Search results for: resource-limited care environments
5282 Research on the Performance Management of Social Organizations Participating in Home-Based Care
Authors: Qiuhu Shao
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Community home-based care service system, which is based on the family pension, supported by community pension and supplied by institutions pension, is an effective pension system to solve the current situation of China's accelerated aging. However, due to the fundamental realities of our country, the government is not able to bear the unilateral supply of the old-age service of the community. Therefore, based on the theory of welfare pluralism, the participation of social organizations in the home-based care service center has become an important part of the diversified supply of the old-age service for the elderly. Meanwhile, the home-based care service industry is still in the early stage, the management is relatively rough, which resulted in a large number of social resources waste. Thus, scientific, objective and long-term implementation is needed for social organizations to participate in home-based care services to guide its performance management. In order to realize the design of the performance management system, the author has done a research work that clarifies the research status of social organization's participation in home-based care service. Relevant theories such as welfare pluralism, community care theory, and performance management theory have been used to demonstrate the feasibility of data envelopment analysis method in social organization performance research. This paper analyzes the characteristics of the operation mode of the home-based care service center, and hackles the national as well as local documents, standards and norms related to the development of the home-based care industry, particularly studies those documents in Nanjing. Based on this, the paper designed a set of performance management PDCA system for home-based care service center in Nanjing and clarified each step of the system in detail. Subsequently, the research methods of performance evaluation and performance management and feedback, which are two core steps of performance management have been compared and screened in order to establish the overall framework of the performance management system of the home-based care service center. Through a large number of research, the paper summarized and analyzed the characteristics of the home-based care service center. Based on the research results, combined with the practice of the industry development in Nanjing, the paper puts forward a targeted performance evaluation index system of home-based care service center in Nanjing. Finally, the paper evaluated and sub-filed the performance of 186 home-based care service centers in Nanjing and then designed the performance optimization direction and performance improvement path based on the results. This study constructs the index system of performance evaluation of home-based care service and makes the index detailed to the implementation level, and constructs the evaluation index system which can be applied directly. Meanwhile, the quantitative evaluation of social organizations participating in the home-based care service changed the subjective impression in the previous practice of evaluation.Keywords: data envelopment analysis, home-based care, performance management, social organization
Procedia PDF Downloads 2615281 Spirituality in Adults with Developmental Disabilities in the Practice of Pastoral Care Ministry
Authors: Olutayo Stephen Shodipo
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This paper explores how individuals with disabilities understand and express their spirituality like everyone else can help provide church ministers and religious leaders with new knowledge of human experience and change the way pastoral care ministry is being practiced with this population. Disability literature has revealed studies on various aspects of disability. However, on the spirituality of people with disabilities, there is a gap. This paper offers a brief overview of what has been studied on the spiritual needs of adults with developmental disabilities (ADDs) and the church and the gap that still exists. Along with explaining this gap, it considers the reality of ADDs’ spiritual needs and why the church needs to validate their spirituality and religious expressions and create an inclusive environment where their spiritual experience and expressions can be enhanced and supported. This paper, then, aims to explore the diverse spiritual experiences of ADDs in faith communities, and their theological, moral, and social implications for Pastoral care ministry practices.Keywords: spirituality, inclusive ministry, pastoral theology, developmental disability, pastoral care
Procedia PDF Downloads 2005280 Compact Optical Sensors for Harsh Environments
Authors: Branislav Timotijevic, Yves Petremand, Markus Luetzelschwab, Dara Bayat, Laurent Aebi
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Optical miniaturized sensors with remote readout are required devices for the monitoring in harsh electromagnetic environments. As an example, in turbo and hydro generators, excessively high vibrations of the end-windings can lead to dramatic damages, imposing very high, additional service costs. A significant change of the generator temperature can also be an indicator of the system failure. Continuous monitoring of vibrations, temperature, humidity, and gases is therefore mandatory. The high electromagnetic fields in the generators impose the use of non-conductive devices in order to prevent electromagnetic interferences and to electrically isolate the sensing element to the electronic readout. Metal-free sensors are good candidates for such systems since they are immune to very strong electromagnetic fields and given the fact that they are non-conductive. We have realized miniature optical accelerometer and temperature sensors for a remote sensing of the harsh environments using the common, inexpensive silicon Micro Electro-Mechanical System (MEMS) platform. Both devices show highly linear response. The accelerometer has a deviation within 1% from the linear fit when tested in a range 0 – 40 g. The temperature sensor can provide the measurement accuracy better than 1 °C in a range 20 – 150 °C. The design of other type of sensors for the environments with high electromagnetic interferences has also been discussed.Keywords: optical MEMS, temperature sensor, accelerometer, remote sensing, harsh environment
Procedia PDF Downloads 3605279 Coping Life with Female Autistic and Cerebral Palsy Teenagers: Stress Developed by Parental Care in Ghana
Authors: Edwina Owusu Panin, Derrick Antwi
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Autism and cerebral palsy are fraternal twins in the world of communication and social interaction challenges. Caring for autistic and cerebral palsied female teenagers in Ghana can be difficult and stressful for parents. We highlight the findings of dealing with stress, where female teenagers are more daunting than male teenagers, related to the demand for a lot of attention linked to the puberty transition. This brief examines the challenges that parents face in caring for teenagers with autism and cerebral palsy in Ghana and the stress that can develop from parental care. The article also highlights the importance of identifying and addressing mental health and self-care issues in parents of disabled female teenagers, as these issues can significantly affect the well-being of both parents and their children. Parents of teenagers with disabilities often face a variety of challenges, including managing their children's care and medical needs, navigating the educational system, and addressing social and emotional needs. These challenges can be even more disheartening in Ghana, where resources and support for families of children with disabilities are limited. In a nutshell, the challenges of caring for female teenagers with autism and cerebral palsy can be significant in Ghana. The article outlines methods that parents in Ghana can take to manage their stress and provide a brighter future for their female teenagers. Parents are better able to cope with the challenges of parenting and provide the best care possible for their female teenagers with disabilities.Keywords: autism, cerebral palsy, female teenagers, parental care
