Education of the medical profession to facilitate delivery of transgender health care in an Australian health district

2020 ◽  
Vol 26 (1) ◽  
pp. 17
Author(s):  
Maansi Arora ◽  
Kaete Walker ◽  
Judy Luu ◽  
Robbert J. Duvivier ◽  
Tinashe Dune ◽  
...  
Keyword(s):  
Health Care ◽  
New England ◽  
Lived Experience ◽  
Medical Profession ◽  
Healthcare Providers ◽  
Health District ◽  
Easy Access ◽  
Local Health ◽  
Community Members ◽  
Transgender Health

Transgender individuals who desire medical transition need to access care through their local healthcare system. This is the first study to explore the perceptions of the community and attitudes of healthcare providers towards the delivery of transgender health care in an Australian context. An anonymous survey was conducted of trans and gender-diverse community members; and physicians and trainees in the Hunter New England Local Health District of New South Wales, Australia. Community members were surveyed about their healthcare experiences. Medical students, GPs and hospital physicians were surveyed on their attitudes towards the delivery of transgender health care before and after a 1-h education session that included the lived experience of a community member. Community members expressed a need for increased education for healthcare providers in transgender medicine. Following the intervention, significantly more healthcare providers felt confident to facilitate transgender health care for adults, adolescents and children; and more healthcare providers agreed that medical and surgical treatment should be offered to transgender patients if desired. The positive safety profile of treatment was felt to be the most persuasive factor for the provision of care. Healthcare providers identified a need for health education in transgender medicine; easy access to evidence-based resources; and local referral pathways as key strategies to improving transgender health care.

scholarly journals Health Care Professionals’ Knowledge of Stalking Perpetrators, Victims, Behaviors, and Coping Strategies: A Preliminary Study among Italian Hospitals

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Daniela Acquadro Maran ◽  
Barbara Loera ◽  
Alberto D’Argenio
Keyword(s):  
Health Care ◽  
Coping Strategies ◽  
Health Care Professionals ◽  
Ad Hoc ◽  
Medical Profession ◽  
Large City ◽  
Local Health ◽  
Male Victims ◽  
Physical Consequences ◽  
And Coping

The aim of this study was to investigate health care professionals’ level of in-depth understanding about the various types and characteristics of stalking. In particular, the study examines knowledge on the characteristics of stalkers and their victims, acted behaviors, and coping strategies used to stop the harassment. The data were collected by means of an ad hoc questionnaire. The sample comprised 210 participants working in local health units in Turin, a large city located in the northern part of Italy. The majority were women (160, 76.2%). The participants were aged 20–64 years, and the mean age was 41.63 years (SD = 11.18). The majority of participants were psychologists (99, 47.1%), 31 (14.8%) were nurses, 31 (14.8%) had an unspecified medical profession, 29 (13.8%) were psychiatrists, and 20 (9.5%) were general practitioners. According to the findings, interventions with male victims of stalking, especially when the stalker is a woman, require attention in particular. Underestimating the stalking experience is a risk, so health care professionals in their interventions must explain to the men the emotive and physical consequences of the victimization. Moreover, in suggesting coping strategies, health care professionals must consider the victim’s fear of reporting the incident not only to law enforcement authorities but also to family and friends. The findings showed that health care professionals need a better understanding of the stalking phenomenon. Education courses are a valuable tool to identify characteristics of the phenomenon, validate existing knowledge, and decrease the level of missing information to develop the skills needed to take appropriate action in cases of stalking.

scholarly journals Integrated mental health atlas of the Western Sydney Local Health District: gaps and recommendations

2017 ◽  
Vol 41 (1) ◽  
pp. 38 ◽  
Author(s):  
Ana Fernandez ◽  
James A. Gillespie ◽  
Jennifer Smith-Merry ◽  
Xiaoqi Feng ◽  
Thomas Astell-Burt ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Lived Experience ◽  
Critical Analysis ◽  
Local Health ◽  
Adult Mental Health ◽  
Local Evidence ◽  
Integrated Mental Health

