approaches to improve access to health care, such as providing powerful and visually accessible communication through the use of sign language, the implementation of important communication technologies, and cultural awareness trainings for health professionals are discussed. Programs that raise health knowledge in Deaf communities and models of primary health care centers for deaf people are also presented. Published documents can empower deaf people to realize their right to enjoy the highest attainable standard of health. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
... of care + Share widget - Select to show Whatâs home health care? What's home health care? Home health care is a wide ... or skilled nursing facility (SNF). Examples of skilled home health services include: Wound care for pressure sores ...
The practice of medicine stands at the threshold of a transformation from its current focus on the treatment of disease events to an emphasis on enhancing health, preventing disease and personalizing care to meet each individual's specific health needs. Personalized health care is a new and strategic approach that is driven by personalized health planning empowered by personalized medicine tools, which are facilitated by advances in science and technology. These tools improve the capability to predict health risks, to determine and quantify the dynamics of disease development, and to target therapeutic approaches to the needs of the individual. Personalized health care can be implemented today using currently available technologies and know-how and thereby provide a market for the rational introduction of new personalized medicine tools. The need for early adoption of personalized health care stems from the necessity to reduce the egregious and wasteful burden of preventable chronic diseases, which is not effectively addressed by our current approach to care. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Davidhizar, R; Dowd, S; Newman Giger, J
Cultural diversity is increasing in the United States as increasing numbers of minorities enter the United States from abroad, and cultural diversity is especially prevalent in the health care workplace. In fact, the health care professions are particularly interested in the presence of minorities among caregivers because this often enhances the cultural competence of care delivery. Nevertheless, subtle discrimination can still be found, and managers must be alert that such behavior is not tolerated. Use of the Giger-Davidhizar Cultural Assessment Model can provide managers with information needed to respond to diversity among staff appropriately.
Sharan, Alok D; Schroeder, Gregory D; West, Michael E; Vaccaro, Alexander R
The increasing focus on the costs of care is forcing health care organizations to critically look at their basic set of processes and activities, to determine what type of value they can deliver. A business model describes the resources, processes, and cost assumptions that an organization makes that will lead to the delivery of a unique value proposition to a customer. As health care organizations are beginning to transform their structure in preparation for a value-based delivery system, understanding business model theory can help in the redesign process.
Valdmanis, Vivian; DeNicola, Arianna; Bernet, Patrick
In this paper, we assess the capacity of Florida's public health departments. We achieve this by using bootstrapped data envelopment analysis (DEA) applied to Johansen's definition of capacity utilization. Our purpose in this paper is to measure if there is, theoretically, enough excess capacity available to handle a possible surge in the demand for primary care services especially after the implementation of the Affordable Care Act that includes provisions for expanded public health services. We measure subunit service availability using a comprehensive data source available for all 67 county health departments in the provision of diagnostic care and primary health care. In this research we aim to address two related research questions. First, we structure our analysis so as to fix budgets. This is based on the assumption that State spending on social and health services could be limited, but patient needs are not. Our second research question is that, given the dearth of primary care providers in Florida if budgets are allowed to vary is there enough medical labor to provide care to clients. Using a non-parametric approach, we also apply bootstrapping to the concept of plant capacity which adds to the productivity research. To preview our findings, we report that there exists excess plant capacity for patient treatment and care, but question whether resources may be better suited for more traditional types of public health services.
Nelson, Leonard J; Morrisey, Michael A; Becker, David J
We examine the impact of the Affordable Care Act (ACA) on medical liability and the controversy over whether federal medical reform including a damages cap could make a useful contribution to health care reform. By providing guaranteed access to health care insurance at community rates, the ACA could reduce the problem of under-compensation resulting from damages caps. However, it may also exacerbate the problem of under-claiming in the malpractice system, thereby reducing incentives to invest in loss prevention activities. Shifting losses from liability insurers to health insurers could further undermine the already weak deterrent effect of the medical liability system. Republicans in Congress and physician groups both pushed for the adoption of a federal damages cap as part of health care reform. Physician support for damages caps could be explained by concerns about the insurance cycle and the consequent instability of the market. Our own study presented here suggests that there is greater insurance market stability in states with caps on non-economic damages. Republicans in Congress argued that the enactment of damages caps would reduce aggregate health care costs. The Congressional Budget Office included savings from reduced health care utilization in its estimates of cost savings that would result from the enactment of a federal damages cap. But notwithstanding recent opinions offered by the CBO, it is not clear that caps will significantly reduce health care costs or that any savings will be passed on to consumers. The ACA included funding for state level demonstration projects for promising reforms such as offer and disclosure and health courts, but at this time the benefits of these reforms are also uncertain. There is a need for further studies on these issues.
Journal of Community Medicine and Primary Health Care. ... environmental health, clinical care, health planning and management, health policy, health ... non-communicable diseases within the Primary Health Care system in the Federal ... Assessment of occupational hazards, health problems and safety practices of petrol ...
issues in disaster management in Nigeria among others from a public health perspective and the ..... the supply chain (medical equipment and .... gadgets including use of global positioning ... procurement and logistics, inefficient utilization.
