scholarly journals Weighing up the costs of seeking health care for dengue symptoms: a grounded theory study of backpackers’ decision-making processes

2015 ◽  
Vol 21 (2) ◽  
pp. 245 ◽  
Author(s):  
Bálint Vajta ◽  
Mette Holberg ◽  
Jane Mills ◽  
William J. H. McBride
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Grounded Theory ◽  
Dengue Fever ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Public Health Issue ◽  
Structured Interviews ◽  
Australian Health ◽  
Core Category

Dengue fever, a mosquito-borne virus, is an ongoing public health issue in North Queensland. Importation of dengue fever by travellers visiting or returning to Australia can lead to epidemics. The mosquito can acquire the virus in the symptomatic viraemic phase, so timely recognition of cases is important to prevent epidemics. There is a gap in the literature about backpackers’ knowledge of dengue fever and the decision-making process they use when considering utilising the Australian health-care system. This study uses grounded theory methods to construct a theory that explains the process backpackers use when seeking health care. Fifty semi-structured interviews with backpackers, hostel receptionists, travel agents and pharmacists were analysed, resulting in identification of a core category: ‘weighing up the costs of seeking health care’. This core category has three subcategories: ‘self-assessment of health status’, ‘wait-and-see’ and ‘seek direction’. Findings from this study identified key areas where health promotion material and increased access to health-care professionals could reduce the risk of backpackers spreading dengue fever.

scholarly journals Ethical dilemmas concerning decision-making within health care leadership: a systematic literature review

Medicina ◽  
2010 ◽  
Vol 46 (9) ◽  
pp. 595 ◽  
Author(s):  
◽  
Tarja Suominen ◽  
Päivi Åstedt-Kurki ◽  
Daiva Lepaitė
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Care Management ◽  
Ethical Dilemmas ◽  
Qualitative Content Analysis ◽  
Health Care Management ◽  
Structured Interview ◽  
Health Care Leadership

The objective was to describe the research methods and research focuses on ethical dilemmas concerning decision-making within health care leadership. Material and methods. The search was conducted on Medline and PubMed databases (1998–2008). The systematic review included 21 selected articles. Results. The ethical dilemmas concerning decision-making within health care leadership are related to three levels: institutional (particular organization), political and local interface (local governmental structure), and national (professional expertise and system). The terms that are used as adequate to the term of “ethical dilemma” are the following: “continuous balancing,” “result of resource allocation,” “gap between professional obligations and possibilities,” “ethically controversial situation,” “concern about interactions,” “ethical difficulty,” “outcome of medical choices,” “concern about society access to health care resources,” “ethically difficult/ challenging situation,” “(the consequence of) ethical concern/ethical issue.” In qualitative studies, a semi-structured interview and qualitative content analysis are the most commonly applied methods; in quantitative studies, questionnaire surveys are employed. In the research literature, there is a lack of specification according to professional qualification of health care professionals concerning ethical dilemmas by decision-making within health care management/administration. Conclusions. The research on ethical dilemmas in health care leadership, management, and administration should integrate data about levels at which ethical dilemmas occur and investigate ethical dilemmas as complex phenomena because those are attached to decision-making and specific nuances of health care management/administration. In this article, the presented scientific problem requires extensive scientific discussions and research on ethical dilemmas concerning decision-making within health care leadership at various levels.

scholarly journals Perspectives of Patients, Families, and Health Care Professionals on Decision-Making about Dialysis Modality—the Good, the Bad, and the Misunderstandings!

2013 ◽  
Vol 33 (3) ◽  
pp. 280-289 ◽  
Author(s):  
Konstadina Griva ◽  
Zhi Hui Li ◽  
Alden Yuanhong Lai ◽  
Meng Chan Choong ◽  
Marjorie Wai Yin Foo
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Care Professionals ◽  
Asian Population ◽  
Dialysis Modality ◽  
Subjective Experiences ◽  
Dialysis Patients ◽  
Structured Interviews ◽  
Learning Barriers ◽  
The Family

