scholarly journals Maori experiences and perceptions of gout and its treatment: a kaupapa Maori qualitative study

2013 ◽  
Vol 5 (3) ◽  
pp. 214 ◽  
Author(s):  
Leanne Te Karu ◽  
Linda Bryant ◽  
C Raina Elley
Keyword(s):  
Health Care ◽  
Health Professionals ◽  
Negative Impact ◽  
Health Care Systems ◽  
Health Status Disparities ◽  
Preventive Treatment ◽  
Structured Interviews ◽  
Self Blame ◽  
Kaupapa Māori ◽  
Care Systems

INTRODUCTION: The prevalence of gout among Maori is one of the highest in the world. This study explores the perceptions, understanding and treatment of gout among Maori. METHODS: A qualitative general inductive approach was used, guided by kaupapa Maori principles. Participants included 12 Maori aged 48–79 years with gout. Semi-structured interviews were undertaken, taped and transcribed. Themes were identified from transcripts. FINDINGS: Participants described overwhelming sufferance due to gout, which was sometimes considered inevitable. All participants believed or had been informed that gout is caused by food and/or drink. This led to feelings of self-blame and blame from partners and employers. Whanau (family) were a resource for information and a support when independence was limited. Rongoa (traditional medicine) played a role in the lives of rural but not urban participants. Many reported stoicism, putting up with pain and putting others before themselves, as the ‘Maori way’. Medicines used for gout management were predominantly non-steroidal anti-inflammatory drugs, colchicine and prednisone, with allopurinol only playing a role late in the disease. Medications were often poorly understood and consequently improperly used. Relationships with health professionals were important, but cultural, financial and time barriers impaired access and understanding. Gout had a huge, negative impact on the lives of participants. CONCLUSION: The quality of lives of many people with gout could be improved by better understanding through educational campaigns for health professionals and the community. Culturally sensitive health care systems and a paradigm shift in gout management and early preventive treatment are needed. KEYWORDS: Drug therapy; ethnic groups; gout; health status disparities; primary health care; qualitative research

The making and sustaining of leaders in health care

2019 ◽  
Vol 33 (2) ◽  
pp. 241-262 ◽  
Author(s):  
Terry J. Boyle ◽  
Kieran Mervyn
Keyword(s):  
Health Care ◽  
Community Health ◽  
Health Care Services ◽  
Health Care Systems ◽  
Structured Interviews ◽  
Healthcare Provision ◽  
Triple Aim ◽  
Content Type ◽  
Care Services ◽  
Care Systems

Purpose Many nations are focussing on health care’s Triple Aim (quality, overall community health and reduced cost) with only moderate success. Traditional leadership learning programmes have been based on a taught curriculum, but the purpose of this paper is to demonstrate more modern approaches through procedures and tools. Design/methodology/approach This study evolved from grounded and activity theory foundations (using semi-structured interviews with ten senior healthcare executives and qualitative analysis) which describe obstructions to progress. The study began with the premise that quality and affordable health care are dependent upon collaborative innovation. The growth of new leaders goes from skills to procedures and tools, and from training to development. Findings This paper makes “frugal innovation” recommendations which while not costly in a financial sense, do have practical and social implications relating to the Triple Aim. The research also revealed largely externally driven health care systems under duress suffering from leadership shortages. Research limitations/implications The study centred primarily on one Canadian community health care services’ organisation. Since healthcare provision is place-based (contextual), the findings may not be universally applicable, maybe not even to an adjacent community. Practical implications The paper dismisses outdated views of the synonymity of leadership and management, while encouraging clinicians to assume leadership roles. Originality/value This paper demonstrates how health care leadership can be developed and sustained.

