Search results for: care knowledge
9817 A Dimensional Approach to Family Involvement in Forensic Mental Health Settings - Prevention of the Systemic Replication of Abuse, Need for Accepted Falsehoods and Family Guilt and Shame
Authors: Katie E. Jennings
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The interactions between family dynamics and environmental factors with mental health vulnerability in individuals are well known and are a theme for on-going research and debate. The impact upon mental health issues and forensic issues on family dynamics, experience, and emotional wellbeing cannot be over-Emphasised. For forensic patients with diagnosed mental disorders, these relationships and environments may have also been functionally linked to the development and maintenance of those disorders; with significant adverse childhood experiences being a common feature of many Patient’s histories. Mental health hospitals remove the patient from their home environments and provide treatment outside of these relationships and often outside of the home area. There is, therefore, a major focus on Services ensuring that patients are able to build and maintain relationships with family and friends, requiring services to involve families in Patients' care and treatment wherever possible. There are standards set by Government and clinical bodies that require absolute demonstration of the inclusion of family and friends in all aspects of the care and treatment of forensic patients. For some patients and family members, this push to take on a “role” in care can be unhelpful, extremely stressful, and has constant implications for the potential delicate reparation of relationships. Based on work undertaken for over 20 years in forensic mental health settings, this paper explores the positive psychology approach to a dimensional model to family inclusion in mental health care that learns from family court work and allows for the maintenance of relationships to be at both proximal and Distil levels; to prevent the replication of abuse, decrease the need for falsehoods and assist the recovery of all. The model is based on allowing families to choose to not be involved or be involved in different ways if this is seen to be more helpful. It also allows patients to choose the level of potential involvement that they would find helpful, and for this to be reviewed at a timeframe agreed by all parties, rather than when the next survey is due or the patient has a significant care meeting. This paper is significant as there is a lack of research to support services to use a positive psychology approach to work in this area, the assumption that being asked to be involved must be positive for all seems naïve at best for this patient group. Work relating to the psychology of family can significantly contribute to the development of knowledge in this area. The development of a dimensional model will support choice within families and assist in the development of more honest and open relationships.Keywords: family dynamics, forensic, mental disorder, positive psychology
Procedia PDF Downloads 1489816 Therapeutic Nihilism: Challenging Aging Diseases in Cameroon
Authors: Chick Loveline Ayoh Epse Ndi
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Our cultural stance has deep implications for the psychological and physical well-being of the old. Cameroon is still rooted on the traditional belief that stipulates that; the aged are best catered for in the family setting where the children and grandchildren are supposed to give in return for services invested on them by the former. This is why up till date, there are no “Rest Homes” or “Convalescent hospitals” despite the rising challenges faced by the aged in this context. Beside the special measure set aside to cater for the aged, such as “Rest Homes” for the healthy, “Convalescent hospitals” are created set to cater for the health of the aged in the Western context with other facilities such as geriatric units. The health care practitioners are aware of aging diseases and have trained human resources like Gerontologists to cater for the aged and aging diseases. Meanwhile, in Africa and Cameroon in particular, such infrastructural and human resources are still to be considered in the health care system. It can be assumed that the aged and aging diseases are still to be considered in the health care system in this context. This is why we talk of therapeutic nihilism, where the aged are mixed up with other categories of patients with no special attention given to them. This qualitative study carried out in the Yaounde, the capital city of Cameroon, with their best referent hospitals, reveal that; the aged and aging diseases are still a myth in this context. Data collected in both private and public health institutions show that there is only one public institution in Cameroon that has a geriatric unit with no specialists. Patients who aretreated in this unit are considered as aged with terminal diseases that need palliative care and not intensive care. Cameroon is still lacking in terms of health care to the aged and ageing diseases. Like other patients, the aged are treated with a lot of laxity and no value. There is an emergency to create special health care units for geriatrics and and train gerontologist. Mentally or physically ill aged faced medical rational with psychodynamic treatment considered as waste of time. The aged are less likely to be regarded salvageable when they enter a hospital in serious conditions due to the lack of specialists and geriatric units for them. The implication of this study is to sensitization the stake holders for an urgent need to extend special care units for the aged and aging diseases in this context.Keywords: challeng, therapy, agtng, diseases cameroon
Procedia PDF Downloads 949815 Unheard Voices: Workplace Ostracism, Personality Traits, and Knowledge Sharing Behaviour Among Women Professors
Authors: Naziya Haseena
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Professors play an indispensable role in education settings, sharing their knowledge and providing guidance and practical insights to the students. This study will investigate the relationship between personality traits, workplace ostracism, and knowledge-sharing behaviour among women professors. The sample of this quantitative study will consist of 200 professors from the Chennai district. It will use a convenient sampling technique to collect data using the workplace ostracism scale developed by Ferris et al. (2008), the big five personality inventory (BFI 44) developed by John (1999), and an adapted version of knowledge-sharing behavior developed by Lin (2007). The findings will provide insights and help to build the gender gap in academia to conduct personality development programs and academic collaboration among professors.Keywords: workplace ostracism, knowledge sharing behaviour, academia, personality traits
Procedia PDF Downloads 229814 Building Knowledge Partnership for Collaborative Learning in Higher Education – An On-Line ‘Eplanete’ Knowledge Mediation Platform
Authors: S. K. Ashiquer Rahman
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This paper presents a knowledge mediation platform, “ePLANETe Blue” that addresses the challenge of building knowledge partnerships for higher education. The purpose is to present, as an institutional perception, the ‘ePLANETe' idea and functionalities as a practical and pedagogical innovation program contributing to the collaborative learning goals in higher education. In consequence, the set of functionalities now amalgamated in ‘ePLANETe’ can be seen as an investigation of the challenges of “Collaborative Learning Digital Process.” It can exploit the system to facilitate collaborative education, research and student learning in higher education. Moreover, the platform is projected to support the identification of best practices at explicit levels of action and to inspire knowledge interactions in a “virtual community” and thus to advance in deliberation and learning evaluation of higher education through the engagement of collaborative activities of different sorts.Keywords: mediation, collaboration, deliberation, evaluation
Procedia PDF Downloads 1409813 We Have Never Seen a Dermatologist. Reaching the Unreachable Through Teledermatology
