scholarly journals The health care system as a social determinant of health: qualitative insights from South Australian maternity consumers

2009 ◽  
Vol 33 (1) ◽  
pp. 62 ◽  
Author(s):  
Lareen A Newman
Keyword(s):  
Health Care ◽  
Demographic Data ◽  
Qualitative Interviews ◽  
Significant Proportion ◽  
South Australia ◽  
Social Determinant ◽  
Service Planning ◽  
Consumer Feedback ◽  
Relationship Health

Health systems and policies are important determinants of health because they influence the type and quality of health care available to a population. This study included semi-structured qualitative interviews and a questionnaire to collect demographic data and household details for a purposeful sample of 38 mothers and 24 fathers from four socioeconomic areas of metropolitan South Australia who had at least one child aged between 1 and 6 years of age. The participants reported that birth experiences within the predominantly medicalised maternity system were at odds with the expectations of a significant proportion of contemporary consumers that maternity care will leave them not only with a healthy mother and baby, but also with no undue adverse impacts on their physical, mental and relationship health. There appears to be no formal mechanism in place for regular consumer feedback of experiences into system and service planning.

scholarly journals Improving the Quality of Children’s Mental Health Care with Progress Measures: A Mixed-Methods Study of PCIT Therapist Attitudes

2021 ◽  
Author(s):  
Corinna C. Klein ◽  
B. Erika Luis Sanchez ◽  
Miya L. Barnett
Keyword(s):  
Mental Health ◽  
Health Care ◽  
General Practice ◽  
Qualitative Interviews ◽  
Behavioral Observation ◽  
Parent Report ◽  
Therapist Attitudes ◽  
Child Interaction ◽  
Report Measure

AbstractProgress measures are an evidence-based technique for improving the quality of mental health care, however, clinicians rarely incorporate them into treatment. Research into how measure type impacts clinician preference has been recommended to help improve measure implementation. Parent–Child Interaction Therapy (PCIT) is an assessment-driven treatment that serves as an ideal intervention through which to investigate measure preferences given its routine use of two types of assessments, a behavioral observation (the Dyadic Parent–Child Interaction Coding System) and a parent-report measure (the Eyberg Child Behavior Inventory). This study investigated PCIT therapist attitudes towards progress measures used within PCIT and children’s mental health treatment generally. A mixed-method (QUAN + QUAL) study design examined PCIT therapist attitudes towards two types of progress measures and measures used in two contexts (PCIT and general practice). Multi-level modeling of a survey distributed to 324 PCIT therapists identified predictors of therapist attitudes towards measures, while qualitative interviews with 23 therapists expanded and clarified the rationale for differing perceptions. PCIT therapists reported more positive attitudes towards a behavioral observation measure, the DPICS, than a parent-report measure, the ECBI, and towards measures used in PCIT than in general practice. Clinician race/ethnicity was significantly related to measure-specific attitudes. Qualitative interviews highlighted how perceptions of measure reliability, type of data offered, ease of use, utility in guiding sessions and motivating clients, and embeddedness in treatment protocol impact therapist preferences. Efforts to implement progress monitoring should consider preferences for particular types of measures, as well as how therapists are trained to embed measures in treatment.

scholarly journals Patients with chronic pain: evaluating depression and their quality of life in a single center study in Greece

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Ekaterini Rapti ◽  
Dimitrios Damigos ◽  
Paraskevi Apostolara ◽  
Vasiliki Roka ◽  
Chara Tzavara ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Chronic Pain ◽  
Regression Analysis ◽  
Short Form ◽  
Medical Center ◽  
Demographic Data ◽  
Greek Language ◽  
Common Location

