Search results for: primary care research

Authors: Carmen Silvia Gabriel, Maria de Fátima Paiva Brito, Mariane de Paula Candido, Vanessa Barato Oliveira

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Patient identification is a necessary practice to ensure patient safety in any healthcare environment, including emergency care units, test laboratories, home care and clinics. The present study aimed to provide evidence that can effectively contribute to practices concerning patient identification. Its objective was to investigate patient identification in basic healthcare units through patient safety standards. To do so, a descriptive and non-experimental research outline study was carried out to inquire how patient identification takes place in a particular situation. All technical manager nurses from the chosen healthcare facilities were included in the sample for the study. Data was collected in September of 2014 after approval from the Committee of Ethics. All researched institutions fit the same profile: they’re public facilities for general care with observation beds. None of them has a wristband identification protocol or policy. Only one institution mentioned using some kind of visual identification; namely, body tags separated by colors according to the type of care, but it still does not apply the recommended tags by the Brazilian Ministry of Health. This study allowed the authors to acknowledge how important the commitment from the whole healthcare team in the patient identification process is and also acknowledge how necessary it is to implement institutional policies that may aid the healthcare units in this area to promote a quality and safe patient care.

Keywords: patient safety, identification, nursing, emergency care units

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Authors: Sylvie Ekanga Lumumba

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Background and Significance of the Study: Over the past three decades, the perception of sexual violence has changed significantly, it is now recognized that men and boys are victims of sexual violence. However, the body of research on male victims and particularly on their attackers is much more limited. Research on the above is thus more than required. To contribute to the above quest for further studies, the researcher conducted this study on sexual violence perpetrated against men and boys by women, in the Municipality of Ibanda, Town of Bukavu, Province of South Kivu, Democratic Republic of Congo. The main study objectives were the following: to investigate on the statement of sexual violence perpetrated against men and boys in the Municipality of Ibanda, to investigate into its consequences and the statement of medical and psycho-social care given to victims. Methodology: Data were collected using valid and reliable Survey Questionnaire and Interview Schedule. Study population: the 85,882 men and boys from the Municipality of Ibanda. Sampling: led to 150 men and boys, received discreetly by the researcher during November-December 2015. Major findings: First, findings related to sexual abuse and its procedure: 74.2% of men and boys were victims of sexual violence perpetrated by a woman, more than a year ago. 13.3% however, were victims for less than a year now. 79.7% of victims have experienced sexual violence by a sexual act; 3.9% through the intention of the woman to cause the death of the victim, by serious injury to the genitals. The Second group of findings related to the consequences of sexual violence revealed that HIV/AIDS is the most important physical consequence experienced by 77.3 % of victims. Physical psychological consequences are: urinary or defecation problems (72.7%); while key psycho-emotional and behavioral consequence is: living a state of deep shame and humiliation: 68.8%. As for sexual consequences: 71.1% indicated a chronic avoidance of sexual activity and 57% reported sexual dysfunctions. The third group of findings is related to medical and psycho-social care: repetitively, more than 80% of male victims affirmed that with the help of friends and traditional healers, they took care of themselves for all the eight WHO phases of clinical care of rape victims, this was hence not effectively done. Concluding Statement: for this study, the statement of sexual violence of men and boys by women in the Eastern Congo and its consequences are not researched upon and are underestimated; the study also revealed that the care of male victims is grossly ill-conducted, as opposed to female victims care. It therefore calls for further research and further vulgarization of the research results, to convince other stakeholders (politicians for example) to immediately take action.

Keywords: sexual violence, men and boys, medical care, psycho-social care

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Authors: Pannathorn Chachvarat, Smarnjit Piromrun

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Aging is the reality for the future world. An urgent priority for the development of the elderlies’ quality living is needed. The promotion of quality the elderly to live longer in their dignity and being independence are essential. The objective of this descriptive research was to study the self-care regarding to the valuable living in Thai elderly. The randomized sample was 100 elderly who live in Muang district of Phayao province. The tools included 2 parts; 1) Personal data (gender, age, income, occupation, marital status, living condition and disease), and 2) the self-care regarding to the valuable living questionnaire consisted of 3 domains, physical (21items), spiritual (13 items) and social domain (12 items). The content validity tool was tested the IOC ranged between 0.60 – 1.00 and the reliability test, Cronbach Alpha was 0.82. The research found that; The most participants were female (60 %), Farmer (37%), and underlying disease (65 %). The range of age was 68 years. Overall of the self-care regarding to the valuable living of physical, spiritual and social were at the high level.The highest level of physical activities was self-taking bath twice a day (morning and evening), and slept at least 5-6 hours at night time.The highest level of spirit activities was a good member of the family, contributions to persons in family, good emotion. Additionally were enjoyable, accepting changes in the body such as the dry skin and the blurred vision, accepting the roles and duties in taking care of house and grandchildren, selecting the applicable activities and practice according to religious Buddhateachingfor the happiness and meditated life.The highest of the social activities were the good relationship between other elderlies and family members, happy to help social activities as of their capacity, and being happy to help other people who have problems.