Procedia PDF Downloads 795278 A Systematic Review on Communication and Relations between Health Care Professionals and Patients with Cancer in Outpatient Settings Matter
Authors: Anne Prip, Kirsten Alling Møller, Dorte Lisbet Nielsen, Mary Jarden, Marie-Helene Olsen, Anne Kjaergaard Danielsen
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Background: The development in cancer care has shifted towards shorter hospital stays and more outpatient treatment. Today, cancer care and treatment predominantly takes place in outpatient settings where encounters between patients and health care professionals are often brief. This development will probably continue internationally as the global cancer burden seems to be growing significantly. Furthermore, the number of patients who require ambulatory treatments such as chemotherapy is increasing. Focusing on the encounters between health care professionals and patients during oncology treatment has thus become increasingly important due to a growing trend in outpatient cancer management. Objective: The aim of the systematic review was to summarize the literature from the perspective of the patient, on experiences of and the need for communication and relationships with the health care professional during chemotherapy treatment in an outpatient setting. Method: The review was designed and carried out according to the PRISMA guidelines and PICO framework. The systematic search was conducted in Medline, CINAHL, The Cochrane Library and Joanna Briggs Institute Evidence Based Practice Database. Results: In all, 1174 studies were identified by literature search. After duplicates were removed, the remaining studies (n = 1053) were screened for inclusion. Nine studies were included; qualitative (n = 5) and quantitative (n = 4) as they met the inclusions criteria. The review identified that communication and relationships between health care professionals and patients were important for the patients’ ability to cope with cancer and also had an impact on patients’ satisfaction with care in the outpatient clinic. Furthermore, the review showed that hope and positivity was a need and strategy for patients with cancer and was facilitated by health care professionals. Finally, it revealed that outpatient clinic visits framed and influenced communication and relationships. Conclusions: This review identified the significance of communication and the relationships between patients and health care professionals in the outpatient setting as it supports patients’ ability to cope with cancer. The review showed the need for health care professionals to pay attention to the relational aspects of communication in an outpatient clinic as encounters are often brief. Furthermore, the review helps to specify which elements of the communication are central in the patient-health care professional interaction from the patients' perspective. Finally, it shows a need for more research to investigate which type of interaction and intervention would be the most effective in supporting patients’ coping during chemotherapy in an outpatient clinic.Keywords: ambulatory chemotherapy, communication, health care professional-patient relation, nurse-patient relation, outpatient care, systematic review
Procedia PDF Downloads 4195277 A Fast Silhouette Detection Algorithm for Shadow Volumes in Augmented Reality
Authors: Hoshang Kolivand, Mahyar Kolivand, Mohd Shahrizal Sunar, Mohd Azhar M. Arsad
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Real-time shadow generation in virtual environments and Augmented Reality (AR) was always a hot topic in the last three decades. Lots of calculation for shadow generation among AR needs a fast algorithm to overcome this issue and to be capable of implementing in any real-time rendering. In this paper, a silhouette detection algorithm is presented to generate shadows for AR systems. Δ+ algorithm is presented based on extending edges of occluders to recognize which edges are silhouettes in the case of real-time rendering. An accurate comparison between the proposed algorithm and current algorithms in silhouette detection is done to show the reduction calculation by presented algorithm. The algorithm is tested in both virtual environments and AR systems. We think that this algorithm has the potential to be a fundamental algorithm for shadow generation in all complex environments.Keywords: silhouette detection, shadow volumes, real-time shadows, rendering, augmented reality
Procedia PDF Downloads 4345276 Communication Barriers in Midwifery Students in the Field of Perinatal Palliative Care
Authors: Magdalena Hasplova, Katerina Ivanova
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Perinatal palliative care is a relatively young and developing field that includes the care of a fetus or newborn with a life-threatening or limiting defect and his family. However, the training of midwives in perinatal palliative care is insufficient and midwives do not feel prepared for this aspect of their work. This fact can affect the barriers to communication with the mother or family of the endangered child. The main aim was to analyze the awareness of midwifery students on the issue of perinatal palliative care in the Czech Republic. Based on the analysis, draw attention to possible communication barriers that may be caused by insufficient information. The research was carried out using a qualitative method, the method of data collection was a semi-structured interview. Eleven female students took part in the research, and the respondents were selected using the Snowballing method. Some methods of grounded theory (open coding and category creation) were used to analyze the data. Based on the results of the research, questions were set in a questionnaire focused on communication barriers between mothers (family) and health care professionals in the care of newborns with life-threatening or limiting disabilities. Based on the analysis of data, categories 1 were determined. Knowledge of perinatal palliative care 2. Education 3. Practical experience 4. Readiness and concerns in the provision of perinatal palliative care 6. Supervision. The questions in the questionnaire were then derived taking into account the data obtained, and the operationalization of health literacy in the field of perinatal palliative care was performed. The analysis of the interviews revealed that the education of midwives in the Czech Republic in the issue of perinatal palliative care is not uniform. The research confirmed the insufficient knowledge and skills of midwifery students preparing to provide perinatal palliative care. Respondents reported feelings of unpreparedness in the areas of communication with a woman after perinatal loss, psychological support for a woman and her family, the care of a stillborn or dying child, or self-coping with death. The questions in the questionnaire then develop these areas. We assumed that by analyzing and interpreting the data obtained from our research, we will help to better understand the concerns and motivations of students in providing holistic perinatal palliative care. We came to the conclusion that it would be appropriate to set up a unified and comprehensive education on this issue in the Czech Republic. Healthcare professionals are in a unique position that can positively or negatively affect the intensity of perinatal loss. Already properly set up education of health professionals leads to overcoming barriers in communication between health professionals and the family, experiencing perinatal loss.Keywords: midwife, perinatal loss, perinatal palliative care, communication, barriers, mothers, family
