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BMC Health Services Research

Pia Cecilie Bing-Jonsson, Paul Slater, Brendan McCormack, Lisbeth Fagerström
BACKGROUND: Person-centred health care has widespread recognition, but there are few instruments aimed at measuring the provision of person-centred practice among health care professionals across a range of settings. The Person-centred Practice Inventory - Staff (PCPI-S) is a new instrument for this purpose, theoretically aligned with McCormack & McCance's person-centred framework, which has been translated and culturally adapted into Norwegian. METHODS: The study used a two-stage research design involving: translation and cultural adaption of the PCPI-S from English to Norwegian language (phase 1), and a quantitative cross sectional survey following psychometric evaluation (phase 2)...
July 16, 2018: BMC Health Services Research
Elizabeth Aylett, Nicola Small, Peter Bower
BACKGROUND: Anxiety disorders are common, yet treatment options in general practice are often limited to medication or CBT. There is a lack of evidence for the effectiveness of exercise in the treatment of anxiety in patients who present to general practice and also about the intensity of exercise required to lead to improvement. The aim of this systematic review was to assess the use of exercise versus waiting list control groups in the treatment of anxiety and also to assess the benefit of high intensity exercise vs low intensity exercise...
July 16, 2018: BMC Health Services Research
Sayem Ahmed, Md Zahid Hasan, Mohammad Wahid Ahmed, Farzana Dorin, Marufa Sultana, Ziaul Islam, Andrew J Mirelman, Clas Rehnberg, Jahangir A M Khan, Mahbub Elahi Chowdhury
BACKGROUND: Rapidly increasing healthcare costs and the growing burden of non-communicable diseases have increased the out-of-pocket (OOP) spending (63.3% of total health expenditure) in Bangladesh. This increasing OOP spending for healthcare has catastrophic economic impact on households. To reduce this burden, the Health Economics Unit (HEU) of the Ministry of Health and Family Welfare has developed the Shasthyo Surokhsha Karmasuchi (SSK) health protection scheme for the below-poverty line (BPL) population...
July 16, 2018: BMC Health Services Research
Ann Mari Gransjøen, Siri Wiig, Kristin Bakke Lysdahl, Bjørn Morten Hofmann
BACKGROUND: Diagnostic imaging has been a part of medicine for the last century. It has been difficult to implement guidelines in this field, and unwarranted imaging has been a frequent problem. Some work has been done to explain these phenomena separately. Identifying the barriers to and facilitators of guideline use has been one strategy. The aim of this study is to offer a more comprehensive explanation of deviations from the guideline by studying the two phenomena together. METHODS: Eight general practitioners and 10 radiologists from two counties in Norway agreed to semi-structured interviews...
July 16, 2018: BMC Health Services Research
Ian Couper, Sunanda Ray, Duane Blaauw, Gideon Ng'wena, Lucy Muchiri, Eren Oyungu, Akinyinka Omigbodun, Imran Morhason-Bello, Charles Ibingira, James Tumwine, Daphney Conco, Sharon Fonn
BACKGROUND: Africa's health systems rely on services provided by mid-level health workers (MLWs). Investment in their training is worthwhile since they are more likely to be retained in underserved areas, require shorter training courses and are less dependent on technology and investigations in their clinical practice than physicians. Their training programs and curricula need up-dating to be relevant to their practice and to reflect advances in health professional education. This study was conducted to review the training and curricula of MLWs in Kenya, Nigeria, South Africa and Uganda, to ascertain areas for improvement...
July 16, 2018: BMC Health Services Research
Luigi Lepore, Concetta Metallo, Francesco Schiavone, Loris Landriani
BACKGROUND: The effective adoption and use of digital and computerized systems and records in hospitals are crucial for increasing the overall quality, safety and outcomes of any national health community. Prior research found that hospitals' dominant cultural orientation affects the adoption of new technology. However, the organizational culture of hospitals can greatly vary between public and private hospitals. Thus, the ownership type of the hospital is likely to affect, to some extent, the aforementioned relationship between culture and information system success...