Authors: Innocent Atuhe, Babra Nalwadda, Grace Mulyowa Kitunzi, Annabella Haninka Ejiri
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Background: Atopic Dermatitis (AD) is one of the most prevalent and growing chronic inflammatory skin diseases in African prisons. AD care is limited in African due to lack of information about the disease amongst primary care workers, limited access to dermatologists, lack of proper training of healthcare workers, and shortage of appropriate treatments. We designed and implemented the Prisons Telederma project based on the recommendations of the International Society of Atopic Dermatitis. Our overall goal was to increase access to dermatologist-led care for prisoners with AD through teledermatology in Uganda. We aimed to; i) to increase awareness and understanding of teledermatology among prison health workers; and ii) to improve treatment outcomes of prisoners with atopic dermatitis through increased access to and utilization of consultant dermatologists through teledermatology in Uganda prisons: Approach: We used Store-and-forward Teledermatology (SAF-TD) to increase access to dermatologist-led care for prisoners and prisons staff with AD. We conducted a five days training for prison health workers using an adapted WHO training guide on recognizing neglected tropical diseases through changes on the skin together with an adapted American Academy of Dermatology (AAD) Childhood AD Basic Dermatology Curriculum designed to help trainees develop a clinical approach to the evaluation and initial management of patients with AD. This training was followed by blended e-learning, webinars facilitated by consultant Dermatologists with local knowledge of medication and local practices, apps adjusted for pigmented skin, WhatsApp group discussions, and sharing pigmented skin AD pictures and treatment via zoom meetings. We hired a team of Ugandan Senior Consultant dermatologists to draft an iconographic atlas of the main dermatoses in pigmented African skin and shared this atlas with prison health staff for use as a job aid. We had planned to use MySkinSelfie mobile phone application to take and share skin pictures of prisoners with AD with Consultant Dermatologists, who would review the pictures and prescribe appropriate treatment. Unfortunately, the National Health Service withdrew the app from the market due to technical issues. We monitored and evaluated treatment outcomes using the Patient Oriented Eczema Measure (POEM) tool. We held four advocacy meetings to persuade relevant stakeholders to increase supplies and availability of first-line AD treatments such as emollients in prison health facilities. Results: Draft iconographic atlas of the main dermatoses in pigmented African skin Increased proportion of prison health staff with adequate knowledge of AD and teledermatology from 20% to 80% Increased proportion of prisoners with AD reporting improvement in disease severity (POEM scores) from 25% to 35% in one year. Increased proportion of prisoners with AD seen by consultant dermatologist through teledermatology from 0% to 20% in one year. Increased the availability of AD recommended treatments in prisons health facilities from 5% to 10% in one yearKeywords: teledermatology, prisoners, reaching, un-reachable
Procedia PDF Downloads 1169812 A Tool to Represent People Approach to the Use of Pharmaceuticals and Related Criticality and Needs: A Territory Experience
Authors: Barbara Pittau, Piergiorgio Palla, Antonio Mastino
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Communication is fundamental to health education. The proper use of medicinal products is a crucial aspect of the health of citizens that affects both safety and health care spending. Therefore, encouraging/promoting communication, concerning the importance of proper use of pharmaceuticals, has substantial implications in terms of individual health, health care, and health care system sustainability. In view of these considerations, in the context of two projects, one of which is still in progress, a relational database-backed web application named COLLABORAFARMACISOLA has been designed and developed as a tool to analyze and visualize how people approach the use of medicinal products, with the aim of improving and enhancing communication efficacy. The software application is being used to collect information (anonymously and voluntarily) from the citizens of Sardinia, an Italian region, regarding their knowledge, experiences, and opinions towards pharmaceuticals. This study that was conducted to date on thousand of interviewed people, has focused on different aspects such as: the treatment interruption and the "self-prescription” without medical consultation, the attention paid to reading the leaflets, the awareness of the economic value of the pharmaceuticals, the importance of avoiding the waste of medicinal products and the attitudes towards the use of generics. To this purpose, our software application provides a set of ad hoc parsing routines, to store information into the structure of a relational database and to process and visualize it through a set of interactive tools aimed to emphasize the findings and the insights obtained. The results of our preliminary analysis show the efficacy of the awareness plan and, at the same time, the criticality and the needs of the territory under examination. The ultimate goal of our study is to provide a contribution to the community by improving communication that can result in a benefit for public health in a context strictly connected to the reality of the territory.Keywords: communication, pharmaceuticals, public health, relational database, tool, web application
Procedia PDF Downloads 1379811 Expert and Novice Problem-Solvers Differences: A Discourse for Effective Teaching Delivery in Physics Classrooms
Authors: Abubakar Sa’adatu Mohammed
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This paper reports on a study of problem solving differences between expert and novice Problem solvers for effective physics teaching. Significant differences were found both at the conceptual level and at the level of critical thinking, creative thinking and reasoning. It is suggested for a successful solution of a problem, conceptual knowledge alone may not be sufficient. There is the need of the knowledge of how the conceptual knowledge should be applied (problem solving skills). It is hoped that this research might contribute to efforts of exploring ways for students to acquire a powerful conceptual toolkit based on experts like problem solvers approach for effective teaching delivery.Keywords: conceptual knowledge, procedural knowledge, critical thinking, creative thinking, reasoning ability
Procedia PDF Downloads 2999810 Comparing the Contribution of General Vocabulary Knowledge and Academic Vocabulary Knowledge to Learners' Academic Achievement
Authors: Reem Alsager, James Milton
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Coxhead’s (2000) Academic Word List (AWL) believed to be essential for students pursuing higher education and helps differentiate English for Academic Purposes (EAP) from General English as a course of study, and it is thought to be important for comprehending English academic texts. It has been described that AWL is an infrequent, discrete set of vocabulary items unreachable from general language. On the other hand, it has been known for a period of time that general vocabulary knowledge is a good predictor of academic achievement. This study, however, is an attempt to measure and compare the contribution of academic knowledge and general vocabulary knowledge to learners’ GPA and examine what knowledge is a better predictor of academic achievement and investigate whether AWL as a specialised list of infrequent words relates to the frequency effect. The participants were comprised of 44 international postgraduate students in Swansea University, all from the School of Management, following the taught MSc (Master of Science). The study employed the Academic Vocabulary Size Test (AVST) and the XK_Lex vocabulary size test. The findings indicate that AWL is a list based on word frequency rather than a discrete and unique word list and that the AWL performs the same function as general vocabulary, with tests of each found to measure largely the same quality of knowledge. The findings also suggest that the contribution that AWL knowledge provides for academic success is not sufficient and that general vocabulary knowledge is better in predicting academic achievement. Furthermore, the contribution that academic knowledge added above the contribution of general vocabulary knowledge when combined is really small and noteworthy. This study’s results are in line with the argument and suggest that it is the development of general vocabulary size is an essential quality for academic success and acquiring the words of the AWL will form part of this process. The AWL by itself does not provide sufficient coverage, and is probably not specialised enough, for knowledge of this list to influence this general process. It can be concluded that AWL as an academic word list epitomizes only a fraction of words that are actually needed for academic success in English and that knowledge of academic vocabulary combined with general vocabulary knowledge above the most frequent 3000 words is what matters most to ultimate academic success.Keywords: academic achievement, academic vocabulary, general vocabulary, vocabulary size
