‘Some patients are more equal than others’: Patient-centred care differential in two-tier inpatient ward hospitals in Ghana

2016 ◽  
Vol 99 (3) ◽  
pp. 370-377 ◽  
Author(s):  
Roger A. Atinga ◽  
Justice N. Bawole ◽  
Alexis Nang-Beifubah
Keyword(s):  
Patient Centred Care ◽  
Inpatient Ward

GPS' PERCEPTION OF THE PATIENT ORIENTED INTERVENTIONS AS KEY ELEMENTS OF PATIENT CENTRED CARE FOR PEOPLE WITH MULTIMORBIDITY.pdf

2018 ◽  
Vol 28 (2) ◽  
pp. 561-565
Author(s):  
Radost Assenova ◽  
Levena Kireva ◽  
Gergana Foreva
Keyword(s):  
Chronic Conditions ◽  
Patient Centered Care ◽  
Self Management ◽  
Multiple Chronic Conditions ◽  
Positive Health ◽  
Patient Centered ◽  
Effective Response ◽  
Patient Centred Care ◽  
Centered Care ◽  
Health Related

Background: Patients with multimorbidity represent a significant portion of the primary healthcare population. For healthcare providers, managing patients with multiple chronic conditions represents a challenge given the complexity and the intensity of interventions. Integrated and patient-centered care is considered an effective response to the needs of people who suffer from multiple chronic conditions. According to the literature providing patient-centered care is one of the most important interventions in terms of positive health-related outcomes for patients with multimorbidity.Aim: The aim of the study is to evaluate the GPs’ perception of patient oriented interventions as key elements of patient centred care for patients with multimorbidity.Material and methods: A cross-sectional pilot study was conducted among randomly selected 73 GPs. A direct individual anonymous survey was performed to explore the opinion of respondents about the importance of two patient-oriented interventions, each one including specific elements of patient-centered care for patients with multimorbidity. The tool was developed as a result of the scoping review performed by Smith et al. (2012;2016). A 5-point Likert scale (0-not at all, 1-little, 2-rather, 3-much, 4-very strong) was used. The data were analysed using descriptive statistics. In processing the data, the software product for statistical analyses - SPSS version 17 was performed for Windows XP.Results: Our results show that both categories - providing patient-oriented approach and self-management support interventions were highly accessed by the respondents. The most frequent categories of interventions identified in our study were Creating individualized and adapted interventions, Performing regular contacts and Reinforcing adherence. Less frequently reported elements such as Considering relatives’ needs and Developing self-management plan are still underestimated by the Bulgarian GPs.Conclusions: The acceptance and understanding of innovative patient-centered interventions adapted to patients with multimorbidity could be accepted as a good indicator for improving health-related outcomes and care for patients with multiple chronic conditions.

Medicines management for nursing practice

2013 ◽  
Author(s):  
Graham Brack ◽  
Penny Franklin ◽  
Jill Caldwell
Keyword(s):  
Patient Safety ◽  
Case Studies ◽  
Nursing Practice ◽  
Medicines Management ◽  
Knowledge And Skills ◽  
Practical Advice ◽  
Patient Centred Care ◽  
The Common ◽  
Skills Learning ◽  
Straightforward Approach

Medicines Management for Nursing Practice: Pharmacology, Patient Safety, and Procedures is a friendly guide designed to equip pre-registration and newly qualified nurses with the medicines management knowledge and skills to provide safe patient-centred care. Balancing theory with practical advice, this accessible text covers basic pharmacology, drug calculations, key legislation and standards, and patient safety. Drawing from the most up-to-date sources of evidence and advice, including NMC and BNF guidelines, Medicines Management for Nursing Practice prepares nurses to promote their patients' safety, concordance, understanding of medicines, and wellbeing. This book takes a lively and straightforward approach to a vital set of nursing skills. Learning features such as reflection points, exercises, and further reading help readers to develop and consolidate their knowledge. Chapters on pharmacology and drug calculations take a step-by-step approach and are supported by diagrams and examples to aid understanding. Case studies relate guidelines and theories to the common practical scenarios that nurses encounter on a day-to-day basis.

