Search results for: health care professional-patient relation

Authors: Davod Ahmadigheidari, Isabel Alvarez, Kate Sinclair, Marnie Davidson, Patrick Cortbaoui, Hugo Melgar-Quiñonez

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The burden of collecting water tends to disproportionately fall on women and girls in low-income countries. Specifically, women spend between one to eight hours per day fetching water for domestic use in Sub-Saharan Africa. While there has been research done on the global time burden for collecting water, it has been mainly focused on water quality parameters; leaving the relationship between water fetching and health outcomes understudied. There is little available evidence regarding the relationship between water fetching and maternal child care practices. The main objective of this study was to help fill the aforementioned gap in the literature. Data from two surveys in Ethiopia and Malawi conducted by CARE Canada in 2016-2017 were used. Descriptive statistics indicate that women were predominantly responsible for collecting water in both Ethiopia (87%) and Malawi (99%) respectively, with the majority spending more than 30 minutes per day on water collection. With regards to child care practices, in both countries, breastfeeding was relatively high (77% and 82%, respectively); and treatment for malnutrition was low (15% and 8%, respectively). However, the same consistency was not found for weighing; in Ethiopia only 16% took their children for weighting in contrast to 94% in Malawi. These three practices were summed to create one variable for regressions analyses. Unadjusted logistic regression findings showed that only in Ethiopia was time fetching water significantly associated with child care practices. Once adjusted for covariates, this relationship was no longer found to be significant. Adjusted logistic regressions also showed that the factors that did influence child care practices differed slightly between the two countries. In Ethiopia, a lack of access to community water supply (OR= 0.668; P=0.010), poor attitudes towards gender equality (OR= 0.608; P=0.001), no access to land and (OR=0.603; P=0.000), significantly decreased a women’s odd of using positive childcare practices. Notably, being young women between 15-24 years (OR=2.308; P=0.017), and 25-29 (OR=2.065; P=0.028) increased probability of using positive childcare practices. Whereas in Malawi, higher maternal age, low decision-making power, significantly decreased a women’s odd of using positive childcare practices. In conclusion, this study found that even though amount of time spent by women fetching water makes a difference for childcare practices, it is not significantly related to women’s child care practices when controlling the covariates. Importantly, women’s age contributes to child care practices in Ethiopia and Malawi.

Keywords: time fetching water, community water supply, women’s child care practices, Ethiopia, Malawi

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Authors: Jui-Hung Hung, Ching-Liang Hsieh, Yi-Wen Lin

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Modern medicine highly emphasizes the importance of palliative treatment. The inception of palliative and hospice care recently developed into the concept of caring for the patients’ and families’ physical, psychological and spiritual problems. There are several benefits related to palliative care such as reducing medical expenses, decreasing patients’ suffer, and supporting patient go through the finale of the life. Nowadays, in Taiwan, over 60-70% terminal cancer patients were covered in hospice care, and the coverage rate increased annually. Acupuncture is a well-known therapy used more than thousand years to relieve symptoms of cancer patient. Many reports showed that, even in the Western society, many reputable medical centers can provide Acupuncture therapy for patients. Accordingly, using Acupuncture for cancer patient care is a global trend. There are increased evidences indicate that Acupuncture can relieve the symptoms for cancer patients including pain, reduce the dosage of anesthetic, improve the cancer-related fatigue, relieve the chemotherapy-related nausea and vomiting, ease anxiety mood and even improving the quality of life. Furthermore, some trials show that Acupuncture may help relieve xerostomia, hot flash, sleep disorders, and some GI discomfort and so on. Acupuncture therapy has many advantages for clinical use with effective, low-cost, minimal side effect, suitable for cancer patients and even for elderly population. Especially in nowadays, there are more diversified challenges in modern medicine, all of them will make the higher medical budget. We suggest that Acupuncture will be one of methods for palliative care for cancer patients.

Keywords: Acupuncture, cancer, integrative medicine, palliative care

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Authors: Pushpendra S. Bharti

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Process yield of electric discharge machining (EDM) is directly related to optimal combination(s) of process parameters. Optimization of process parameters of EDM is a multi-objective optimization problem owing to the contradictory behavior of performance measures. This paper employs Grey Relation Analysis (GRA) method as a multi-objective optimization technique for the optimal selection of process parameters combination. In GRA, multi-response optimization is converted into optimization of a single response grey relation grade which ultimately gives the optimal combination of process parameters. Experiments were carried out on die-sinking EDM by taking D2 steel as work piece and copper as electrode material. Taguchi's orthogonal array L36 was used for the design of experiments. On the experimental values, GRA was employed for the parametric optimization. A significant improvement has been observed and reported in the process yield by taking the parametric combination(s) obtained through GRA.

Keywords: electric discharge machining, grey relation analysis, material removal rate, optimization

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Authors: Goldie Lynn Diaz, Ma. Teresa Tricia G. Bautista, Elisabeth Engeljakob, Mary Glaze Rosal

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Introduction: Residents are expected to convey unfavorable news, discuss prognoses, and relieve suffering, and address do-not-resuscitate orders, yet some report a lack of competence in providing this type of care. Recognizing this need, Family Medicine residency programs are incorporating end-of-life care from symptom and pain control, counseling, and humanistic qualities as core proficiencies in training. Objective: This study determined the competency of Family Medicine Residents from various institutions in Metro Manila on rendering care for the dying. Materials and Methods: Trainees completed a Palliative Care Evaluation tool to assess their degree of confidence in patient and family interactions, patient management, and attitudes towards hospice care. Results: Remarkably, only a small fraction of participants were confident in performing independent management of terminal delirium and dyspnea. Fewer than 30% of residents can do the following without supervision: discuss medication effects and patient wishes after death, coping with pain, vomiting and constipation, and reacting to limited patient decision-making capacity. Half of the respondents had confidence in supporting the patient or family member when they become upset. Majority expressed confidence in many end-of-life care skills if supervision, coaching and consultation will be provided. Most trainees believed that pain medication should be given as needed to terminally ill patients. There was also uncertainty as to the most appropriate person to make end-of-life decisions. These attitudes may be influenced by personal beliefs rooted in cultural upbringing as well as by personal experiences with death in the family, which may also affect their participation and confidence in caring for the dying. Conclusion: Enhancing the quality and quantity of end-of-life care experiences during residency with sufficient supervision and role modeling may lead to knowledge and skill improvement to ensure quality of care. Fostering bedside learning opportunities during residency is an appropriate venue for teaching interventions in end-of-life care education.