ObjectivesThis study explored the factors influencing decision-making about dialysis modality, integrating the perspectives of patients, their families, and health care professionals within an Asian population. The study further sought to understand the low penetration rate of peritoneal dialysis (PD) in Singapore.MethodsA sample of 59 participants comprising pre-dialysis patients, dialysis patients, caregivers, and health care professionals (HCPs) participated in semi-structured interviews to explore the decision-making process and their views about various dialysis modalities. Data were thematically analyzed using NVivo9 (QSR International, Doncaster, Australia) to explore barriers to and facilitators of various dialysis modalities and decisional support needs.ResultsFear of infection, daily commitment to PD, and misperceptions of PD emerged as barriers to PD. Side effects, distance to dialysis centers, and fear of needling and pain were barriers to hemodialysis (HD). The experiences of other patients, communicated informally or opportunistically, influenced the preferences and choices of patients and family members for a dialysis modality. Patients and families value input from HCPs and yet express strong needs to discuss subjective experiences of life on dialysis (PD or HD) with other patients before making a decision about dialysis modality.ConclusionsPre-dialysis education should expand its focus on the family as the unit of care and should provide opportunities for interaction with dialysis patients and for peer-led learning. Barriers to PD, especially misperceptions and misunderstandings, can be targeted to improve PD uptake.

The response of health care workers to AIDS patients' requests for euthanasia

1999 ◽  
Vol 35 (3) ◽  
pp. 312-330 ◽  
Author(s):  
Roger S. Magnusson ◽  
Peter H. Ballis
Keyword(s):  
Health Care ◽  
Social Relations ◽  
Health Care Workers ◽  
Health Care Professionals ◽  
Terminal Illness ◽  
Qualitative Methodology ◽  
Structured Interviews ◽  
Attitudes And Practices ◽  
Australian Health ◽  
Care Workers

This paper reports on research into the practice of euthanasia amongst Australian health care professionals specialising in HIV/AIDS. It draws on data from thirty-nine semi-structured interviews carried out in Sydney, Melbourne, Brisbane and Canberra with physicians, general practitioners, hospital and community nurses, therapists and community workers. Using a qualitative methodology, the study seeks to identify how (illegal) euthanasia is currently practised, the degrees of involvement, the various forms that involvement takes, and the social relations which provide the context for involvement. In this paper we outline three categories of 'doers' to illustrate the range of attitudes and practices concerning euthanasia. This 'typology' carries a number of implications for recent policy debates over the legalisation of euthanasia. In particular it illustrates, at least within the context of AIDS care, the fragmentation of consensus over euthanasia amongst health care workers, the reality of current illegal euthanasia practices, and the limitations of a prohibitionist policy. While the legalisation of euthanasia within a regulatory framework is sometimes portrayed as an extreme or 'radical' response to terminal illness, the data presented in this paper suggest that prohibitionism is also radical in its failure to control euthanasia practice.

The challenges of providing primary health care to Afghan immigrants in Tehran: a key global human right issue

2020 ◽  
Vol 13 (3) ◽  
pp. 259-273 ◽  
Author(s):  
Afsaneh Takbiri ◽  
AmirHossein Takian ◽  
Abbas Rahimi Foroushani ◽  
Ebrahim Jaafaripooyan
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Insurance Coverage ◽  
Structured Interviews ◽  
Human Right ◽  
Content Type ◽  
Primary Health ◽  
Afghan Immigrants

Purpose This study aims to explore the challenges of providing primary health care (PHC) to Afghan immigrants in Tehran as an important global human right issue. Design/methodology/approach In this exploratory study, a total of 25 purposively selected PHC providers, including physicians, psychologists and midwives, were approached for face-to-face, semi-structured interviews, lasting 30 min on average. Thematic analysis was used to analyze the data. Findings The most common challenges of providing PHC to Afghan immigrants were categorized at individual, organizational and societal levels. Communication barriers and socioeconomic features emerged at the individual level. The organizational challenges included mainly the lack of insurance coverage for all immigrants and the lack of a screening system upon the immigrants’ arrival from the borders. At the societal level, the negative attitudes toward Afghan immigrants were causing a problematic challenge. Research limitations/implications The main limitation was the possibility that only health-care professionals with particular positive or negative perspectives about immigrants enter into the study, because of the voluntary nature of participation. Practical implications Findings can help policymakers adopt evidence-informed strategies for facilitating PHC provision and improving the access to health care in immigrants as a global human right concern. Social implications This study alerts about undesirable consequences of certain attitudes and behaviors of the society toward immigrant health. Originality/value To the best of the authors’ knowledge, this is one of the first studies conducted in PHC centers in Tehran Province that explores the challenges of providing PHC to Afghan immigrants.