Objective Australian mental health care remains hospital centric and fragmented; it is riddled with gaps and does little to promote recovery. Reform must be built on better knowledge of the shape of existing services. Mental health atlases are an essential part of this knowledge base, enabling comparison with other regions and jurisdictions, but must be based on a rigorous classification of services. The main aim of this study is to create an integrated mental health atlas of the Western Sydney LHD in order to help decision makers to better plan informed by local evidence. Methods The standard classification system, namely the Description and Evaluation of Services and Directories in Europe for Long-term Care model, was used to describe and classify adult mental health services in the Western Sydney Local Health District (LHD). This information provided the foundation for accessibility maps and the analysis of the provision of care for people with a lived experience of mental illness in Western Sydney LHD. All this data was used to create the Integrated Mental Health Atlas of Western Sydney LHD. Results The atlas identified four major gaps in mental health care in Western Sydney LHD: (1) a lack of acute and sub-acute community residential care; (2) an absence of services providing acute day care and non-acute day care; (3) low availability of specific employment services for people with a lived experience of mental ill-health; and (4) a lack of comprehensive data on the availability of supported housing. Conclusions The integrated mental health atlas of the Western Sydney LHD provides a tool for evidence-informed planning and critical analysis of the pattern of adult mental health care. What is known about the topic? Several reports have highlighted that the Australian mental health system is hospital based and fragmented. However, this knowledge has had little effect on actually changing the system. What does this paper add? This paper provides a critical analysis of the pattern of adult mental health care provided within the boundaries of the Western Sydney LHD using a standard, internationally validated tool to describe and classify the services. This provides a good picture of the availability of adult mental health care at the local level that was hitherto lacking. What are the implications for practitioners? The data presented herein provide a better understanding of the context in which mental health practitioners work. Managers and planners of services providing care for people with a lived experience of mental illness can use the information herein for better planning informed by local evidence.

scholarly journals Is health systems integration being advanced through Local Health District planning?

2017 ◽  
Vol 41 (2) ◽  
pp. 154
Author(s):  
Carla Saunders ◽  
David J. Carter
Keyword(s):  
Health Care ◽  
Health Service ◽  
Health Systems ◽  
Systems Integration ◽  
Health District ◽  
Local Health ◽  
Service Plan ◽  
Integration Strategies ◽  
Health Systems Integration ◽  
Health Districts

Objective Delivering genuine integrated health care is one of three strategic directions in the New South Wales (NSW) Government State Health Plan: Towards 2021. This study investigated the current key health service plan of each NSW Local Health District (LHD) to evaluate the extent and nature of health systems integration strategies that are currently planned. Methods A scoping review was conducted to identify common key principles and practices for successful health systems integration to enable the development of an appraisal tool to content assess LHD strategic health service plans. Results The strategies that are planned for health systems integration across LHDs focus most often on improvements in coordination, health care access and care delivery for complex at-risk patients across the care continuum by both state- and commonwealth-funded systems, providers and agencies. The most common reasons given for integrated activities were to reduce avoidable hospitalisation, avoid inappropriate emergency department attendance and improve patient care. Conclusions Despite the importance of health systems integration and finding that all NSW LHDs have made some commitment towards integration in their current strategic health plans, this analysis suggests that health systems integration is in relatively early development across NSW. What is known about the topic? Effective approaches to managing complex chronic diseases have been found to involve health systems integration, which necessitates sound communication and connection between healthcare providers across community and hospital settings. Planning based on current health systems integration knowledge to ensure the efficient use of scarce resources is a responsibility of all health systems. What does this paper add? Appropriate planning and implementation of health systems integration is becoming an increasingly important expectation and requirement of effective health systems. The present study is the first of its kind to assess the planned activity in health systems integration in the NSW public health system. NSW health districts play a central role in health systems integration; each health service plan outlines the strategic directions for the development and delivery of all state-funded services across each district for the coming years, equating to hundreds of millions of dollars in health sector funding. The inclusion of effective health systems integration strategies allows Local Health Districts to lay the foundation for quality patient outcomes and long-term financial sustainability despite projected increases in demand for health services. What are the implications for practice? Establishing robust ongoing mechanisms for effective health systems integration is now a necessary part of health planning. The present study identifies several key areas and strategies that are wide in scope and indicative of efforts towards health systems integration, which may support Local Health Districts and other organisations in systematic planning and implementation.

scholarly journals Building health system responsiveness to noncommunicable diseases for Gweru District adults, Zimbabwe: a case study

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Blender Muzvondiwa ◽  
Roy Batterham
Keyword(s):  
Health Care ◽  
Lived Experience ◽  
Health Systems ◽  
Grey Literature ◽  
Care Staff ◽  
Noncommunicable Diseases ◽  
Health Care Staff ◽  
Local Health ◽  
Content Type ◽  
Local Health Care