Keywords: end of life care, geriatrics, palliative care, residency training skill

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Authors: W. Mazari, K. Boucherit, Z. Boucherit-Otmani, M. N. Rahmoun, M. Benabdallah

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The hospital or any other establishment of care can be considered as an ecosystem where the patient comes into contact with a frightening microbial universe and a risk to contract infection that is referred to as nosocomial or health care-associated. In these last years, the incidence of these infections has risen sharply. Several microorganisms are the cause of these nosocomial infections and the emergence of resistance of the microbial strains against antibiotics creates a danger to public health. The search for new antimicrobial agents to overcome this problem has produced interesting compounds through chemical synthesis, which plays a very important role in the research and discovery of new drugs. It is in this framework that our study was conducted at our laboratory and it involves evaluating the antibacterial activity of thirteen 2-pyridone derivatives synthesized by two methods, the diffusion disc method and the dilution method against eight Gram negative bacterial strains. The results seem interesting especially for two products that have shown the best activities against Escherichia coli ATCC 25922 and Enterobacter cloacae ATCC 13047 with CMI of 512µg/ml.

Keywords: heterocyclic derivatives, chemical synthesis, antimicrobial activity, biotechnology

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Authors: Ridha Abdulla Al Hammam

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Purpose: to measure the extent of perceived structural empowerment and work commitment the intensive care unit in SMC have in their work place. Background: nurses’ access to power structures (information, recourses, opportunity, and support) directly influences their productivity, retention, and job satisfaction. Exploring nurses’ level and sources of work commitment (affective, normative, and continuance) is very essential to guide nursing leaders making decisions to improve work environment to facilitate effective nursing care. Both concepts (Structural Empowerment and Work Commitment) were never investigated in our critical care unit. Methods: a sample of 50 nurses attained from the Intensive Care Unit (Adult). Conditions for Workplace Effectiveness Questionnaire and Three-Component Model Employee Commitment Survey were used to measure the two concepts respectively. The study is quantitative, descriptive, and correlational in design. Results: the participants reported moderate structural empowerment provided by their work place (M=15 out of 20). The sample perceived high access to opportunity mainly through gaining more skills (M=4.45 out of 5) where the rest power structures were perceived with moderate accessibility. The participants’ affective commitment (M=5.6 out of 7) to work in the ICU overweighed their normative and continuance commitment (M=5.1, M=4.9 out of 7) implying a stronger emotional connection with their unit. Strong positive and significant correlations were observed between the participants’ structural empowerment scores and all work commitment sources. Conclusion: these results provided an insight on aspects of work environment that need to be fostered and improved in our intensive care unit which have a direct linkage to nurses’ work commitment and potentially to their quality of care they provide.

Keywords: structural empowerment, commitment, intensive care, nurses

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Authors: Kimberly Winnie Achieng Otieno

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The Nairobi Hospital plays a pivotal role in healthcare provision in East and Central Africa, yet it faces challenges in providing accessible dialysis care. This paper explores strategic interventions to enhance dialysis care, improve access and streamline health information management, with an aim of fostering an integrated and patient-centered healthcare system in our region. Challenges at The Nairobi Hospital The Nairobi Hospital currently grapples with insufficient dialysis machines which results in extended turn around times. This issue stems from both staffing bottle necks and infrastructural limitations given our growing demand for renal care services. Our Paper-based record keeping system and fragmented flow of information downstream hinders the hospital’s ability to manage health data effectively. There is also a need for investment in expanding The Nairobi Hospital dialysis facilities to far reaching communities. Setting up satellite clinics that are closer to people who live in areas far from the main hospital will ensure better access to underserved areas. Community Outreach and Education Implementing education programs on kidney health within local communities is vital for early detection and prevention. Collaborating with local leaders and organizations can establish a proactive approach to renal health hence reducing the demand for acute dialysis interventions. We can amplify this effort by expanding The Nairobi Hospital’s corporate social responsibility outreach program with weekend engagement activities such as walks, awareness classes and fund drives. Enhancing Efficiency in Dialysis Care Demand for dialysis services continues to rise due to an aging Kenyan population and the increasing prevalence of chronic kidney disease (CKD). Present at this years International Nursing Conference are a diverse group of caregivers from around the world who can share with us their process optimization strategies, patient engagement techniques and resource utilization efficiencies to catapult The Nairobi Hospital to the 21st century and beyond. Plans are underway to offer ongoing education opportunities to keep staff updated on best practices and emerging technologies in addition to utilizing a patient feedback mechanisms to identify areas for improvement and enhance satisfaction. Staff empowerment and suggestion boxes address The Nairobi Hospital’s organizational challenges. Current financial constraints may limit a leapfrog in technology integration such as the acquisition of new dialysis machines and an investment in predictive analytics to forecast patient needs and optimize resource allocation. Streamlining Health Information Management Fully embracing a shift to 100% Electronic Health Records (EHRs) is a transformative step toward efficient health information management. Shared information promotes a holistic understanding of patients’ medical history, minimizing redundancies and enhancing overall care quality. To manage the transition to community-based care and EHRs effectively, a phased implementation approach is recommended. Conclusion By strategically enhancing dialysis care access and streamlining health information management, The Nairobi Hospital can strengthen its position as a leading healthcare institution in both East and Central Africa. This comprehensive approach aligns with the hospital’s commitment to providing high-quality, accessible, and patient-centered care in an evolving landscape of healthcare delivery.

Keywords: Africa, urology, diaylsis, healthcare

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Authors: Selina Doncevic, Lisa Perla, Angela Kindvall

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The Global War on Terror which began after September 11, 2011, increased survivability of severe injuries requiring varying trajectories of rehabilitation and recovery. The costs encompass physiologic, functional, social, emotional, psychological, vocational and scholastic domains of life. The purpose of this poster is to inform private sector health care practitioners and clinicians at various levels of the unique and long term dynamics of healthcare recovery for polytrauma, and traumatic brain injured service members and veterans in the United States of America. Challenges include care delivery between the private sector, the department of defense, and veterans affairs healthcare systems while simultaneously supporting the dynamics of acute as well as latent complications associated with severe injury and illness. Clinical relevance, subtleties of protracted recovery, and overwhelmed systems of care are discussed in the context of lessons learned and in reflection on previous wars. Additional concerns for consideration and discussion include: the cost of protracted healthcare, various U.S. healthcare payer systems, lingering community reintegration challenges, ongoing care giver support, the rise of veterans support groups and the development of private sector clinical partnerships.