Keywords: self-care, valuable living, elderly, Thai

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Authors: Supalak Fakkhum, Wannita Pochanakul

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This research is qualitative research that aims to study the application of local wisdom in health care of early childhood at Ban Nam Chieo Community, Laem Ngop, Trat Province. The target is one folk medicine healer and 45 parents who have children or grandchildren aged between 0-5 years. The folk medicine healer was interviewed and observed during early childhood health care practice. Parents were interviewed. The results showed that local wisdom in health care of early childhood are as follows: 1. Local wisdom about early childhood diseases: It is believed that the disease was determined while the child was still in the womb, in the third month of pregnancy. When a child is born, they will have La, La-ong and Saang diseases, which are URI (upper respiratory infection) and DI (diarrhea) diseases. Supernatural aspect is also considered. 2. The treatment is chosen to match the symptoms of the disease. Caring for early childhood includes psychological therapy by rituals and spells. 3. For local wisdom concerning prevention and health promotion, parents normally bring their child to folk medicine healers for “throat paint” as an act of protection and health promotion. Folk healers often prescribe food according to belief and local wisdom.

Keywords: local wisdom, early childhood, folk medicine, healer

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Authors: Ryan J. Trefethen, Vincent H. Smith

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This study explores the relationship between national spending on the Medicaid program, and total Medicaid spending and enrollment in Montana, a state that ranks thirty-third in per capita income and thirty-seventh in median household income in the United States. The purpose of the research is to estimate the potential effects that specific changes to national healthcare policy would likely have on funding for the Montana Medicaid Program and enrollees in the program, members of families in poverty whose incomes are low, even though in many cases they have steady jobs. A particular concern is the effect on access to care for children in poverty who tend to be food insecure and, therefore, especially in need of access to health care. The research uses data collected from a variety of government publications, including the Medicaid Financial Management Report, the Medicaid Managed Care Enrollment Report, and the Centers for Medicare and Medicaid Services MSIS State Summaries for fiscal years 2000-2015. These data were examined using econometric analysis, to assess these impacts. The evidence indicates that the changes included in recent congressional legislative initiatives would potentially leave an additional 50,000 to 60,000 Montana residents, five to six percent of the state’s population, in poverty without access to health care. Impacts on children in poverty would potentially be substantial.

Keywords: children, healthcare, medicaid, montana, poverty

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Authors: Ching-Yi Huang, Pi-Fen Cheng, Hui-Zhu Chen, Shi Ting Huang, Heng-Hua Wang

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This is a case of oral cancer after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap. The nursing period lasted From September 25 to October 3, 2017, through observation, interview, physical assessment, and medical record review, the author identified the following nursing problems: acute pain, impaired oral mucous membrane, and body image change. During the nursing period, the author provided individual and overall nursing care and established mutual trust through the use of empathy. Author listened and eased the patient's physical indisposition, such as wound pain, we use medications and acupuncture massage to relieve pain. However, for oral mucosa change caused by surgery, provide continuous and complete oral care and oral exercise training to improve oral mucosal healing and restore swallowing function. In the body-image changes, guided him to express his feeling after the body-image change, and enhanced support and from the family, and encouraged him to attend head and neck cancer survivor alliance which allowed the patient to accept the altered body image and reaffirm self-worth. Hopefully, through sharing this nursing experience will help to the nursing care quality of nursing care for oral cancer patients after extensive resection and modified right lateral neck lymph node dissection followed by reconstruction with a skin flap.

Keywords: oral cancer, acute pain, impaired oral mucous membrane, body image change

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Authors: Maria Luisa T. Uayan

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The global need for qualified nurses to take care of the clients with various health needs is an incessant occurrence that persistently cause migration of nurses from developing to developed countries. The pull-push theory of migration greatly affects health care delivery systems of sending countries which is the same way affects nursing management. The exodus of nurses prepared to provide the much needed leadership at the bedside leaves the country in clusters giving health care institutions limited time to develop the next front-line managers that will assure quality patient care. This paper focuses on the extent and consequences of the massive recurring migration phenomena that is felt ONLY IN THE PHILIPPINE health care arena. It deals with the causes, problems, and effects of the cyclical loss of competent Filipina nurses in terms of emigration. Also, it will highlights the difficulties confronted by nursing service departments and health care teams when more experienced nurses set out for the “greener pastures” and patients are placed under the care of novice nurses. Fundamentally, it will emphasize the impact of suffering the loss of competent nurse managers in the Philippine health care institutions and provide contemporary recommendations on how to responsd accordingly to this very timely issue.

Keywords: Migration, Nurse Manager, Philippines

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Authors: Fionnuala Tynan, Margaret Nohilly

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Wellbeing in not only a national priority in Ireland but in the international context. A review of the literature highlights the consistent efforts of researchers to define the concept of wellbeing. This study sought to explore the understating of Wellbeing in Irish primary schools. National Wellbeing Guidelines in the Irish context frame the concept of wellbeing through a mental health paradigm, which is but one aspect of wellbeing. This exploratory research sought the views of Irish primary-school teachers on their understanding of the concept of wellbeing and the practical application of strategies to promote wellbeing both in the classroom and across the school. Teacher participants from four counties in the West of Ireland were invited to participate in focus group discussion and workshops through the Education Centre Network. The purpose of this process was twofold; firstly to explore teachers’ understanding of wellbeing in the primary school context and, secondly, for teachers to be co-creators in the development of practical strategies for classroom and whole school implementation. The voice of the teacher participants was central to the research design. The findings of this study indicate that the definition of wellbeing in the Irish context is too abstract a definition for teachers and the focus on mental health dominates the discourse in relation to wellbeing. Few teachers felt that they were addressing wellbeing adequately in their classrooms and across the school. The findings from the focus groups highlighted that while teachers are incorporating a range of wellbeing strategies including mindfulness and positive psychology, there is a clear disconnect between the national definition and the implementation of national curricula which causes them concern. The teacher participants requested further practical strategies to promote wellbeing at whole school and classroom level within the framework of the Irish Primary School Curriculum and enable them to become professionally confident in developing a culture of wellbeing. In conclusion, considering wellbeing is a national priority in Ireland, this research promoted the timely discussion the wellbeing guidelines and the development of a conceptual framework to define wellbeing in concrete terms for practitioners. The centrality of teacher voices ensured the strategies proposed by this research is both practical and effective. The findings of this research have prompted the development of a national resource which will support the implementation of wellbeing in the primary school at both national and international level.