U.S. Department of Health & Human Services — For more than 20 years, the Dartmouth Atlas Project has documented glaring variations in how medical resources are distributed and used in the United States. The...
... any part of the body Hematology -- blood disorders Immunology -- disorders of the immune system Infectious disease -- infections ... Read more NIH MedlinePlus Magazine Read more Health Topics A-Z Read more A.D.A.M., ...
2Shell Petroleum Development Company Nigeria (Sabbatical) ... educating, safety, involvement in construction Nigeria is the lopsided distribution ... low to effectively deliver essential health services ... disabled persons and prison inmates. .... Cottage Hospital and elsewhere during the period. feeling of personal fulfillment.
Jul 31, 2014 ... health problems in communities by providing promotive, preventive, .... determinants so as to evolve ways to solve them. It ... importance of evidence based programming through ..... against the selective PHC concept with its.
Mascarenhas, O A
Providing cost-contained comprehensive quality health care to maintain healthy and productive employees is a challenging problem for all employers. Using a representative panel of metropolitan employees, the author investigates the internal and external structure of employee satisfaction with company-sponsored health care plans. Employee satisfaction is differentiated into four meaningful groups of health care benefits, whereas its external structure is supported by the traditional satisfaction paradigms of expectation-disconfirmation, attribution, and equity. Despite negative disconfirmation, employees register sufficiently high health care satisfaction levels, which suggests some useful strategies that employers may consider implementing.
Williamson, Kathleen M
This exploratory study involved the triangulation of qualitative (interview and observation) and quantitative methods (Psychological Empowerment Instrument). This study examined the individual home care nurses' perception of empowerment and how it influences decisions in the home clinical setting. Fifteen nurses were self-selected to participate. All completed an interview, and were observed and given Likert Instrument to complete. A framework analysis was performed to identify mutually exclusive and exhaustive emergent themes and patterns within the data. Home care nurses described that enpowerment is in the interaction between nurse and patient, and nurse and health care provider. Empowered is defined as being independent, confident, trusting, and comfortable with providing quality care. Home health care nurses believe that having the ability to practice collaboratively and build professional relationships was essential. Nurses in this study perceived empowerment as having meaning, choice, and competence in their job.
Vázquez Navarrete, M Luisa; Vargas Lorenzo, Ingrid; Farré Calpe, Joan; Terraza Núñez, Rebeca
There has been a tendency recently to abandon competition and to introduce policies that promote collaboration between health providers as a means of improving the efficiency of the system and the continuity of care. A number of countries, most notably the United States, have experienced the integration of health care providers to cover the continuum of care of a defined population. Catalonia has witnessed the steady emergence of increasing numbers of integrated health organisations (IHO) but, unlike the United States, studies on health providers' integration are scarce. As part of a research project currently underway, a guide was developed to study Catalan IHOs, based on a classical literature review and the development of a theoretical framework. The guide proposes analysing the IHO's performance in relation to their final objectives of improving the efficiency and continuity of health care by an analysis of the integration type (based on key characteristics); external elements (existence of other suppliers, type of services' payment mechanisms); and internal elements (model of government, organization and management) that influence integration. Evaluation of the IHO's performance focuses on global strategies and results on coordination of care and efficiency. Two types of coordination are evaluated: information coordination and coordination of care management. Evaluation of the efficiency of the IHO refers to technical and allocative efficiency. This guide may have to be modified for use in the Catalan context.
Sharan, Alok D; Schroeder, Gregory D; Millhouse, Paul W; West, Michael E; Vaccaro, Alexander R
Significant changes are occurring in the health care field, and spine surgeons must have an understanding of business strategy if they are going to adapt to the new health care environment. Spine surgeons will be required to demonstrate how their service provides a unique value to their patients or else the patients will obtain care from competitors. Classic methods for demonstrating value such as academic prestige and superior clinical outcomes may no longer be sufficient in the evolving health care field, and surgeons will need to demonstrate a comprehensive and cost-effective treatment algorithm for a diagnosis. This article will discuss the basics of business strategy for the spine surgeon, and ways in which the surgeon may demonstrate value to their patients.
Graff, Heidi Jeannet; Siersma, Volkert Dirk; Kragstrup, Jakob
comprised internationallyadopted children (n = 6,820), adopted between 1994 and2005, and all non-adopted children (n = 492,374) who couldbe matched with the adopted children on sex, age, municipalityand family constellation at the time of adoption. Results: International adoption increased the use......Introduction: Several studies have documented thatinternational adoptees have an increased occurrence ofhealth problems and contacts to the health-care systemafter arriving to their new country of residence. This maybe explained by pre-adoption adversities, especially for theperiod immediately...... after adoption. Our study aimed to theassess health-care utilisation of international adoptees inprimary and secondary care for somatic and psychiatricdiagnoses in a late post-adoption period. Is there an increaseduse of the health-care system in this period, evenwhen increased morbidity in the group...