PurposeGweru District, Zimbabwe faces a major challenge of noncommunicable diseases (NCDs). Globally, health systems have not responded successfully to problems in prevention and management of NCDs. Despite numerous initiatives, reorienting health services has been slow in many countries. Gweru District has similar challenges. The purpose of this paper is to explore what the health systems in Zimbabwe have done, and are doing to respond to increasing numbers of NCD cases in adults in the nation, especially in the district of GweruDesign/methodology/approachThe study employed a descriptive narrative review of the academic and grey literature, supplemented by semi-structured key informant interviews with 14 health care staff and 30 adults living with a disease or caring for an adult with a disease in Gweru District.FindingsRespondents identified many limitations to the response in Gweru. Respondents said that screening and diagnosis cease to be helpful when it is difficult securing medications. Nearly all community respondents reported not understanding why they are not freed of the diseases, showing poor understanding of NCDs. The escalating costs and scarcity of medications have led people to lose trust in services. Government and NGO activities include diagnosis and screening, provision of health education and some medication. Health personnel mentioned gaps in transport, medication shortages, poor equipment and poor community engagement. Suggestions include: training of nurses for a greater role in screening and management of NCDs, greater resourcing, outreach activities/satellite clinics and better integration of diverse NCD policies.Research limitations/implicationsParticipant responses were greatly influenced by the current political and economic situation in Zimbabwe, so responses may reflect short-term crises rather than long-term trends.Originality/valueThis research offers an understanding of NCD strategies and their limitations from the bottom-up, lived experience perspective of local health care workers and community members.

scholarly journals Modern Classification and Outcomes of Heart Failure in Hunter New England Local Health District (HNELHD)

2019 ◽  
Vol 28 ◽  
pp. S183
Author(s):  
M. Al-Omary ◽  
S. Sugito ◽  
D. McIvor ◽  
T. Majeed ◽  
A. Boyle ◽  
...  
Keyword(s):  
Heart Failure ◽  
New England ◽  
Health District ◽  
Local Health ◽  
Modern Classification

scholarly journals Opinions of the Healthcare Providers Regarding a Medically Oriented Sri Lankan Teledrama

2021 ◽  
pp. 45-53
Author(s):  
H. T. D. W. Ariyarathna
Keyword(s):  
Health Care ◽  
Health Professionals ◽  
Medical Profession ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Medical Professionals ◽  
P Value ◽  
Ethical Behaviour ◽  
Care Hospital ◽  
Female Ratio

Introduction: A considerable portion of the ethics related to the medical curriculum is taught to the students by a department of forensic medicine. Medical professionals generally depict good ethical behavior while any deviations from the ethical practices negatively affect the intended health care. Ethical behaviour in the professional setting cannot be compromised by healthcare providers as it is a cornerstone of providing the best possible health care. “Television reality’ is a term that needs to be explored by medical professionals once the health care sector is being portrayed in it. Objectives: The primary goal of this study was to investigate how medical professionals perceive their respective characters when they are portrayed through the eyes of others via a teledrama. Other goals included determining how different strata of health professionals felt about the teledrama that was aired, what they thought about health professionals' ethical behaviour, and whether health professionals liked how they were portrayed in the drama. Methods: The study was a descriptive cross-sectional study completed at a tertiary care hospital. The questionnaire was pretested and designed to be a self-administered questionnaire comprised of multiple-choice questions. The participants were allowed to watch an episode of the teledrama before being asked to complete a questionnaire. The findings were analyzed using the SPSS version 23. A p-value ≤ 0.05 was considered as significant.  Results: 401 people took part in total (doctors: nurses: other = 109:197:95). The male-to-female ratio was 1:3 (males, n = 113 (28.2%) and females n=288 (71.8%). Only 6.7% (n=27) of participants thought the teledrama was beneficial to society, while the majority thought the opposite.  Approximately two-thirds of the participants (n= 268) expressed dissatisfaction with the drama. According to 56.1% (n=225) of the participants, the producer intended to humiliate the medical profession.   34.7 % of participants (n=139) thought the teledrama should be banned.  Conclusion: It is one of the prime duties of health professionals to safeguard the medical profession. At the same time the freedom of the producers of teledramas should equally be respected. Anyhow the overall findings were consistent with the fact that a clear majority of participants are hesitant to continue watching such programmes because they negatively portray professionals and the health profession. As a result, before approving the telecast, a scrutinizing mechanism should be established through a responsible body of the Ministry of Health, Sri Lanka.

scholarly journals Perceptions, attitudes and practices towards scabies in communities on the Bijagós Islands, Guinea-Bissau

2019 ◽  
Author(s):  
Maria João Lopes ◽  
Eunice Teixeira da Silva ◽  
Janete Ca ◽  
Adriana Gonçalves ◽  
Amabelia Rodrigues ◽  
...  
Keyword(s):  
Health Care ◽  
Healthcare Workers ◽  
Community Education ◽  
Community Support ◽  
Traditional Healers ◽  
Local Health ◽  
Community Members ◽  
Access To Treatment ◽  
Attitudes And Practices ◽  
Guinea Bissau