Keywords: brain injury, future, polytrauma, rehabilitation

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Authors: Fujian Wang, Shubin Ruan, Meiwei Dai

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Speed dispersion has tight relation to traffic safety. In this paper, several kinds of indicating parameters (the standard speed deviation, the coefficient of variation, the deviation of V85 and V15, the mean speed deviations, and the difference between adjacent car speeds) are applied to investigate the characteristics of speed dispersion, where V85 and V15 are 85th and 15th percentile speed, respectively. Their relationships are into full investigations and the results show that: there exists a positive relation (linear) between mean speed and the deviation of V85 and V15; while a negative relation (quadratic) between traffic flow and standard speed deviation. The mean speed deviation grows exponentially with mean speed while the absolute speed deviation between adjacent cars grows linearly with the headway. The results provide some basic information for traffic management.

Keywords: headway, indicating parameters, speed dispersion, urban expressway

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Authors: Duane Booysen, Ashraf Kagee

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There is a high prevalence of violent crime and trauma exposure in South African society. Considering the prevalence of continuous violent crimes and traumatization in South Africa, the public mental health sector is required to combat the burgeoning effect of traumatic stress in South Africa. Trauma counselors, especially, provide important mental health services at primary health care to persons affected by traumatic events. Therefore, the evaluation and implementation of evidence-based trauma therapies is essential at a primary health care level in treating traumatic stress. A single-case design was used to evaluate the treatment effect of a Brief Trauma Treatment Programme treating persons who present with symptoms of posttraumatic stress disorder at a primary care trauma centre in Cape Town, South Africa. The sample consisted of six adult participants who presented with symptoms of posttraumatic stress and were assessed at baseline, during treatment, post-intervention and at 3-month follow. All participants received six sessions of trauma therapy. Assessment measures included the posttraumatic stress disorder symptom scale interviews for Diagnostic and Statistical Manual fifth edition (DSM5), the posttraumatic disorder checklist for DSM5, Beck Depression Inventory and Beck Anxiety Inventory. Results demonstrate that participants had noticeable reduced symptoms for traumatic stress, anxiety and depression despite living in contexts of violent crime and trauma. In conclusion, the article critically reflects on the need to evaluate and implement evidence-based treatments for the South African context, and how evidence-based treatments are used in developing socio-economic and cultural diverse contexts with continuous levels of violence and traumatization.

Keywords: psychological interventions, public mental health, traumatic stress, single-case design

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Authors: Jiranun Sreecharit, Anongnat Boonrut, Kunvadee Munvaradee, Phechnoy Singchungchai

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Hatyai Hospital as center of hospital with a capacity of 670 beds. Medicine intensive care units (MICU240) provide care for critically ill patients who are at high risk need to be monitored closely. Intravenous catheter is vital to help assess the level of water in the body fluids and medications. Potential complications such as infection. We need to have guidelines for the care of patients who received intravenous catheter used to achieve good results. The operations research in this study was intended 1) To study the effects of practice for nurses in caring for patients with central venous catheter to infection rate and 2) To assess the satisfaction of nurses and patient care practices in central venous catheterization patients in the MICU 240. The sample of the patient's central venous catheter crisis that everyone who admitted in MICU 240 during the period from October 2013 to May 2014. Samples prior to practice and 148 samples with 249 case of practice. A systematic review of the research NSWHealth Statewide Guideline for Intensive Care. Data were analyzed by statistics, percentages and frequency NON-PARAMETRICS with Mann-Whitney U. The finding revealed that: 1. Results of the practice patient care central venous catheter infection rates were found to be reduced from 35.14 percent to 25.3 percent. 2. The results of the evaluation of nurses and patients in the patient care practices central venous catheter found to be satisfied and happy to work 85 percent.

Keywords: clinical practice guidelines, central venous catheter, infection satisfaction

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Authors: Mariko Nishikawa, Masaaki Yamanaka, Ayami Kondo

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Background: International visitors to Japan are at a risk of travel-related illnesses or injury that could result in hospitalization in a country where the language and customs are unique. Over twelve million international visitors came to Japan in 2015, and more are expected leading up to the Tokyo Olympics. One aspect of this is the potentially greater demand on healthcare services by foreign visitors. Nurses who take care of them have anxieties and concerns of their knowledge of the Japanese health system. Objectives: An effective distribution of travel-health information is vital for facilitating care for international visitors. Our research investigates whether a four-minute digital animation (Mari Info Japan), designed and developed by the authors and applied to a survey of 513 nurses who take care of foreigners daily, could clarify travel health procedures, reduce anxieties, while making it enjoyable to learn. Methodology: Respondents to a survey were divided into two groups. The intervention group watched Mari Info Japan. The control group read a standard guidebook. The participants were requested to fill a two-page questionnaire called Mari Meter-X, STAI-Y in English and mark a face scale, before and after the interventions. The questions dealt with knowledge of health promotion, the Japanese healthcare system, cultural concerns, anxieties, and attitudes in Japan. Data were collected from an intervention group (n=83) and control group (n=83) of nurses in a hospital, Japan for foreigners from February to March, 2016. We analyzed the data using Text Mining Studio for open-ended questions and JMP for statistical significance. Results: We found that the intervention group displayed more confidence and less anxiety to take care of foreign patients compared to the control group. The intervention group indicated a greater comfort after watching the animation. However, both groups were most likely to be concerned about language, the cost of medical expenses, informed consent, and choice of hospital. Conclusions: From the viewpoint of nurses, the provision of travel-health information by digital animation to international visitors to Japan was more effective than traditional methods as it helped them be better prepared to treat travel-related diseases and injury among international visitors. This study was registered number UMIN000020867. Funding: Grant–in-Aid for Challenging Exploratory Research 2010-2012 & 2014-16, Japanese Government.