P0203EARLY DETECTION OF BREAST ARTERIAL CALCIFICATION IN DIFFERENT STAGES OF CHRONIC KIDNEY DISEASE PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Basma Sultan ◽  
Hamdy Omar ◽  
Housseini Ahmed ◽  
Mahmoud Elprince ◽  
Osama Anter adly ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Lipid Profile ◽  
Statistical Significance ◽  
University Hospital ◽  
Arterial Calcification ◽  
Control Group ◽  
Inpatient Ward ◽  
Stage 4 ◽  
Ckd Stage

Abstract Background and Aims Vascular calcification (VC) plays a major role in cardiovascular disease (CVD), which is one of the main causes of mortality in patients with chronic kidney disease (CKD). The study aims at early detection of breast arterial calcification (BAC) in different stages of CKD (stage 2, 3& 4) patients as an indicator of systemic VC. Method A case control study was conducted targeting CKD women, aged 18- 60 years old. The sample was divided into 3 groups; A,B,C (representing stage 2, 3 & 4 of CKD) from women who attended nephrology and Internal medicine clinics and admitted in inpatient ward in Suez Canal University Hospital. A 4th group (D) was formed as a control group and included women with normal kidney functions (each group (A, B, C, D) include 22 women). The selected participants were subjected to history taking, mammogram to detect BAC and biochemical assessment of lipid profile, Serum creatinine (Cr), Mg, P, Ca, PTH and FGF23. Results Our study detected presence of BAC in about 81.8% of hypertensive stage 4 CKD patients compared with 50% in stage 3 CKD, also in the majority of stage 4 CKD patients who had abnormal lipid profile parameters and electrolyte disturbance. Most of the variables had statistical significance regarding the presence of BAC. Conclusion Although it is difficult to determine the definite stage at which the risk of VC begins but in our study, it began late in stage 2 CKD, gradually increased prevalence through stage 3 and became significantly higher in stage 4. These results suggest that preventive strategies may need to begin as early as stage 2 CKD.

scholarly journals Understanding what matters most to patients in acute care in seven countries, using the flash mob study design

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eva S. van den Ende ◽  
◽  
Bo Schouten ◽  
Marjolein N. T. Kremers ◽  
Tim Cooksley ◽  
...  
Keyword(s):  
Acute Care ◽  
Patient Perspective ◽  
Large Scale ◽  
Healthcare Professionals ◽  
Well Being ◽  
Good Health ◽  
Care Needs ◽  
Patient Centred Care ◽  
Trial Register ◽  
What Matters

Abstract Background Truly patient-centred care needs to be aligned with what patients consider important, and is highly desirable in the first 24 h of an acute admission, as many decisions are made during this period. However, there is limited knowledge on what matters most to patients in this phase of their hospital stay. The objective of this study was to identify what mattered most to patients in acute care and to assess the patient perspective as to whether their treating doctors were aware of this. Methods This was a large-scale, qualitative, flash mob study, conducted simultaneously in sixty-six hospitals in seven countries, starting November 14th 2018, ending 50 h later. One thousand eight hundred fifty adults in the first 24 h of an acute medical admission were interviewed on what mattered most to them, why this mattered and whether they felt the treating doctor was aware of this. Results The most reported answers to “what matters most (and why)?” were ‘getting better or being in good health’ (why: to be with family/friends or pick-up life again), ‘getting home’ (why: more comfortable at home or to take care of someone) and ‘having a diagnosis’ (why: to feel less anxious or insecure). Of all patients, 51.9% felt the treating doctor did not know what mattered most to them. Conclusions The priorities for acutely admitted patients were ostensibly disease- and care-oriented and thus in line with the hospitals’ own priorities. However, answers to why these were important were diverse, more personal, and often related to psychological well-being and relations. A large group of patients felt their treating doctor did not know what mattered most to them. Explicitly asking patients what is important and why, could help healthcare professionals to get to know the person behind the patient, which is essential in delivering patient-centred care. Trial registration NTR (Netherlands Trial Register) NTR7538.