Keywords: primary education, shared understanding, teacher voice, wellbeing

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Authors: B. Nair, S. Singh

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Oral health behaviors such as dietary preferences and tooth brushing are acquired during a child’s primary socialization period yet many oral health promotion interventions are implemented without taking into account the role and impact of parental influence in supporting healthy oral health behaviors. The aim and objective of this study was to determine the relationship between parental income and level of education with knowledge, attitudes and perceptions of oral health care practices. Methods: The study design was cross-sectional and exploratory, and data collection occurred in two phases. Phase 1 comprised of a self-administered questionnaire. The sample consisted of parents of 313 Grade 1 learners aged between 5-6 years old attending one of twelve selected public primary schools in the Chatsworth Circuit, Durban, South Africa. Phase 2 comprised of focus group discussions held at 5 purposively selected schools. Data collection comprised of a semi-structured face-to-face group interview with the objective of obtaining a deeper understanding of parental knowledge, attitudes and perceptions of dental caries. Results and Discussion: Almost 56% of participants earned a monthly income of less than R6000 (600 US dollars). Nearly three quarters (77.5%) of participants indicated that they did not have medical aid/insurance scheme. More than three-quarters of the participants (76.6%) identified diet as being the primary cause of decayed teeth. More than half of the study sample (56.1%) indicated that milk teeth were important and that rotten teeth (74.6%) could affect the child’s health. Almost half (49.8%) of participants reported that “bad teeth” were inherited. With more than two-thirds of the participants (77.7%), having at most a high school education, there was a correlation between the level of the caregiver’s education and the oral health care of the child. The analysis of the correlation between a child having decayed teeth and income (p=.007); and the manner in which the income is received (p=.003) was statistically significant. The results indicate that more effort needs to be placed in understanding parental knowledge, perceptions and attitudes towards dental caries. Parental level of education, income and oral health literacy is shown to be related to attitudes, and perceptions towards dental caries and its subsequent preventive measures. These findings have important implications for oral health planning at community and facility-based levels.

Keywords: oral health prevention, parental education, dental caries, attitudes and perceptions

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Authors: Kim H. K. Choy, Oliva H. K. Chu, W. Y. Keung, B. Lim, Winnie P. Y. Tang

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Background: The prevalence of workplace obesity is rising worldwide; therefore, the workplace is an ideal venue to implement weight control intervention. This pilot randomized controlled trial aimed to develop, implement, and evaluate a nutritional wellness program for obese health care providers working in a hospital. Methods: This hospital-based nutritional wellness program was an 8-week pilot randomized controlled trial for obese health care providers. The primary outcomes were body weight and body mass index (BMI). The secondary outcomes were serum fasting glucose, fasting cholesterol, triglyceride, high-density (HDL) and low-density (LDL) lipoprotein, body fat percentage, and body mass. Participants were randomly assigned to the intervention (n = 20) or control (n = 22) group. Participants in both groups received individual nutrition counselling and nutrition pamphlets, whereas only participants in the intervention group were given mobile phone text messages. Results: 42 participants completed the study. In comparison with the control group, the intervention group showed approximately 0.98 kg weight reduction after two months. Participants in intervention group also demonstrated clinically significant improvement in BMI, serum cholesterol level, and HDL level. There was no improvement of body fat percentage and body mass for both intervention and control groups. Conclusion: The nutritional wellness program for obese health care providers was feasible in hospital settings. Health care providers demonstrated short-term weight loss, decrease in serum fasting cholesterol level, and HDL level after completing the program.

Keywords: weight management, weight control, health care providers, hospital

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Authors: Mohd Rashid Bin Hj. Md Idris, Lajiman Bin Janoory, Abdullah Bin Yusof, Mahzir Bin Ibrahim

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The Malay language curriculum at primary school level in Malaysia is instrumental in ensuring the status of the language as the official and national language, the language of instruction as well as the language that unites the various ethnics in Malaysia. A research addressing issues related to the curriculum standard is, therefore, essential to provide value added quality to the existing National Education Philosophy in ongoing efforts to produce an individual who is balanced in intellectual, spiritual, emotional and physical developments. The objective of this study is to examine the Philosophy of Language Theory, to review the content of the Malay language subject in relation to the Standard Curriculum for Primary Schools (KSSR), and to identify aspects of Theory of Philosophy in the Standard Curriculum for Primary Schools. The Malay language Primary School Curriculum is designed to enable students to be competent speakers and communicators of the language in order to gain knowledge, skills, information, values, and ideas and to enhance skills in social relations. Therefore, this study is designed to help educators to achieve all the stated goals. At the same time students at primary school level are expected to be able to apply the principle of language perfection as stated in the Philosophy of Language Theory to enable them to understand, appreciate and to take pride in being a Malaysian who speaks the language well.