Keywords: digital animation, health promotion, international visitor, Japan, nurse

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Authors: Xue Bai, Ranran He, Chang Liu

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Care planning before the onset of intensive care needs can benefit older adults’ psychological well-being and increases families’ ability to manage caregiving crises and cope with care transitions. Effective care planning requires collaborative ‘team-work’ in families. However, future care planning has not been substantially examined in intergenerational or family contexts, let alone among immigrant families who have to face particular challenges in parental caregiving. From a family systems perspective, this study intends to explore the extent, processes, and contents of intergenerational care planning of Mainland immigrant ageing families in Hong Kong and to examine the intergenerational congruence and discrepancies in the care planning process. Adopting a qualitative research design, semi-structured in-depth interviews were conducted with 17 adult child-older parent pairs and another 33 adult children. In total, 50 adult children who migrated to Hong Kong after the age of 18 with more than three years’ work experience in Hong Kong had at least one parent aged over 55 years old who was not a Hong Kong resident and considered his/herself as the primary caregiver of the parent were recruited. Seventeen ageing parents of the recruited adult children were invited for dyadic interviews. Scarcity of caregiving resources in the context of cross-border migration, intergenerational discrepancies in care planning stages, both generations’ struggle and ambivalence toward filial care, intergenerational transmission of care values, and facilitating role of accumulated family capital in care preparation were primary themes concluded from participants’ narratives. Compared with ageing parents, immigrant adult children generally displayed lower levels of care planning. Although with a strong awareness of parents’ future care needs, few adult children were found engaged in concrete planning activities. This is largely due to their uncertainties toward future life and career, huge work and living pressure, the relatively good health status of their parents, and restrictions of public welfare policies in the receiving society. By contrast, children’s cross-border migration encouraged ageing parents to have early and clear preparation for future care. Ageing parents mostly expressed low filial care expectations when realizing the scarcity of family caregiving resources in the cross-border context. Even though they prefer in-person support from children, most of them prepare themselves for independent ageing to prioritize the next generation’s needs or choose to utilize paid services, welfare systems, friend networks, or extended family networks in their sending society. Adult children were frequently found caught in the dilemma of desiring to provide high quality and in-person support for their parents but lacking sufficient resources. Notably, a salient pattern of intergenerational transmission in terms of family and care values and ideal care arrangement emerged from intergenerational care preparation. Moreover, the positive role of accumulated family capital generated by a reunion in care preparation and joint decision-making were also identified. The findings of the current study will enhance professionals’ and service providers’ awareness of intergenerational care planning in cross-border migration contexts, inform services to alleviate unpreparedness for elderly care and intergenerational discrepancies concerning care arrangements and broaden family services to encompass intergenerational care planning interventions. Acknowledgment: This study is supported by a General Research Grant from the Research Grants Council of the HKSAR, China (Project Number: 15603818).

Keywords: intergenerational care planning, mainland immigrants in Hong Kong, migrant family, older adults

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Authors: Ellen Bryant, Virginia Behmer, Rebecca Garbed, Jeanette O’Quin, Dana Howard

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As it currently stands, veterinary care in the United States is not accessible to everyone, and veterinarians regularly face cases of clients who are unable to provide necessary care to their animals regardless of the client’s desire to do so. There is currently limited research into how veterinarians address these issues of access to care. It is apparent that veterinarians regularly utilize funding or offer discounted services to treat cases that otherwise would go without care. With need currently exceeding the amount of funds and services available, veterinarians are tasked with deciding which cases are most deserving of assistance. This mixed methods study distributed a survey to companion animal veterinarians practicing in the United States to identify current trends in how these professionals apply principles of distributive justice in the scope of veterinary medicine. Ethical frameworks identified in human bioethics research into distributive justice were presented, along with demographic questions, to identify relationships between veterinarian priorities and the scope of their practice/respective roles/geographic region. By surveying veterinarians across a wide range of specialties, practice types, and clientele this study was able to assess how priorities and opinions shift based on external factors as well as among the respondents themselves. Participants were asked not only to choose how to distribute aid between different clients and case scenarios, but also asked directly which is the best way to distribute aid when need exceeds the resources available.

Keywords: access to veterinary care, bioethics, decision-making, distributive justice, subsidized care

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Authors: Omar Mayyas

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Clinical decision-making (CDM) is essential to community health nursing (CHN) education. For this reason, nursing educators are responsible for developing these skills among nursing students because nursing students are exposed to highly critical conditions after graduation. However, due to limited exposure to real-world situations, many nursing students need help developing clinical decision-making skills in this area. Therefore, the impact of Virtual Simulation (VS) on community health nursing students' clinical decision-making in nursing education has to be investigated. This study aims to examine the difference in CDM ability among CHN students who received traditional education compared to those who received VS classes, to identify the factors that may influence CDM ability differences between CHN students who received a traditional education and VS classes, and to provide recommendations for educational programs that can enhance the CDM ability of CHN students and improve the quality of care provided in community settings. A mixed-method study will conduct. A randomized controlled trial will compare the CDM ability of CHN students who received 1hr traditional class with another group who received 1hr VS scenario about diabetic patient nursing care. Sixty-four students in each group will randomly select to be exposed to the intervention from undergraduate nursing students who completed the CHN course at York University. The participants will receive the same Clinical Decision Making in Nursing Scale (CDMNS) questionnaire. The study intervention will follow the Medical Research Council (MRC) approach. SPSS and content analysis will use for data analysis.

Keywords: clinical decision-making, virtual simulation, community health nursing students, community health nursing education

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Authors: E. Njuguna, S. Ilovi, P. Muiruri, K. Mutai, J. Kinuthia, P. Njoroge

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Introduction: Cervical cancer is the commonest cause of cancer-related morbidity and mortality among women in developing countries in Sub Saharan Africa. Screening for cervical cancer in all women regardless of HIV status is crucial for the early detection of cancer of the cervix when treatment is most effective in curing the disease. It is particularly more important to screen HIV infected women as they are more at risk of developing the disease and progressing faster once infected with HPV (Human Papilloma Virus). We aimed to determine the factors affecting the utilization of cervical cancer screenings among HIV infected women above 18 years of age at Kenyatta National Hospital (KNH) Comprehensive Care Center (CCC). Materials and Methods: A cross-sectional mixed quantitative and qualitative study involving randomly and purposefully selected HIV positive female respectively was conducted. Qualitative data collection involved 4 focus group discussions of eligible female participants while quantitative data were acquired by one to one interviewer administered structured questionnaires. The outcome variable was the utilization of cervical cancer screening. Data were entered into Access data base and analyzed using Stata version 11.1. Qualitative data were analyzed after coding for significant clauses and transcribing to determine themes arising. Results: We enrolled a total of 387 patients, mean age (IQ range) 40 years (36-44). Cervical cancer screening utilization was 46% despite a health care provider recommendation of 85%. The screening results were reported as normal in 72 of 81 (88.9%) and abnormal 7 of 81(8.6%) of the cases. Those who did not know their result were 2 of 81(2.5%). Patients were less likely to utilize the service with increasing number of years attending the clinic (OR 0.9, 95% CI 0.86-0.99, p-value 0.02), but more likely to utilize the service if recommendation by a staff was made (OR 10, 95% CI 4.2-23.9, p<0.001), and if cervical screening had been done before joining KNH CCC (OR 2.9, 95% CI 1.7-4.9, p < 0.001). Similarly, they were more likely to rate the services on cervical cancer screening as good (OR 5.0, 95% CI 1.7-3.4, p <0.001) and very good (OR 8.1, 95% CI 2.5-6.1, p<0.001) if they had utilized the service. The main barrier themes emerging from qualitative data included fear of screening due to excessive pain or bleeding, lack of proper communication on screening procedures and increased waiting time. Conclusions: Utilization of cervical cancer screening services was low despite health care recommendation. Patient socio-demographic characteristics did not influence whether or not they utilized the services, indicating the important role of the health care provider in the referral and provision of the service.