Procedia PDF Downloads 2199809 Quality of Care of Medical Male Circumcisions: A Non-Negotiable for Right to Care
Authors: Nelson Igaba, C. Onaga, S. Hlongwane
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Background: Medical Male Circumcision (MMC) is part of a comprehensive HIV prevention strategy. The quality of MMC done at Right To Care (RtC) sites is maintained by Continuous Quality Improvement (CQI) based on findings of assessments by internal and independent external assessors who evaluate such parameters as the quality of the surgical procedure, infection control, etc. There are 12 RtC MMC teams in Mpumalanga, two of which are headed by Medical Officers and 10 by Clinical Associates (Clin A). Objectives: To compare the quality (i) of care rendered at doctor headed sites (DHS) versus Clin A headed sites (CHS); (ii) of CQI assessments (external versus internal). Methodology: A retrospective review of data from RightMax™ (a novel RtC data management system) and CQI reports (external and internal) was done. CQI assessment scores of October 2015 and October 2016 were taken as the baseline and latest respectively. Four sites with 745-810 circumcisions per annum were purposively selected; the two DHS (group A) and two CHS (group B). Statistical analyses were conducted using R (2017 version). Results: There were no significant difference in latest CQI scores between the two groups (DHS and CHS) (Anova, F = 1.97, df = 1, P = 0.165); between internal and external CQI assessment scores (Anova, F = 2.251, df = 1, P = 0.139) or among the individual sites (Anova, F = 1.095, df = 2, P = 0.341). Of the total of 16 adverse events reported by the four sites in the 12 months reviewed (all were infections), there was no statistical evidence that the documented severity of the infection was different for DHS and CHS (Fisher’s exact test, p-value = 0.269). Conclusion: At RtC VMMC sites in Mpumalanga, internal and external/independent CQI assessments are comparable, and quality of care of VMMC is standardized with the performance of well-supervised clinical associates comparing well with those of medical officers.Keywords: adverse events, Right to Care, male medical circumcision, continuous quality improvement
Procedia PDF Downloads 1769808 Data Mining and Knowledge Management Application to Enhance Business Operations: An Exploratory Study
Authors: Zeba Mahmood
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The modern business organizations are adopting technological advancement to achieve competitive edge and satisfy their consumer. The development in the field of Information technology systems has changed the way of conducting business today. Business operations today rely more on the data they obtained and this data is continuously increasing in volume. The data stored in different locations is difficult to find and use without the effective implementation of Data mining and Knowledge management techniques. Organizations who smartly identify, obtain and then convert data in useful formats for their decision making and operational improvements create additional value for their customers and enhance their operational capabilities. Marketers and Customer relationship departments of firm use Data mining techniques to make relevant decisions, this paper emphasizes on the identification of different data mining and Knowledge management techniques that are applied to different business industries. The challenges and issues of execution of these techniques are also discussed and critically analyzed in this paper.Keywords: knowledge, knowledge management, knowledge discovery in databases, business, operational, information, data mining
Procedia PDF Downloads 5389807 Knowledge Management for Competitiveness and Performances in Higher Educational Institutes
Authors: Jeyarajan Sivapathasundram
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Knowledge management has been recognised as an emerging factor for being competitive among institutions and performances in firms. As such, being recognised as knowledge rich institution, higher education institutes have to be recognised knowledge management based resources for achieving competitive advantages. Present research picked result out of postgraduate research conducted in knowledge management at non-state higher educational institutes of Sri Lanka. Besides, the present research aimed to discover knowledge management for competition and firm performances of higher educational institutes out of the result produced by the postgraduate study. Besides, the results are found in a pair that developed out of knowledge management practices and the reason behind the existence of the practices. As such, the present research has developed a filter to pick the pairs that satisfy its condition of competition and performance of the firm. As such, the pair, such as benchmarking is practised to be ethically competing through conducting courses. As the postgraduate research tested results of foreign researches in a qualitative paradigm, the finding of the present research are generalise fact for knowledge management for competitiveness and performances in higher educational institutes. Further, the presented research method used attributes which explain competition and performance in its filter to discover the pairs relevant to competition and performances. As such, the fact in regards to knowledge management for competition and performances in higher educational institutes are presented in the publication that the presentation is out of the generalised result. Therefore, knowledge management for competition and performance in higher educational institutes are generalised.Keywords: competition in and among higher educational institutes, performances of higher educational institutes, noun based filtering, production out of generalisation of a research
Procedia PDF Downloads 1369806 The Effects of Transformational Leadership on Process Innovation through Knowledge Sharing
Authors: Sawsan J. Al-Husseini, Talib A. Dosa
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Transformational leadership has been identified as the most important factor affecting innovation and knowledge sharing; it leads to increased goal-directed behavior exhibited by followers and thus to enhanced performance and innovation for the organization. However, there is a lack of models linking transformational leadership, knowledge sharing, and process innovation within higher education (HE) institutions in general within developing countries, particularly in Iraq. This research aims to examine the mediating role of knowledge sharing in the transformational leadership and process innovation relationship. A quantitative approach was taken and 254 usable questionnaires were collected from public HE institutions in Iraq. Structural equation modelling with AMOS 22 was used to analyze the causal relationships among factors. The research found that knowledge sharing plays a pivotal role in the relationship between transformational leadership and process innovation, and that transformational leadership would be ideal in an educational context, promoting knowledge sharing activities and influencing process innovation in the public HE in Iraq. The research has developed some guidelines for researchers as well as leaders and provided evidence to support the use of TL to increase process innovation within HE environment in developing countries, particularly in Iraq.Keywords: transformational leadership, knowledge sharing, process innovation, structural equation modelling, developing countries