July 16, 2018: BMC Health Services Research
Tim Luckett, Jane Phillips, Meera Agar, Lawrence Lam, Patricia M Davidson, Nicola McCaffrey, Frances Boyle, Tim Shaw, David C Currow, Alison Read, Annmarie Hosie, Melanie Lovell
BACKGROUND: Pain is a common and distressing symptom in people with cancer, but is under-recognised and under-treated. Australian guidelines for 'Cancer Pain Management in Adults' are available on the Cancer Council Australia Cancer Guideline Wiki. This study aims to evaluate the effectiveness and cost-effectiveness of a suite of guideline implementation strategies for improving pain outcomes in adults with cancer in oncology and palliative care outpatient settings. METHODS: The study will use a stepped-wedge cluster randomised controlled design, with oncology and palliative care outpatient services as the clusters...
July 16, 2018: BMC Health Services Research
May McCreaddie, Bethan Benwell, Alice Gritti
BACKGROUND: Research on patients' complaints about healthcare has tended to focus on the typology of complaints and complainants to homogenise complaints and better understand safety implications. Nonetheless, complaints speak to a broader spectrum of harm and suffering that go beyond formal adverse events. Complaints about care episodes can take considerable time and effort, generate negative energy and may leave a dogged 'minority' embittered. METHODS: This study provides an overview of the process and rhetoric of how patients formulate written complaints...
July 16, 2018: BMC Health Services Research
Jongnam Hwang
BACKGROUND: To ensure equal access to necessary care regardless of an individual's socioeconomic status, it is crucial to understand the factors that act as barriers. Unmet health care needs can arise for a variety of complex reasons, including personal choice, financial barriers, or lack of services, and each of these reasons requires a different policy approach. Researchers have advocated for a more granular measure of unmet health care need for better policy implication. This study aimed to assess various factors associated with different types of unmet health care needs in Korea...
July 16, 2018: BMC Health Services Research
Puikwan A Lee, Geva Greenfield, Yannis Pappas
BACKGROUND: There is a growing body of evidence that supports the uses of telehealth to monitor and manage people with diabetes at a distance. Despite this, the uptake of telehealth has been low. The objective of this study is to explore patients' perceptions of using telehealth for type 2 diabetes management. METHODS: Semi-structured interviews were undertaken with 10 patients from the NHS Newham area in London, UK. Data were collected using recorded semi-structured interviews...
July 13, 2018: BMC Health Services Research
Maria Schubert, Roger Schürch, Soenke Boettger, David Garcia Nuñez, Urs Schwarz, Dominique Bettex, Josef Jenewein, Jasmina Bogdanovic, Marina Lynne Staehli, Rebecca Spirig, Alain Rudiger
BACKGROUND: Delirium is a well-known complication in cardiac surgery and intensive care unit (ICU) patients. However, in many other settings its prevalence and clinical consequences are understudied. The aims of this study were: (1) To assess delirium prevalence in a large, diverse cohort of acute care patients classified as either at risk or not at risk for delirium; (2) To compare these two groups according to defined indicators; and (3) To compare delirious with non-delirious patients regarding hospital mortality, ICU and hospital length of stay, nursing hours and cost per case...
July 13, 2018: BMC Health Services Research
Caroline Trillingsgaard Mejdahl, Liv Marit Valen Schougaard, Niels Henrik Hjollund, Erik Riiskjær, Kirsten Lomborg
BACKGROUND: Patient-reported outcome (PRO)-based follow-up is a new model of service delivery, where PRO measures are used as the very basis for demand-driven outpatient follow-up in patients with chronic diseases. Adopting the clinicians' perspective, we aimed to explore what happens when PRO-based follow-up is implemented in routine clinical practice. We also aimed to identify organisational mechanisms related to PRO-based follow-up. METHODS: The methodological approach of this interview study is interpretive description, informed by a perspective of critical realism...
July 13, 2018: BMC Health Services Research
Morten Breinholt Søvsø, Sabina Bay Hermansen, Emil Færk, Tim Alex Lindskou, Marc Ludwig, Jørn Munkhof Møller, Jelena Jonciauskiene, Erika Frischknecht Christensen
BACKGROUND: Emergency departments handle a large proportion of acute patients. In 2007, it was recommended centralizing the Danish healthcare system and establishing emergency departments as the main common entrance for emergency patients. Since this reorganization, few studies describing the emergency patient population in this new setting have been carried out and none describing diagnoses and mortality. Hence, we aimed to investigate diagnoses and 1- and 30-day mortality of patients in the emergency departments in the North Denmark Region during 2014-2016...