Keywords: cervical, cancer, HIV, women, comprehensive care center

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Authors: Reetinder Kaur, R. K. Pathak

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Mental health is recognised as an important global health concern. World Health Organisation in 2004 estimated that neuropsychiatric illnesses in India account for 10.8 percent of the global burden. The prevalence of serious mental illnesses is estimated as 6.5 percent by National Commission of Macroeconomics and Health in 2005. India spends only 0.06 percent of its health budget on mental health. One of the major problems that exist in Indian mental health care is the treatment gap due to scarcity of manpower, inadequate infrastructure and deficiencies in policy initiatives. As a result, traditional healing is a popular resource for mentally ill individuals and their families. The various traditional healing resources include faith healers, healers at temples and Dargahs. Chandigarh is a Union Territory located in North India. It has surplus manpower and infrastructure available for mental health care. Inspite of availability of mental health care services, mentally ill individuals and their families seek help from traditional healers at various Dargahs within or outside Chandigarh. For the present study, the data was collected from four dargahs. A total of thirty patients medically diagnosed with various mental illnesses, their family members who accompanied them and healers were part of this study. The aim of the study was to: Understand the interactions between healer, patient and family members during the course of treatment, understand explanations of mental illnesses and analyse the healing practices in context of culture. The interviews were conducted using an interview guide for the three sets of informants: Healers, patients and family members. The interview guide for healer focussed on the healing process, healer’s understanding of patient’s explanatory models, healer’s knowledge about mental illnesses and types of these illnesses cured by the healer. The interview guide for patients and family members focussed on their understanding of the symptoms, explanations for illness and help-seeking behaviour. The patients were observed over the weeks (every Thursday, the day of pir and healing) during their visits to the healer. Detailed discussions were made with the healer regarding the healing process and benefits of healing. The data was analysed thematically and the themes: The role of sacred, holistic healing, healer’s understanding of patient’s explanatory models of mental illness, the patient’s, and family’s understanding of mental illnesses, healer’s knowledge about mental illnesses, types of mental illnesses cured by the healer, bad dreams and their interpretation emerged. From the analysis of data, it was found that the healers concentrate their interventions in the social arena, ‘curing’ distressed patients by bringing significant changes in their social environment. It is suggested that in order to make the mental health care services effective in India, the collaboration between healers and psychiatrist is essential. However, certain specifications need to be made to make this kind of collaboration successful and beneficial for the stakeholders.

Keywords: Dargah, mental illness, traditional healing, policy

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Authors: Maha Atout, Pippa Hemingway, Jane Seymour

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A preliminary systematic review shows that health professionals experience a tension when communicating with the parents and family members of children with life-threatening and life-limiting conditions. On the one hand, they want to promote open and honest communication, while on the other, they are apprehensive about fostering an unrealistic sense of hope. Defining the boundaries between information that might offer reasonable hope versus that which results in false reassurance is challenging. Some healthcare providers worry that instilling a false sense of hope could motivate parents to seek continued aggressive treatment for their child, which in turn might cause the patient further unnecessary suffering. To date, there has been a lack of research in the Middle East regarding how healthcare providers do or should communicate bad news; in particular, the issue of hope in the field of paediatric palliative care has not been researched thoroughly. This study aims to explore, from the perspective of patients’ mothers, physicians, and nurses, the experience of communicating and receiving bad news in the care of children with palliative care needs. Data were collected using a collective qualitative case study approach across three paediatric units in a Jordanian hospital. Two data collection methods were employed: participant observation and semi-structured interviews. The overall number of cases was 15, with a total of 56 interviews with mothers (n=24), physicians (n=12), and nurses (n=20) completed, as well as 197 observational hours logged. The findings demonstrate that mothers wanted their doctors to provide them with hopeful information about the future progression of their child’s illness. Although some mothers asked their doctors to provide them with honest information regarding the condition of their child, they still considered a sense of hope to be essential for coping with caring for their child. According to mothers, hope was critical to treatment as it helped them to stay committed to the treatment and protected them to some extent from the extreme emotional suffering that would occur if they lost hope. The health professionals agreed with the mothers on the importance of hope, so long as it was congruent with the stage and severity of each patient’s disease. The findings of this study conclude that while parents typically insist on knowing all relevant information when their child is diagnosed with a severe illness, they considered hope to be an essential part of life, and they found it very difficult to handle suffering without any glimmer of it. This study finds that using negative terms has extremely adverse effects on the parents’ emotions. Hence, although the mothers asked the doctors to be as honest as they could, they still wanted the physicians to provide them with a positive message by communicating this information in a sensitive manner including hope.

Keywords: health professionals, children, communication, hope, information, mothers, palliative care

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Authors: Carri Welsby, Jessie Gunson, Pen Roe

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Currently, there is limited research examining health care professionals (HCPs) views on long-acting reversible contraception (LARC) advice and prescription, particularly outside of the general practice (GP) setting. The aim of this study is to systematically review existing evidence around the barriers and enablers of oral contraception (OC) in comparison to LARC, as perceived by HCPs in non-GP settings. Five electronic databases were searched in April 2018 using terms related to LARC, OC, HCPs, and views, but not terms related to GPs. Studies were excluded if they concerned emergency oral contraception, male contraceptives, contraceptive use in conjunction with a health condition(s), developing countries, GPs and GP settings, were non-English or was not published before 2013. A total of six studies were included for systematic reviewing. Five key areas emerged, under which themes were categorised, including (1) understanding HCP attitudes and counselling practices towards contraceptive methods; (2) assessment of HCP attitudes and beliefs about contraceptive methods; (3) misconceptions and concerns towards contraceptive methods; and (4) influences on views, attitudes, and beliefs of contraceptive methods. Limited education and training of HCPs exists around LARC provision, particularly compared to OC. The most common misconception inhibiting HCPs contraceptive information delivery to women was the belief that LARC was inappropriate for nulliparous women. In turn, by not providing the correct information on a variety of contraceptive methods, HCP counselling practices were disempowering for women and restricted them from accessing reproductive justice. Educating HCPs to be able to provide accurate and factual information to women on all contraception is vital to encourage a woman-centered approach during contraceptive counselling and promote informed choices by women.