Hyppönen, Hannele; Ronchi, Elettra; Adler-Milstein, Julia
Health Information Systems (HISs) are expected to have a positive impact on quality and efficiency of health care. Rapid investment in and diffusion of HISs has increased the importance of monitoring the adoption and impacts of them in order to learn from the initiatives, and to provide decision makers evidence on the role of HISs in improving health care. However, reliable and comparable data across initiatives in various countries are rarely available. A four-phase approach is used to compare different HIS indicator methodologies in order to move ahead in defining HIS indicators for monitoring effects of HIS on health care performance. Assessed approaches are strong on different aspects, which provide some opportunities for learning across them but also some challenges. As yet, all of the approaches do not define goals for monitoring formally. Most focus on health care structural and process indicators (HIS availability and intensity of use). However, many approaches are generic in description of HIS functionalities and context as well as their impact mechanisms on health care for HIS benchmarking. The conclusion is that, though structural and process indicators of HIS interventions are prerequisites for monitoring HIS impacts on health care outputs and outcomes, more explicit definition is needed of HIS contexts, goals, functionalities and their impact mechanisms in order to move towards common process and outcome indicators. A bottom-up-approach (participation of users) could improve development and use of context-sensitive HIS indicators.
Lassen, Inger Marie; Strunck, Jeanne; Ottesen, Aase Marie
analyse and discuss how political discourse moments (Rancière 1999; Gamson 1992; Carvalho 2008) influence the contents of the national health quality strategies and how variation in the construal of patient roles and agency indicate discursive struggle in Danish national health care policy. Underlying...
Mannion, Russell; Davies, Huw T.O; Marshall, Martin N
... in performance are intrinsically linked to cultural changes within health care settings. Using theories from a wide range of disciplines including economics, management and organization studies, policy studies and the health sciences, this book sets out definitions of cultures and performance, in particular the specific characteristics that help...
Full Text Available This study analyzes the effect of health care on Middle Eastern countries on the eve of and soon after the Arab Spring. It posits that countries that were most stable were the healthiest ones; countries which underwent revolutions were the unhealthiest ones; whereas countries that settled for reforms were moderate in health. It presents a hypothesis, the Inverted Funnel Model Hypothesis, that states that as the level of health care of a country rises so does its stability, which in turn leads to better health care as if down an inverted funnel to hypothetical maximums of both health care and stability. To test the hypothesis both quantitative and qualitative methods are used. The quantitative part involves first of all compiling seven health indicators based on the World Health Organization Annual Reports on twelve individual countries, for a period of five years preceding the Arab Spring’s onset in 2011 and in the immediate aftermath of 2011, and, second of all running correlations with political stability of each country, grouped in a three-way typology of countries. This is supplemented by a qualitative part which analyzes the health perceptions and demands of Arab Spring protesters in search of social justice.
Racine, Andrew D
The persistence of child poverty in the United States and the pervasive health consequences it engenders present unique challenges to the health care system. Human capital theory and empirical observation suggest that the increased disease burden experienced by poor children originates from social conditions that provide suboptimal educational, nutritional, environmental, and parental inputs to good health. Faced with the resultant excess rates of pediatric morbidity, the US health care system has developed a variety of compensatory strategies. In the first instance, Medicaid, the federal-state governmental finance system designed to assure health insurance coverage for poor children, has increased its eligibility thresholds and expanded its benefits to allow greater access to health services for this vulnerable population. A second arm of response involves a gradual reengineering of health care delivery at the practice level, including the dissemination of patient-centered medical homes, the use of team-based approaches to care, and the expansion of care management beyond the practice to reach deep into the community. Third is a series of recent experiments involving the federal government and state Medicaid programs that includes payment reforms of various kinds, enhanced reporting, concentration on high-risk populations, and intensive case management. Fourth, pediatric practices have begun to make use of specific tools that permit the identification and referral of children facing social stresses arising from poverty. Finally, constituencies within the health care system participate in enhanced advocacy efforts to raise awareness of poverty as a distinct threat to child health and to press for public policy responses such as minimum wage increases, expansion of tax credits, paid family leave, universal preschool education, and other priorities focused on child poverty. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights
Zikusooka, C M; Kyomuhang, R; Orem, J N; Tumwine, M
Health care financing provides the resources and economic incentives for operating health systems and is a key determinant of health system performance. Equitable financing is based on: financial protection, progressive financing and cross-subsidies. This paper describes Uganda's health care financing landscape and documents the key equity issues associated with the current financing mechanisms. We extensively reviewed government documents and relevant literature and conducted key informant interviews, with the aim of assessing whether Uganda's health care financing mechanisms exhibited the key principles of fair financing. Uganda's health sector remains significantly under-funded, mainly relying on private sources of financing, especially out-of-pocket spending. At 9.6 % of total government expenditure, public spending on health is far below the Abuja target of 15% that GoU committed to. Prepayments form a small proportion of funding for Uganda's health sector. There is limited cross-subsidisation and high fragmentation within and between health financing mechanisms, mainly due to high reliance on out-of-pocket payments and limited prepayment mechanisms. Without compulsory health insurance and low coverage of private health insurance, Uganda has limited pooling of resources, and hence minimal cross-subsidisation. Although tax revenue is equitable, the remaining financing mechanisms for Uganda are inequitable due to their regressive nature, their lack of financial protection and limited cross-subsidisation. Overall, Uganda's current health financing is inequitable and fragmented. The government should take explicit action to promote equitable health care financing by establishing pre-payment schemes, enhancing cross-subsidisation mechanisms and through appropriate integration of financing mechanisms.
