scholarly journals Experiencia en tiempos de pandemia

2020 ◽  
Vol 1 (2) ◽  
pp. 21-31
Author(s):  
Santos Ibáñez Barceló ◽  
Luis Alcaraz Clemente ◽  
Francisca Del Valle Cebrián
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Workers ◽  
Psychological Needs ◽  
Contact Tracing ◽  
Care Providers ◽  
Care Services ◽  
Phone Calls ◽  
Primary Care Services

En los últimos meses, el virus SARS-CoV-2 ha generado una crisis global que atañe a todos los ámbitos de la vida. La enorme velocidad de propagación y el elevado número de contagios entre los profesionales de la salud han requerido aumentar la disponibilidad de personal sanitario. En respuesta, numerosos países han propuesto la posibilidad de que estudiantes de medicina y recién graduados sean contratados para realizar diversos trabajos que alivien estas carencias. En España, la declaración del Estado de Alarma inició la regulación legal para que esta posibilidad fuese llevada a cabo, lo que ha permitido contratar a estudiantes y médicos pre-MIR en diversos territorios. Dentro de este marco, se describe la experiencia llevada a cabo en la Gerencia de Atención Integrada de Almansa (Albacete), con la creación de un equipo integrado por dos graduados en medicina a la espera de escoger plaza MIR y una especialista de oftalmología. En el período comprendido entre el 27 de marzo y el 21 de abril de 2020, se ha realizado seguimiento clínico vía telefónica de 274 pacientes dados de alta con diagnóstico o sospecha de COVID-19, 790 llamadas y 26 derivaciones al servicio de Urgencias. El seguimiento telefónico supone una tarea que, aunque cuenta con limitaciones, puede ser desempeñada por médicos con menor experiencia laboral. Su papel ha sido clave en estos momentos, pues disminuye la congestión de los servicios hospitalarios y permite el adecuado control epidemiológico de los casos y sus contactos. Esta experiencia ha puesto de manifiesto otros puntos que atañen a la incertidumbre en tiempos cambiantes, las necesidades psicológicas de acompañamiento o el refuerzo de valores. Elementos como la telemedicina, el valor de la atención primaria, o la consideración de los estudiantes en la asistencia sanitaria deberán tenerse en cuenta por los planes de estudio de ahora en adelante. In recent months SARS-CoV-2 has generated a global crisis, which has had an impact on all aspects of life. The quick spread of the virus amongst medical professionals has meant that more and more health workers are needed. To address this demand, many countries have approached Medicine graduates to assist health care providers. The state of emergency in Spain started the legal process so this initiative could materialise and, ultimately, Medicine students and pre-resident medical interns could be hired across different territories. This account describes the experience of two pre-specialty graduates and a consultant ophthalmologist within this context. This team conducted clinical follow-up phone calls on 274 patients discharged from hospital with confirmed or suspected COVID-19, 790 calls and 26 referrals to A&E. Although with limitations, clinical follow- up conversations can be carried out by less experienced doctors. Their role has been key as they ease up congestion in hospital services as well as contributing towards the provision of epidemiological control and contact tracing. This experience has brought to light other issues related to the uncertainty in these fast-moving times, the psychological needs of social interaction and the strengthening of human values. Therefore, aspects such as telemedicine, the importance of primary care services and the role of students in health care will have to be taken into account in university programmes of study in the future.

scholarly journals Primary Health Care Services of Urban Villages

2020 ◽  
Author(s):  
Ramonita J. Sencio ◽  
Mauro Allan Padua Amparado
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Health Workers ◽  
Care Providers ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services ◽  
Significant Difference