Health Portals

2011 ◽  
pp. 57-64
Author(s):  
Daniel Carbone
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Professionals ◽  
Health Knowledge ◽  
Health Care Systems ◽  
Efficient Technology ◽  
Technical Content ◽  
Care Systems ◽  
Barriers And Opportunities ◽  
Delivery Of Health Services

A lack of health services has long been the thorn in the side of many communities, especially rural and regional communities. The high costs of treating ever growing chronic and complex conditions in traditional settings, where rural allied health services providers are non-existent and doctors are already overcommitted, are prompting a shift in focus to more efficient technology driven delivery of health services. Moreover, these days it is also increasingly unlikely that health professionals will encounter patients who have not used information technology to influence their health knowledge, health behaviour, perception of symptoms, and illness behaviour. Advances in Internet technologies offer promise towards the development of an e-health care system. This article will postulate whether portal technologies can play a role facilitating the transition to such e-health care systems. This article aims at reviewing the literature to present to the reader the barriers and opportunities out here for effective health portals. However, the article does not intend to provide a one-fits-all technical/content solution, only to make implementers and developers aware of the potential implications.

scholarly journals Physician perceptions of the types of roles interpreters play in limited English proficient pediatric encounters and how they evaluate the quality of interpretation

2019 ◽  
Vol 20 ◽  
Author(s):  
Rebecca J. Schwei ◽  
Natalie Guerrero ◽  
Alissa L. Small ◽  
Elizabeth A. Jacobs
Keyword(s):  
Health Care ◽  
Limited English Proficient ◽  
Health Care Systems ◽  
Care Staff ◽  
Health Care Staff ◽  
Structured Interviews ◽  
Team Members ◽  
Medical Interpreters ◽  
Care Systems

AbstractPurposeThe purpose of this study is to understand different roles that interpreters play in a pediatric, limited English proficient (LEP) health care encounter and to describe what factors within each role inform physicians’ assessment of the overall quality of interpretation.BackgroundLanguage barriers contribute to lower quality of care in LEP pediatric patients compared to their English-speaking counterparts. Use of professional medical interpreters has been shown to improve communication and decrease medical errors in pediatric LEP patients. In addition, in many pediatric encounters, interpreters take on roles beyond that of a pure language conduit.MethodsWe conducted 11 semi-structured interviews with pediatricians and family medicine physicians in one health system. Transcripts were audio-recorded and transcribed verbatim. We analyzed our data using directed content analysis. Two study team members coded all transcripts, reviewed agreement, and resolved discrepancies.FindingsPhysicians described four different interpreter roles: language conduit, flow manager, relationship builder, and cultural insider. Within each role, physicians described components of quality that informed their assessment of the overall quality of interpretation during a pediatric encounter. We found that for many physicians, a high-quality interpreted encounter involves multiple roles beyond language transmission. It is important for health care systems to understand how health care staff conceptualize these relationships so that they can develop appropriate expectations and trainings for medical interpreters in order to improve health outcomes in pediatric LEP patients.

scholarly journals Cooperate, coordinate, communicate or collaborate?

2007 ◽  
Vol 31 (1) ◽  
pp. 5
Author(s):  
Sandra G Leggat
Keyword(s):  
Health Care ◽  
Health Professionals ◽  
Health Care Systems ◽  
Institute Of Medicine ◽  
Theory Analysis ◽  
Individual Outcomes ◽  
System Components ◽  
Care Systems ◽  
Competitive Behaviour ◽  
Improve Health

IN HEALTH CARE we use these ?C? words regularly ? describing what health professionals, patients, consumers, politicians and managers need to do to improve health care systems. A snapshot of each of these is provided below. The Institute of Medicine?s Crossing the Quality Chasm report suggested that cooperation among clinicians was a priority.1 Yet game theorists have long shown that cooperation results in better individual outcomes than competitive behaviour. 2 Driven to achieve the best outcomes, people will choose to cooperate more often than they choose to compete. Most recently, game theory analysis has even been applied to the evolution of cancer, with the resulting conclusion of ?malignancy from cooperation?3 ? tumours grow because it is the nature of cells to cooperate. Given this tremendous innate ?force? for cooperation, why is there the appearance of less cooperation among health system components than we would like?