Procedia PDF Downloads 1065275 An Evaluation Framework for Virtual Reality Learning Environments in Sports Education
Authors: Jonathan J. Foo, Keng Hao Chew
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Interest in virtual reality (VR) technologies as virtual learning environments have been on the rise in recent years. With thanks to the aggressively competitive consumer electronics environment, VR technology has been made affordable and accessible to the average person with developments like Google Cardboard and Oculus Go. While the promise of virtual access to unique virtual learning environments with the benefits of experiential learning sounds extremely attractive, there are still concerns over user comfort in the psychomotor, cognitive, and affective domains. Reports of motion sickness and short durations create doubt and have stunted its growth. In this paper, a multidimensional framework is proposed for the evaluation of VR learning environments within the three dimensions: tactual quality, didactic quality, and autodidactic quality. This paper further proposes a mixed-methods experimental research plan that sets out to evaluate a virtual reality training simulator in the context of amateur sports fencing. The study will investigate if an immersive VR learning environment can effectively simulate an authentic learning environment suitable for instruction, practice, and assessment while providing the user comfort in the tactual, didactic, and autodidactic dimensions. The models and recommendations developed for this study are designed in the context of fencing, but the potential impact is a guide for the future design and evaluation of all VR developments across sports and technical classroom education.Keywords: autodidactic quality, didactic quality, tactual quality, virtual reality
Procedia PDF Downloads 1255274 High Touch Objects and Infection Control in Intensive Care Units
Authors: Shakiera Sallie, Angela James
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Global concern about healthcare-associated infections through the transmission of microorganisms, resulting in outbreaks in overcrowded intensive care units (ICU), is current. Medical equipment and surfaces in the immediate patient zone, the high-touch objects, may become contaminated. A study was conducted across six intensive care units in a healthcare facility to determine the understanding and practice of the cleaning of high-touch objects (HTO), and an intervention program was undertaken. A mixed-method approach with the selection of ICUs, HTOs, and healthcare personnel was undertaken. Data collection included Ultra-Violet instruments, a questionnaire, and an intervention. In the pre-intervention, 41 (52.5%) of the healthcare personnel (n=78) rated their understanding of HTOs as “sufficient”; post-intervention, it was 67 (75%), (n=89), p=0.0015, indicates an improvement. The UV stamp percentage compliance to indicate whether cleaning of the HTOs had taken place across the six intensive care units before the intervention ranged from 0% compliance to 88% compliance, and after, it ranged from 67% to 91%. An intervention program on the cleaning of HTOs and the transmission cycle of microorganisms in the ICUs enhanced the healthcare personnel’s understanding and practices on the importance of environmental cleaning.Keywords: high touch objects, infections, intensive care units, intervention program, microorganisms
Procedia PDF Downloads 1385273 Factors Affecting Adequate Utilisation of Ante-natal Health Care Services among Pregnant Women in Dutsin-Ma Local Government Area of Katsina State
Authors: Ilim Moses Msughter
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The study was carried out to examine the availability of Ante-natal care services and the socio-cultural factors affecting the utilization of these services in Dutsin-Ma Local Government Area of Katsina State. Four specific objectives were outlined as thus to examine the availability of antenatal care services in Dutsin-Ma local government area, to identify the socio-cultural factors affecting the utilisation of ante-natal care services, to ascertain the challenges affecting utilisation of ante-natal care services and suggest strategies to improve efficiency in ante-natal service delivery and utilisation of same services. Data were collected from 110 respondents using a questionnaire and through the use of the interview. Data were analysed quantitatively and qualitatively. The findings revealed that ante-natal care services are available in the study area, but access to such services is hindered by several factors, which include religious and traditional beliefs, cost of services and poor attitudes of health care workers which has an adverse effect on people’s desire to visit ante-natal centres. The study recommended that Traditional Birth Attendants (TBA) need to be trained on how to handle pregnancy-related complications. It is also recommended that essential ante-natal drugs and services should be subsidised or made free by the government, and this must be closely monitored to ensure efficiency. Finally, human relation training should be organised for nurses and midwives to improve their attitudes towards patients during ante-natal visits.Keywords: utilisation, religion, traditional birth attendant, ante-natal
Procedia PDF Downloads 1605272 Pracademia in Irish Higher Education: The Only Solution to Contemporary Regulation in Professional Social Care Practice
Authors: Aoife Prendergast
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The synergy between theory and practice can be considered elusive, the touchstone for the development of successful undergraduate programmes particularly in allied health professions such as social care. A 'pracademic' is a person who spans both the somewhat ethereal world of academia as a scholar and the pragmatic world of practice. This paper examines the concept of 'pracademia' in relation to the role of the social care practitioner and continuing professional development. It also assists in the understanding of the synergy between social care professionals and higher education. A consideration of the identity and position in terms of approach to regulation is explored as well as an acknowledgement of the strengths and opportunities for sharing power in hierarchical positions. The world of practice serves as the centre point of the academic compass for most professional programs. Just as schools of engineering and law are disciplined by the marketplace, which seeks well-trained students, so our social care programmes must perennially find ways to address the fast changing needs of practitioners, whether they be government, not-for-profit organizations, consulting firms or contractors. We may not expect such traditional academic disciplines as history, sociology, or political science to cater to the needs of external audiences or practitioners— indeed, these disciplines' insulation from public concerns and issues is considered a strength by some. This paper aims to explore the integration of academic teaching and research with the communities of practice in social care. This appears to be a fundamental aspiration of the social care profession. While building and integrating an important body of academic theory and concepts from a variety of disciplines, social care as a field has embraced a professional orientation by seeking to be relevant to practitioners at various levels. While teaching theory, social care programmes, and faculty are often acutely aware that their academic content and credibility, in part, rest on a deep connection with practitioners. While theory can be self-contained, the impact of our research and teaching arguably finds its most compelling and highest audience when it addresses the agenda items and concerns of practitioners.Keywords: social care, pracademia, supervision, practice education