Keywords: language, philosophy, theory, curriculum, standard, national education philosophy

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Authors: Ru-Yu Lien, Shih-Hsin Hung, Shu-Fen Lu, Ju-Jen Shie, Wen-Ju Yang, Yuann-Meei Tzeng, Chien-Ying Wang

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Background: The quality of care in intensive care units (ICUs) is crucial, especially for terminally ill patients. Shared decision-making (SDM) with families is essential to ensure appropriate care and reduce suffering. Aim: This study explores the effectiveness of an end-of-life decision support Patient Decision Aid (PDA) in an ICU setting. Methods: This study employed a cross-sectional research design conducted in an ICU from August 2020 to June 2023. Participants included family members of end-of-life patients aged 20 or older. A total of 319 participants. Family members of end-of-life patients received the PDA, and data were collected after they made medical decisions. Data collection involved providing family members with a PDA during family meetings. A post-PDA questionnaire with 17 questions assessed PDA effectiveness and anxiety levels. Statistical analysis was performed using SPSS 22.0. Results: The PDA significantly reduced anxiety levels among family members (p < 0.001). It helped them organize their thoughts, prepare for discussions with doctors, and understand critical decision factors. Most importantly, it influenced decision outcomes, with a shift towards palliative care and withdrawal of life-sustaining treatment. Conclusion: This study highlights the importance of family-centered end-of-life care in ICUs. PDAs promote informed decision-making, reduce conflicts, and enhance patient and family involvement. These tools align patient values and goals with medical recommendations, ultimately leading to decisions that prioritize comfort and quality of life. Implementing PDAs in healthcare systems can ensure that patients' care aligns with their values.

Keywords: shared decision-making, patient decision aid, end-of-life care, intensive care unit, family-centered care

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Authors: Rosy Chaudhary, Pushpa Parajuli

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Background and Objectives: Informational support to family members has a significant potential for reducing this distress related to hospitalization of their patient into the critical care unit, enabling them to cope better and support the patient. The objective of the study is to assess family members’ perception of informational support, anxiety, satisfaction with care and to reveal the association with selected socio-demographic variables and to investigate the correlation between informational support, anxiety and satisfaction with care. Materials and Methods: A descriptive cross-sectional study was conducted in 39 family caregivers of patients admitted in critical care unit of BPKIHS(B.P. Koirala Institute of Health Sciences). Consecutive sampling technique was used wherein data was collected over duration of one month using interview schedule. Descriptive and inferential statistics were used. Results: The mean age of the respondents was 34.97 ± 10.64 and two third (66.70%) were male. Mean score for informational support was 25.72(SD = 5.66; theoretical range of 10 - 40). Mean anxiety was 10.41 (SD = 5.02; theoretical range of 7 - 21). Mean score for satisfaction with care was 40.77 (SD = 6.77; theoretical range of 14 - 64). A moderate positive correlation was found between informational support and satisfaction with care (r = 0.551, p < .001) and a moderate negative correlation was found between anxiety and satisfaction with care (r = -0.590; p = 0.000). No relationship was noted between informational support and anxiety. Conclusion: The informational support and satisfaction of the family caregivers with the care provided to their patients was satisfactory. More than three fourth of the family caregivers had anxiety; the factors associated being educational status of the caregivers, the family income and duration of visiting hours. There was positive correlation between informational support and satisfaction with care provided justifying the need for comprehensive information to the family caregivers by the health personnel. There was negative correlation between anxiety and satisfaction with care.

Keywords: anxiety, caregivers, critical care unit, informational support, family

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Authors: Yadchol Tawetanawanich

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Depression of elderly is a mental health problem that impacts tremendously on the elderly themselves, their family, and society. the purposes of this descriptive research were to examine prevalence rate of elderly depression and to study factors related to depression in elderly including 1) individual factors: sex, education, marital status, 2) economic factors: occupation, adequate income 3) health factors: chronic illnesses , disability, 4) social factors: family relationship, community relationship, 5) knowledge of depression, and 6) self-care behavior. The subject in this study included 273 elderly in Ladboakao sub-district, Banpong district, Ratchaburi province, Thailand. Data were collected through questionnaires and were analyzed using percentage, mean, standard deviation, chi-square, and one-way ANOVA. The results of the study revealed that: The prevalence rate of elderly depression were 21.61%, factors included economic factors, health factors, knowledge about depression, and self-care behavior were statistically significant positively related to depression of elderly (p<0.05), but individual factors and social factors were not significantly related to depression. It is also important for nurses to assess factors related to depression of the elderly in order to develop the model of care and use self-care strategies to contribute the positive outcomes.

Keywords: associated factors, depression, elderly, self-care

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Authors: Nabaweesi Josephine, Namwanje Regina Germina

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Antenatal care is referred to as the totality of care given to pregnant women from conception to delivery from a certified health care setting. A number of 8 contacts is recommended throughout pregnancy, according to WHO, 2016. Antenatal services are free in Uganda courtesy of the government of Uganda, though attendance is still very low, which has continued to cause maternal and infant mortality and morbidity from preventable causes. Early booking has an advantage for proper pregnancy information sharing and pregnancy monitoring. The purpose of this study was to determine pregnant women's knowledge, attitudes, and practices towards attendance of antenatal care at Mukono General Hospital. A sample of 60 pregnant women was used, and a descriptive quantitative design was employed. Data was collected using a structured questionnaire consisting of questions about socio-demographic factors, knowledge, attitude, and practice, and this was affected using the structured interview method. Pregnant women had good practice at 90.2%, a positive attitude of 94.6%, and slightly less knowledge of 66.7%. Only 12% were knowledgeable about the number of antenatal care visits recommended, 45% had knowledge about when to initiate first antenatal care visit, and 79% had a positive attitude towards the early booking. We recommend that pregnant women are given all the necessary information regarding antenatal care with special emphasis on the recommended number of visits and when to initiate their first visit and encourage early booking in order to achieve the 8 contacts WHO policy for antenatal care since when we increase knowledge, we increase antenatal care utilization according to Anderson's behavioral model.