Objectives: The study determined the awareness on Primary Health Care (PHC) services as perceived by the residents and the level of implementation of PHC services as perceived by the Volunteer Health Workers in Bulacao and Pardo, Cebu City, Cebu, Philippines. The findings served as basis for a series of re-orientation seminars on PHC programs. Specifically, the study answered the following questions:1.What is the level of awareness on PHC services as perceived by the residents in terms of:1.1.health education;1.2.locally endemic disease control;1.3.expanded program on immunization;1.4.maternal health, child health and family planning; 1.5.provision of essential drugs;1.6.adequate food and proper nutrition;1.7.control of communicable diseases;1.8.environmental sanitation; and1.9.provision of medical care and emergency treatment?2.What is the level of implementation on PHC services as perceived by Volunteer Health Workers in the same areas?3.Is there a significant difference in the level of awareness and the level of implementation of the PHC programs as perceived by the respondents?4.What problems were encountered by health care providers on the implementation of the PHC programs?5.Based on the findings of the study, what appropriate series of re-orientation seminars can be proposed?Methods:This study utilized the descriptive-evaluative design. The study was conducted in two villages in Cebu City, namely, Bulacao and Pardo. The study includes 379 community residents and 26 volunteer health workers. A researcher-made tool composed of 45 items on the nine components of PHC was used. An interview guide was prepared to gather more information and confirm responses from the tool. Findings and Conclusion:The study revealed that the residents were aware of the PHC services. It also showed that the level of implementation of the volunteer health workers on PHC services was high. There was a significant difference in the perceptions of the residents on the level of awareness and the volunteer health workers’ level of implementation of PHC services. The top three problems encountered by the health care providers were inadequate medicines, inadequate clinic space for consultation, and availability of medical doctors. In conclusion, when the targeted beneficiaries are aware of the primary health care services, the volunteer health workers will feel more determined to perform their roles to render improved primary health care services. Recommended citation:Sencio, Ramonita J. & Amparado, M. A. P. (2010, March). PrimaryHealth Care Services of Urban Villages. 2010 Southwestern University Research Congress, 2(1), 22-24.

scholarly journals Responding to the Psychological Needs of Health Workers During Pandemic: Ten Lessons From Humanitarian Work

2020 ◽  
pp. 1-7
Author(s):  
Elena Cherepanov
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Disaster Preparedness ◽  
Health Workers ◽  
Well Being ◽  
Psychological Needs ◽  
Self Awareness ◽  
Aid Workers ◽  
Care Providers ◽  
Humanitarian Aid Workers

ABSTRACT When a complex emergency (CE) overwhelms infrastructure, the ability of health-care providers to work efficiently under duress saves lives. The author uses her experience of providing mental health supports to humanitarian aid workers and the pieces of training conducted for internal medicine practitioners to offer guidance on how to manage severe job-related stresses during the response to the coronavirus disease 2019 (COVID-19) pandemic. This work reminds responders about their professional mission and purpose, but its extreme physical and mental demands can take a toll on their well-being and health. In CEs, the sheer volume of work and the emotional over-engagement tend to produce toxic fantasies (eg, rescuer or helper fantasies), acting upon which threatens integrity of care and increases risks for both patients and providers. Accumulated fatigue and exposure to mass suffering and mortality can change the perceived value of life and increase reckless, risk-taking, and suicidal behaviors. Introducing a self-awareness framework prioritizes the awareness of the available choices and making situation-appropriate and informed decisions about balancing one’s own and others’ needs. The COVID-19 response has demonstrated that fostering peer supports, changing organizational culture, addressing self-awareness within a training and supervisory context, and strengthening supports for managers are important parts of disaster preparedness. It also revealed that more research is needed to better understand and meet the special psychological needs of health-care responders.

scholarly journals Understanding the role of lady health workers in improving access to eye health services in rural Pakistan – findings from a qualitative study

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Stevens Bechange ◽  
Elena Schmidt ◽  
Anna Ruddock ◽  
Itfaq Khaliq Khan ◽  
Munazza Gillani ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Workers ◽  
Negative Impact ◽  
Care Providers ◽  
Eye Care ◽  
Care Services ◽  
Eye Health ◽  
Wide Range