Procedia PDF Downloads 3369805 An Investigation into the Decision-Making Process of Choosing Long-Term Care Services in Taiwan
Authors: Yu-Ching Liu
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Background: Family numbers usually take responsibility for taking care of their elderly relatives, especially parents. Caring for a patient with chronic diseases is a stressful experience, which makes carers suffer physical and mental health stress, difficulties maintaining family relationships and issues in participating in the labor market, which may lower their quality of life (QoL). The issue of providing care to relatives with chronic illness has been widely explored in Taiwan, but most studies focus on the need for full-time caregivers. Objective: The main goal of this study was to examine the topic of working carers involved in the decision-making process of LTC services and to explore what affects working carers considering when they choose the care services for their disabled, elderly relatives. Method: A total of 7 working caregivers were enrolled in this study. A face-to-face and semi-structured in-depth qualitative interview study were conducted to explore the caregivers' perspectives. Results: Working carers have a positive experience of using LTC service because it allows them to kill two birds with one stone, continue employment, and care for an elderly disabled relative. However, working carers have still been struggling to find friendly community-based LTC services. There were no longer available community services that could be used with the illness condition of patients getting worse. As such, patients have to be cared for at home, which might increase the caregiver burden of carers. Conclusion: Working family caregivers suffer from heavy physical and psychological burdens as they not only have to maintain their employment but care for elderly disabled relatives; however, the current support provided is insufficient. The design of services should consider working carers' employment situation and need rather than the only caring situation of patients at home.Keywords: family caregiver, Long-term care, work-life balance, decision-making
Procedia PDF Downloads 1809804 Lessons Learned from Implementation of Remote Pregnant and Newborn Care Service for Vulnerable Women and Children During COVID-19 and Political Crisis in Myanmar
Authors: Wint Wint Thu, Htet Ko Ko Win, Myat Mon San, Zaw Lin Tun, Nandar Than Aye, Khin Nyein Myat, Hayman Nyo Oo, Nay Aung Lin, Kusum Thapa, Kyaw Htet Aung
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Background: In Myanmar, the intense political instability happened to start in Feb-2021, while the COVID-19 pandemic waves are also threatening the public health system, which subsequently led to severe health sector crisis, including difficulties in accessing maternal and newborn health care for vulnerable women and children. The Remote Pregnant and Newborn Care (RPNC) uses a telehealth approach United States Agency for International Development (USAID)-funded Essential Health Project. Implementation: The Remote Pregnant and Newborn Care (RPNC) service has adapted to the MNCH needs of vulnerable pregnant women and was implemented to mitigate the risk of limited access to essential quality MNH care in Yangon, Myanmar, under women, and the project trained 13 service providers on a telehealth care package for pregnancy and newborn developed Jhpiego to ensure understanding of evidence-based MNCH care practices. The phone numbers of the pregnant women were gathered through the preexisting and functioning community volunteers, who reach the most vulnerable pregnant women in the project's targeted area. A total of 212 pregnant women have been reached by service providers for RPNC during the implementation period. The trained service providers offer quality antenatal and postnatal care, including newborn care, via telephone calls. It includes 24/7 incoming calls and time-allotted outgoing calls to the pregnant women during antenatal and postnatal periods, including the newborn care. The required data were collected daily in time with the calls, and the quality of the medical services is made assured with the track of the calls, ensuring data privacy and patient confidentiality. Lessons learned: The key lessons are 1) cost-effectiveness: RPNC service could reduce out of pocket expenditure of pregnant women as it only costs 1.6 United States dollars (USD) per one telehealth call while it costs 8 to 10 USD per one time in-person care service at private service providers, including transportation cost, 2) network of care: telehealth call could not replace the in-person antenatal and postnatal care services, and integration of telehealth calls with in-person care by local healthcare providers with the support of the community is crucial for accessibility to essential MNH services by poor and vulnerable women, and 3) sharing information on health access points: most of the women seem to have financial barriers in accessing private health facilities while public health system collapse and telehealthcare could provide information on low-cost facilities and connect women to relevant health facilities. These key lessons are important for future efforts regarding the implementation of remote pregnancy and newborn care in Myanmar, especially during the political crisis and COVID-19 pandemic situation.Keywords: telehealth, accessibility, maternal care, newborn care
Procedia PDF Downloads 1019803 Using India’s Traditional Knowledge Digital Library on Traditional Tibetan Medicine
Authors: Chimey Lhamo, Ngawang Tsering
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Traditional Tibetan medicine, known as Sowa Rigpa (Science of healing), originated more than 2500 years ago with an insightful background, and it has been growing significant attention in many Asian countries like China, India, Bhutan, and Nepal. Particularly, the Indian government has targeted Traditional Tibetan medicine as its major Indian medical system, including Ayurveda. Although Traditional Tibetan medicine has been growing interest and has a long history, it is not easily recognized worldwide because it exists only in the Tibetan language and it is neither accessible nor understood by patent examiners at the international patent office, data about Traditional Tibetan medicine is not yet broadly exist in the Internet. There has also been the exploitation of traditional Tibetan medicine increasing. The Traditional Knowledge Digital Library is a database aiming to prevent the patenting and misappropriation of India’s traditional medicine knowledge by using India’s Traditional knowledge Digital Library on Sowa Rigpa in order to prevent its exploitation at international patent with the help of information technology tools and an innovative classification systems-traditional knowledge resource classification (TKRC). As of date, more than 3000 Sowa Rigpa formulations have been transcribed into a Traditional Knowledge Digital Library database. In this paper, we are presenting India's Traditional Knowledge Digital Library for Traditional Tibetan medicine, and this database system helps to preserve and prevent the exploitation of Sowa Rigpa. Gradually it will be approved and accepted globally.Keywords: traditional Tibetan medicine, India's traditional knowledge digital library, traditional knowledge resources classification, international patent classification
Procedia PDF Downloads 1289802 Assessing the Informed Consent Practices during Normal Vaginal Delivery Process and Immediate Postpartum Care in Tertiary Level Hospitals of Bangladesh
Authors: Md. Abdul Karim, Syed Imran Ahmed, Pandora T. Hardtman