Townsend, Anne; Amarsi, Zubin; Backman, Catherine L; Cox, Susan M; Li, Linda C
Background While use of the Internet is increasingly widespread in research, little is known about the role of routine electronic mail (email) correspondence during recruitment and early volunteer?researcher interactions. To gain insight into the standpoint of volunteers we analyzed email communications in an early rheumatoid arthritis qualitative interview study. Objectives The objectives of our study were (1) to understand the perspectives and motivations of individuals who volunteered for ...
Full Text Available This study aimed to examine possible changes from 2008 to 2012 in the skills of health care staff in identifying and intervening in domestic violence (DV. A longitudinal descriptive study design with volunteer samples (baseline; n=68, follow-up; n=100 was used to acquire information regarding the present state and needs of the staff in practices related to DV. The results of the baseline survey were used as a basis for planning two interventions: staff training and drafting practical guidelines. Information was collected by questionnaires from nurses, physicians, and social workers and supplemented by responses from the interviews. The data were analysed using both quantitative and qualitative methods. A chi-square test was used to test the statistical significance of the data sets. In addition, participants’ quotes are used to describe specific phenomena or issues. The comparison showed that overall a small positive change had taken place between the study periods. However, the participants were aware of their own shortcomings in identifying and intervening in DV. Changes happen slowly, and administrative support is needed to sustain such changes. Therefore, this paper offers recommendations to improve health care providers’ response to DV. Moreover, there is a great need for evaluating the training programme used.
Full Text Available Abstract Background Financial protection against the cost of unforeseen ill health has become a global concern as expressed in the 2005 World Health Assembly resolution (WHA58.33, which urges its member states to "plan the transition to universal coverage of their citizens". An important element of financial risk protection is to distribute health care financing fairly in relation to ability to pay. The distribution of health care financing burden across socio-economic groups has been estimated for European countries, the USA and Asia. Until recently there was no such analysis in Africa and this paper seeks to contribute to filling this gap. It presents the first comprehensive analysis of the distribution of health care financing in relation to ability to pay in Ghana. Methods Secondary data from the Ghana Living Standard Survey (GLSS 2005/2006 were used. This was triangulated with data from the Ministry of Finance and other relevant sources, and further complemented with primary household data collected in six districts. We implored standard methodologies (including Kakwani index and test for dominance for assessing progressivity in health care financing in this paper. Results Ghana's health care financing system is generally progressive. The progressivity of health financing is driven largely by the overall progressivity of taxes, which account for close to 50% of health care funding. The national health insurance (NHI levy (part of VAT is mildly progressive and formal sector NHI payroll deductions are also progressive. However, informal sector NHI contributions were found to be regressive. Out-of-pocket payments, which account for 45% of funding, are regressive form of health payment to households. Conclusion For Ghana to attain adequate financial risk protection and ultimately achieve universal coverage, it needs to extend pre-payment cover to all in the informal sector, possibly through funding their contributions entirely from tax, and
Akazili, James; Gyapong, John; McIntyre, Diane
Financial protection against the cost of unforeseen ill health has become a global concern as expressed in the 2005 World Health Assembly resolution (WHA58.33), which urges its member states to "plan the transition to universal coverage of their citizens". An important element of financial risk protection is to distribute health care financing fairly in relation to ability to pay. The distribution of health care financing burden across socio-economic groups has been estimated for European countries, the USA and Asia. Until recently there was no such analysis in Africa and this paper seeks to contribute to filling this gap. It presents the first comprehensive analysis of the distribution of health care financing in relation to ability to pay in Ghana. Secondary data from the Ghana Living Standard Survey (GLSS) 2005/2006 were used. This was triangulated with data from the Ministry of Finance and other relevant sources, and further complemented with primary household data collected in six districts. We implored standard methodologies (including Kakwani index and test for dominance) for assessing progressivity in health care financing in this paper. Ghana's health care financing system is generally progressive. The progressivity of health financing is driven largely by the overall progressivity of taxes, which account for close to 50% of health care funding. The national health insurance (NHI) levy (part of VAT) is mildly progressive and formal sector NHI payroll deductions are also progressive. However, informal sector NHI contributions were found to be regressive. Out-of-pocket payments, which account for 45% of funding, are regressive form of health payment to households. For Ghana to attain adequate financial risk protection and ultimately achieve universal coverage, it needs to extend pre-payment cover to all in the informal sector, possibly through funding their contributions entirely from tax, and address other issues affecting the expansion of the National
Glick, S M
In planning healthcare reforms increasing attention has been focused on the issue of equity. Inequities in the provision of healthcare exist even in relatively egalitarian societies. Poverty is still one of the major contributors to ill health and there are many powerful influences in society that continue to thwart the goal of a maximally equitable system for the provision of healthcare. The principles of equity in a healthcare system have been well articulated in recent years. It is incumbent on healthcare professionals who understand the issues to join the efforts towards a more humane and equitable healthcare system in their societies.
