scholarly journals Exploring the Unmet Needs of the Patients in the Outpatient Respiratory Medical Clinic: Patients versus Clinicians Perspectives

2015 ◽  
Vol 2015 ◽  
pp. 1-13
Author(s):  
Lone Birgitte Skov Jensen ◽  
Ulf Brinkjær ◽  
Kristian Larsen ◽  
Hanne Konradsen
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Unmet Needs ◽  
Lifestyle Changes ◽  
Medical Clinic ◽  
Ethical Implications ◽  
Emotional Suffering ◽  
Medical Clinics ◽  
Guidance Program ◽  
Fitting In

Aim. Developing a theoretical framework explaining patients’ behaviour and actions related to unmet needs during interactions with health care professionals in hospital-based outpatient respiratory medical clinics.Background. The outpatient respiratory medical clinic plays a prominent role in many patients’ lives regarding treatment and counselling increasing the need for a better understanding of patients’ perspective to the counselling of the health care professionals.Design. The study is exploratory and based on Charmaz’s interpretation of grounded theory.Methods. The study included 65 field observations with a sample of 43 patients, 11 doctors, and 11 nurses, as well as 30 interviews with patients, conducted through theoretical sampling from three outpatient respiratory medical clinics in Denmark.Findings. The patients’ efforts to share their significant stories triggered predominantly an adaptation or resistance behaviour, conceptualized as “fitting in” and “fighting back” behaviour, explaining the patients’ counterreactions to unrecognized needs during the medical encounter.Conclusion. Firstly this study allows for a better understanding of patients’ counterreactions in the time-pressured and, simultaneously, tight structured guidance program in the outpatient clinic. Secondly the study offers practical and ethical implications as to how health care professionals’ attitudes towards patients can increase their ability to support emotional suffering and increase patient participation and responsiveness to guidance in the lifestyle changes.

scholarly journals Steganography Based Authenticated Data Sharing in Health Care

2020 ◽  
pp. 435-437
Author(s):  
Thangaraj P ◽  
Salomi M ◽  
Devipriya A
Keyword(s):  
Health Care ◽  
Physiological Signals ◽  
Body Sensor Networks ◽  
Medical Clinic ◽  
Information Classification ◽  
Medical Clinics ◽  
Encryption And Decryption ◽  
Security Regulations ◽  
Similar Cost ◽  
Glucose Reading

As per Health Insurance Portability and Accountability Act (HIPAA)the patient's protection and protection are significant in assurance of medical care protection. Simultaneously, the quantity of maturing populace is developing essentially. Purpose Of-care in medical clinics utilized generally around the globe. The Security Regulations are represented in order to provide data veracity, privacy, and accessibility. Consequently, patient’s ECG along with other physiological signals, for example, temperature, pulse, glucose reading, position, and so forth, were gathered by utilizing Body Sensor Networks (BSNs) and transmitted. At a similar cost, understanding protection is ensured against stalkers while information direct in vulnerable organization and placed in medical clinic workers. Likewise, the accompanying system was consolidated in this venture: (1) encryption and decryption for information classification and trustworthiness (2) ECG based Steganography to trade information. Our plan additionally guarantees security, efficiency, and scalability.

scholarly journals Determinants of Successful eHealth Coaching for Consumer Lifestyle Changes: Qualitative Interview Study Among Health Care Professionals

2018 ◽  
Vol 20 (7) ◽  
pp. e237 ◽  
Author(s):  
Carl Joakim Brandt ◽  
Gabrielle Isidora Søgaard ◽  
Jane Clemensen ◽  
Jens Søndergaard ◽  
Jesper Bo Nielsen
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Qualitative Interview ◽  
Interview Study ◽  
Lifestyle Changes ◽  
Qualitative Interview Study

Self-management of chronic conditions in a rural and remote context

2015 ◽  
Vol 21 (1) ◽  
pp. 90 ◽  
Author(s):  
Adem Sav ◽  
Michelle A. King ◽  
Fiona Kelly ◽  
Sara S. McMillan ◽  
Elizabeth Kendall ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Urban Areas ◽  
Chronic Conditions ◽  
Health Care Services ◽  
Management Strategies ◽  
Lifestyle Changes ◽  
Self Management ◽  
Rural And Remote ◽  
North West