Keywords: ANC- antenatal care, contacts, mortality, morbidity

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Authors: Balwinder Singh

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In the current competitive environment, casting industry has several challenges such as production of intricate castings, near net shape castings, decrease lead-time from product design to production, improved casting quality and to control costs. The raw materials used to make ceramic shell play an important role in determining the overall final ceramic shell characteristics. In this work, primary slurries were formulated using various combinations of zircon flour, fused silica and aluminosilicate powders as filler, colloidal silica as binder along with wetting and antifoaming agents (Catalyst). Taguchi’s parameter design strategy has been applied to investigate the effect of primary slurry parameters on the viscosity of the slurry and primary coating of shell. The result reveals that primary coating with low viscosity slurry has produced a rough surface of the shell due to stucco penetration.

Keywords: ceramic shell, primary slurry, filler, slurry viscosity, surface roughness

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Authors: Rabeab Khunpukdee, Aranya Sukchoui, Nonluk Somgit, Chitima Bunnaul

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Endotracheal displacement is a major risk of life threatening among critically ill patients. Standard nursing protocol is needed to minimize this risk and to improve clinical outcomes. To evaluate the effectiveness of the endothacheal care nursing guideline. The incidence rates of endochacheal displacement, oxygen deficiency after extubation, re-intubation, and nurse’s satisfaction on the utilization of the endotracheal care nursing guideline. An evidence-based nursing practice framework was used to develop the endotracheal care nursing guideline. The guideline valid content was review by a 3 panel of experts. The index of item objective (IOC) of the guideline was 0.93. The guideline was implemented in 130 patients (guideline group) and 19 registered nurses at a medicine ward, Had Yai hospital, Thailand. Patient’s outcomes were evaluated by comparison with those 155 patients who received the routine nursing care (routine care group). Descriptive statistics, frequency, percentage, mean, standard deviation and Mann Whitney U-test was analyzed using the computer program. All significantly and better outcomes were found in the guideline group compared to the routine care group. The guideline group has less incidence rates of endotracheal displacement (1.54 % vs 9.03 %, p < 0.05), and none of the guideline group had oxygen deficiency after extubation (0 % vs 83.33%) compared to the routine care group. All of the 2 patients in the guideline group, compared to 6 of 14 patients in the routine care group were re-intubation. The overall rate of re-intubation in the total group (n = 130 vs 155) was seen less in the guideline group than the routine care group (1.54 % vs 3.87). Overall, nurses satisfaction was at high-level (89.50%) on the utilization of the guideline.

Keywords: endotracheal care, nursing guideline, re-intubation, satisfaction

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Authors: Naseem M. Twaissi

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Medical professionals play an important role in society, and in general, they care more about their patients than about their personal well-being. They need to take a professional approach to maintain a work-life balance. Through a collection of primary data from 1020 medical professionals and the application of relevant statistical tools, this paper explores the pressures on medical professionals with reference to their work-life balance. This study highlights how hospital management, in addition to economic reasons, needs to identify variables to enhance the work-life balance of medical professionals so that quality healthcare facilities may be provided to the citizens of Jordan. Results indicate that formulation and implementation of policies for enhancing work-life balance together with career and retention plans for medical professionals would enhance the performance of hospitals and the quality of health care in Jordan, leading to greater societal well-being.

Keywords: work life balance, job environment, job satisfaction, employee well-being, stress, hospital industry

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Authors: L. Donelle, S. Regan, R. Booth, M. Kerr, J. McMurray, D. Fitzsimmons

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Palliative home health care provision within the Canadian context is challenged by: (i) a shortage of registered nurses (RN) and RNs with palliative care expertise, (ii) an aging population, (iii) reliance on unpaid family caregivers to sustain home care services with limited support to conduct this ‘care work’, (iv) a model of healthcare that assumes client self-care, and (v) competing economic priorities. In response, an interprofessional team of service provider organizations, a software/technology provider, and health care providers developed and implemented a technology-enabled model of home care, the eShift model of palliative home care (eShift). The eShift model combines communication and documentation technology with non-traditional utilization of health human resources to meet patient needs for palliative care in the home. The purpose of this study was to investigate the structure, processes, and outcomes of the eShift model of care. Methodology: Guided by Donebedian’s evaluation framework for health care, this qualitative-descriptive study investigated the structure, processes, and outcomes care of the eShift model of palliative home care. Interviews and focus groups were conducted with health care providers (n= 45), decision-makers (n=13), technology providers (n=3) and family care givers (n=8). Interviews were recorded, transcribed, and a deductive analysis of transcripts was conducted. Study Findings (1) Structure: The eShift model consists of a remotely-situated RN using technology to direct care provision virtually to patients in their home. The remote RN is connected virtually to a health technician (an unregulated care provider) in the patient’s home using real-time communication. The health technician uses a smartphone modified with the eShift application and communicates with the RN who uses a computer with the eShift application/dashboard. Documentation and communication about patient observations and care activities occur in the eShift portal. The RN is typically accountable for four to six health technicians and patients over an 8-hour shift. The technology provider was identified as an important member of the healthcare team. Other members of the team include family members, care coordinators, nurse practitioners, physicians, and allied health. (2) Processes: Conventionally, patient needs are the focus of care; however within eShift, the patient and the family caregiver were the focus of care. Enhanced medication administration was seen as one of the most important processes, and family caregivers reported high satisfaction with the care provided. There was perceived enhanced teamwork among health care providers. (3) Outcomes: Patients were able to die at home. The eShift model enabled consistency and continuity of care, and effective management of patient symptoms and caregiver respite. Conclusion: More than a technology solution, the eShift model of care was viewed as transforming home care practice and an innovative way to resolve the shortage of palliative care nurses within home care.