scholarly journals Admission Decision-Making in Hospital Emergency Departments: The Role of the Accompanying Person

2020 ◽  
Vol 7 ◽  
pp. 233339362093002
Author(s):  
Susanna Rance ◽  
Debra Westlake ◽  
Heather Brant ◽  
Ingrid Holme ◽  
Ruth Endacott ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Emergency Departments ◽  
Participant Observation ◽  
Structured Interviews ◽  
Discharge Care ◽  
Conversational Skills ◽  
Hospital Emergency Departments

In resource-stretched emergency departments, people accompanying patients play key roles in patients’ care. This article presents analysis of the ways health professionals and accompanying persons talked about admission decisions and caring roles. The authors used an ethnographic case study design involving participant observation and semi-structured interviews with 13 patients, 17 accompanying persons and 26 health care professionals in four National Health Service hospitals in south-west England. Focused analysis of interactional data revealed that professionals’ standardization of the patient–carer relationship contrasted with accompanying persons’ varied connections with patients. Accompanying persons could directly or obliquely express willingness, ambivalence and resistance to supporting patients’ care. The drive to avoid admissions can lead health professionals to deploy conversational skills to enlist accompanying persons for discharge care without exploring the meanings of their particular relationship with the patients. Taking a relationship-centered approach could improve the attention to accompanying persons as co-producers of health care and participants in decision-making.

scholarly journals Experiences of Trauma Health Care Professionals When Providing Healthcare to Immigrants in Durban Public Hospitals, South Africa.

2021 ◽  
Author(s):  
Rowan Madzamba ◽  
Kantharuben Naidoo ◽  
Barbara Ntombi Ngwenya
Keyword(s):  
South Africa ◽  
Health Care ◽  
Health Professionals ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Care Service ◽  
Health Care Service ◽  
Public Hospitals ◽  
Structured Interviews ◽  
Local Language

Abstract BackgroundExisting research on access to health care for immigrants in South Africa has focused on access and use of services by immigrants. Focus has been on immigrants concerns around issues of citizenship acquisition and the burdening of the country’s resource-constrained healthcare system. Limited empirical research has been conducted to explore health care professionals’ views, daily experiences and challenges when attending to immigrant patients in South African public hospitals. This study purports to fill in this knowledge gap by capturing experiences and challenges of trauma health care professionals when providing healthcare to immigrants in Durban public hospitals, KwaZulu Natal province in South Africa.MethodData were collected based on a multicase qualitative study design through face-to-face in-depth structured interviews with twenty (20) trauma health care professionals from four (4) trauma centers in Durban public hospitals. Criterion based expert purposive sampling was used to recruit participants for the study. Data collected were analysed using thematic analysis.ResultsInability of immigrant patient to converse in English or any other local language posed a major constraint for trauma medical professional health care service provision. Poor communication and culturally based differences in interpretations of sickness causality as well as desired treatment were also reported as challenges health professionals face when attending to immigrant patients. Doctors were concerned about how these barriers presented risks of prescribing wrong treatment and the possibility of patient’s non-compliance especially those who cannot not speak English or any local language. ConclusionTo health professionals’ language and communication barrier, different cultural interpretation of sickness and cause of sickness is a challenge health professional are facing when attending to immigrant patients. There is need for interpreters at hospitals or for hospitals to make it compulsory for patients who do not speak native language or English to always be accompanied by an interpreter.

Forms of trust and polypharmacy among older adults

2020 ◽  
pp. 1-16
Author(s):  
Alison Ross ◽  
James Gillett
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Decision Making ◽  
Social Networks ◽  
Health Care Professionals ◽  
Communicative Action ◽  
Medication Use ◽  
Modern Society ◽  
Structured Interviews ◽  
Life World