Abstract Background Chronic pain constitutes one of the most common reasons for seeking health care services and may even lead to disability. Chronic pain has been associated with depression and deterioration of the quality of life. The aim of our study is to outline the burden of chronic pain in the context of a primary health care (PHC) setting in Greece and to investigate its association with depression and quality of life. Methods A cross-sectional study was conducted from September 2016 to November 2016. The subjects of the study comprised 200 individuals who visited the regional medical center of Ag. Theodoroi, Greece. The collected data were from a representative sample of 200 adults and included demographic data, social and medical history, presence and characteristics of chronic pain and questions from three questionnaires for the assessment of pain (BPI- short form), the investigation of depression (PHQ-9) and the evaluation of the quality of life (EuroQ-5D) validated in Greek language. Multiple regression analysis was used in order to find associated factors with quality of life, depression and chronic pain. Results A percentage of 56.8% of the participants, the majority of whom (62%) were women, reported chronic pain. Among individuals with pain, lower back area was the most common location. Based on the given questionnaire, depression was detected in 22. 5% of the participants who claimed chronic pain. Regression analyses revealed that women and respondents with chronic mental disorders like depression and anxiety had significantly higher scores on the pain scale and suffered pain which had a greater impact on their daily activities. According to regression analysis decreased quality of life was expressed by women, as well as participants with a chronic mental disorder. A significant reverse correlation emerged between the quality of life, depression and pain scales. Conclusion Chronic pain, as it has been studied within this PHC setting, is a common health care problem. Individuals who had experienced chronic pain and depression had a lower health-related quality of life.

Obtaining and Using Client Feedback in Community Health Services

1998 ◽  
Vol 4 (4) ◽  
pp. 105
Author(s):  
Gwyneth Jolley ◽  
Libby Kalucy ◽  
Joanne McNamara
Keyword(s):  
Health Care ◽  
Health Services ◽  
Community Health ◽  
Service Providers ◽  
South Australia ◽  
Organisational Change ◽  
Community Health Services ◽  
Service Planning ◽  
Power Sharing ◽  
Client Feedback

Client feedback is an important component of two primary health care strategies: participation and evaluation. Workers need feedback from clients to ensure that their practice meets the criterion of providing affordable, accessible and appropriate services to enhance the health of their communities. Telephone interviews were conducted with thirty staff and thirty clients from women's and community health services in South Australia, to identify current practice in obtaining and using feedback from users of one-to-one services and group health promotion and community development activities. Factors which encourage feedback to be given and used include: trust and effective communications between all stakeholders; and supportive organisational philosophies, culture and practices. Client feedback is more likely to be used when given in written form. Collection and use of feedback are discouraged by inappropriate methods and timing, rapid organisational change, and clients' lack of awareness of, or confidence in, giving feedback about the services they receive. Verbal feedback, although preferred by many clients, is less likely to be recorded and used in service planning and evaluation. Client feedback is a valuable tool to reinforce the notion of partnership and power sharing between clients and health care workers. Staff at all levels should be engaged in obtaining feedback and the information gained should be disseminated throughout the agency in order to improve the quality and effectiveness of services. The challenge is now for service providers and users to adopt new, and support currently successful, ways of obtaining and using feedback so that service providers and users are engaged in working in partnership to ensure the needs of the community are best met.

Bipolar I and II Disorders in a Random and Representative Australian Population

2005 ◽  
Vol 39 (8) ◽  
pp. 726-729 ◽  
Author(s):  
Robert D. Goldney ◽  
Laura J. Fisher ◽  
Eleonora Dal Grande ◽  
Anne W. Taylor ◽  
Graeme Hawthorne
Keyword(s):  
Quality Of Life ◽  
Health Status ◽  
Demographic Data ◽  
South Australia ◽  
Bipolar Disorders ◽  
International Studies ◽  
Australian Population ◽  
Mood Disorder Questionnaire ◽  
Use Of Services

Objective: To assess the prevalence of bipolar I and II disorders in an Australian population. Method: The Mood Disorder Questionnaire (MDQ) was administered to 3015 respondents in a random and representative sample in South Australia. Health status, quality of life and demographic data were also collected. Results: There was a 2.5% lifetime prevalence of bipolar I and II disorders delineated by the MDQ. Those people had a significantly greater use of services and a poorer health status and quality of life than those who were MDQ-negative. Conclusions: These results in an Australian population are consistent with other international studies showing a greater prevalence of bipolar disorders than hitherto appreciated.