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Informed consent is one of the basic human and ethical rights for childbearing women. It plays a central role in promoting informed decision making between patients and service providers during the labor process. It gives mothers rights to accept or reject any examination and/or procedure, increases the respect and dignity of the mother during pregnancy, delivery and postpartum care. To assess the practices of this right during normal vaginal delivery and immediate postpartum care in tertiary level hospital setting in Bangladesh, a quantitative study with cross-sectional design was conducted in Dhaka Medical College & Hospital (DMCH) and Sir Salimullah Medical College & Mitford Hospital (SSMCH) in Dhaka in November 2015. A prevalence-based sample size of 190 was calculated where prevalence, confidence interval and level of significance were at 9.7%, 98% and 5% respectively. The respondents were the mothers who gave normal vaginal childbirth within past 24 hours and received postpartum care there. They were selected through systematic random sampling technique and their face-to-face interview of 190 mothers was done using a structured questionnaire. Data were entered into the spreadsheet (MS Excel 2013 version) and descriptive analysis of findings was done. The result shows the complete absence of informed consent practices and mostly absence of consented care such as right to information, respect for choices of preferences for examination and/or procedure of childbearing women. Although 95% of the mothers were informed that they were being proceeded with normal vaginal delivery, their choice of preference was absent during the process. Only consent (not informed consent) was taken from 50%-72% mothers for examination (except breast examination ‘0%’) and 8%-83% for any procedures during postpartum care. Only one-ninth (11%) of the mothers could ask service providers regarding the services they received. No consent was taken from 3% of the mothers- neither in the labor process nor in postpartum care. This current practice doesn’t comply with the Respectful Maternity Care (RMC) Charter 2011. The issue is not even clarified in the current Standard Clinical Management Protocols of the country. So, improvement of the existing protocol and increased awareness are essential to address this right of child-bearing women and to practice it during normal vaginal delivery and postpartum care.Keywords: informed consent, normal vaginal delivery, respectful maternity care, tertiary level hospital
Procedia PDF Downloads 1589801 Validation of an Acuity Measurement Tool for Maternity Services
Authors: Cherrie Lowe
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The TrendCare Patient Dependency System is currently utilized by a large number of Maternity Services across Australia, New Zealand and Singapore. In 2012, 2013, and 2014 validation studies were initiated in all three countries to validate the acuity tools used for Women in Labour, and Postnatal Mothers and Babies. This paper will present the findings of the validation study. Aim: The aim of this study was to; Identify if the care hours provided by the TrendCare Acuity System was an accurate reflection of the care required by Women and Babies. Obtain evidence of changes required to acuity indicators and/or category timings to ensure the TrendCare acuity system remains reliable and valid across a range of Maternity care models in three countries. Method: A non-experimental action research methodology was used across four District Health Boards in New Zealand, two large public Australian Maternity services and a large tertiary Maternity service in Singapore. Standardized data collection forms and timing devices were used to collect Midwife contact times with Women and Babies included in the study. Rejection processes excluded samples where care was not completed/rationed. The variances between actual timed Midwife/Mother/Baby contact and actual Trend Care acuity times were identified and investigated. Results: 87.5% (18) of TrendCare acuity category timings matched the actual timings recorded for Midwifery care. 12.5% (3) of TrendCare night duty categories provided less minutes of care than the actual timings. 100% of Labour Ward TrendCare categories matched actual timings for Midwifery care. The actual times given for assistance to New Zealand independent Midwives in Labour Ward showed a significant deviation to previous studies demonstrating the need for additional time allocations in Trend Care. Conclusion: The results demonstrated the importance of regularly validating the Trend Care category timings with the care hours required, as variances to models of care and length of stay in Maternity units have increased Midwifery workloads on the night shift. The level of assistance provided by the core labour ward staff to the Independent Midwife has increased substantially. Outcomes: As a consequence of this study changes were made to the night duty TrendCare Maternity categories, additional acuity indicators developed and times for assisting independent Midwives increased. The updated TrendCare version was delivered to Maternity services in 2014.Keywords: maternity, acuity, research, nursing workloads
Procedia PDF Downloads 3789800 The Relationship between Absorptive Capacity and Green Innovation
Authors: R. Hashim, A. J. Bock, S. Cooper
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Absorptive capacity generally facilitates the adoption of innovation. How does this relationship change when economic return is not the sole driver of innovation uptake? We investigate whether absorptive capacity facilitates the adoption of green innovation based on a survey of 79 construction companies in Scotland. Based on the results of multiple regression analyses, we confirm that existing knowledge utilisation (EKU), knowledge building (KB) and external knowledge acquisition (EKA) are significant predictors of green process GP), green administrative (GA) and green technical innovation (GT), respectively. We discuss the implications for theories of innovation adoption and knowledge enhancement associated with environmentally-friendly practices.Keywords: absorptive capacity, construction industry, environmental, green innovation
Procedia PDF Downloads 5269799 Primary School Teachers’ Conceptual and Procedural Knowledge of Rational Number and Its Effects on Pupils’ Achievement in Rational Numbers
Authors: R. M. Kashim
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The study investigated primary school teachers’ conceptual and procedural knowledge of rational numbers and its effects on pupil’s achievement in rational numbers. Specifically, primary school teachers’ level of conceptual knowledge about rational numbers, primary school teachers’ level of procedural knowledge about rational numbers, and the effects of teachers conceptual and procedural knowledge on their pupils understanding of rational numbers in primary schools is investigated. The study was carried out in Bauchi metropolis in the Bauchi state of Nigeria. The design of the study was a multi-stage design. The first stage was a descriptive design. The second stage involves a pre-test, post-test only quasi-experimental design. Two instruments were used for the data collection in the study. These were Conceptual and Procedural knowledge test (CPKT) and Rational number achievement test (RAT), the population of the study comprises of three (3) mathematics teachers’ holders of Nigerian Certificate in Education (NCE) teaching primary six and 210 pupils in their intact classes were used for the study. The data collected were analyzed using mean, standard deviation, analysis of variance, analysis of covariance and t- test. The findings indicated that the pupils taught rational number by a teacher that has high conceptual and procedural knowledge understand and perform better than the pupil taught by a teacher who has low conceptual and procedural knowledge of rational number. It is, therefore, recommended that teachers in primary schools should be encouraged to enrich their conceptual knowledge of rational numbers. Also, the superiority performance of teachers in procedural knowledge in rational number should not become an obstruction of understanding. Teachers Conceptual and procedural knowledge of rational numbers should be balanced so that primary school pupils will have a view of better teaching and learning of rational number in our contemporary schools.Keywords: conceptual, procedural knowledge, rational number, pupils
Procedia PDF Downloads 4529798 Meeting Criminogenic Needs to Reduce Recidivism: The Diversion of Vulnerable Offenders from the Criminal Justice System into Care
Authors: Paulo Rocha