Abstract This article examines how older adults make decisions about their medications through interconnected axes of trust that operate across social networks. Trust is negotiated by older adults enrolled in a deprescribing programme which guides them through the process of reducing medications to mitigate risks associated with polypharmacy. Habermas’ work on the significance of communicative action in negotiating trust within social relationships informs our analysis, specifically in-depth semi-structured interviews with older adults about their medication use and the role of social networks in managing their health. Participants were age 70+ and experiencing polypharmacy. Our analysis discusses the social nature of medication practices and the importance of social networks for older adults’ decision-making. Their perspective reflects the critique of late-modern society put forward by Habermas. Negotiating trust in pharmaceutical decision-making requires navigating tensions across and between system networks (health-care professionals) and life-world networks (family and friends). This study contributes to our knowledge of how distinct forms of trust operate in different social spheres, setting the context for the way health-care decisions are made across social networks. Our analysis reinforces the need for older adults to engage meaningfully in health-care decision-making such that a convergence between system-world and life-world structures is encouraged. This would improve deprescribing programmes’ efficacy as older adults optimise their medication use and improve overall quality of life.

scholarly journals Palliative care as a public health issue: understanding disparities in access to palliative care for the homeless population living in Toronto, based on a policy analysis

2017 ◽  
Vol 24 (3) ◽  
pp. 187 ◽  
Author(s):  
B. Henry ◽  
N. Dosani ◽  
L. Huynh ◽  
N. Amirault
Keyword(s):  
Public Health ◽  
Health Care ◽  
Decision Making ◽  
Palliative Care ◽  
Access To Health Care ◽  
Death And Dying ◽  
Support Network ◽  
Homeless Population ◽  
Public Health Issue ◽  
Good Decision

Even in a developed country such as Canada, there are disparities in just access to adequate health care—and, more specifically, palliative care. That inequality is most notable in an underserved group such as the homeless population. Even the word “homeless” has become both a negative descriptor and a stereotype in our society. We posit that the provision of hospice palliative care is structured on several problematic assumptions: an expectation that patients will have an informal support network (family and friends), a stable and secure residence, a predictive terminal illness trajectory, and reasonable access to health care. Those assumptions create structural inequality within the system.Homeless individuals have considerable experience with death and dying, and qualitative research has shown them to hold the expectation that their death will be both sudden and violent. Here, we look at the current data concerning known disparities in access to good palliative care services experienced by the homeless population, based on a stakeholder analysis of the available literature. That information, coupled with the use of a public health ethics decision-making tool, such as the Good Decision Making in Real Time framework, is used to explore the common ethics challenges that can arise in public health interventions aimed at the provision of end-of-life care to homeless adults. A broad exploration of the system that underlies our care is critical to the proper and appropriate provision of care for homeless individuals.

Potentially Inappropriate Medications Use in A Population of Iraqi Geriatric Outpatients According to Beers Criteria

2019 ◽  
Vol 10 (02) ◽  
Author(s):  
Ola Albaghdadi ◽  
Salam , Mohammad Hassan Morteza, Firas A Ahjel ◽  
Mohammad Hassan Morteza ◽  
Firas Aziz Rahi
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Public Health Issue ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Cross Sectional ◽  
Face To Face ◽  
Inappropriate Drugs ◽  
Elderly Outpatients ◽  
Inappropriate Medications

Aims: Elderly in Iraq kept suffering multiple burdens, as they are a truly fragile and vulnerable segment. A major public health issue among elderly is adverse drug reactions. This study is aimed at contributing in overcoming this treatment gap by determining the prevalence of inappropriate medications used by a group of Iraqi elderly outpatients. Methods: A cross-sectional, questionnaire-based study was conducted in a sample of 85 Iraqi elderly aged ≥65 years of either gender. Participants had face-to-face interviews to answer a comprehensive questionnaire. Each drug taken by the patient was evaluated according to Beers criteria. Results: Females constituted 45.9% of the total. The average age was 69.9 years (± 4.6). Nearly 30% of the patients had 3 different diseases, and 17.8% had ≥4 different ones, with cardiovascular diseases were the most prevalent. Polypharmacy was notably identified in 47.1% of the total studied population. Twenty-eight out of 85 patients did not know the actual reason of taking at least one of their medications, and 42% were not taking their drugs as directed. Remarkably, 43.5% of patients were recognized as taking at least one medication to be avoided in elderly people according to the Beers criteria. The most common inappropriate drugs were glyburide, and proton-pump inhibitors. Conclusion: There was an obvious absence of any role of pharmacists in the health care system for our studied population. Health care professionals are encouraged to review the medications prescribed for geriatric patients using updated safety guidelines to prevent the risks associated with potentially inappropriate medications.

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