“She Is NOT a Genuine Client”: Exploring Health Practitioner’s Mistrust of Rape Survivors in Nairobi, Kenya

2018 ◽  
Vol 38 (4) ◽  
pp. 217-224 ◽  
Author(s):  
Leso Munala ◽  
Emily Welle ◽  
Emily Hohenshell ◽  
Nene Okunna
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Sexual Violence ◽  
Qualitative Interviews ◽  
Rape Survivors ◽  
Health Care Practitioners ◽  
Health Practitioners ◽  
Care Facilities ◽  
Forms Of Violence

Sexual violence is one of the most common forms of violence against women in Kenya. Recognizing this, the Kenyan government introduced health care sector guidelines for survivors of sexual violence. This study explores the care of rape survivors from the perspective of health-care practitioners and identifies a number of recommendations for improving the quality of care. Qualitative interviews were conducted with 28 health practitioners from eight post-rape care facilities located in Nairobi, Kenya. Data were analyzed using the Colaizzi’s 1978 analytical model. The study uncovered a troubling tendency of health practitioners questioning the authenticity of a woman’s claim, deeming some not to be genuine rape survivors. Doubts about the veracity of the client’s story led to additional emotional drain on health practitioners. This judgment negatively impacted the quality of care for rape survivors and in some cases, leading practitioners to deny services and exposing survivors to secondary victimization.

Does one person provide it all? Defining the social support of women with cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 8611-8611
Author(s):  
D. S. Dizon ◽  
J. Gass ◽  
C. Bandera ◽  
S. Weitzen ◽  
M. Clark
Keyword(s):  
Social Support ◽  
Health Care ◽  
Cancer Diagnosis ◽  
Demographic Data ◽  
Gynecologic Cancer ◽  
Current Status ◽  
Categorical Variables ◽  
Chi Square Analysis ◽  
Primary Support

8611 Background: Medical care encourages the appointment of a health care proxy in the event the patient cannot make decisions and it is assumed that this same person will serve other critical roles for the patient. Yet, this assumption that a patient truly relies on the same person for various supportive roles has never been formally evaluated. We hypothesized that there may be a large proportion of women with cancer who do not rely on the same person to be their primary support (PS), to participate in health care decision making as proxy (HCP), and serve as an emergency contact (EC). In order to evaluate this we conducted a questionnaire over a six-month period for women treated in the Program in Women’s Oncology (PWO). Methods: Patients seen at the PWO for a cancer diagnosis were invited to participate in a four part survey on social supports. Demographic data including age, race, cancer diagnosis, date of diagnosis, and current status were collected by chart review. Categorical variables were analyzed using Fisher’s Exact Test or Chi-square analysis. Results: Over 6 months, 224/228 women (98%) agreed to participate. The median age was 58 (range, 30–85). 138 (62%) had breast cancer, 78 (35%) had a gynecologic cancer, and 8 (3.5%) had a non-gyn/non-breast tumor (6/8 colorectal). 66% were married, 8% had a partner, and 26% did not identify a partner. In this sample, 43% did not name the same person as EC, PS, and HCP. 75% named the EC as HCP, 68% EC as PS, and 62% PS as HCP (p<0.05). Of married women (n=147) only 60% named their spouse to all three roles. Divorced women were not as likely to name a partner to one of these roles as were single women with partners. When asked to define primary support, women had diverse perspectives spanning the emotional, physical, intimate, and spiritual dimensions. Age did not appear to be a significant predictor of how these questions were answered. Conclusions: This study demonstrates the complex social support structures of women with cancer. Understanding these relationships may help to enable more effective patient-centered interventions designed to improve quality of care and ultimately the quality of life of cancer survivors. No significant financial relationships to disclose.

scholarly journals UNDERSTANDING SYSTEM FAILURE IN HEALTH CARE: A MENTAL MODEL FOR DEMAND MANAGEMENT

2021 ◽  
Vol 32 (2) ◽  
Author(s):  
Dieter Hartmann ◽  
John Bicheno ◽  
Bruno Emwanu ◽  
Teresa Sharon Hattingh
Keyword(s):  
Health Care ◽  
Demand Management ◽  
Waiting Times ◽  
Significant Proportion ◽  
System Failure ◽  
Academic Assessment ◽  
Reducing Costs ◽  
Diagnostic Framework ◽  
Insight Into