Procedia PDF Downloads 1605271 Requirements Engineering via Controlling Actors Definition for the Organizations of European Critical Infrastructure
Authors: Jiri F. Urbanek, Jiri Barta, Oldrich Svoboda, Jiri J. Urbanek
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The organizations of European and Czech critical infrastructure have specific position, mission, characteristics and behaviour in European Union and Czech state/ business environments, regarding specific requirements for regional and global security environments. They must respect policy of national security and global rules, requirements and standards in all their inherent and outer processes of supply-customer chains and networks. A controlling is generalized capability to have control over situational policy. This paper aims and purposes are to introduce the controlling as quite new necessary process attribute providing for critical infrastructure is environment the capability and profit to achieve its commitment regarding to the effectiveness of the quality management system in meeting customer/ user requirements and also the continual improvement of critical infrastructure organization’s processes overall performance and efficiency, as well as its societal security via continual planning improvement via DYVELOP modelling.Keywords: added value, DYVELOP, controlling, environments, process approach
Procedia PDF Downloads 4045270 Spatial Differentiation of Elderly Care Facilities in Mountainous Cities: A Case Study of Chongqing
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In this study, a web crawler was used to collect POI sample data from 38 districts and counties of Chongqing in 2022, and ArcGIS was combined to coordinate and projection conversion and realize data visualization. Nuclear density analysis and spatial correlation analysis were used to explore the spatial distribution characteristics of elderly care facilities in Chongqing, and K mean cluster analysis was carried out with GeoDa to study the spatial concentration degree of elderly care resources in 38 districts and counties. Finally, the driving force of spatial differentiation of elderly care facilities in various districts and counties of Chongqing is studied by using the method of geographic detector. The results show that: (1) in terms of spatial distribution structure, the distribution of elderly care facilities in Chongqing is unbalanced, showing a distribution pattern of ‘large dispersion and small agglomeration’ and the asymmetric pattern of ‘west dense and east sparse, north dense and south sparse’ is prominent. (2) In terms of the spatial matching between elderly care resources and the elderly population, there is a weak coordination between the input of elderly care resources and the distribution of the elderly population at the county level in Chongqing. (3) The analysis of the results of the geographical detector shows that the single factor influence is mainly the number of elderly population, public financial revenue and district and county GDP. The high single factor influence is mainly caused by the elderly population, public financial income, and district and county GDP. The influence of each influence factor on the spatial distribution of elderly care facilities is not simply superimposed but has a nonlinear enhancement effect or double factor enhancement. It is necessary to strengthen the synergistic effect of two factors and promote the synergistic effect of multiple factors.Keywords: aging, elderly care facilities, spatial differentiation, geographical detector, driving force analysis, Mountain city
Procedia PDF Downloads 295269 Empowering Volunteers at Tawanchai Centre for Patients with Cleft Lip and Palate
Authors: Suteera Pradubwong, Darawan Augsornwan, Pornpen Pathumwiwathana, Benjamas Prathanee, Bowornsilp Chowchuen
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Background: Cleft lip and palate (CLP) congenital anomalies have a high prevalence in the Northeast of Thailand. A care team’s understand of treatment plan would help to guide the family of patients with CLP to achieve the treatment. Objectives: To examine the impact of the empowering volunteer project, established in the northeast Thailand. Materials and Methods: The Empowering Volunteer project was conducted in 2008 under the Tawanchai Royal Granted project. The patients and family’s general information, treatment, the group brainstorming, and satisfaction with the project were analyzed. Results: Participants were 12 children with CLP, their families and five volunteers with CLP; the participating patients were predominantly females and the mean, age was 12.2 years. The treatment comprised of speech training, dental hygiene care, bone graft and orthodontic treatment. Four issues were addressed including: problems in taking care of breast feeding; instructions’ needs for care at birth; difficulty in access information and society impact; and needs in having a network of volunteers. Conclusions: Empowering volunteer is important for holistic care of patients with CLP which provides easy access and multiple channels for patients and their families. It should be developed as part of the self-help and family support group, the development of community based team and comprehensive CLP care program.Keywords: self-help and family support group, community based model, volunteer, cleft lip-cleft palate
Procedia PDF Downloads 2745268 Educators’ Perceived Capacity to Create Inclusive Learning Environments: Exploring Individual Competencies and District Policy
Authors: Thuy Phan, Stephanie Luallin
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Inclusive education policies have demonstrated benefits for students with and without disabilities in the US. There are several laws that relate to inclusive education, such as 'No Child Left Behind', 'The Individuals with Disabilities Education Act'. However, the application of these inclusive education laws and policies vary per state and school district. Classroom teachers in an inclusive classroom often experience confusion as to how to apply these policies in order to create appropriate inclusive learning environments that meet the abilities and needs of their diverse student population. The study aims to investigate teachers’ perspective of their capacities to create an appropriate learning environment for their diverse student population including students with disabilities. Qualitative method is implemented in this study, using open-end interview questions to investigate teachers’ perspective of their capacities to create an appropriate inclusive learning environment for all students based on current inclusive education laws and district policies in the state of Colorado, USA. These findings may indicate a lack of confidence in teachers’ capacity to create appropriate inclusive learning environments based on laws and district policies; including challenges that classroom teachers may experience in creating inclusive learning environments. The purpose of this study is to examine the adequate preparation of classroom teachers in creating inclusive classrooms with the intent of determining implications for developing policies in inclusive education.Keywords: educator’s capacity, inclusive education, inclusive learning environment, policy