Eissler, Lee Ann; Casken, John
The purpose of this study was the exploration of international travel experiences for the purpose of medical or dental care from the perspective of patients from Alaska and to develop insight and understanding of the essence of the phenomenon of medical tourism. The study is conceptually oriented within a model of health-seeking behavior. Using a qualitative design, 15 Alaska medical tourists were individually interviewed. The data were analyzed using a hermeneutic process of inquiry to uncover the meaning of the experience. Six themes reflecting the experiences of Alaska medical tourists emerged: "my motivation," "I did the research," "the medical care I need," "follow-up care," "the advice I give," and "in the future." Subthemes further categorized data for increased understanding of the phenomenon. The thematic analysis provides insight into the experience and reflects a modern approach to health-seeking behavior through international medical tourism. The results of this study provide increased understanding of the experience of obtaining health care internationally from the patient perspective. Improved understanding of medical tourism provides additional information about a contemporary approach to health-seeking behavior. Results of this study will aid nursing professionals in counseling regarding medical tourism options and providing follow-up health care after medical tourism. Nurses will be able to actively participate in global health policy discussions regarding medical tourism trends. © 2013 Sigma Theta Tau International.
Dunlop, D W
The economic realities of health sector development in Africa has been analyzed in this paper. Both the global and national macroeconomic context has been defined. Given the available data, it is clear that most African countries face increasingly serious economic realities, such as slow or even declining economic growth (per capita), a depressed food production situation, severe balance of payments crises, and increasing dependence on external financial assistance. Given the limited but increasingly available 1981 and 1982 data, the economic situation in many countries is more constrained than those indicated by the data contained in this paper. In this context, the potential competitive situation facing governmental health care systems was reviewed. In addition, the diversity in the sources of health expenditures between countries in Africa was highlighted. These data provide clear evidence that governments clearly do not finance the entire health care system and that individual payment for service in many countries represent an important source of revenue for many care providers in various health care systems operating in any given country. The potential for governments to finance either an expansion of or improvements to the government component of their health care systems is then reviewed. The highlights of this analysis include the following points. First, the tax structure in many African countries is highly dependent on export and import duties, which in turn creates dependency on sustained foreign demand for exports.(ABSTRACT TRUNCATED AT 250 WORDS)
Høy, Bente; Wagner, Lis; Hall, Elisabeth O.C.
into self-care as a significant health resource of elders with different health status. It suggests that an elder's self-care ability is determined by the interaction of various sub-resources and conditions and emphasizes the constantly evolving nature of self-care. The framework may be of use in clinical......AIM: To review the literature related to self-care and health promotion for elders and to develop an understanding of self-care as a health resource. BACKGROUND: Self-care may improve health and prevent illness and disabilities in elders. Although studies of self-care are numerous, the significance...... of the concept as a health resource for elders lacks clarity. Before 1989, research focused principally on medical self-care at the expense of health care, and self-care was seen more as supplementary to professional health care rather than as a health-promoting approach in health care. METHOD...
Schokkaert, Erik; Van de Voorde, Carine
Curbing the growth of public sector health expenditures has been the proclaimed government objective in Belgium since the 1980s. However, the respect for freedom of choice for patients and for therapeutic freedom for providers has blocked the introduction of microeconomic incentives and quality control. Therefore--with some exceptions, particularly in the hospital sector--policy has consisted mainly of tariff and supply restrictions and increases in co-payments. These measures have not been successful in curbing the growth of expenditures. Moreover, there remains a large variation in medical practices. While the structure of health financing is relatively progressive from an international perspective, socioeconomic and regional inequalities in health persist. The most important challenge is the restructuring of the basic decision-making processes; i.e. a simplification of the bureaucratic procedures and a re-examination of the role of regional authorities and sickness funds. Copyright (c) 2002 John Wiley & Sons, Ltd.