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Once in touch with the Criminal Justice System, offenders with mental disorder tend to return to custody more often than nondisordered individuals, which suggests they have not been receiving appropriate treatment in prison. In this scenario, diverting individuals into care as early as possible in their trajectory seems to be the appropriate approach to rehabilitate mentally unwell offenders and alleviate overcrowded prisons. This paper builds on an ethnographic research investigating the challenges encountered by practitioners working to divert offenders into care while attempting to establish cross-boundary interactions with professionals in the Criminal Justice System and Mental Health Services in the UK. Drawing upon the findings of the study, this paper suggests the development of adequate tools to enable liaison between agencies which ultimately results in successful interventions.Keywords: criminogenic needs, interagency collaboration, liaison and diversion, recidivism
Procedia PDF Downloads 1689797 Case-Based Reasoning: A Hybrid Classification Model Improved with an Expert's Knowledge for High-Dimensional Problems
Authors: Bruno Trstenjak, Dzenana Donko
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Data mining and classification of objects is the process of data analysis, using various machine learning techniques, which is used today in various fields of research. This paper presents a concept of hybrid classification model improved with the expert knowledge. The hybrid model in its algorithm has integrated several machine learning techniques (Information Gain, K-means, and Case-Based Reasoning) and the expert’s knowledge into one. The knowledge of experts is used to determine the importance of features. The paper presents the model algorithm and the results of the case study in which the emphasis was put on achieving the maximum classification accuracy without reducing the number of features.Keywords: case based reasoning, classification, expert's knowledge, hybrid model
Procedia PDF Downloads 3679796 Engaging Women Entrepreneurs in School Adolescent Health Program to Ensure Menstrual Hygiene Management in Rural Bangladesh
Authors: Toslim Uddin Khan, Jesmin Akter, Mohiuddin Ahmed
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Menstrual hygiene management (MHM) and personal health-care practice is a critical issue to prevent morbidity and other reproductive health complications among adolescent girls in Bangladesh. Inadequate access to water, sanitation and hygiene (WASH) facilities lead to unhealthy MHM practices that resulted in poor reproductive health outcomes. It is evident from different studies that superstitions and misconception are more common in rural communities that limit young girls’ access to and understanding of the menstrual hygiene and self care practices. The state-of-the-art approach of Social Marketing Company (SMC) is proved to be instrumental in delivering reinforcing health messages, making public health and hygiene products available at the door steps of the community through community mobilization programs in rural Bangladesh. School health program is one of the flagship interventions of SMC to equip adolescent girls and boys with correct knowledge of health and hygiene practices among themselves, their families and peers. In Bangladeshi culture, adolescent girls often feel shy to ask fathers or male family members about buying sanitary napkin from local pharmacy and they seem to be reluctant to seek help regarding their menstrual problems. A recent study reveals that 48% adolescent girls are using sanitary napkins while majority of them are unaware of menstrual hygiene practices in Bangladesh. Under school adolescent program, SMC organizes health education sessions for adolescent girls from grade seven to ten using enter-educate approach with special focus on sexual and reproductive health and menstrual hygiene issues including delaying marriage and first pregnancy. In addition, 2500 rural women entrepreneurs branded as community sales agents are also involved in disseminating health messages and selling priority health products including sanitary napkin at the household level. These women entrepreneurs are serving as a source of sustainable supply of the sanitary napkins for the rural adolescent girls and thereby they are earning profit margins on the sales they make. A recent study on the impact of adolescent program activities reveals that majority (71%) of the school adolescent girls are currently using sanitary napkins. Health education equips and empowers adolescent girls with accurate knowledge about menstrual hygiene practices and self-care as well. Therefore, engagement of female entrepreneurs in school adolescent health program at the community level is one of the promising ways to improve menstrual hygiene practices leading to increased use of sanitary napkin in rural and semi-rural communities in Bangladesh.Keywords: school adolescent program, social marketing, women entrepreneurs, menstrual hygiene management
Procedia PDF Downloads 1979795 Patients with Chronic Obstructive Pulmonary Feelings of Uncertainty
Authors: Kyngäs Helvi, Patala-Pudas, Kaakinen Pirjo
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It has been reported that COPD -patients may experience much emotional distress, which can compromise positive health outcomes. The aim of this study was to explore disease-related uncertainty as reported by Chronic Obstructive Pulmonary Disease (COPD) patients. Uncertainty was defined as a lack of confidence; negative feelings; a sense of confidence; and awareness of the sources of uncertainty. Research design was a non-experimental cross-sectional survey. The data (n=141) was collected by validated questionnaire during COPD -patients’ visits or admissions to a tertiary hospital. The response rate was 62%. The data was analyzed by statistical methods. Around 70% of the participants were male with COPD diagnosed many years ago. Fifty-four percent were under 65 years and used an electronic respiratory aid apparatus (52%) (oxygen concentrator, ventilator or electronic inhalation device). Forty-one percent of the participants smoked. Disease-related uncertainty was widely reported. Seventy-three percent of the participants had uncertainty about their knowledge of the disease, the pulmonary medication and nutrition. One-quarter (25%) did not feel sure about managing COPD exacerbation. About forty percent (43%) reported that they did not have a written exacerbation decision aid indicating how to act in relation to COPD symptoms. Over half of the respondents were uncertain about self-management behavior related to health habits such as exercise and nutrition. Over a third of the participants (37%) felt uncertain about self-management skills related to giving up smoking. Support from the care providers was correlated significantly with the patients’ sense of confidence. COPD -patients who felt no confidence stated that they received significantly less support in care. Disease-related uncertainty should be considered more closely and broadly in the patient care context, and those strategies within patient education that enhance adherence should be strengthened and incorporated into standard practice.Keywords: adherence, COPD, disease-management, uncertainty
Procedia PDF Downloads 2399794 Islamization of Knowledge with Special Reference to Mohd Kamal Hassan's Perspective
Authors: Abdul Latheef O. Mavukkandy