Procedia PDF Downloads 1675267 Intensive Care Experience of Providing Palliative Care for a Terminal Lung Cancer Patient
Authors: Ting-I Lin
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Objective: This article explores the nursing care experience of a 51-year-old terminal lung cancer patient admitted to the intensive care unit (ICU) following an upper right lobectomy. The patient initially sought emergency treatment due to worsening cough and dyspnea. A sudden deterioration led to the placement of an endotracheal tube. Follow-up CT scans and chest X-rays revealed a mass in the upper right lung with metastases to the lungs, liver, bones, and adrenal glands. The patient underwent a right upper lobectomy and a wedge resection of the right middle lobe. Biopsy staging: T4N3M1c s/p. Methods: During the care period, the nurse continuously monitored physiological data, conducted observations, direct care, interviews, and physical assessments, and reviewed the patient’s medical records. The nurse collaborated with the critical care team and the palliative care team to conduct a comprehensive evaluation using Gordon’s Eleven Functional Health Patterns. Key health problems identified included pain related to postoperative cancer resection and invasive devices, fear of death due to rapid disease progression, and altered tissue perfusion associated with hemodynamic instability. Results: Postoperatively, the patient experienced pain from the surgical wound and increased dyspnea due to widespread metastases, often presenting with confusion. Adjusting the dosage of pain medication reduced the patient’s discomfort, with Morphine 8mg in 0.9% N/S 60ml IV drip q6h prn and Ultracet 37.5 mg/325 mg 1# PO q6h. The FLACC pain score decreased from 7 to below 3. After respiratory training, the endotracheal tube was removed, and the patient's breathing stabilized at 16-18 breaths per minute. Body temperature remained between 35.8°C and 36.1°C, with a mean arterial pressure of 60-80 mmHg. Conclusion: The critical care team, together with the palliative care team, held a family meeting to address not only the patient’s care but also the emotional well-being of the family. By facilitating open visiting hours and fostering expressions of love and gratitude, the patient and family were able to strengthen their emotional connection and reduce anxiety from severe to mild. The family expressed no regrets. After the patient was transferred to the general ward, ongoing care continued with genuine empathy, compassion, and religious support, offering end-of-life care that helped the patient and family through the final stage of life.Keywords: multiple metastases, lung cancer, palliative care, nursing experience
Procedia PDF Downloads 65266 Links between Moral Distress of Registered Nurses and Factors Related to Patient Care at the End of Their Life: A Cross Sectional Survey
Authors: L. Laurs, A. Blazeviciene, D. Milonas
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Introduction: Nursing as a profession is grounded in moral obligation. Nursing practice is grounded in ethical standards: to not harm, to promote justice, to be accountable, and to provide safe and competent care. The nature of the nurse-patient therapeutic relationship requires acting on the patient's behalf. Moral distress consists of negative stress symptoms that occur in situations that involve ethical situations that the nurse perceives as discordant with their professional values. Aim of the Study: The purpose of this study was to assess links between moral distress of registered nurses and factors related to patient care at the end of their life. Methods and Sample: A descriptive, cross-sectional, correlational design was applied in this study. Registered nurses were recruited from seven municipal multi-profile hospitals providing both general and specialized healthcare services in Lithuania (N=1055). Research instruments included two questionnaires: Obstacles and Facilitating at the End of Life Care and Moral Distress Scale (revised). Results: Spearman’s correlation analysis was performed to assess the relationship between nurses' attitudes towards patient care at the end of life and the experienced moral distress. A statistically significant correlation between moral distress and the following factors related to patient end-of-life care has been identified: conversations with physicians on patient end-of-life problems have a positive impact on job satisfaction; some patients may be excluded from decisions about their treatment and nursing because they are questioned about their ability to assess the situation. These situations increased moral distress. Patient consciousness should not be permanently suppressed by calming medications, and the patient should be provided with all nursing care services and moral distress. Conclusions: The moral distress of nurses is significantly related to the end-of-life care of patients and their determinants: moral distress increased due to lack of discussion with doctors about problem-solving and exclusion of patients from decision-making. And it diminished by refusing calming medications to permanently suppress a patient's consciousness and providing good care for patients.Keywords: moral distress, registered nurses, end of life, care
Procedia PDF Downloads 1085265 Effects of the Affordable Care Act On Preventive Care Disparities
Authors: Cagdas Agirdas
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Background: The Affordable Care Act (ACA) requires non-grandfathered private insurance plans, starting with plan years on or after September 23rd, 2010, to provide certain preventive care services without any cost sharing in the form of deductibles, copayments or co-insurance. This requirement may affect racial and ethnic disparities in preventive care as it provides the largest copay reduction in preventive care. Objectives: We ask whether the ACA’s free preventive care benefits are associated with a reduction in racial and ethnic disparities in the utilization of four preventive services: cholesterol screenings, colonoscopies, mammograms, and pap smears. Methods: We use a data set of over 6,000 individuals from the 2009, 2010, and 2013 Medical Expenditure Panel Surveys (MEPS). We restrict our data set only to individuals who are old enough to be eligible for each preventive service. Our difference-in-differences logistic regression model classifies privately-insured Hispanics, African Americans, and Asians as the treatment groups and 2013 as the after-policy year. Our control group consists of non-Hispanic whites on Medicaid as this program already covered preventive care services for free or at a low cost before the ACA. Results: After controlling for income, education, marital status, preferred interview language, self-reported health status, employment, having a usual source of care, age and gender, we find that the ACA is associated with increases in the probability of the median, privately-insured Hispanic person to get a colonoscopy by 3.6% and a mammogram by 3.1%, compared to a non-Hispanic white person on Medicaid. Similarly, we find that the median, privately-insured African American person’s probability of receiving these two preventive services improved by 2.3% and 2.4% compared to a non-Hispanic white person on Medicaid. We do not find any significant improvements for any racial or ethnic group for cholesterol screenings or pap smears. Furthermore, our results do not indicate any significant changes for Asians compared to non-Hispanic whites in utilizing the four preventive services. These reductions in racial/ethnic disparities are robust to reconfigurations of time periods, previous diagnosis, and residential status. Conclusions: Early effects of the ACA’s provision of free preventive care are significant for Hispanics and African Americans. Further research is needed for the later years as more individuals became aware of these benefits.Keywords: preventive care, Affordable Care Act, cost sharing, racial disparities