This article critically appraises a process of recognising prior learning (RPL) using analytical tools from Habermas' theory of communicative action. The RPL process is part of an in-service training program for health care assistants where the goal is to become a licensed practical nurse. Data about the RPL process were collected using interviews…
M. Westerdijk (MacHiel); J.J. Zuurbier (Joost); M. Ludwig (Martijn); S. Prins (Sarah)
textabstractA case-mix project started in the Netherlands with the primary goal to define a complete set of health care products for hospitals. The definition of the product structure was completed 4 years later. The results are currently being used for billing purposes. This paper focuses on the
Cawsey, A J; Webber, B L; Jones, R B
Good communication is vital in health care, both among health care professionals, and between health care professionals and their patients. And well-written documents, describing and/or explaining the information in structured databases may be easier to comprehend, more edifying, and even more convincing than the structured data, even when presented in tabular or graphic form. Documents may be automatically generated from structured data, using techniques from the field of natural language generation. These techniques are concerned with how the content, organization and language used in a document can be dynamically selected, depending on the audience and context. They have been used to generate health education materials, explanations and critiques in decision support systems, and medical reports and progress notes.
DO, YOUNG KYUNG; NORTON, EDWARD C.; STEARNS, SALLY C.; VAN HOUTVEN, COURTNEY HAROLD
This study aims to measure the causal effect of informal caregiving on the health and health care use of women who are caregivers, using instrumental variables. We use data from South Korea, where daughters and daughters-in-law are the prevalent source of caregivers for frail elderly parents and parents-in-law. A key insight of our instrumental variable approach is that having a parent-in-law with functional limitations increases the probability of providing informal care to that parent-in-law, but a parent-in-law’s functional limitation does not directly affect the daughter-in-law’s health. We compare results for the daughter-in-law and daughter samples to check the assumption of the excludability of the instruments for the daughter sample. Our results show that providing informal care has significant adverse effects along multiple dimensions of health for daughter-in-law and daughter caregivers in South Korea. PMID:24753386
Goldsmith, J C
Does it sound familiar? Resources are scarce, competition is tough, and government regulations and a balanced budget are increasingly hard to meet at the same time. This is not the automobile or oil industry but the health care industry, and hospital managers are facing the same problems. And, maintains the author of this article, they must borrow some proven marketing techniques from business to survive in the new health care market. He first describes the features of the new market (the increasing economic power of physicians, new forms of health care delivery, prepaid health plans, and the changing regulatory environment) and then the possible marketing strategies for dealing with them (competing hard for physicians who control the patient flow and diversifying and promoting the mix of services). He also describes various planning solutions that make the most of a community's hospital facilities and affiliations.
Tumusiime, David Katuruba; Agaba, Gad; Kyomuhangi, Teddy; Finch, Jan; Kabakyenga, Jerome; MacLeod, Stuart
A substantial literature suggests that mobile phones have great potential to improve management and survival of acutely ill children in rural Africa. The national strategy of the Ugandan Ministry of Health calls for employment of volunteer community health workers (CHWs) in implementation of Integrated Community Case Management (iCCM) of common illnesses (diarrhea, acute respiratory infection, pneumonia, fever/malaria) affecting children under five years of age. A mobile phone enabled system was developed within iCCM aiming to improve access by CHWs to medical advice and to strengthen reporting of data on danger signs and symptoms for acutely ill children under five years of age. Herein critical steps in development, implementation, and integration of mobile phone technology within iCCM are described. Mechanisms to improve diagnosis, treatment and referral of sick children under five were defined. Treatment algorithms were developed by the project technical team and mounted and piloted on the mobile phones, using an iterative process involving technical support personnel, health care providers, and academic support. Using a purposefully developed mobile phone training manual, CHWs were trained over an intensive five-day course to make timely diagnoses, recognize clinical danger signs, communicate about referrals and initiate treatment with appropriate essential drugs. Performance by CHWs and the accuracy and completeness of their submitted data was closely monitored post training test period and during the subsequent nine month community trial. In the full trial, the number of referrals and correctly treated children, based on the agreed treatment algorithms, was recorded. Births, deaths, and medication stocks were also tracked. Seven distinct phases were required to develop a robust mobile phone enabled system in support of the iCCM program. Over a nine month period, 96 CHWs were trained to use mobile phones and their competence to initiate a community trial was
Ruben, Mollie A; Shipherd, Jillian C; Topor, David; AhnAllen, Christopher G; Sloan, Colleen A; Walton, Heather M; Matza, Alexis R; Trezza, Glenn R
Culturally competent health care is especially important among sexual and gender minority patients because poor cultural competence contributes to health disparities. There is a need to understand how to improve health care quality and delivery for lesbian, gay, bisexual, and transgender (LGBT) veterans in particular, because they have unique physical and mental health needs as both LGBT individuals and veterans. The following article is a case study that focuses on the policy and clinical care practices related to LGBT clinical competency, professional training, and ethical provision of care for veteran patients in the VA Boston Healthcare System. We apply Betancourt et al.'s (2003) cultural competence framework to outline the steps that VA Boston Healthcare System took to increase cultural competency at the organizational, structural, and clinical level. By sharing our experiences, we aim to provide a model and steps for other health care systems and programs, including other VA health care systems, large academic health care systems, community health care systems, and mental health care systems, interested in developing LGBT health initiatives.