Abstract Background In 1994, the Lady Health Workers (LHWs) Programme was established in Pakistan to increase access to essential primary care services and support health systems at the household and community levels. In Khyber Pakhtunkhwa (KPK) province in northern Pakistan, eye care is among the many unmet needs that LHWs were trained to address, including screening and referral of people with eye conditions to health facilities. However, despite an increase in referrals by LHWs, compliance with referrals in KPK has been very low. We explored the role of LHWs in patient referral and the barriers to patient compliance with referrals. Methods Qualitative methodology was adopted. Between April and June 2019, we conducted eight focus group discussions and nine in-depth interviews with 73 participants including patients, LHWs and their supervisors, district managers and other stakeholders. Data were analysed thematically using NVivo software version 12. Results LHWs have a broad understanding of basic health care and are responsible for a wide range of activities at the community level. LHWs felt that the training in primary eye care had equipped them with the skills to identify and refer eye patients. However, they reported that access to care was hampered when referred patients reached hospitals, where disorganised services and poor quality of care discouraged uptake of referrals. LHWs felt that this had a negative impact on their credibility and on the trust and respect they received from the community, which, coupled with low eye health awareness, influenced patients’ decisions about whether to comply with a referral. There was a lack of trust in the health care services provided by public sector hospitals. Poverty, deep-rooted gender inequities and transportation were the other reported main drivers of non-adherence to referrals. Conclusions Results from this study have shown that the training of LHWs in eye care was well received. However, training alone is not enough and does not result in improved access for patients to specialist services if other parts of the health system are not strengthened. Pathways for referrals should be agreed and explicitly communicated to both the health care providers and the patients.

scholarly journals Sexual assault survivors’ perspectives on clinical follow-up in the Eden District, South Africa: A qualitative study

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Gail Holton ◽  
Kate Joyner ◽  
Robert Mash
Keyword(s):  
Health Care ◽  
Sexual Assault ◽  
Health Care Providers ◽  
Care Providers ◽  
Sexual Assault Survivors ◽  
Care Services ◽  
Follow Up Care ◽  
Negative Perceptions ◽  
Assault Survivors

Background: Although effective follow-up of sexual assault survivors is linked to optimal recovery, attendance at follow-up consultations is poor. It is therefore essential that health care providers maximise the benefit of follow-up care for every sexual assault survivor.Aim: This study explored the personal experiences of sexual assault survivors to better understand the enablers of, and barriers to, attendance at follow-up consultations.Methods: This phenomenological qualitative study was conducted at the three hospitals which manage most sexual assault survivors within the Eden District. Using purposive sampling, 10 participants were selected. Consenting participants shared their experiencesduring semi-structured interviews with the researcher.Results: Authoritative, client-held documentation was a powerful enabler to accessing follow-up care. Individualised, patient-centred care further enhanced participants’ access to, and utilisation of, health care services. The failure of health care providers to integrate follow-up care for sexual assault survivors into established chronic care services was a missedopportunity in the continuum of care. Negative perceptions, based on others’ or personal prior experience of police, judicial and health care systems, were further barriers to follow-up care.Conclusion: This study highlights the need of survivors of sexual assault for integrated,patient-centred care, encompassing principles of good communication. Committed actions of all stakeholders are necessary to tackle negative perceptions that create barriers to follow-upcare. A simple practical strategy, the provision of a scheduled appointment on official stationery, is easy to effect at facility level. As a powerful enabler to follow-up care, this should be implemented as a priority intervention.

scholarly journals Brazil’s Community Health Workers Practicing Narrative Medicine: Patients’ Perspectives

2021 ◽  
Author(s):  
Rogério Meireles Pinto ◽  
Rahbel Rahman ◽  
Margareth Santos Zanchetta ◽  
W. Galhego-Garcia
Keyword(s):  
Health Care ◽  
Community Health ◽  
Community Health Workers ◽  
Health Care Providers ◽  
Health Workers ◽  
Hybrid Approach ◽  
Narrative Medicine ◽  
Structured Interview ◽  
Patient Perspectives ◽  
Care Providers