Keywords: advice, contraceptives, health care professionals, long acting reversible contraception, oral contraception, reproductive justice

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Authors: Gayani K. Nandasiri, Tilak Dias, William Hurley

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Venous disease of human lower limb could range from minor asymptomatic incompetence of venous valves to chronic venous ulceration. The sheer prevalence of varicose veins and its associated significant costs of treating late complications such as chronic ulcers contribute to a higher burden on health care resources. In most of western countries with developed health care systems, treatment costs associated with Venous disease accounts for a considerable portion of their total health care budget, and it has become a high-cost burden to National Health Service (NHS), UK. The established gold standard of treatment for the venous disease is the graduated compression, where the pressure at the ankle being highest and decreasing towards the knee and thigh. Currently, medical practitioners use two main methods to treat venous disease; i.e. compression bandaging and compression stockings. Both these systems have their own disadvantages which lead to the current programme of research. The aim of the present study is to revolutionize the compression therapy by using a novel active compression system to deliver a controllable and more accurate pressure profiles using a series of inflatable mini bladders. Two types of commercially available silicones were tested for the application. The mini bladders were designed with a special fabrication procedure to provide required pressure profiles, and a series of experiments were conducted to characterise the mini bladders. The inflation/deflation heights of these mini bladders were investigated experimentally and using a finite element model (FEM), and the experimental data were compared to the results obtained from FEM simulations, which showed 70-80% agreement. Finally, the mini bladders were tested for its pressure transmittance characteristics, and the results showed a 70-80% of inlet air pressure transmitted onto the treated surface.

Keywords: finite element analysis, graduated compression, inflatable bladders, venous disease

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Authors: Jonathan Turner, Julie Doyle, Laura O’Philbin, Dympna O’Sullivan

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People living with dementia should be at the centre of decision-making regarding goals for daily living. These goals include basic activities (dressing, hygiene, and mobility), advanced activities (finances, transportation, and shopping), and meaningful activities that promote well-being (pastimes and intellectual pursuits). However, there is limited involvement of people living with dementia in the design of technology to support their goals. A project is described that is co-designing intelligent computer-based support for, and with, people affected by dementia and their carers. The technology will support self-management, empower participation in shared decision-making with carers and help people living with dementia remain healthy and independent in their homes for longer. It includes information from the patient’s care plan, which documents medications, contacts, and the patient's wishes on end-of-life care. Importantly for this work, the plan can outline activities that should be maintained or worked towards, such as exercise or social contact. The authors discuss how to integrate care goal information from such a care plan with data collected from passive sensors in the patient’s home in order to deliver individualized planning and interventions for persons with dementia. A number of scientific challenges are addressed: First, to co-design with dementia patients and their carers computerized support for shared decision-making about their care while allowing the patient to share the care plan. Second, to develop a new and open monitoring framework with which to configure sensor technologies to collect data about whether goals and actions specified for a person in their care plan are being achieved. This is developed top-down by associating care quality types and metrics elicited from the co-design activities with types of data that can be collected within the home, from passive and active sensors, and from the patient’s feedback collected through a simple co-designed interface. These activities and data will be mapped to appropriate sensors and technological infrastructure with which to collect the data. Third, the application of machine learning models to analyze data collected via the sensing devices in order to investigate whether and to what extent activities outlined via the care plan are being achieved. The models will capture longitudinal data to track disease progression over time; as the disease progresses and captured data show that activities outlined in the care plan are not being achieved, the care plan may recommend alternative activities. Disease progression may also require care changes, and a data-driven approach can capture changes in a condition more quickly and allow care plans to evolve and be updated.

Keywords: care goals, decision-making, dementia, self-care, sensors

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Authors: Shyam lamsal

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Introduction: Karnali Academy of Health Sciences (KAHS) has been established in 2011, by an Act of parliament of Nepal, in Jumla, to provide health services in easy way in backward areas, to produce skilled health professionals & conduct research. The backward areas mentioned in act of KAHS are Humla, Jumla, Kalikot, Dolpa, Mugu districts of Karnali zone, Jajarkot district of Bheri zone & Bajura, Baghang & Achham districts of Seti zone in Nepal occupying around 25 % of the total national geography. Backward area of Nepal is specific to having worst health indicators with life expectancy (47 years), HDI (0.35), Literacy rate (58%), global acute malnutrition (13%), crude birth rate (33.6), crude death rate (9.6), Total fertility rate (4.2), infant mortality rate (61.5 per 1000 live births), under five mortality rate (59 per 1000 live births) and maternal mortality ratio (400 per 1000 live births). History of health facilities in backward region: All the nine districts of this region have a district hospital with very few grass root level health manpower. Government of Nepal regularly deploys one or two medical officers to each district who generally are not regular to their care. Jumla district itself was having one medical officer before the establishment of KAHS. Development activities: Establishment of 100 bedded specialty teaching hospital with 10 medical officers and five specialists, accredited its own nursing school for running diploma nursing programme, started “Karnali health survey” which covers 55 thousand households of backward region, started community care and school health camps, planning phase completed for 300 bedded teaching hospital construction. Future Plan: Expansion of the teaching hospital to 300 beds within 3 years, start health assistant and bachelor midwifery course in 2015 AD, start bachelor in laboratory and bachelor in public health course in 2016 AD and start MBBS course in 2018 AD. Deploy the medical officers and family physicians to all the district hospitals within 3 years. KAHS provides reservation up to 45% students from backward region with the commitment to stay for at least five years of their service period. Conclusion: This institution may be the example for the rest of the world in providing nursing care, education in remote areas as well as the best model for nursing manpower retention in remote areas of developing countries.

Keywords: backward area, nursing school

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Authors: Tara Hunter, Kristine Concepcion, Wendy Cheng, Brianna Pike, Jane Estoesta, Anne Stuart

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In 2015, Family Planning NSW was contracted by the NSW Ministry of Health to design and deliver Sexual Safety Policy training (SSPT) to mental health professionals across NSW. The training was based on their current guidelines and developed in consultation with an expert reference group. From October 2015 to April 2017 it was delivered to over 2,400 mental health professionals with a view to supporting implementation of consistent prevention and intervention related to sexual safety in the mental health setting. An evaluation was undertaken to determine the knowledge and confidence of participants related to sexual safety before and after the training, and whether any improvements were translated into changes in practice. Participants were invited to complete a survey prior to the training, upon completion and three to six months thereafter. Telephone interviews were conducted among service managers and mental health champions six months post-training. Prior to training, the majority of mental health professionals reported being slightly to moderately confident in identifying a sexual safety incident. When asked on their understanding of sexual safety, gender sensitive practice and trauma informed care, they reported no confidence, slight confidence and moderate confidence. Immediately after the training, 54.5% reported being very confident and 10.9% extremely confident in identifying a sexual safety incident. More than half felt very confident or extremely confident in their understanding of sexual safety principles. The impact survey (six months later) found that the majority of participants (91%) were highly confident in identifying a sexual safety incident. Telephone interviewees reported a change in workplace culture and increased awareness after the training. Mental health professionals experienced increased knowledge and confidence about sexual safety principles following the training and were able to implement positive changes and concrete actions to better address sexual safety issues in their workplace.