AbstractIntroductionScabies is highly endemic among impoverished populations and has been recently included in the WHO’s list of neglected tropical diseases (NTDs). Community support and behavioural changes are essential for the success of control interventions. This study aimed to explore beliefs, prevention attitudes and health care-seeking behaviours towards scabies in the Bijagós Archipelago of Guinea-Bissau.MethodsData were collected through two methods. Community key informants (community members, community health workers, healthcare workers and traditional healers) were interviewed using snowball sampling. A questionnaire covering perceptions, attitudes and practices was administered to community members using random cluster sampling. Thematic analysis of qualitative data was applied to identify themes. Descriptive statistics were used for quantitative data analysis.ResultsThere was a satisfactory awareness about scabies, but perceptions about disease causation and transmission were imprecise. Misconceptions about personal hygiene as the primary measure for scabies prevention were recurrent. Some participants recognised the importance of early treatment to interrupt transmission. Treatment of close contacts was not considered important. Costs were the main determining factor for treatment choice between traditional healer and the local health centre. Late presentation and delayed treatment were common and associated with poverty and stigmatisation. Scabies impaired quality of life by affecting social interactions, health, fitness to work and school attendance.ConclusionsThere is a need to improve education, recognition, management and affordable access to treatment. Community education, healthcare workers’ training and skin NTDs integrated control programmes should address the challenges highlighted in this study.Authors SummaryScabies is a common skin infection in low income settings. We conducted a study in Guinea-Bissau to explore the knowledge, attitudes and practices about scabies. We conducted interviews with healthcare workers, traditional healers and community members and additionally used an oral-administered questionnaire with a larger sample of community residents. Most individuals had knowledge of scabies and were aware that person to person transmission occurred. However personal and environmental hygiene were both incorrectly identified as particularly important in the transmission of scabies. Cost played a major role in determining where individuals sought care and both poverty and disease associated stigma resulted in delays seeking care. There is a need to improve community and health care worker education about scabies and improve affordable access to treatment.

scholarly journals Feasibility testing of a community dialogue approach for promoting the uptake of family planning and contraceptive services in Zambia

2020 ◽  
Author(s):  
Margarate Nzala Munakampe ◽  
Theresa Nkole ◽  
Adam Silumbwe ◽  
Joseph Mumba Zulu ◽  
Joanna Paula Cordero ◽  
...  
Keyword(s):  
Health Care ◽  
Family Planning ◽  
Health Care Providers ◽  
Health Workers ◽  
Quality Care ◽  
Healthcare Providers ◽  
Care Providers ◽  
Community Members ◽  
Community Dialogue ◽  
Feasibility Testing

Abstract Background: Community dialogues have been used in participatory approaches in various health prevention and awareness programs, including family planning interventions, to increase understanding and alignment of particular issues from different peoples’ perspectives. The main objective of this paper is to document the feasibility of a community dialogue approach, which aimed to promote dialogue between healthcare providers and community members. The feasibility testing was part of formative-phase research needed to design an intervention, with the ultimate goal of increasing the uptake of family planning and contraception. The community dialogue intervention generated discussions on key approaches to improve family planning and contraception provision and uptake. Methods: Key stages of the community dialogue were undertaken, with representation from healthcare providers and community members. Participants included frontline and managerial health care providers, community health workers, family planning and contraception users, the youth, other stakeholders from the education sector, and civil society. How the dialogue was implemented (operational feasibility) as well as the cultural feasibility of the community dialogue content was evaluated through participant observations during the dialogue, using a standardised feasibility testing tick-list, and through focus group discussions with the stakeholders who participated in the community dialogue. Results: Overall, 21 of the 30 invited participants attended the meeting- 70 per cent attendance. The approach facilitated discussions on how quality care could be achieved in family planning and contraception provision, guided by the ground rules that were agreed upon by the different stakeholders. A need for more time for the discussion was noted. Participants also noted the need for more balanced representation from adolescents as well as other family planning stakeholders, such as community members, especially in comparison to healthcare providers. Some participants were not comfortable with the language used. Young people felt older participants used complicated terminologies while community members felt the health care providers outnumbered them, in terms of representation. Conclusion: Generally, the community dialogue was well received by the community members and the healthcare providers, as was observed from the sentiments expressed by both categories. Some key considerations for refining the approach included soliciting maximum participation from otherwise marginalized groups like the youth would provide stronger representation.

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