Living in a rural or remote environment presents unique challenges for people with chronic conditions, mainly those created by limited health-care services and the physical and emotional isolation. Yet, research on how people self-manage their chronic conditions in such locations is limited. This study aims to contribute to research and clinical practice by describing the ways in which a diverse group of rural and remote people with a range of chronic conditions, and their unpaid carers, self-manage their conditions. Using semi-structured in-depth interviews, data was collected from a sample of 32 participants, residing in one of two regions of Australia: Mount Isa/North West region of Queensland and the Northern Rivers area of New South Wales. Our findings suggest that although self-managing in a rural and remote context requires many of the lifestyle changes necessary in urban areas, the uniqueness of the rural lifestyle and the limited availability of health care results in, at times, creative forms of self-management. Health-care professionals and policy makers need to be cognisant of the ways in which rural and remote residents modify self-management strategies to suit their needs, and help them develop self-management plans tailored to the realities of their rural environment.

scholarly journals Promoção da saúde articulada aos determinantes sociais: possibilidade para a equidade

2019 ◽  
Vol 13 (4) ◽  
pp. 943
Author(s):  
Daniella Santos Figueredo ◽  
Ivonete Teresinha Schulter Buss Heidemann ◽  
Gisele Cristina Manfrini Fernandes ◽  
Aline Megumi Arakawa-Belaunde ◽  
Lays Souza De Oliveira ◽  
...  
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Primary Health Care ◽  
Social Determinants ◽  
Health Care Professionals ◽  
Family Health ◽  
Lifestyle Changes ◽  
Structured Interviews ◽  
Primary Health ◽  
Recursos Humanos

RESUMO Objetivo: conhecer as práticas de promoção da saúde articuladas aos determinantes sociais e desenvolvidas por profissionais da Atenção Primária à Saúde. Método: trata-se de estudo qualitativo, descritivo, exploratório. Realizaram-se 19 entrevistas semiestruturadas com profissionais de saúde inseridos em duas Unidades Básicas de Saúde. Avaliaram-se os dados a partir da técnica de Análise de Conteúdo na modalidade Análise Temática. Resultados: desenvolvem-se as práticas de Promoção da Saúde, em sua maioria, em grupos de educação em saúde, com orientações sobre mudança de estilo de vida durante as consultas agendadas. Apontaram-se, como potencialidades, o adequado processo de trabalho das equipes de saúde, o apoio e o incentivo da gestão atual e o vínculo com a comunidade. Citaram-se, como principais desafios, a demanda excessiva de usuários para consultas individuais e a falta de recursos humanos, apontando algumas fragilidades da gestão. Conclusão: ressalta-se a pertinência da Promoção da Saúde na Atenção Primária como forma de cuidado e autonomia do indivíduo e da comunidade, considerando os determinantes sociais, mas requerendo investimentos na educação permanente frente aos desafios apontados. Descritores: Promoção da Saúde; Estratégia Saúde da Família; Determinantes Sociais da Saúde; Atenção Primária à Saúde; Enfermagem; Equidade em Saúde.ABSTRACT Objective: to know the practices of health promotion articulated to social determinants and developed by Primary Health Care professionals. Method: this is a qualitative, descriptive, exploratory study. Nineteen semi-structured interviews were conducted with health professionals enrolled in two Basic Health Units. Data were evaluated using the Content Analysis technique in the Thematic Analysis modality. Results: health promotion practices are developed, mostly in health education groups, with orientations on lifestyle changes during the scheduled consultations. As potentialities, the adequate work process of the health teams, the support and the incentive of the current management and the bond with the community were pointed out. The main challenges were the excessive user demand for individual consultations and the lack of human resources, pointing out some management weaknesses. Conclusion: the relevance of Health Promotion in Primary Care as a form of care and autonomy of the individual and of the community, considering the social determinants, but requiring investments in the permanent education facing the challenges pointed out. Descriptors: Health Promotion; Family Health Strategy; Social Determinants of Health; Primary Health Care; Nursing; Equity in Health.RESUMEN Objetivo: conocer las prácticas de promoción de la salud articuladas a los determinantes sociales y desarrolladas por profesionales de la Atención Primaria a la Salud. Método: se trata de un estudio cualitativo, descriptivo, exploratorio. Se realizaron 19 entrevistas semiestructuradas con profesionales de salud insertados en dos Unidades Básicas de Salud. Se evaluaron los datos a partir de la técnica de Análisis de Contenido en la modalidad Análisis Temático. Resultados: se desarrollan las prácticas de Promoción de la Salud, en su mayoría, en grupos de educación en salud, con orientaciones sobre cambio de estilo de vida durante las consultas programadas. Se señalaron, como potencialidades, el adecuado proceso de trabajo de los equipos de salud, el apoyo y el incentivo de la gestión actual y el vínculo con la comunidad. Se citaron, como principales desafíos, la demanda excesiva de usuarios para consultas individuales y la falta de recursos humanos, apuntando algunas debilidades de la gestión. Conclusión: se resalta la pertinencia de la Promoción de la Salud en la Atención Primaria como forma de cuidado y autonomía del individuo y de la comunidad, considerando los determinantes sociales, pero requiriendo inversiones en la educación permanente frente a los desafíos señalados. Descriptores: Promoción de la Salud, Estrategia de la Salud Familiar; Determinantes Sociales de la Salud; Enfermería; Equidad en Salud.