Procedia PDF Downloads 1465264 Caring for a Spinal Cord Injury Patient with Diabetic Nephropathy Receiving Hospice Palliative Care
Authors: Li-Ting Kung, Hui-Zhu Chen, Hsin-Tzu Lee, Wan-Yin Hsu
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Patients with spinal cord injury combined with diabetic nephropathy may under a lot of painful conditions due to complications related to the illness itself or treatments, such as recurrent pressure ulcers, autonomic and peripheral neuropathy, as well as dialysis, for long term. This case report illustrated the nursing experience of transferring a spine cord injure patient who received hemodialysis due to adverse lifestyle-induced diabetic nephropathy to the hospice ward. Nursing care was provided in this patient from July 25th to August 30th, 2015. The tool of 'Gordon’s 11-item functional health assessment' and clinical observation, interviews as well as physical examination were used as data collections. Based on results of health assessment as above, the patient’s health problems were identified as the following: impaired skin integrity, chronic pain, and hopeless. Besides to relieve the symptom of pain due to disease or the treatment of hemodialysis and provide wound care, the first author also played a role to assist the patient to achieve his goal of receiving the hospice palliative care. Finally, with much effort of nurses to communicate with medical teams between the surgical and hospice wards, the patient was transferred to the hospice ward to have fulfilled his last wish of having a good death. We hope this nursing experience can be applied to other similar cases in the future.Keywords: diabetic nephropathy, hospice care, palliative care, spinal cord injury
Procedia PDF Downloads 1475263 A Social Care Intervention for Improving the Quality of Life of People Living with HIV/AIDS in Ghana
Authors: Tina Abrefa-Gyan
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Background: In Ghana and the rest of sub-Saharan Africa, HIV/AIDS is a public health threat and also causes medical crises for many who are infected with the virus. Objective: This study tested a social care intervention developed to help improve the quality of life of those living with HIV/AIDS in Ghana. Method: Adult respondents (N = 248) were assigned to receive the intervention or usual care for six weeks. Results: Results of the study revealed significant differences between the treatment and control groups in their reports of quality of life. Respondents reported better quality of life upon receiving the intervention. Implication: This study sheds light on the positive relationship between the intervention and quality of life among those living with HIV/AIDS in Ghana. Conclusion: The intervention is innovative and novel in the setting. It will, therefore, help to reduce the risks such as depression, low cognitive functioning, and low physical functioning associated with low quality of life among people living with HIV/AIDS in Ghana in specific, and in sub-Saharan Africa in general.Keywords: social care intervention, HIV/AIDS, Ghana, quality of life
Procedia PDF Downloads 4615262 Courtesy to Things and Sense of Unity with the Things: Psychological Evaluation Based on the Teaching of Buddha
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This study aims to clarify factors of courtesy to things and the effect of courtesy on a sense of unity with things based on the teaching of Buddha. The teaching of Buddha explains when dealing with things in a courteous manner carefully, the border between selves and the external world disappears, then both are united. This is an example in Buddhist way that explains the connections with all existences, and in the modern world, it is also a lesson that humans should not let matters go to waste and treat them politely. In order to reveal concrete ways to practice courtesy to things, we clarify the factors of courtesy (Study 1) and examine the effect of courtesy on the sense of unity with the things (Study 2). In Study 1, 100 Japanese (mean age=54.39, SD=15.04, 50% female) described freely about what is courtesy to things that they use daily. These descriptions were classified, and 25 items were made asking for the degree of courtesy to the things. Then different 678 Japanese (mean age=44.72, SD=13.14, 50% female) answered the 25 items on 7-point about tools they use daily. An exploratory factor analysis revealed two factors. The first factor (α=.97) includes 'I deal with the thing carefully' and 'I clean up the thing after use'. This factor reflects how gently people care about things. The second factor (α=.96) includes 'A sense of self-control has come to me through using the thing' and 'I have got inner strength by taking care of the thing'. The second factor reflects how people learn by dealing with things carefully. In this Study 2, 200 Japanese (mean age=49.39, SD=11.07, 50% female) answered courtesy about things they use daily and the degree of sense of unity with the things using the inclusion of other in the self scale, replacing 'Other' with 'Your thing'. The ANOVA was conducted to examine the effect of courtesy (high/low level of two factors) on the score of sense of unity. The results showed the main effect of care level. People with a high level of care have a stronger sense of unity with the thing. The tendency of an interaction effect is also found. The condition with a high level of care and a high level of learning enhances the sense of unity more than the condition of a low level of care and high level in learning. Study 1 found that courtesy is composed of care and learning. That is, courtesy is not only active care to the things but also to learn the meaning of the things and grow personally with the things. Study 2 revealed that people with a high level of care feel a stronger sense of unity and also people with both a high level of care and learn tend to do so. The findings support the idea of the teaching of Buddha. In the future, it is necessary to examine a combined effect of care and learning.Keywords: courtesy, things, sense of unity, the teaching of Buddha
Procedia PDF Downloads 1465261 Microfluidic Lab on Chip Platform for the Detection of Arthritis Markers from Synovial Organ on Chip by Miniaturizing Enzyme-Linked ImmunoSorbent Assay Protocols
Authors: Laura Boschis, Elena D. Ozzello, Enzo Mastromatteo
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Point of care diagnostic finds growing interest in medicine and agri-food because of faster intervention and prevention. EliChip is a microfluidic platform to perform Point of Care immunoenzymatic assay based on ready-to-use kits and a portable instrument to manage fluidics and read reliable quantitative results. Thanks to miniaturization, analyses are faster and more sensible than conventional ELISA. EliChip is one of the crucial assets of the Europen-founded Flamingo project for in-line measuring inflammatory markers.Keywords: lab on chip, point of care, immunoenzymatic analysis, synovial arthritis
Procedia PDF Downloads 1775260 The Utilization of Healthcare by African Migrants: The Lived Experiences of Unaccompanied Adolescent Migrants in South Africa