scholarly journals Validation of the Patient-Centred Care Competency Scale Instrument for Finnish Nurses

2021 ◽  
Vol 11 (6) ◽  
pp. 583
Author(s):  
Riitta Suhonen ◽  
Katja Lahtinen ◽  
Minna Stolt ◽  
Miko Pasanen ◽  
Terhi Lemetti
Keyword(s):  
Factor Analysis ◽  
Root Mean Square ◽  
Goodness Of Fit ◽  
Item Analysis ◽  
Healthcare Delivery ◽  
Mean Square ◽  
Cronbach’S Alpha ◽  
Patient Centred Care ◽  
Cronbach's Alpha ◽  
Confirmatory Factor

Patient-centredness in care is a core healthcare value and an effective healthcare delivery design requiring specific nurse competences. The aim of this study was to assess (1) the reliability, validity, and sensitivity of the Finnish version of the Patient-centred Care Competency (PCC) scale and (2) Finnish nurses’ self-assessed level of patient-centred care competency. The PCC was translated to Finnish (PCC-Fin) before data collection and analyses: descriptive statistics; Cronbach’s alpha coefficients; item analysis; exploratory and confirmatory factor analyses; inter-scale correlational analysis; and sensitivity. Cronbach’s alpha coefficients were acceptable, high for the total scale, and satisfactory for the four sub-scales. Item analysis supported the internal homogeneity of the items-to-total and inter-items within the sub-scales. Explorative factor analysis suggested a three-factor solution, but the confirmatory factor analysis confirmed the four-factor structure (Tucker–Lewis index (TLI) 0.92, goodness-of-fit index (GFI) 0.99, root mean square error of approximation (RMSEA) 0.065, standardized root mean square residual (SRMR) 0.045) with 61.2% explained variance. Analysis of the secondary data detected no differences in nurses’ self-evaluations of contextual competence, so the inter-scale correlations were high. The PCC-Fin was found to be a reliable and valid instrument for the measurement of nurses’ patient-centred care competence. Rasch model analysis would provide some further information about the item level functioning within the instrument.

scholarly journals Effects of intermittent pneumatic compression on femoral vein peak venous velocity during active ankle exercise

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199810
Author(s):  
Kenta Sakai ◽  
Naonobu Takahira ◽  
Kouji Tsuda ◽  
Akihiko Akamine
Keyword(s):  
Femoral Vein ◽  
Bed Rest ◽  
Intermittent Pneumatic Compression ◽  
Postoperative Rehabilitation ◽  
Venous Flow ◽  
Compression Phase ◽  
Superficial Femoral Vein ◽  
Inpatient Ward ◽  
Vein Thrombosis ◽  
Strong Compression

Introduction: The risk of developing deep vein thrombosis (DVT) is high even after the period of bed rest following major general surgery including total joint arthroplasty (TJA). Mobile intermittent pneumatic compression (IPC) devices allow the application of IPC during postoperative exercise. Although ambulation included ankle movement, no reports have been made regarding the effects of IPC during exercise, including active ankle exercise (AAE), on venous flow. This study was performed to examine whether using a mobile IPC device can effectively augment the AAE-induced increase in peak velocity (PV). Methods: PV was measured by Doppler ultrasonography in the superficial femoral vein at rest, during AAE alone, during IPC alone, and during AAE with IPC in 20 healthy subjects in the sitting position. PV in AAE with IPC was measured with a mobile IPC device during AAE in the strong compression phase. AAE was interrupted from the end of the strong compression phase to minimize lower limb fatigue. Results: AAE with IPC (76.2 cm/s [95%CI, 69.0–83.4]) resulted in a significant increase in PV compared to either AAE or IPC alone (47.1 cm/s [95%CI, 38.7–55.6], p < 0.001 and 48.1 cm/s [95%CI, 43.7–52.4], p < 0.001, respectively). Discussion: Reduced calf muscle pump activity due to the decline in ambulation ability reduced venous flow. Therefore, use of a mobile IPC device during postoperative rehabilitation in hospital and activity including self-training in an inpatient ward may promote venous flow compared to postoperative exercise without IPC. Conclusion: Use of a mobile IPC device significantly increased the PV during AAE, and simultaneous AAE with IPC could be useful evidence for the prevention of DVT in clinical settings, including after TJA.