scholarly journals Survey on Acceptance of Passive Technology Monitoring for Early Detection of Cognitive Impairment

2020 ◽  
pp. 9-15
Author(s):  
Sylvia Josephy-Hernandez ◽  
Catherine Norise ◽  
Jee-young Han ◽  
Kara M. Smith
Keyword(s):  
Health Care ◽  
Early Detection ◽  
Health Care Professionals ◽  
Public Perception ◽  
Health Care Systems ◽  
Smartphone Application ◽  
Ethical Implications ◽  
The Usa ◽  
The Impact ◽  
Digital Biomarkers

<b><i>Introduction:</i></b> Digital biomarkers may act as a tool for early detection of changes in cognition. It is important to understand public perception of technologies focused on monitoring cognition to better guide the design of these tools and inform patients appropriately about the associated risks and benefits. Health care systems may also play a role in the clinical, legal, and financial implications of such technologies. <b><i>Objective:</i></b> To evaluate public opinion on the use of passive technology for monitoring cognition. <b><i>Methods:</i></b> This was a one-time, Internet-based survey conducted in English and Spanish. <b><i>Results:</i></b> Within the English survey distributed in the USA (<i>n</i> = 173), 58.1% of respondents would be highly likely to agree to passive monitoring of cognition via a smartphone application. Thirty-eight percent of those with a higher degree of experience with technology were likely to agree to monitoring versus 20% of those with less experience with technology (<i>p</i> = 0.003). Sixty-two percent of non-health-care professionals were likely to agree to monitoring versus 45% of health-care workers (<i>p</i> = 0.012). There were significant concerns regarding privacy (<i>p</i> &#x3c; 0.01). We compared the surveys answered in Spanish in Costa Rica via logistic regression (<i>n</i> = 43, total <i>n</i> = 216), adjusting for age, education level, health-care profession, owning a smartphone, experience with technology, and perception of cognitive decline. Costa Rican/Spanish-speaking respondents were 7 times more likely to select a high probability of agreeing to such a technology (<i>p</i> &#x3c; 0.01). English-speaking respondents from the USA were 5 times more likely to be concerned about the impact on health insurance (<i>p</i> = 0.001) and life insurance (<i>p</i> = 0.01). <b><i>Conclusions:</i></b> Understanding public perception and ethical implications should guide the design of digital biomarkers for cognition. Privacy and the health-care system in which the participants take part are 2 major factors to be considered. It is the responsibility of researchers to convey the ethical and legal implications of cognition monitoring.

scholarly journals Financial Incentives for Healthy Living for Patients With Cardiac Disease From the Perspective of Health Care Professionals: Interview Study (Preprint)

2021 ◽  
Author(s):  
David de Buisonjé ◽  
Jessica Van der Geer ◽  
Mike Keesman ◽  
Roos Van der Vaart ◽  
Thomas Reijnders ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Digital Literacy ◽  
Financial Incentives ◽  
Lifestyle Change ◽  
Lifestyle Changes ◽  
Target Group ◽  
Incentive System ◽  
Healthy Living ◽  
Face To Face

BACKGROUND A promising new approach to support lifestyle changes in patients with cardiovascular disease (CVD) is the use of financial incentives. Although financial incentives have proven to be effective, their implementation remains controversial, and ethical objections have been raised. It is unknown whether health care professionals (HCPs) involved in CVD care find it acceptable to provide financial incentives to patients with CVD as support for lifestyle change. OBJECTIVE This study aims to investigate HCPs’ perspectives on using financial incentives to support healthy living for patients with CVD. More specifically, we aim to provide insight into attitudes toward using financial incentives as well as obstacles and facilitators of implementing financial incentives in current CVD care. METHODS A total of 16 semistructured, in-depth, face-to-face interviews were conducted with Dutch HCPs involved in supporting patients with CVD with lifestyle changes. The topics discussed were attitudes toward an incentive system, obstacles to using an incentive system, and possible solutions to facilitate the use of an incentive system. RESULTS HCPs perceived an incentive system for healthy living for patients with CVD as possibly effective and showed generally high acceptance. However, there were concerns related to focusing too much on the extrinsic aspects of lifestyle change, disengagement when rewards are insignificant, paternalization and threatening autonomy, and low digital literacy in the target group. According to HCPs, solutions to mitigate these concerns included emphasizing intrinsic aspects of healthy living while giving extrinsic rewards, integrating social aspects to increase engagement, supporting autonomy by allowing freedom of choice in rewards, and aiming for a target group that can work with the necessary technology. CONCLUSIONS This study mapped perspectives of Dutch HCPs and showed that attitudes are predominantly positive, provided that contextual factors, design, and target groups are accurately considered. Concerns about digital literacy in the target group are novel findings that warrant further investigation. Follow-up research is needed to validate these insights among patients with CVD.