Keywords: palliative home care, health information technology, patient-centred care, interprofessional health care team

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Authors: Yazan M. Alatrash, Han-ok Kang, Hyun-gi Yoon, Shen Zhang, Juhyeon Yoon

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Flow coastdown phenomena are very important to secure nuclear fuel integrity during loss of off-site power accidents. In this study, primary coolant flow coastdown phenomena are investigated for the Jordan Research and Training Reactor (JRTR) using a simulation software package, Modular Modelling System (MMS). Two MMS models are built. The first one is a simple model to investigate the characteristics of the primary coolant pump only. The second one is a model for a simulation of the Primary Coolant System (PCS) loop, in which all the detailed design data of the JRTR PCS system are modelled, including the geometrical arrangement data. The same design data for a PCS pump are used for both models. Coastdown curves obtained from the two models are compared to study the PCS loop coolant inertia effect on a flow coastdown. Results showed that the loop coolant inertia effect is found to be small in the JRTR PCS loop, i.e., about one second increases in a coastdown half time required to halve the coolant flow rate. The effects of different flywheel inertia on the flow coastdown are also investigated. It is demonstrated that the coastdown half time increases with the flywheel inertia linearly. The designed coastdown half time is proved to be well above the design requirement for the fuel integrity.

Keywords: flow coastdown, loop inertia, modelling, research reactor

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Authors: Mutaz Shurahabeel Ahmed Ombada

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This paper investigates potential health and financial settlement of health information technology, this paper evaluates health care with the use of IT and other associated industries. It assesses prospective savings and costs of extensive acceptance of Electronic Medical Record Systems (EMRS), models significant to health as well as safety remuneration, and conclude that efficient EMRS execution and networking could ultimately save more than US $55 billion annually through recuperating health care effectiveness and that Health Information Technology -enabled prevention and administration of chronic disease could eventually double those savings while rising health and other social remuneration. On the contrary, this is improbable to be realized without related to significant modifications to the health care system.

Keywords: electronic medical record systems, health care economics, EMRS

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Authors: Rosemary Saunders, Courtney Glass, Karla Seaman, Karen Gullick, Julie Andrew, Anne Wilkinson, Ashwini Davray

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Current literature demonstrates that most Australians receive end-of-life care in a hospital setting, despite most hoping to die within their own home. The necessity for high quality end-of-life care has been emphasised by the Australian Commission on Safety and Quality in Health Care and the National Safety and Quality in Health Services Standards depict the requirement for comprehensive care at the end of life (Action 5.20), reinforcing the obligation for continual organisational assessment to determine if these standards are suitably achieved. Limited research exploring clinical staff perspectives of end-of-life care delivery has been conducted within an Australian private health context. This study aimed to investigate clinical staff member perceptions of end-of-life care delivery at a private hospital in Western Australia. The study comprised of a multi-faceted mixed-methods methodology, part of a larger study. Data was obtained from clinical staff utilising surveys and focus groups. A total of 133 questionnaires were completed by clinical staff, including registered nurses (61.4%), enrolled nurses (22.7%), allied health professionals (9.9%), non-palliative care consultants (3.8%) and junior doctors (2.2%). A total of 14.7% of respondents were palliative care ward staff members. Additionally, seven staff focus groups were conducted with physicians (n=3), nurses (n=26) and allied health professionals including social workers (n=1), dietitians (n=2), physiotherapists (n=5) and speech pathologists (n=3). Key findings from the surveys highlighted that the majority of staff agreed it was part of their role to talk to doctors about the care of patients who they thought may be dying, and recognised the importance of communication, appropriate training and support for clinical staff to provide quality end-of-life care. Thematic analysis of the qualitative data generated three key themes: creating the setting which highlighted the importance of adequate resourcing and conducive physical environments for end-of-life care and to support staff and families; planning and care delivery which emphasised the necessity for collaboration between staff, families and patients to develop care plans and treatment directives; and collaborating in end-of-life care, with effective communication and teamwork leading to achievable care delivery expectations. These findings contribute to health professionals better understanding of end-of-life care provision and the importance of collaborating with patients and families in care delivery. It is crucial that health care providers implement strategies to overcome gaps in care, so quality end-of-life care is provided. Findings from this study have been translated into practice, with the development and implementation of resources, training opportunities, support networks and guidelines for the delivery of quality end-of-life care.

Keywords: clinical staff, end-of-life care, mixed-methods, private hospital.