Keywords: sexual safety, mental health professionals, trauma informed care, policy training

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Authors: Jovina Concepcion Bachynski, Lenora Duhn, Idevania G. Costa, Pilar Camargo-Plazas

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Kidney failure is a life-limiting condition for which treatment, such as dialysis (hemodialysis and peritoneal dialysis), can exact a tremendously high physical and psychosocial symptom burden. Kidney failure can be severe enough to require a palliative approach to care. The term supportive care can be used in lieu of palliative care to avoid the misunderstanding that palliative care is synonymous with end-of-life or hospice care. Kidney supportive care, encompassing advance care planning, is an approach to care that improves the quality of life for people receiving dialysis through early identification and treatment of symptoms throughout the disease trajectory. Advanced care planning involves ongoing conversations about the values, goals, and preferences for future care between individuals and their healthcare teams. Kidney supportive care is underutilized and often initiated late in this population. There is evidence to indicate nurses are not providing the necessary elements of supportive kidney care. Dialysis nurses’ delay or lack of engagement in supportive care until close to the end of life may result in people dying without receiving optimal palliative care services. Using Charmaz’s constructivist grounded theory, the purpose of this doctoral study is to develop a substantive theory that explains the process of engagement in supportive care by nurses working in dialysis settings in Canada. Through initial purposeful and subsequent theoretical sampling, 23 nurses with current or recent work experience in outpatient hemodialysis, home hemodialysis, and peritoneal dialysis settings drawn from across Canada were recruited to participate in two intensive interviews using the Zoom© teleconferencing platform. Concurrent data collection and data analysis, constant comparative analysis of initial and focused codes until the attainment of theoretical saturation, and memo-writing, as well as researcher reflexivity, have been undertaken to aid the emergence of concepts, categories, and, ultimately, the constructed theory. At the time of abstract submission, data analysis is currently at the second level of coding (i.e., focused coding stage) of the research study. Preliminary categories include: (a) focusing on biomedical care; (b) multi-dimensional challenges to having the conversation; (c) connecting and setting boundaries with patients; (d) difficulty articulating kidney-supportive care; and (e) unwittingly practising kidney-supportive care. For the conference, the resulting theory will be presented. Nurses working in dialysis are well-positioned to ensure the delivery of quality kidney-supportive care. This study will help to determine the process and the factors enabling and impeding nurse engagement in supportive care in dialysis to effect change for normalizing advance care planning conversations in the clinical setting. This improved practice will have substantive beneficial implications for the many individuals living with kidney failure and their supporting loved ones.

Keywords: dialysis, kidney failure, nursing, supportive care

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Authors: Anum Obaid, Bushra Noor, Zoshia Zainab

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In South Asian countries, Pakistan faces significant public health challenges regarding maternal and neonatal health (MNH). Despite global efforts to improve maternal, newborn, child, and health (MNCH) outcomes through initiatives like the Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs), high maternal and neonatal mortality rates persist. In patriarchal societies, cultural norms, family dynamics, and gender roles heavily influence healthcare accessibility and decision-making processes, often leading to delayed and inadequate maternal care. Addressing these socio-cultural barriers and enhancing healthcare resources is crucial to improving maternal health outcomes in areas like Faisalabad. A qualitative study was conducted involving two groups of informants: gynecologists practicing in private clinics and first-time pregnant women receiving care in government hospitals. Data collection included obtaining institutional permission, conducting semi-structured in-depth interviews, and using non-probability sampling techniques. A proactive strategy to overcome maternal health challenges involves using aversion therapy and disseminating knowledge among family members. This approach aims to foster a deep understanding within the family unit regarding the importance of maternal well-being, thereby creating a supportive environment and facilitating informed decision-making related to healthcare access and lifestyle choices. The findings indicate that maternal health is compromised both physiologically and psychologically, with significant implications for the baby's health. Mental well-being, in particular, is profoundly affected, largely due to familial behavior and entrenched cultural taboos.

Keywords: maternal health, neonatal health, socio-cultural norms, primigravida women, gynecologist, familial conduct, cultural taboos

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Authors: Reyhaneh Hashemi, Shahrooz Saviz

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In his study, we have survey the theory of gyrotron amplifier in a vane-loaded waveguide with inner dielectric material. Dispersion relation for electromagnetic waves emitted by a cylindrical waveguide that provided with wedge-shaped metal vanes projecting radially inward from the wall of the guide and exited in the transverse-electric mode was analysed. From numerical analysis of this dispersion relation, it is shown that the stability behavior of the fast-wave mode is dependent of the dielectric constant. With a small axial momentum spreed, a super bandwidth is shown to be attainable by a mixed mode operation. Also, with the utilization from the numeric analysis of relation dispersion. We show that in the –speed mode, the constant is independent de-electric. With the ratio of dispersion of smell, high –bandwith was obtained for the combined mode. And at the end, we were comparing the result of our work (vane-loaded) by the waveguide with a smooth wall.