Medical Narratives and Patient Analogs: The Ethical Implications of Electronic Patient Records

1999 ◽  
Vol 38 (04/05) ◽  
pp. 253-259 ◽  
Author(s):  
E.-H. W. Kluge
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Electronic Patient Record ◽  
Patient Records ◽  
Electronic Patient Records ◽  
Specific Patient ◽  
Patient Profile ◽  
Ethical Implications ◽  
Data Space ◽  
Medical Narratives

AbstractAn electronic patient record consists of electronically stored data about a specific patient. It therefore constitutes a data-space. The data may be combined into a patient profile which is relative to a particular speciality as well as phenomenologically unique to the specific professional who constructs the profile. Further, a diagnosis may be interpreted as a path taken by a health care professional with a certain specialty through the data-space relative to the patient profile constructed by that professional. This way of looking at electronic patient records entails certain ethical implications about privacy and accessibility. However, it also permits the construction of artificial intelligence and competence algorithms for health care professionals relative to their specialties.

scholarly journals Financial Incentives for Healthy Living for Patients With Cardiac Disease From the Perspective of Health Care Professionals: Interview Study

JMIR Cardio ◽  
10.2196/27867 ◽  
2021 ◽  
Vol 5 (2) ◽  
pp. e27867
Author(s):  
David de Buisonjé ◽  
Jessica Van der Geer ◽  
Mike Keesman ◽  
Roos Van der Vaart ◽  
Thomas Reijnders ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Digital Literacy ◽  
Financial Incentives ◽  
Lifestyle Change ◽  
Lifestyle Changes ◽  
Target Group ◽  
Incentive System ◽  
Healthy Living ◽  
Face To Face

Background A promising new approach to support lifestyle changes in patients with cardiovascular disease (CVD) is the use of financial incentives. Although financial incentives have proven to be effective, their implementation remains controversial, and ethical objections have been raised. It is unknown whether health care professionals (HCPs) involved in CVD care find it acceptable to provide financial incentives to patients with CVD as support for lifestyle change. Objective This study aims to investigate HCPs’ perspectives on using financial incentives to support healthy living for patients with CVD. More specifically, we aim to provide insight into attitudes toward using financial incentives as well as obstacles and facilitators of implementing financial incentives in current CVD care. Methods A total of 16 semistructured, in-depth, face-to-face interviews were conducted with Dutch HCPs involved in supporting patients with CVD with lifestyle changes. The topics discussed were attitudes toward an incentive system, obstacles to using an incentive system, and possible solutions to facilitate the use of an incentive system. Results HCPs perceived an incentive system for healthy living for patients with CVD as possibly effective and showed generally high acceptance. However, there were concerns related to focusing too much on the extrinsic aspects of lifestyle change, disengagement when rewards are insignificant, paternalization and threatening autonomy, and low digital literacy in the target group. According to HCPs, solutions to mitigate these concerns included emphasizing intrinsic aspects of healthy living while giving extrinsic rewards, integrating social aspects to increase engagement, supporting autonomy by allowing freedom of choice in rewards, and aiming for a target group that can work with the necessary technology. Conclusions This study mapped perspectives of Dutch HCPs and showed that attitudes are predominantly positive, provided that contextual factors, design, and target groups are accurately considered. Concerns about digital literacy in the target group are novel findings that warrant further investigation. Follow-up research is needed to validate these insights among patients with CVD.

scholarly journals Determinants of Successful eHealth Coaching for Consumer Lifestyle Changes: Qualitative Interview Study Among Health Care Professionals (Preprint)