Younger, David S
The Russian Federation health system has its roots in the country's complex political history. The Ministry of Health and Social Development and its associated federal services are the principal Russian institutions subserving the Russian Federation. Funding for the health system goes through 2 channels: the general revenue budget managed by federal, regional, and local health authorities, and the Mandatory Health Insurance Fund. Although the Soviet Union was the first country in the world to guarantee free medical care as a constitutional right to all its citizens, quality and accessibility are in question. Copyright © 2016 Elsevier Inc. All rights reserved.
rural Nigerian communities, out-of-pocket more than a stated percentage ... experience for final year medical students of A total of six hundred and eighty six (686) .... health centre were lack of money (55.2%), household income was not ...
Thompson, Michael; Cutler, Charles M
One of the contributing factors to both the increase in health care costs and the backlash to managed care was the lack of consumer awareness of the cost of health care service, the effect of health care costs on profits and wages, and the need to engage consumers more actively as consumers in health care decisions. This article reviews the birth of the health care consumerism movement and identifies gaps in health care consumerism today. The authors reveal some of the keys to building a sustainable health care consumerism framework, which involves enlisting consumers as well as other stakeholders.
Rafiei, Masoud; Ezzatian, Reza; Farshad, Asghar; Sokooti, Maryam; Tabibi, Ramin; Colosio, Claudio
A healthy workforce is vital for maintaining social and economic development on a global, national and local level. Around half of the world's people are economically active and spend at least one third of their time in their place of work while only 15% of workers have access to basic occupational health services. According to WHO report, since the early 1980s, health indicators in Iran have consistently improved, to the extent that it is comparable with those in developed countries. In this paper it was tried to briefly describe about Health care system and occupational Health Services as part of Primary Health care in Iran. To describe the health care system in the country and the status of occupational health services to the workers and employers, its integration into Primary Health Care (PHC) and outlining the challenges in provision of occupational health services to the all working population. Iran has fairly good health indicators. More than 85 percent of the population in rural and deprived regions, for instance, have access to primary healthcare services. The PHC centers provide essential healthcare and public-health services for the community. Providing, maintaining and improving of the workers' health are the main goals of occupational health services in Iran that are presented by different approaches and mostly through Workers' Houses in the PHC system. Iran has developed an extensive network of PHC facilities with good coverage in most rural areas, but there are still few remote areas that might suffer from inadequate services. It seems that there is still no transparent policy to collaborate with the private sector, train managers or provide a sustainable mechanism for improving the quality of services. Finally, strengthening national policies for health at work, promotion of healthy work and work environment, sharing healthy work practices, developing updated training curricula to improve human resource knowledge including occupational health
Health care-associated infections cause approximately 75,000 deaths annually, in addition to increasing morbidity and costs. Over the past decade, a downward trend in health care-associated infections has occurred nationwide. Basic prevention measures include administrative support, educating health care personnel, and hand hygiene and isolation precautions. Prevention of central line- or catheter-associated infections begins with avoidance of unnecessary insertion, adherence to aseptic technique when inserting, and device removal when no longer necessary. Specific recommendations for preventing central line-associated bloodstream infections include use of chlorhexidine for skin preparation, as a component of dressings, and for daily bathing of patients in intensive care units. Catheter-associated urinary tract infections are the most common device-related health care-associated infection. Maintaining a closed drainage system below the patient reduces the risk of infection. To prevent ventilator-associated pneumonia, which is associated with high mortality, mechanically ventilated patients should be placed in the semirecumbent position and receive antiseptic oral care. Prevention of surgical site infections includes hair removal using clippers, glucose control, and preoperative antibiotic prophylaxis. Reducing transmission of Clostridium difficile and multidrug-resistant organisms in the hospital setting begins with hand hygiene and contact precautions. Institutional efforts to reduce unnecessary antibiotic prescribing are also strongly recommended. Reducing rates of methicillin-resistant Staphylococcus aureus infection can be achieved through active surveillance cultures and decolonization therapy with mupirocin.
People often make decisions in health care that are not in their best interest, ranging from failing to enroll in health insurance to which they are entitled, to engaging in extremely harmful behaviors. Traditional economic theory provides a limited tool kit for improving behavior because it assumes that people make decisions in a rational way, have the mental capacity to deal with huge amounts of information and choice, and have tastes endemic to them and not open to manipulation. Melding economics with psychology, behavioral economics acknowledges that people often do not act rationally in the economic sense. It therefore offers a potentially richer set of tools than provided by traditional economic theory to understand and influence behaviors. Only recently, however, has it been applied to health care. This article provides an overview of behavioral economics, reviews some of its contributions, and shows how it can be used in health care to improve people's decisions and health.
Health insurers are generally guided by the principle of "actuarial fairness," according to which they distinguish among various risks on the basis of cost-related factors. Thus, insurers often limit or deny coverage for vision care, hearing aids, mental health care, and even AIDS treatment based on actuarial justifications. Furthermore, approximately forty-two million Americans have no health insurance at all, because most of these individuals cannot afford the cost of insurance. This Article argues that Americans have come to demand more than actuarial fairness from health insurers and are increasingly concerned by what I call "moral fairness." This is evidenced by the hundreds of laws that have been passed to constrain insurers' discretion with respect to particular coverage decisions. Legislative mandates are frequent, but seemingly haphazard, following no systematic methodology. This Article suggests an analytical framework that can be utilized to determine which interventions are appropriate and evaluates a variety of means by which moral fairness could be promoted in the arena of health care coverage.