Staff Competence in Dealing with Traditional Approaches

2008 ◽  
Vol 23 (S1) ◽  
pp. s59-s68 ◽  
Author(s):  
M. Kastrup
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Professionals ◽  
Health Professionals ◽  
Cultural Context ◽  
Systems Of Care ◽  
Health Care Systems ◽  
Value Systems ◽  
Care Systems ◽  
Traditional Approaches

AbstractHealth care and health care systems should be seen and understood in their socio-cultural context. Modern urbanized societies are likely to exhibit health care pluralism, and different therapeutic approaches are available side-by-side. The various models may take their origin in different cultural traditions, but in most societies one type of care is at a given time considered “above” the others. However health care activities in all societies show a degree of interrelation, reflecting societal changes in which normative practices, value systems and structures change over time. In the current Western health systems evidence-based biomedical care is the prevailing system taught to all professionals.The present paper outlines the prevailing health paradigms, and the advantages and shortcomings of the various approaches and their relation to modern care will be discussed. With increased multicultural backgrounds of patients there is a need for mental health professionals to recognize the existence of traditional approaches and be aware of the parallel systems of care. Competent treatment of such patients requires that mental health professionals are aware of this and exhibit a willingness and ability to bridge between the more traditional and the Western approaches to treatment. The delineations and various aspects of the concept cultural competence and its dimensions will be discussed from a clinical perspective.Comparative studies of the various Western and the traditional approaches respectively will be reviewed.

scholarly journals Comprehensive Treatment of Women with Postpartum Psychosis across Health Care Systems from Swedish Psychiatrists' Perspectives

2014 ◽  
Author(s):  
Inger Engqvist ◽  
Arne Åhlin ◽  
Ginette Ferszt ◽  
Kerstin Nilsson
Keyword(s):  
Health Care ◽  
High Risk ◽  
Health Care Organizations ◽  
Health Care Systems ◽  
Psychiatric Hospitals ◽  
Postpartum Psychosis ◽  
Comprehensive Treatment ◽  
Structured Interviews ◽  
Peer Supervision ◽  
Care Systems

Studies concerning the psychiatrist's experiences of treating women with postpartum psychosis (PPP) or how they react to these women are limited in the literature. In this study a qualitative design is used. Data collection includes semi-structured interviews with nine Swedish psychiatrists working in psychiatric hospitals. The audio-taped interviews are transcribed verbatim and analyzed using content analysis. The findings consist of the categories: Protection, Treatment, Care, and Reactions. The psychiatrists describe emotions such as compassion, empathy and distress. A conclusion is that the psychiatrists focus on protecting the women from suicide and/or infanticide. Given the degree of stress the psychiatrists can experience caring for high risk challenging patients, health care organizations need to provide support and/or opportunities for peer supervision.

scholarly journals Primary Care Networks and Eritrean Immigrants’ Experiences with Health Care Professionals in Switzerland: A Qualitative Approach

2019 ◽  
Vol 16 (14) ◽  
pp. 2614 ◽  
Author(s):  
Carla Wallimann ◽  
Andreas Balthasar
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Health Care Systems ◽  
European Countries ◽  
Care Providers ◽  
Swiss Health ◽  
Care Systems

Growing migration in European countries has simultaneously increased cultural diversity in health care. Migrants’ equal access to health care systems and migrant friendly health care have therefore become relevant topics. Findings gathered in recent years have mainly focussed on the perspective of care providers, whereas this study includes migrant perspectives. It explores the primary care network of Eritrean immigrants in Switzerland as well as their experiences of interacting with health professionals. Semi-structured face-to-face interviews with intercultural interpreters from Eritrea were conducted. On the basis of a thematic analysis, the study identified the important informal and formal contacts in these Eritrean immigrants’ primary care networks and the specific forms of support each actor provides. In this network, encounters with health professionals were predominately expressed positively. The main barriers reported were language difficulties and intercultural understanding. On the basis of the participants’ statements, six key lessons for practice have been derived. These lessons are specifically important for facilitating Eritrean immigrants’ access to the Swiss health care system. Nevertheless, they are also relevant for other groups of migrants in European countries.

Sign in / Sign up

Export Citation Format

Share Document