2018 ◽  
Author(s):  
Carl Joakim Brandt ◽  
Gabrielle Isidora Søgaard ◽  
Jane Clemensen ◽  
Jens Søndergaard ◽  
Jesper Bo Nielsen
Keyword(s):  
Health Care ◽  
Weight Loss ◽  
Health Care Professionals ◽  
Response Times ◽  
Lifestyle Change ◽  
Lifestyle Changes ◽  
Activity Level ◽  
Face To Face ◽  
Qualitative Interview Study

BACKGROUND Success with lifestyle change, such as weight loss, tobacco cessation, and increased activity level, using electronic health (eHealth) has been demonstrated in numerous studies short term. However, evidence on how to maintain the effect long-term has not been fully explored, even though there is a pressing need for long-term solutions. Recent studies indicate that weight loss can be achieved and maintained over 12 and 20 months in a primary care setting using a collaborative eHealth tool. The effect of collaborative eHealth in promoting lifestyle changes depends on competent and skilled dieticians, nurses, physiotherapists, and occupational therapists acting as eHealth coaches. How such health care professionals perceive delivering asynchronous eHealth coaching and which determinants they find to be essential to achieving successful long-term lifestyle coaching have only been briefly explored and deserve further exploration. OBJECTIVE The aim of this study is to analyze how health care professionals perceive eHealth coaching and to explore what influences successful long-term lifestyle change for patients undergoing hybrid eHealth coaching using a collaborative eHealth tool. METHODS A total of 10 health care professionals were recruited by purposive sampling. They were all women aged 36 to 65 years of age with a mean age of 48 years of age. A total of 8/10 (80%) had more than 15 years of experience in their field, and all had more than six months of experience providing eHealth lifestyle coaching using a combination of face-to-face meetings and asynchronous eHealth coaching. They worked in 5 municipalities in the Region of Southern Denmark. We performed individual, qualitative, semistructured, in-depth interviews in their workplace about their experiences with health coaching about lifestyle change, both for their patients and for themselves, and mainly how they perceived using a collaborative eHealth solution as a part of their work. RESULTS The health care professionals all found establishing and maintaining an empathic relationship essential and that asynchronous eHealth lifestyle coaching challenged this compared to face-to-face coaching. The primary reason was that unlike typical in-person encounters in health care, they did not receive immediate feedback from the patients. We identified four central themes relevant to the health care professionals in their asynchronous eHealth coaching: (1) establishing an empathic relationship, (2) reflection in asynchronous eHealth coaching, (3) identifying realistic goals based on personal barriers, and (4) staying connected in asynchronous coaching. CONCLUSIONS Establishing and maintaining an empathic relationship is probably the most crucial factor for successful subsequent eHealth coaching. It was of paramount importance to get to know the patient first, and the asynchronous interaction aspect presented challenges because of the delay in response times (both ways). It also presented opportunities for reflection before answering. The health care professionals found they had to provide both relational communication and goal-oriented coaching when using eHealth solutions. Going forward, the quality of the health care professional–patient interaction will need attention if patients are to benefit from collaborative eHealth coaching fully.

scholarly journals Development of screening questions for doctor–patient consultation assessing the quality of life and psychosocial burden of glioma patients: an explorative study

2021 ◽  
Author(s):  
Hannah Voß ◽  
Peter Scholz-Kreisel ◽  
Christoph Richter ◽  
Florian Ringel ◽  
Susanne Singer ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Online Survey ◽  
Unmet Needs ◽  
Neurocognitive Deficits ◽  
Psychosocial Burden ◽  
Main Area ◽  
Patient Interviews ◽  
Screening Questions ◽  
Physical Changes

Abstract Purpose Psychosocial screening for glioma patients is challenging because many patients suffer from neurocognitive deficits, which may impair assessment. This study’s aim was to exploratively develop three screening questions for unmet needs to prospectively be applicable in patient–doctor consultation. Methods Patient interviews, a survey for health-care professionals and a weighted scoring procedure were developed for this study. Six main areas were defined according to main areas of validated questionnaires (psyche, cognition, body, role functioning, social support, unmet needs). Patients and health-care professionals rated the importance of these areas and corresponding items, patients additionally stated whether the issues addressed affected them. Results A total of 50 patients were included, and 36 health-care professionals participated in the online survey. The three areas (psyche, body and cognition) considered to be most relevant by both, health-care professionals and patients, generated three screening questions. If the patient was affected by the issue addressed with a screening question, a subordinate question from that area that our patient sample considered most important could additionally be asked. The elaborated screening questions are the following: (1) main area psyche: “Has your mood worsened?”, (2) main area body: “Do physical changes put a strain on you?”, and (3) main area cognition: “Has your memory capacity worsened?” Conclusion These questions represent a basis for further research regarding their application in neuro-oncological clinical routine.

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