Keywords: gyrotron amplifier, waveguide, vane-loaded waveguide, dielectric material, dispersion relation, cylindrical waveguide, fast-wave mode, mixed mode operation

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Authors: Zakia Hammouni

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Healthcare professionals’ well-being is becoming a priority during this Covid-19 pandemic due to stress, fatigue, and workload. Well before this pandemic, contemporary hospitals are endowed with environmental attributes that contribute to achieving well-being within their environment with the emphasis on the patient. The patient-centered care approach has been followed by the patient-centered design approach. Studies that have focused on the physical environment in hospitals have dealt with the patient's recovery process and his well-being. Prior scientific literature has placed less emphasis on the healthcare professionals’ interactions within the physical environment and to guide hospital designers to make evidence-based design choices to meet the needs and expectations of hospital users by considering, in addition to patients, healthcare professionals. This paper examines these issues related to the daily stress of professionals who provide care in a hospital environment. In this exploratory study, the interest was to grasp the issues related to this environment and explores the current realities of newly built hospitals based on design approaches and what attributes of the physical setting support healthcare professional’s well-being. Within a constructivist approach, this study was conducted in two care units in a new hospital in a big city in Canada before the Covid-19 pandemic (august 2nd to November 2nd 2018). A spatial evaluation of these care units allowed us to understand the interaction of health professionals in their work environment, to understand the spatial behavior of these professionals, and the narratives from 44 interviews of various healthcare professionals. The mental images validated the salient components of the hospital environment as perceived by these healthcare professionals. Thematic analysis and triangulation of the data set were conducted. Among the key attributes promoting the healthcare professionals’ well-being as revealed by the healthcare professionals are the overall light-color atmosphere in the hospital and care unit, particularly in the corridors and public areas of the hospital, the maintenance and cleanliness. The presence of the art elements also brings well-being to the health professionals as well as panoramic views from the staff lounge and corridors of the care units or elevator lobbies. Despite the overall positive assessment of this environment, some attributes need to be improved to ensure the well-being of healthcare professionals and to provide them with a restructuring environment. These are the supply of natural light, softer colors, sufficient furniture, comfortable seating in the restroom, and views, which are important in allowing these healthcare professionals to recover from their work stress. Noise is another attribute that needs to be further improved in the hospital work environment, especially in the nursing workstations and consultant's room. In conclusion, this study highlights the importance of providing healthcare professionals with work and rest areas that allow them to resist the stress they face, particularly during periods of extreme stress and fatigue such as a Covid-19 pandemic.

Keywords: healthcare facilities, healthcare professionals, physical environment, well-being

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Authors: A. Zurraini, Syed Alwi Sar, H. Helmy, H. Nazeefah

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Early Dementia Questionnaire (EDQ) was developed as a screening tool to detect patients with early dementia in primary care. It was developed based on 20 symptoms of dementia. From a preliminary study, EDQ had been shown to be a promising alternative for screening of early dementia. This study was done to further test on EDQ’s reliability and validity. Using a systematic random sampling, 200 elderly patients attending primary health care centers in Kuching, Sarawak had consented to participate in the study and were administered the EDQ. Geriatric Depression Scale (GDS) was used to exclude patients with depression. Those who scored >21 MMSE, were retested using the EDQ. Reliability was determined by Cronbach’s alpha for internal consistency and construct validity was assessed using confirmatory factor analysis (principle component with varimax rotation). The result showed that the overall Cronbach’s alpha coefficient was good which was 0.874. Confirmatory factor analysis on 4 factors indicated that the Cronbach’s alpha for each domain were acceptable with memory (0.741), concentration (0.764), emotional and physical symptoms (0.754) and lastly sleep and environment (0.720). Pearson correlation coefficient between the first EDQ score and the retest EDQ score among those with MMSE of >21 showed a very strong, positive correlation between the two variables, r = 0.992, N=160, P <0.001. The results of the validation study showed that Early Dementia Questionnaire (EDQ) is a valid and reliable tool to be used as a screening tool to detect early dementia in primary care.

Keywords: Early Dementia Questionnaire (EDQ), screening, primary care, construct validity

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Authors: Kasman, Darmawansyah, Alimin Maidin, Amran Razak

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Background: In decentralization, advocacy is needed to increase the health budget in Parepare District. One of the advocacy methods recommended by the World Bank is the economic loss approach. Methods: This research is observational in the field of health economics that contributes directly to the magnitude of the economic loss of the community and the government and provides advocacy to the executive and legislative to see the harm it causes. Results: The research results show the amount of direct cost, which consists of household expenditure for transport Rp.295,865,500. Indirect Cost of YLD of Rp.14.688.000, and YLL of Rp.28.986.336.00, so the amount of DALY is Rp.43.674.336.000. The total economic loss of Rp.43.970.201.500. These huge economic losses can be prevented by increasing the allocation of health budgets for promotive and preventive efforts and expanding the coverage of health insurance for the community. Conclusion: There is a need to advocate the executive and legislative about the importance of guarantee on public health financing by conducting studies in terms of economic losses so that all strategic alliances believe that health is an investment.

Keywords: advocacy, economic lost, health insurance, economic losses

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Authors: Hsiao-Lin Fang

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Every life is precious, and comprehensive care should be provided to individuals who are in the final stages of their lives. Hospice-shared care aims to provide optimal symptom control and palliative care to terminal (cancer) patients through the implementation of shared care, and to support patients and their families in making various physical and psychological adjustments in the face of death. This report examines a 10-year-boy diagnosed with Out-of-Hospital Cardiac Arrest (OHCA). The individual fainted when swimming at school and underwent 31 minutes of cardiopulmonary resuscitation (CPR). While receiving treatment at the hospital, the individual received extracorporeal membrane oxygenation(ECMO) due to unstable hemodynamics. Urgent cardiac catheterization found: Suspect acute fulminant myocarditis or underlying cardiomyopathy with acute decompensation, After the active rescue by the medical team, hemodynamics still showed only mean pressure value. With respect to the patient, interdepartmental hospice-shared care was implemented and a do-not-resuscitate (DNR) order was signed after family discussions were conducted. Assistance and instructions were provided as part of the comfort care process. A farewell gathering attended by the patient’s relatives, friends, teachers, and classmates was organized in an intensive care unit (ICU) in order to look back on the patient’s life and the beautiful memories that were created, as well as to alleviate the sorrow felt by family members, including the patient’s father and sister. For example, the patient was presented with drawings and accompanied to a garden to pick flowers. In this manner, the patient was able to say goodbye before death. Finally, the patient’s grandmother and father participated in the clinical hospice care and post-mortem care processes. A hospice-shared care clinician conducted regular follow-ups and provided care to the family of the deceased, supporting family members through the sorrowful period. Birth, old age, sickness, and death are the natural phases of human life. In recent years, growing attention has been paid to human-centered hospice care. Hospice care is individual holistic care provided by a professional team and it involves the provision of comprehensive care to a terminal patient. Hospice care aims to satisfy the physical, psychological, mental, and social needs of patients and their families. It does not involve the cessation of treatment but rather avoids the exacerbation or extension of the suffering endured by patients, thereby preserving the dignity and quality of life during the end-of-life period. Patients enjoy the company of others as they complete the last phase of their lives, and their families also receive guidance on how they can move on with their own lives after the patient’s death.

Keywords: hospice-shared care, extracorporeal membrane oxygenation (ECMO), hospice-shared care, child patient

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