Abstract Background Narrative medicine (NM) encourages health care providers to draw on their personal experiences to establish therapeutic alliances with patients of prevention and care services. NM medicine practiced by nurses and physicians has been well documented, yet there is little understanding of how community health workers (CHWs) apply NM concepts in their day-to-day practices from patient perspectives. Objective To document how CHWs apply specific NM concepts in Brazil’s Family Health Strategy (FHS), the key component of Brazil’s Unified Health System. Design We used a semi-structured interview, grounded in Charon’s (2001) framework, including four types of NM relationships: provider–patient, provider–colleague, provider–society, and provider–self. A hybrid approach of thematic analysis was used to analyze data from 27 patients. Key Results Sample: 18 females; 13 White, 12 “Pardo” (mixed races), 12 Black. We found: (1) provider–patient relationship—CHWs offered health education through compassion, empathy, trustworthiness, patience, attentiveness, jargon-free communication, and altruism; (2) provider–colleague relationship—CHWs lacked credibility as perceived by physicians, impacting their effectiveness negatively; (3) provider–society relationship—CHWs mobilized patients civically and politically to advocate for and address emerging health care and prevention needs; (4) provider–self relationship—patients identified possible low self-esteem among CHWs and a need to engage in self-care practices to abate exhaustion from intense labor and lack of resources. Conclusion This study adds to patient perspectives on how CHWs apply NM concepts to build and sustain four types of relationships. Findings suggest the need to improve provider–colleague relationships by ongoing training to foster cooperation among FHS team members. More generous organizational supports (wellness initiatives and supervision) may facilitate the provider–self relationship. Public education on CHWs’ roles is needed to enhance the professional and societal credibility of their roles and responsibilities. Future research should investigate how CHWs’ personality traits may influence their ability to apply NM.

Needs assessment for gender sensitive reproductive health services for adolescents

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Fatemeh Rahmanian ◽  
Soheila Nazarpour ◽  
Masoumeh Simbar ◽  
Ali Ramezankhani ◽  
Farid Zayeri
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Health Services ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Providers ◽  
Reproductive Health Services ◽  
Care Needs ◽  
Reproductive Health Care ◽  
Care Services

AbstractBackgroundA dimension of reproductive health services that should be gender sensitive is reproductive health services for adolescents.ObjectiveThis study aims to assess needs for gender sensitive reproductive health care services for adolescents.MethodsThis was a descriptive cross-sectional study on 341 of health care providers for adolescents in health centers and hospitals affiliated to Shiraz University of Medical Sciences in Iran in 2016. The subjects of the study were recruited using a convenience sampling method. The tools for data collection were: (1) a demographic information questionnaire and; (2) a valid and reliable questionnaire to Assess the Needs of Gender-Sensitive Adolescents Reproductive Health Care Services (ANQ-GSARHS) including three sections; process, structure and policy making for the services. Data were analyzed using SPSS 21.ResultsThree hundred and forty-one health providers with an average working experience of 8.77 ± 5.39 [mean ± standard deviation (SD)] years participated in the study. The results demonstrated the highest scores for educational needs (92.96% ± 11.49%), supportive policies (92.71% ± 11.70%) and then care needs (92.37% ± 14.34%) of the services.ConclusionsProviding gender sensitive reproductive health care services for adolescents needs to be reformed as regards processes, structure and policies of the services. However, the gender appropriate educational and care needs as well as supportive policies are the priorities for reform of the services.

TELE-MONITORING SYSTEM OF RISK IN RESPIRATORY PATIENTS

2021 ◽  
pp. 2150041
Author(s):  
Awad Al-Zaben ◽  
Lina M.K. Al-Ebbini ◽  
Badr Qatashah
Keyword(s):  
Health Care ◽  
Signal Processing ◽  
Health Care Providers ◽  
Mobile Phones ◽  
Model Parameters ◽  
Care Providers ◽  
Server Side ◽  
Respiration Signal ◽  
At Home