Authors: Kwanele Shishane
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Numerous countries are faced with challenges such as disease, poverty and other social ills and inadequate government support to meet the needs of the entire population. In developing countries, the concept of child-headed households has become a ubiquitous phenomenon and lived experience. As such, migration of children is common in these countries. This study aims to explore the lived experiences of unaccompanied adolescent migrant, with regards to the utilization of health care in South Africa. The objectives of the study are to examine the lived experiences of health care utilization by unaccompanied adolescent migrants; examine the predisposing, enabling and need factors influencing utilization of health care among unaccompanied adolescent migrants; examine the social and cultural influences on health care utilization among unaccompanied adolescent migrants; and identify the health system barriers to utilization of health care by unaccompanied adolescent migrants. Andersen and Newman’s Model of Health Care Utilization (1995) which explains factors determining the utilization of healthcare will provide the theoretical framework for the empirical investigation of this study. The target population for this study is unaccompanied adolescent migrants, seeking to access services from migrant service organizations in four provinces in South Africa (Limpopo, KwaZulu-Natal, Free State, and Gauteng). Participants will be selected using a purposive sampling procedure. A qualitative research approach utilizing a descriptive phenomenological epistemology will be utilized in this study. Data will be collected through conducting in-depth interviews and focus group discussions with unaccompanied migrant adolescents, to explore their lived experiences related to access and utilization of health care, as an unaccompanied migrant in SA. The qualitative data will be analysed using Tech’s (1990) thematic analytical approach.Keywords: health care utilisation, unaccompanied migrant youth, South Africa, lived experiences
Procedia PDF Downloads 1665259 Associated Factors to Depression of the Elderly in Ladboakao Sub-District, Banpong District, Ratchaburi Province, Thailand
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
Procedia PDF Downloads 3845258 Effect of Lullabies on Babies Growth and Development, Vital Signs and Hospitalization Times in the Neonatal Intensive Care Units
Authors: Işın Alkan, Meltem Kürtüncü
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Objective: This study was carried out with an experimental design in order to determine whether the lullaby, which was listened from mother’s voice and a stranger’s voice to the babies born at term and hospitalized in neonatal intensive care unit, had an effect on saturation values (SpO2), peak heart rate (PHR), respiration, fever, growth and development and hospitalization times of the infants. Method: Data from the study were obtained from 90 newborn babies who were hospitalized in Neonatal Intensive Care Unit of Zonguldak Maternity And Children Hospital between September 2015-January 2016 and who met the eligibility criteria. Lullaby concert was performed by choosing one of the suitable care hours. SpO2, PHR, respiration, fever, growth and development and hospitalization times of the infants were recorded by the researcher on “Newborn response follow-up form” at pre-care and post-care. Vital signs of babies every day, weight, height and head circumference measurements at admission, weakly rated at an output. Results: In the experimental and control groups, like weight, height and head circumference anthropometric measurements were not found statistically significant difference intensive care units admission and output times. Hospitalization times on babies who listen to lullaby mother’s voice revealed statistically significant difference according to babies who listen to lullaby stranger’s voice. Before care and after care were examined, SpO2 rates of babies who listen to lullaby mother’s voice revealed statistically significant higher difference according to babies who listen to lullaby stranger’s voice and control group babies. Before care on PHR of babies in three groups were not found the statistical difference, but aftercare, it was found that statistically lower (normal range) on babies who listen to lullaby mother’s voice according to babies who listen to lullaby stranger’s voice. Before care in three groups were not found the statistical difference on respiration values of babies, but aftercare, it was found that statistically lower (normal range) on babies who listen to lullaby stranger’s voice according to babies who listen to mother’s voice and control groups. Before care and after care were examined, fever signs did not reveal statistically significant difference in three groups. Conclusion: Lullaby concerts as being normal ranges of vital signs of infants and also helping to shorten hospitalization times should be preferred in the neonatal intensive care units.Keywords: growth and development, lullaby, mother voice, vital signs
Procedia PDF Downloads 2095257 Care and Support for Infants and Toddlers with Special Needs
Authors: Florence A. Undiyaundeye, Aniashie Akpanke
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Early identification of developmental disorders in infants and toddlers is critical for the well being of children. It is also an integral function of the primary care medical provider and the early care given in the home or crèche. This paper is focused at providing information on special need infants and toddlers and strategies to support them in developmental concern to cope with the challenges in and out of the classroom and to interact with their peers without stigmatization and inferiority complex. The target children are from birth through three years of age. There is a strong recommendation for developmental surveillance to be incorporated at every well child preventive care program in training and practical stage of formal school settings. The paper posits that any concerns raised during surveillance should be promptly addressed with standardized developmental screening by appropriate health service providers. In addition screening tests should be administered regularly at age 9+, 19+ and 30 months of these infants. The paper also establishes that the early identification of these developmental challenges of the infants and toddlers should lead to further developmental and medical evaluation, diagnosis and treatment, including early developmental school intervention, control and teaching and learning integration and inclusion for proper career build up. Children diagnosed with developmental disorders should be identified as children with special needs so that management is initiated and its underlying etiology may also drive a range of treatment of the child, to parents. Conselling and school integration as applicable to the child’s specific need and care for sustenance in societal functioning.Keywords: care, special need, support, infants and toddlers, management and developmental disorders
Procedia PDF Downloads 3805256 Music Education in Aged Care: Positive Ageing through Instrumental Music Learning
Authors: Ellina Zipman