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Authors: Adriane Amend, Leidiene Ferreira Santos, Daniella Pires Nunes

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The experience of assuming or caring for older persons dependents by relatives is a complex task that encompasses or affective involvement, the demand for technical activities and or psychological support. It would be necessary to understand the situations related to the caregiver, the person and the environment, which help the family difficulty, as a caregiver to lead this role. Objective: To identify the forces that drive and restrict the care process of family caregivers of the older adults. Method: Descriptive and exploratory research, with a qualitative approach, which has as a reference the Force Field Theory. Five family caregivers of older adult’s dependents residing in the city of Palmas, Tocantins, Brazil will participate. The data were collected from December 2021 to February 2022, through a semi-structured individual interview, and submitted to content analysis. Results: As forces that drive or process of caring for family caregivers were: the account of compassionate attitudes and patience of the caregiver (I); to the collaboration of the other person to the care and to the body structure of the same (Other); and the supports of other people not cared for and structural, such as adaptations in the room, read and bathroom, as in the presence of air conditioners (Environment). Among the restrictive forces of care we mention difficulties in delegating care to another person, or stress of care and other personal demands (I); imposition of the older person about care and e a transfer from bed to hip (Other); e lack of accessibility of the house and absence of air conditioning and hospital bed (Environment). Conclusion: The results show that there are driving forces with the caregiver's attitude and feelings, a bond as an idol and support for the caregiver and the environment. On the other hand, conflicting ties, absence of physical structure and daily and continuous care shifts, can significantly compromise well-being or the cycle of older adult, caregiver and care.

Keywords: caregivers, frail elderly, perception, geriatric nursing

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Authors: Dina Maratovna Aikenova

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Child care policy must be a priority area of public authorities in any country. This study investigates child care policy in Kazakhstan in accordance with the current position of children and laws. The results show that Kazakhstan policy in this sphere needs more systematic model including state economic and social measures, parental involvement and role of non-government organizations.

Keywords: children, Kazakhstan, policy, vulnerability

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Authors: Zarish Jawad, Nikita Chugh, Karina Dadar

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Introduction: This paper aims to identify barriers indigenous women face in accessing prenatal care in Canada. It explores the differences in prenatal care received between indigenous and non-indigenous women. The objective is to look at changes or programs in Canada's healthcare system to reduce barriers to accessing safe prenatal care for indigenous women. Methods: A literature search of 12 papers was conducted using the following databases: PubMed, Medline, OVID, Google Scholar, and ScienceDirect. The studies included were written in English only, including indigenous females between the age of 19-35, and review articles were excluded. Participants in the studies examined did not have any severe underlying medical conditions for the duration of the study, and study designs included in the review are prospective cohort, cross-sectional, case report, and case-control studies. Results: Among all the barriers Indigenous women face in accessing prenatal care, the three most significant barriers Indigenous women face include a lack of culturally safe prenatal care, lack of services in the Indigenous community, proximity of prenatal facilities to Indigenous communities and costs of transportation. Discussion: The study found three significant barriers indigenous women face in accessing prenatal care in Canada; the geographical distribution of healthcare facilities, distrust between patients and healthcare professionals, and cultural sensitivity. Some of the suggested solutions include building more birthing and prenatal care facilities in rural areas for indigenous women, educating healthcare professionals on culturally sensitive healthcare, and involving indigenous people in the decision-making process to reduce distrust and power imbalances. Conclusion: The involvement of indigenous women and community leaders is important in making decisions regarding the implementation of effective healthcare and prenatal programs for indigenous women. However, further research is required to understand the effectiveness of the solutions and the barriers that make prenatal care less accessible for indigenous women in Canada.

Keywords: indigenous, maternal health, prenatal care, barriers

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Authors: Herlin Vallejo, Jhon Osorio

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Quality is a concept that has gained importance in different scenarios over time, especially in the area of health. The nursing staff is one of the actors that contributes most to the care process and the satisfaction of the users in the evaluation of quality. However, until now, there are few tools to measure the quality of care in specialized performance scenarios. Patients receiving ambulatory cancer treatments can face various problems, which can increase their level of distress, so improving the quality of outpatient care for cancer patients should be a priority for oncology nursing. The experience of the patient in relation to the care in these services has been little investigated. The purpose of this study was to understand the perception that patients have about quality care in outpatient chemotherapy services. A qualitative, exploratory, descriptive study was carried out in 9 patients older than 18 years, diagnosed with cancer, who were treated at the Institute of Cancerology, in outpatient chemotherapy rooms, with a minimum of three months of treatment with curative intention and which had given your informed consent. The total of participants was determined by the theoretical saturation, and the selection of these was for convenience. Unstructured interviews were conducted, recorded and transcribed. The analysis of the information was done under the technique of content analysis. Three categories emerged that reflect the perception that patients have regarding quality care: patient-centered care, care with love and effects of care. Patients highlighted situations that show that care is centered on them, incorporating elements of patient-centered care from the institutional, infrastructure, qualities of care and what for them, in contrast, means inappropriate care. Care with love as a perception of quality care means for patients that the nursing staff must have certain qualities, perceive caring with love as a family affair, limits on care with love and the nurse-patient relationship. Quality care has effects on both the patient and the nursing staff. One of the most relevant effects was the confidence that the patient develops towards the nurse, besides to transform the unreal images about cancer treatment with chemotherapy. On the other hand, care with quality generates a commitment to self-care and is a facilitator in the transit of oncological disease and chemotherapeutic treatment, but from the perception of a healing transit. It is concluded that care with quality from the perception of patients, is a construction that goes beyond the structural issues and is related to an institutional culture of quality that is reflected in the attitude of the nursing staff and in the acts of Care that have positive effects on the experience of chemotherapy and disease. With the results, it contributes to better understand how quality care is built from the perception of patients and to open a range of possibilities for the future development of an individualized instrument that allows evaluating the quality of care from the perception of patients with cancer.