In many situations, health care professionals need to evaluate the respiration rate (RR) for home patients. Moreover, when cases are more than health care providers’ capacity, it is important to follow up cases at home. In this paper, we present a complete system that enables healthcare providers to follow up with patients with respiratory-related diseases at home. The aim is to evaluate the use of a mobile phone’s accelerometer to capture respiration waveform from different patients using mobile phones. Whereas measurements are performed by patients themselves from home, and not by professional health care personnel, the signals captured by mobile phones are subjected to many unknowns. Therefore, the validity of the signals has to be evaluated first and before any processing. Proper signal processing algorithms can be used to prepare the captured waveform for RR computations. A validity check is considered at different stages using statistical measures and pathophysiological limitations. In this paper, a mobile application is developed to capture the accelerometer signals and send the data to a server at the health care facility. The server has a database of each patient’s signals considering patient privacy and security of information. All the validations and signal processing are performed on the server side. The patient’s condition can be followed up over a few days and an alarm system may be implemented at the server-side in case of respiration deterioration or when there is a risk of a patient’s need for hospitalization. The risk is determined based on respiration signal features extracted from the received respiration signal including RR, and Autoregressive (AR) moving average (ARMA) model parameters of the signal. Results showed that the presented method can be used at a larger scale enabling health care providers to monitor a large number of patients.

Payment Accuracy in Value-Based Care Contracts

2021 ◽  
Vol 6 (3) ◽  
Author(s):  
Mackenzie A ◽  
◽  
Wang J ◽  
Teppema S ◽  
Duncan I ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Providers ◽  
Model Risk ◽  
Care Services ◽  
Value Based Care ◽  
Stochastic Risk

Reimbursement for health care services is transferring more risk away from payers and toward health care providers in the form of Alternative Payment Models (APMs), also known as Value-Based Care (VBC) models. VBC models cover a wide variety of forms but all include guarantees by providers of services to improve quality of care and/or reduce cost. Types of risk include performance risk, contract design risk or stochastic risk (because of the random variation in health care services and costs). A form of contract risk that can be a significant driver of cost is model risk, defined as the probability that the savings calculated at contract reconciliation will deviate from the actual savings generated. To estimate the degree of risk we quantify the potential variance in outcomes in a naïve population prior to intervention and the components that could affect outcomes, using examples of maternity and type 2 diabetes. This analysis has implications for both participants in, and designers of value-based contracts.

Training health workers to provide person-centred maternal and newborn health care in Burkina Faso

2013 ◽  
Vol 3 (2) ◽  
pp. 154-159
Author(s):  
Janet Perkins ◽  
Aminata Bargo ◽  
Cecilia Capello ◽  
Carlo Santarelli
Keyword(s):  
Health Care ◽  
Burkina Faso ◽  
Health Care Providers ◽  
Health Workers ◽  
Healthcare Providers ◽  
Newborn Health ◽  
World Health ◽  
Maternal And Newborn Health ◽  
Care Providers ◽  
Maternal And Newborn

Assuring the provision of person-centred care is critical in maternal and newborn health (MNH). As a component of the national strategy to improve MNH, Burkina Faso Ministry of Health, supported by Enfants du Monde, La Fondation pour le Développement Communautaire/Burkina Faso and UNFPA, is implementing the World Health Organization’s (WHO) framework for Working with Individuals, Families and Communities (IFC) to improve MNH. As a first step in district implementation, participatory community assessments were conducted. These assessments consistently revealed that poor interactions with healthcare providers posed one important barrier preventing women from seeking MNH services. In order to address this barrier, healthcare providers were trained to improve their interpersonal skills and in counselling women. During 2011-12 a total of 175 personnel were trained over a 5-day course developed using a WHO manual. The course was met with enthusiasm as providers expressed their need and desire for such training. Immediate post-test results revealed an impressive increase in knowledge and anecdotal evidence suggests that training has influenced provider’s behaviours in their interactions with women. In addition, health care providers are taking concrete action to build the capabilities of women to experience pregnancy and birth safely by engaging directly with communities.  While early findings are promising, an evaluation will be necessary to measure how the training has influenced practices, whether this translates into a shift of perceptions at community level and ultimately its contribution toward promoting person-centred care in Burkina Faso.

Using ePROMs for follow-up after palliative radiotherapy: an exploratory study with patients and health care providers.

2021 ◽  
Author(s):  
Eva Oldenburger ◽  
Inge Neyens ◽  
Annemarie Coolbrandt ◽  
Sofie Isebaert ◽  
Aline Sevenants ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Exploratory Study ◽  
Palliative Radiotherapy ◽  
Care Providers
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