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Islamization of knowledge (IOK) is an intellectual movement emerged in the middle of 1970s to address the threats by modern western civilizational onslaughts. This paper analyzes the discourse of Islamization of knowledge with special reference to the views of Kamal Hassan who prefers an alternative term called 'Islamicization'. First of all the theoretical and practical outlines of IOK movement were presented by Ismail Raji al-Faruqi in his book 'Islamization of Knowledge; General Principles and Work Plan' in 1982. He identified that the educational system in the Muslim world accounted for the decline of Muslim Ummah through de-Islamization and demoralization. So, the need for IOK was an academic challenge to reconstruct the Ummah. Kamal Hassan kept just different view from Ismail Raji al-Faruqi and Muhammed Naquib al-Attas that he coined the terms 'Relevantization and Contextualization'. So, he wanted the 'Islamization of Islamic Revealed Knowledge'. So, he used Islamization of Human Knowledge (IOHK) instead of IOK. As part of this movement, the IOK identified that the textbooks used in Muslim educational institutions systematically keep the students estranged from Islam and its heritage. Furthermore, the modern secular knowledge develops secular attitude devoid of Islamic moral philosophy and the sense of mission in life. Based upon the content analysis of some of the sources, this study found that Islamization of Knowledge is an important movement in Islamic world, but the IOK project is not practicable completely because of the lack of trained teachers and resources. Although, the project resulted in the foundation of some universities and publishing more works, journals and doctoral thesis on different dimensions of Islamization of Knowledge.Keywords: Islamization, Islamicization, releventization, human knowledge
Procedia PDF Downloads 4279793 Impact of Primary Care Telemedicine Consultations On Health Care Resource Utilisation: A Systematic Review
Authors: Anastasia Constantinou, Stephen Morris
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Background: The adoption of synchronous and asynchronous telemedicine modalities for primary care consultations has exponentially increased since the COVID-19 pandemic. However, there is limited understanding of how virtual consultations influence healthcare resource utilization and other quality measures including safety, timeliness, efficiency, patient and provider satisfaction, cost-effectiveness and environmental impact. Aim: Quantify the rate of follow-up visits, emergency department visits, hospitalizations, request for investigations and prescriptions and comment on the effect on different quality measures associated with different telemedicine modalities used for primary care services and primary care referrals to secondary care Design and setting: Systematic review in primary care Methods: A systematic search was carried out across three databases (Medline, PubMed and Scopus) between August and November 2023, using terms related to telemedicine, general practice, electronic referrals, follow-up, use and efficiency and supported by citation searching. This was followed by screening according to pre-defined criteria, data extraction and critical appraisal. Narrative synthesis and metanalysis of quantitative data was used to summarize findings. Results: The search identified 2230 studies; 50 studies are included in this review. There was a prevalence of asynchronous modalities in both primary care services (68%) and referrals from primary care to secondary care (83%), and most of the study participants were females (63.3%), with mean age of 48.2. The average follow-up for virtual consultations in primary care was 28.4% (eVisits: 36.8%, secure messages 18.7%, videoconference 23.5%) with no significant difference between them or F2F consultations. There was an average annual reduction of primary care visits by 0.09/patient, an increase in telephone visits by 0.20/patient, an increase in ED encounters by 0.011/patient, an increase in hospitalizations by 0.02/patient and an increase in out of hours visits by 0.019/patient. Laboratory testing was requested on average for 10.9% of telemedicine patients, imaging or procedures for 5.6% and prescriptions for 58.7% of patients. When looking at referrals to secondary care, on average 36.7% of virtual referrals required follow-up visit, with the average rate of follow-up for electronic referrals being higher than for videoconferencing (39.2% vs 23%, p=0.167). Technical failures were reported on average for 1.4% of virtual consultations to primary care. When using carbon footprint estimates, we calculate that the use of telemedicine in primary care services can potentially provide a net decrease in carbon footprint by 0.592kgCO2/patient/year. When follow-up rates are taken into account, we estimate that virtual consultations reduce carbon footprint for primary care services by 2.3 times, and for secondary care referrals by 2.2 times. No major concerns regarding quality of care, or patient satisfaction were identified. 5/7 studies that addressed cost-effectiveness, reported increased savings. Conclusions: Telemedicine provides quality, cost-effective, and environmentally sustainable care for patients in primary care with inconclusive evidence regarding the rates of subsequent healthcare utilization. The evidence is limited by heterogeneous, small-scale studies and lack of prospective comparative studies. Further research to identify the most appropriate telemedicine modality for different patient populations, clinical presentations, service provision (e.g. used to follow-up patients instead of initial diagnosis) as well as further education for patients and providers alike on how to make best use of this service is expected to improve outcomes and influence practice.Keywords: telemedicine, healthcare utilisation, digital interventions, environmental impact, sustainable healthcare
Procedia PDF Downloads 579792 Rural-Urban Knowledge Transfer: Directions and Outcomes
Authors: J. Banski
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Regardless of residence place, the type of business and the social system, an individual or groups of people use the accumulated knowledge and continuously deepen and expand its scope. Knowledge is needed by human beings to carry out certain tasks, achieve desired goals or make decisions. Knowledge is an attribute of the people of a region and is identified with the total experience and information that its residents and institutions possess, including the ability to use it. It is subject to constant development, which is the result of both the deepening and exchange of knowledge among the residents of a particular area, as well as the influx of knowledge with newly arriving residents. A good example of the aforementioned processes is in rural areas, where we are dealing with two basic groups of people between whom knowledge transfer takes place. The first group is made up of people who have lived in the village for a long time, while the second group is made up of people who migrate temporarily or permanently to the countryside. The English-language literature uses the terms oldtimers and newcomers for these groups, respectively. Newcomers, usually possessing different life experiences, cultural patterns and competencies, can be rich sources of knowledge for villagers. At the same time, the latter, with different knowledge and experience, along with knowledge of local conditions and customs, can also be an important source of knowledge for incomers to the countryside. The countryside is a particularly interesting environment for studying social interactions and the accompanying transfer of knowledge. This is because it is characterized by a high intensity of neighborly contact and a high level of trust in the private sphere. As a result of the migratory influx of new residents, the social and cultural image of the countryside is changing due to the interpenetration of urban and rural life patterns. Research on rural-urban knowledge transfer is both an opportunity to halt negative trends in the social and economic development of rural areas and support the establishment of a basis for rural renewal. This paper discusses the results of research on urban-rural knowledge transfer based on case studies carried out in a dozen villages from different regions of Poland. Their purpose was to answer three basic research questions: 1) what types of knowledge are transferred between urban and rural residents? 2) what are the main directions and intensity in knowledge transfer? And 3) what are the consequences of knowledge transfer between urban and rural residents?Keywords: rural areas, villages, newcomers, knowledge transfer, Poland
Procedia PDF Downloads 699791 Towards Value-Based Healthcare through a Nursing Sector Management Approach
Authors: Hadeer Hegazy, Wael Ewieda, Ranin Soliman, Samah Elway, Asmaa Tawfik, Ragaa Sayed, Sahar Mousa