Keywords: nursing care, oncology service hospital, quality management, qualitative studies

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Authors: Sandrine Andriantsimietry, Hantanirina Ravaosendrasoa

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Madagascar, in 2018, set up the first best available technology, autoclave, to treat the health care waste in public hospitals according the best environmental practices in health care waste management. Incineration of health care waste, frequently through open burning is the most common practice of treatment and elimination of health care waste across the country. Autoclave is a best available technology for non-incineration of health care waste that permits recycling of treated waste and prevents harm in environment through the reduction of unintended persistent organic pollutants from the health sector. A Global Environment Fund project supported the introduction of the non-incineration treatment of health care waste to help countries in Africa to move towards Stockholm Convention objectives in the health sector. Two teaching hospitals in Antananarivo and one district hospital in Manjakandriana were equipped respectively with 1300L, 250L and 80L autoclaves. The capacity of these model hospitals was strengthened by the donation of equipment and materials and the training of the health workers in best environmental practices in health care waste management. Proper segregation of waste in the wards to collect the infectious waste that was treated in the autoclave was the main step guaranteeing a cost-efficient non-incineration of health care waste. Therefore, the start-up of the switch of incineration into non-incineration treatment was carried out progressively in each ward with close supervision of hygienist. Emissions avoided of unintended persistent organic pollutants during these four months of autoclaves use is 9.4 g Toxic Equivalent per year. Public hospitals in low income countries can be model in best environmental practices in health care waste management but efforts must be made internally for sustainment.

Keywords: autoclave, health care waste management, model hospitals, non-incineration

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Authors: Mohammed Alateeq, Abdulaziz Alrshoud

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Objectives: To examine the attitude and practice of family physicians in giving smoking cessation advice at King Abdul-Aziz Medical City for National Guard, Riyadh. Methods: Cross sectional study using validated self-reported questionnaire that distributed to all family physicians and primary health care doctors at the four main family medicine and primary health care centers, KAMC, Riyadh. Results: 73 physicians are contributed in this study. 28 (38.4%) physicians were from (KASHM ALAN) clinic, 26 (35.6%) physicians were from (UM ALHAMAM) Clinic. 13 (17.8%) physicians were from (ISKAN) clinic. 6 (8.2%) physicians were from the Employee Health Clinic. 73 (100%) of the target population agreed that giving brief smoking cessation advice is part of their duties. 67 (91.7%) agreed that Presence of hospital guidelines and special clinics for smoking cessation will encourage them to provide advice. Only 5 (6.84%) received training courses (1-4 weeks) in smoking cessation interventions. Conclusion: Most of the target population agreed that brief smoking cessation advice is part of their duties. Also, they agreed that Presence of hospital guidelines and special clinics for smoking cessation will encourage them to provide advice although most of them did not received a formal training in smoking cessation advice.

Keywords: advice, attitude, cessation, family physicians, smoking

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Authors: Puteri Zarina M. K., Haddi J. K., Zolkepli N., Shu M. H. B., Hosshan H., Saad M. A.

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This paper provides an overview of the current state of ESL instruction for children with autism in Malaysia. Equal rights, independence, and active participation are guaranteed by the 2006 Convention on the Rights of Persons with Disabilities. Every child is entitled to receive education in an inclusive atmosphere that embraces diversity and ensures equal opportunity for all. The primary objective of the research was to investigate if English as a Second Language (ESL) teachers employ distinct instructional methods and strategies while teaching children diagnosed with autism. Moreover, the objective was to assess the similarities in the challenges faced by teachers when teaching ESL to children with autism in Malaysia. The study aimed to increase understanding of the challenges faced by ESL teachers in teaching autistic students. The study was structured as a qualitative research endeavour. A total of twelve (12) ESL teachers from selected primary schools in Malaysia were involved in this study. The research findings accurately depict the actual state of teaching ESL to autistic children. They confirm the imperative need for additional support in order to facilitate the successful integration of these children into the educational system.

Keywords: autism spectrum disorder, ESL, inclusion, Malaysia, special educational needs

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Authors: B. P. G. Figueira, I. C. Pinto, D. Ferro, F. C. M. Zacharias

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The absenteeism at work constitutes in a temporary absence of labor functions resulting from various reasons, bringing damage to production, increasing costs of care and overburdening other workers, has its principal cause due to illness, often due exposure to several risks in the workplace. This study aims to know, identify and analyze the types and causes of absenteeism, such as the frequency at which it occurs by professional category, for employment contract and days not worked in Emergency Care Public in a city in the interior of São Paulo. We conducted exploratory and descriptive study with a quantitative approach, with nursing professionals, after selection of inclusion criteria was reached a universe of 208 subjects, the data collected are for the years from 2010-2013. Research has shown that the professional category of nursing assistant had 88,11% of total absenteeism, absenteeism lasting 1 day was the with the highest frequency, the women were responsible for 74,80% of absenteeism disease. It was concluded that absenteeism shall be monitored to plan control actions, establishing better political for the management of human resources, because it can be an aggravating factor in the quality of care.

Keywords: absenteeism; nursing; emergency medical services, human resource

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