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This research investigates the place of music education in aged care facilities through the implementation of a program of regular piano lessons for residents. Using a qualitative case study methodology, the research explores aged care residents’ experiences in learning to play the piano. Since the aged care homes are unlikely places for formal learning and since older adults, especially in residential care, are not considered likely candidates for learning, this research opens the door for innovative and transformative thinking about where and to whom educational programs can be delivered. By addressing the educational needs of residents in aged care facilities, this research fills the gap in the literature. The research took place in Australia in two of Melbourne’s residential aged care facilities, engaging two residents (a nonagenarian female and an octogenarian male) to participate in 12-months weekly individual piano lessons. The data was collected through video recording of lessons, observations, interviews, emails, and a reflective journal. Data analysis was done using Nvivo and hard copy analysis with identifications of themes. The case studies revealed that passion for music was a major driver in participants’ motivation to engage in a long-term piano lessons program. This participation led to experiences of positive emotions, positive attitude, successes and challenges, the exercise of control, maintaining and building new relationships, improved self-confidence through autonomy and independent skills development, and discovering new identities through finding a new purpose and new roles in life. Speaking through participants’ voices, this research project demonstrates the importance of music education for older adults and hopes to influence transformation in the residential aged care sector.Keywords: adult music education, quality of life, passion, positive ageing, wellbeing
Procedia PDF Downloads 805255 Split Health System for Diabetes Care in Urban Area: Experience from an Action Research Project in an Urban Poor Neighborhood in Bengaluru
Authors: T. S. Beerenahally, S. Amruthavalli, C. M. Munegowda, Leelavathi, Nagarathna
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Introduction: In majority of urban India, the health system is split between different authorities being responsible for the health care of urban population. We believe that, apart from poor awareness and financial barriers to care, there are other health system barriers which affect quality and access to care for people with diabetes. In this paper, we attempted to identify health system complexity that determines access to public health system for diabetes care in KG Halli, a poor urban neighborhood in Bengaluru. The KG Halli has been a locus of a health systems research from 2009 to 2015. Methodology: The source of data is from the observational field-notes written by research team as part of urban health action research project (UHARP). Field notes included data from the community and the public primary care center. The data was generated by the community health assistants and the other research team members during regular home visits and interaction with individuals who self-reported to be diabetic over four years as part of UHARP. Results: It emerged during data analysis that the patients were not keen on utilizing primary public health center for many reasons. Patient has felt that the service provided at the center was not integrated. There was lack of availability of medicines, with a regular stock out of medicines in a year and laboratory service for investigation was limited. Many of them said that the time given by the providers was not sufficient and there was also a feeling of providers not listening to them attentively. The power dynamics played a huge role in communication. Only the consultation was available for free of cost at the public primary care center. The patient had to spend for the investigations and the major portion for medicine. Conclusion: Diabetes is a chronic disease that poses an important emerging public health concern. Most of the financial burden is borne by the family as the public facilities have failed to provide free care in India. Our study indicated various factors including individual beliefs, stigma and financial constraints affecting compliance to diabetes care.Keywords: diabetes care, disintegrated health system, quality of care, urban health
Procedia PDF Downloads 1555254 In Online and Laboratory We Trust: Comparing Trust Game Behavior in Three Environments
Authors: Kaisa M. Herne, Hanna E. Björkstedt
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Comparisons of online and laboratory environments are important for assessing whether the environment influences behavioral results. Trust game behavior was examined in three environments: 1) The standard laboratory setting with physically present participants (laboratory), 2) An online environment with an online meeting before playing the trust game (online plus a meeting); and 3) An online environment without a meeting (online without a meeting). In laboratory, participants were present in a classroom and played the trust game anonymously via computers. Online plus a meeting mimicked the laboratory in that participants could see each other in an online meeting before sessions started, whereas online without a meeting was a standard online experiment in which participants did not see each other at any stages of the experiment. Participants were recruited through pools of student subjects at two universities. The trust game was identical in all conditions; it was played with the same software, anonymously, and with stranger matching. There were no statistically significant differences between the treatment conditions regarding trust or trustworthiness. Results suggest that conducting trust game experiments online will yield similar results to experiments implemented in a laboratory.Keywords: laboratory vs. online experiment, trust behavior, trust game, trustworthiness behavior
Procedia PDF Downloads 735253 An Audit of the Care in Recovery in Women after an Obstetrics Procedure
Authors: A. Haddick, A. Soltan
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Background: During the period of recovery from an operative obstetric procedure, a woman is not only at risk of the life-threatening complications accompanying labour but also those associated with surgery and anaesthesia. It is speculated that women in the recovery area may receive a lower standard of care over a night shift. Thus obstetric recovery room care should be evaluated regularly to ensure all women receive an equally high standard of care 24/7. Aim: The aim of this audit was to undertake an audit in the Liverpool Women’s Hospital on the care in recovery, and to ascertain the extent to which the standards were met. This audit included the full audit cycle. Method: Standards were taken from the AAGBI, RCOA, NICE and CNST guidelines. There were 12 standards including appropriate documentation of vital signs and appropriate length of stay after surgery. Notes from 100 patients were analysed from March 2011-March 2012. There were 52 day notes and 48 night notes; these were accessed to gain the relevant data. In the re audit 35 notes were accessed from March 14-September 14. Results: The Liverpool Women’s Hospital met in total 10 of these standards. 10 were met during the day shift (83%) and 0 met during the night shift. In the re audit, there was a significant improvement in the standards met at night. 9 of the standards were met during the day and 7 of the standards were met at night. Clearly there are still improvements to be made. Conclusions: In the original audit, an audit action plan was formulated. This was following discussion of the results of this audit in an MDT meeting and presentation with a consultant Obstetrician, the head of Midwifery, the head of Obstetrics theatres and a recovery nurse. This audit will be further discussed in the Liverpool Woman's Hospital in July 2015 for further implementation for improvement.Keywords: care, recovery, room, women
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