The evolution of healthcare towards patient‐centred care and the need for systemic approaches

2021 ◽  
Vol 38 (2) ◽  
pp. 191-196
Author(s):  
Leonie Hallo ◽  
Alex Gorod ◽  
Susan Merchant
Keyword(s):  
Patient Centred Care

scholarly journals Association between doctor-patient familiarity and patient-centred care during general practitioner's consultations: a direct observational study in Chinese primary care practice

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chenwen Zhong ◽  
Mengping Zhou ◽  
Zhuojun Luo ◽  
Cuiying Liang ◽  
Lina Li ◽  
...  
Keyword(s):  
Primary Care ◽  
Observational Study ◽  
Health Knowledge ◽  
Care Practice ◽  
Patient Centred Care ◽  
Time Length ◽  
Significant Difference ◽  
Information Treatment ◽  
Observation Code ◽  
The Relationship

Abstract Background Patient-centred care is a core attribute of primary care. Not much is known about the relationship between patient-centred care and doctor-patient familiarity. This study aimed to explore the association between general practitioner (GP) perceived doctor-patient familiarity and the provision of patient-centred care during GP consultations. Methods This is a direct observational study conducted in eight community health centres in China. Level of familiarity was rated by GPs using a dichotomized variable (Yes/No). The provision of patient-centred care during GP consultations was measured by coding audiotapes using a modified Davis Observation Code (DOC) interactional instrument. Eight individual codes in the modified DOC were selected for measuring the provision of patient-centred care, including ‘family information’, ‘treatment effects’, ‘nutrition guidance’, ‘exercise guidance’, ‘health knowledge’, ‘patient question’, ‘chatting’, and ‘counseling’. Multivariate analyses of covariance were adopted to evaluate the association between GP perceived doctor-patient familiarity and patient-centred care. Results A total of 445 audiotaped consultations were collected, with 243 in the familiar group and 202 in the unfamiliar group. No significant difference was detected in overall patient-centred care between the two groups. For components of patient-centred care, the number of intervals (1.36 vs 0.88, p = 0.026) and time length (7.26 vs. 4.40 s, p = 0.030) that GPs spent in ‘health knowledge’, as well as time length (13.0 vs. 8.34 s, p = 0.019) spent in ‘patient question’ were significantly higher in unfamiliar group. The percentage of ‘chatting’ (11.9% vs. 7.34%, p = 0.012) was significantly higher in the familiar group. Conclusions This study suggested that GP perceived doctor-patient familiarity may not be associated with GPs’ provision of patient-centred care during consultations in the context of China. Not unexpectedly, patients would show more health knowledge and ask more questions when GPs were not familiar with them. Further research is needed to confirm and expand on these findings.

scholarly journals Informing patients: The Bolam legacy

2020 ◽  
Vol 20 (2) ◽  
pp. 103-130
Author(s):  
Emma Cave ◽  
Caterina Milo
Keyword(s):  
Hospital Management ◽  
Medical Advice ◽  
Diagnosis And Treatment ◽  
Health Board ◽  
Management Committee ◽  
Patient Centred Care ◽  
Capacity To Consent ◽  
Incremental Development ◽  
The Uk ◽  
Treatment Alternatives

In the context of medical advice to patients, the UK decision in Montgomery v. Lanarkshire Health Board rejected the application of Bolam v. Friern Hospital Management Committee. This article argues that the rejection is neither complete nor settled. We explore doctrinal, conceptual and practical limitations of Montgomery to demonstrate the vestiges of Bolam’s relevance to medical advice. Medical advice does not end with disclosure of material risk but incorporates information on prognosis, diagnosis and treatment alternatives. Montgomery does not always apply in these cases, nor outside the medical mainstream or where patients lack capacity to consent. We identify ways in which the extension of patient-centred care in the giving of medical advice can be achieved through incremental development of Montgomery and application of the Bolitho gloss to require that processes conform to Montgomery principles of partnership and autonomy.

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