Detmer Don E
Full Text Available Abstract Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries. The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin
Toussaint, John S; Berry, Leonard L
An urgent need in American health care is improving quality and efficiency while controlling costs. One promising management approach implemented by some leading health care institutions is Lean, a quality improvement philosophy and set of principles originated by the Toyota Motor Company. Health care cases reveal that Lean is as applicable in complex knowledge work as it is in assembly-line manufacturing. When well executed, Lean transforms how an organization works and creates an insatiable quest for improvement. In this article, we define Lean and present 6 principles that constitute the essential dynamic of Lean management: attitude of continuous improvement, value creation, unity of purpose, respect for front-line workers, visual tracking, and flexible regimentation. Health care case studies illustrate each principle. The goal of this article is to provide a template for health care leaders to use in considering the implementation of the Lean management system or in assessing the current state of implementation in their organizations. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.
Full Text Available This study describes the content of entrepreneurship education in health care education and the kinds of teaching methods that are used when teaching about entrepreneurship. Health care entrepreneurship has increased in many countries in recent decades and there is evidence that entrepreneurs have also a role in public health care. Therefore the health care professionals need to be educated to have the entrepreneurial skills. Education in the field of health care is still based on traditional forms of teaching and does not give enough attention to the issue of becoming an entrepreneur. The data was collected from teachers (n=111 via e-mail from six Finnish polytechnics. The data were analysed statistically and the open-ended questions were analysed via content analysis. Approximately 23% of the teachers had taught about entrepreneurship. The most popular teaching methods were company visits and cases, lecturing, and project work. The courses dealt with establishing a company, entrepreneurship in general, and marketing. Nearly all of the teachers had cooperated with the entrepreneurs or with the companies in question. Approximately 33% of the teachers took entrepreneurship into consideration often in other courses related to entrepreneurship.
In the current debate about healthcare reform in the USA, advocates for government-ensured universal coverage assume that health care is a right. Although this position is politically popular, it is sometimes challenged by a restricted view of rights popular with libertarians and individualists. The restricted view of rights only accepts 'negative' rights as legitimate rights. Negative rights, the argument goes, place no obligations on you to provide goods to other people and thus respect your right to keep the fruits of your labour. A classic enumeration of negative rights includes life, liberty, and the pursuit of happiness. Positive rights, by contrast, obligate you either to provide goods to others, or pay taxes that are used for redistributive purposes. Health care falls into the category of positive rights since its provision by the government requires taxation and therefore redistribution. Therefore, the libertarian or individualist might argue that health care cannot be a true right. This paper rejects the distinction between positive and negative rights. In fact, the protection of both positive and negative rights can place obligations on others. Furthermore, because of its role in helping protect equality of opportunity, health care can be tied to the rights to life, liberty, and the pursuit of happiness. There is, therefore, good reason to believe that health care is a human right and that universal access should be guaranteed. The practical application, by governments and non-governmental organisations, of several of the arguments presented in this paper is also discussed.
Xiao, Roy; Miller, Jacob A; Zafirau, William J; Gorodeski, Eiran Z; Young, James B
As healthcare costs rise, home health care represents an opportunity to reduce preventable adverse events and costs following hospital discharge. No studies have investigated the utility of home health care within the context of a large and diverse patient population. A retrospective cohort study was conducted between 1/1/2013 and 6/30/2015 at a single tertiary care institution to assess healthcare utilization after discharge with home health care. Control patients discharged with "self-care" were matched by propensity score to home health care patients. The primary outcome was total healthcare costs in the 365-day post-discharge period. Secondary outcomes included follow-up readmission and death. Multivariable linear and Cox proportional hazards regression were used to adjust for covariates. Among 64,541 total patients, 11,266 controls were matched to 6,363 home health care patients across 11 disease-based Institutes. During the 365-day post-discharge period, home health care was associated with a mean unadjusted savings of $15,233 per patient, or $6,433 after adjusting for covariates (p Home health care independently decreased the hazard of follow-up readmission (HR 0.82, p home health care most benefited patients discharged from the Digestive Disease (death HR 0.72, p home health care was associated with significant reduction in healthcare utilization and decreased hazard of readmission and death. These data inform development of value-based care plans. Copyright © 2018 Elsevier Inc. All rights reserved.
Students' Perspectives to Health Care Services in Lithuania Introduction. The Rights of Patients and Compensation for the Damage to Their Health Act defines health care services as safe and effective means to take care of health, identify, diagnose and treat diseases and provide nursing services. The aims set out in a policy of health care services are fairly broad and, among others, include the improvement of both the quality and the availability of health care services. The issues of increa...