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The current healthcare system is facing major challenges in terms of cost, quality of care, and access to services. In response, the concept of value-based healthcare has emerged as a new approach to healthcare delivery. This concept puts the focus on patient values rather than on the traditional medical model of care. To achieve this, healthcare organizations must be agile and able to anticipate and respond quickly to changing needs. Agile management is essential for healthcare organizations to achieve value-based care, as it allows them to rapidly adjust their strategies to changing circumstances. Additionally, it is argued that agile management can help healthcare organizations gain a better understanding of the needs of their patients and develop better care delivery models. Besides, it can help healthcare organizations develop new services, innovate, and become more efficient. The authors provide evidence to support their argument, drawing on examples from successful value-based healthcare initiatives at children’s cancer hospital Egypt-57357. The paper offers insight into how agile management can be used to facilitate the shift towards value-based healthcare and how it can be used to maximize value in the healthcare system.Keywords: value-based healthcare, agility in healthcare, nursing department, patients outcomes
Procedia PDF Downloads 7679790 Actual Nursing Competency among Nurses in Hospital in Vietnam
Authors: Do Thi Ha, Khanitta Nuntaboot
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Background: Competency of nurses is vital to safe nursing practice as well as essential component to drive quality of nursing services. There exists little up to date information concerning actual competency among Vietnamese nurses. Purposes: The purpose of this study is to identify the actual nursing competency among nurses in clinical settings in Vietnam. Methods: A qualitative study, ethnographic method, comprised of the participant-observation, in-depth interview, and focus group discussion with multidisciplinary groups of nurses employing in Cho Ray hospital, Vietnam, managers/administrators, nurse teachers, medical doctors, other health care providers, patients and family members which derived from purposeful sampling technique. Content analysis was used for data analysis. Results: Five essential themes of nursing competencies among nurses were identified include (1) knowledge, (2) skills, (3) attitude and value-based nursing practice, (4) legal and ethical competencies, and (5) transcultural competencies. Basic and advanced knowledge were identified as further two dimensions of knowledge. There were five sub themes identified as further dimensions of skills include technical skills, communication skills, organizing and management skills, teamwork and interrelationship, and critical thinking skills. Conclusions: The findings from this study provide valuable information and understanding of the actual competency among nurses in clinical settings in Vietnam. It is expected that this understanding would assist in developing a guide to nursing education and training, nursing practice and relevant policy regulation used for promoting nursing competency among nurses.Keywords: ethnographic method, nursing competency, qualitative design, Vietnam
Procedia PDF Downloads 2859789 Evaluation of Health Services after Emergency Decrees in Turkey
Authors: Sengul Celik, Alper Ketenci
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In Turkish Constitution about health care in Article 56, it is said that: everyone has the right to live in a healthy and balanced environment. It is the duty of the state and citizens to improve the environment, protect environmental health, and prevent environmental pollution. The state ensures that everyone lives their lives in physical and mental health; it organizes the planning and service of health institutions from a single source in order to realize cooperation by increasing savings and efficiency in human and substance power. The state fulfills this task by utilizing and supervising health and social institutions in the public and private sectors. General health insurance can be established by law for the widespread delivery of health services. To have health care is one of the basic rights of patients. After the coupe attempt in July 2016, the Government of Turkey has announced a state of emergency and issued lots of emergency decrees. By these emergency decrees, lots of people were dismissed from their jobs and lost their some basic social rights. The violations occur in social life. One of the most common observations is the discrimination by government in health care system. This study aims to put forward the violation of human rights in health care system in Turkey due to their discriminated position by an emergency decree. The study is a case study that is based on nine interviews with the people or relatives of people who lost their jobs by an emergency decree in Turkey. In this study, no personally identifiable information was obtained for the safety of individuals. Also no distinctive questions regarding the identity of individuals were asked. The interviews are obtained through internet call applications. The data were analyzed through the requirements of regular health care system in Turkey. The interviews expose that the people or the relatives of people lost their right to have regular health care. They have to pay extra amount both in clinical services and in medication treatment. The patient right to quality medical care without prejudice is violated. It was assessed that the people who are involved in emergency decree and their relatives are discriminated by government and deprived of regular medical care and supervision. Although international legal arrangements and legal responsibilities of the state have been put forward by Article 56, they are violated in practice. To prevent these kinds of violations, some measures should be taken against the deprivation in health care system especially towards the discriminated people by an emergency decree.Keywords: emergency decree in Turkey, health care, discriminated people, patients rights
Procedia PDF Downloads 1099788 Existential Suffering in the Daily Lives of Those Living with Palliative Care Needs Arising from Chronic Obstructive Pulmonary Disease
Authors: Louise Elizabeth Bolton
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Statement of the problem: There are an estimated 328 million cases of COPD worldwide. It is likely to become the third biggest cause of death by 2030. The impact of living with palliative care needs arising from COPD disrupts an individual’s existential situation. Understandings of individuals' existential situations within COPD are limited within the research literature and are rarely addressed within clinical practice, yet existential suffering has been linked to poor health-related quality of life for those living with other chronic conditions. The purpose of this integrative review is to provide a synthesis of existing evidence on existential suffering for those living with palliative care needs arising from COPD. Methods: This is an integrative review undertaken in accordance with PRISMA guidelines. Nine electronic databases were searched from April 2019 to January 2021. Thirty-five empirical research papers of both qualitative and quantitative methodologies, alongside systematic literature reviews, were included. Data analysis was undertaken using an integrative thematic analysis approach. Findings: Identified themes of existential suffering when living with palliative care needs arising from COPD are as follows: Liminality, Lamented Life, Loss of Personal Liberty, Life Meaning and Existential isolation. The absence of life meaning and purpose was of most importance to patients. Conclusion and Significance: This integrative review provides a synthesis of international evidence upon the presence of existential suffering. It is present and of significant impact within the daily lives of those living with palliative care needs arising from COPD. The absence of life meaning has the most significant impact, requiring further exploration of both its physical and psychological impact. Rediscovery of life meaning diminishes feelings of worthlessness and hopelessness in daily life and facilitates feelings of inner peace. For those with COPD living with such a relentless symptom burden, a positive existential situation is desirable.Keywords: palliative care, COPD, existential suffering, end of life care
Procedia PDF Downloads 135