July 13, 2018: BMC Health Services Research
Bertalan Meskó, Gergely Hetényi, Zsuzsanna Győrffy
Artificial intelligence (AI) has the potential to ease the human resources crisis in healthcare by facilitating diagnostics, decision-making, big data analytics and administration, among others. For this we must first tackle the technological, ethical and legal obstacles.The human resource crisis is widening worldwide, and it is obvious that it is not possible to provide care without workforce. How can disruptive technologies in healthcare help solve the variety of human resource problems? Will technology empower physicians or replace them? How can the medical curriculum, including post-graduate education prepare professionals for the meaningful use of technology? These questions have been growing for decades, and the promise of disruptive technologies filling them is imminent with digital health becoming widespread...
July 13, 2018: BMC Health Services Research
Lulu M Muhe, Nemes Iriya, Felixambrose Bundala, Mary Azayo, Maryam Juma Bakari, Asia Hussein, Theopista John
BACKGROUND: The standard 11-days IMCI (Integrated Management of Childhood Illness) training course (standard IMCI) has faced barriers such as high cost to scale up. Distance learning IMCI training program was developed as an alternative to the standard IMCI course. This article presents the evaluation results of the implementation of distance learning IMCI training program in Tanzania. METHODS: From December 2012 to end of June 2015, a total of 4806 health care providers (HCP) were trained on distance learning IMCI from 1427 health facilities {HF) in 68 districts in Tanzania...
July 13, 2018: BMC Health Services Research
Mamothena Carol Mothupi, Lucia Knight, Hanani Tabana
BACKGROUND: Global strategies recommend a continuum of care for maternal health to improve outcomes and access to care in low and middle income countries (LMICs). South Africa has already set priority interventions along the continuum of care for maternal health, and mandated their implementation at the district health level. However, the approach for monitoring access to this continuum of care has not yet been defined. This review assessed measurement approaches in continuum of care for maternal health among LMICs and their implications for the South African context...
July 11, 2018: BMC Health Services Research
Lisa Huddlestone, Harpreet Sohal, Claire Paul, Elena Ratschen
BACKGROUND: Tobacco smoking is extremely prevalent in people with severe mental illness (SMI) and has been recognised as the main contributor to widening health inequalities in this population. Historically, smoking has been deeply entrenched in the culture of mental health settings in the UK, and until recently, smokefree policies tended to be only partially implemented. However, recent national guidance and the government's tobacco control plan now call for the implementation of complete smokefree policies...
July 11, 2018: BMC Health Services Research
Karen Gardner, Beverly Sibthorpe, Mier Chan, Ginny Sargent, Michelle Dowden, Daniel McAullay
BACKGROUND: Continuous Quality Improvement (CQI) programs have been taken up widely by Indigenous primary health care (PHC) services in Australia and there has been national policy commitment to support this. However, international evidence shows that implementing CQI is challenging, impacts are variable and little is known about the factors that impede or enhance effectiveness. A scoping review was undertaken to explore uptake and implementation in Indigenous PHC, including barriers and enablers to embedding CQI in routine practice...
July 11, 2018: BMC Health Services Research
Eric Sarriot, Reeti Desai Hobson
BACKGROUND: Sustainability is, at least in principle, an important criterion for evaluating global health and development programs. The absence of shared metrics for success or achievements in sustainability is however critically lacking. We propose a simple metric, free of causal inference, which can be used to test different empirical models for the sustainment of health outcomes. METHODS: We follow the suggestion of Chambers and use "sustainment" to refer to the verifiable and measured extent to which a health indicator has evolved over time...
July 11, 2018: BMC Health Services Research
Sarah Svege, Blessings Kaunda, Bjarne Robberstad, Thandile Nkosi-Gondwe, Kamija S Phiri, Siri Lange
BACKGROUND: In malaria endemic countries of sub-Saharan Africa, many children develop severe anaemia due to previous and current malaria infections. After blood transfusions and antimalarial treatment at the hospital they are usually discharged without any follow-up. In the post-discharge period, these children may contract new malaria infections and develop rebound severe anaemia. A randomised placebo-controlled trial in Malawi showed 31% reduction in malaria- and anaemia-related deaths or hospital readmissions among children under 5 years of age given antimalarial drugs for 3 months post-discharge...
July 11, 2018: BMC Health Services Research
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