The load on health systems caused by systemic overburden leads to heightened costs, longer waiting times, a reduced quality of care, andassociated problems. This may be caused by ’failure demand’; however, its definition is inadequate for a complex hierarchical system. Although accounting for a significant proportion of load in other industries, the academic assessment of failure demand in health care remains limited. We present a novel way of identifying repeat consumption, which we loosely equate with failure demand. We present a framework that can be used to identify ‘system failure’, the trigger for later repeat consumption. This provides new insight into understanding whether common events represent system failure. A diagnostic framework was developed from observations, the literature, and brainstorming. Commonly observed exit scenarios in health care were tested against the framework to create a system-failure list. The framework and the categorisation table were shared with eight international Lean health-care experts. Following feedback, the framework and categorisations were fine-tuned and consensus was achieved via member-checking. Identifying and managing failure demand for these settings can lead to a reduced system load, thus reducing costs and increasing system efficiency and quality.

scholarly journals Assessment of quality of care provided at a tertiary hospital of Sikkim by patient's degree of responsiveness

2019 ◽  
Vol 8 (9) ◽  
pp. 3710
Author(s):  
Hafizur Rahman ◽  
Ezzat Khalda
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Access ◽  
Significant Proportion ◽  
Tertiary Hospital ◽  
Similar Proportion ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Access

Background: Quality of care is concerned with the interface between provider and patients, between health services and community. The aim of the current study was to evaluate the quality of provided health care and patient experiences at a tertiary hospital based on the concept of responsiveness.Methods: This was a cross-sectional survey among reproductive women of Central Referral Hospital over a period of 5 months from August 2016 to December 2016. A pre-designed, pretested, self-administered response questionnaire on rate of service utilization using the WHO health system responsiveness modulewas used.Results: A total of 450 women were approached and requested to participate during the study period of which 374 women completed the survey. According to the evaluation of in-patient care (Table 2), "able to change doctor if wanted" showed the lowest degree of responsiveness (52.7%). A significant proportion of patients experienced discrimination for different reasons: 9.6% reported feeling they had been treated worse than others because of lack of money, while a similar proportion reported they had been discriminated for the language they speak or because they were having insurance from a company.Conclusions: Health care access in terms of prolong waiting  time in the reception and before being attended by doctor, difficulty to change doctor when wanted and discriminatory experiences were identified as priority areas for actions to improve responsiveness and patient satisfaction.

Patient Satisfaction with Oral Health Care Services Provided by University of Dental Medicine, Yangon

2019 ◽  
Vol 31 (2) ◽  
pp. 165-169
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Oral Health ◽  
Health Care Services ◽  
Demographic Data ◽  
Oral Health Care ◽  
Periodic Review ◽  
Patient Satisfaction Score ◽  
Care Services

Quality of Oral Health Care (OHC) services has received increasing attention in recent years. Little is known about patient satisfaction in quality of it in Myanmar context. Its success can be generally assessed by the level of patient satisfaction in the variety of clinical setting, for instance, private clinics as well as in teaching dental university. This study aimed to determine the level satisfaction of patients after visiting the University of Dental Medicine, Yangon (UDMY). A total of 207 patients visiting five clinical departments of UDMY were investigated from October to December, 2017. A questionnaire covering to assess the demographic data, patient-dentist interaction, technical competency, administrative efficiency and clinic set up environment was used for face- to- face interview. The data were analyzed by descriptive methods followed by inferential method. Out of 207 patients, 41.5% were male and 58.5% were female. The overall patient satisfaction score was 76.3% which showed high level of satisfaction on oral health care services provided by UDMY. The least satisfied item was prolonged waiting time to have an appointment in administrative domain while the most satisfied item was that dentist had been friendly in patient-dentist interaction domain. Over 40 year old group patients were more satisfied with oral health care services (p=0.013). Married patients had higher satisfaction with patient-dentist interaction (p=0.014). This study showed a positive response to the care of patients at the UDMY. Further researches as well as periodic review studies have to be carried out for improvement and utilization of oral health care services in Myanmar.

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