healthcare delivery

医疗保健服务
  • 文章类型: Journal Article
    背景:在新冠肺炎带来的挑战中,评估印度的医疗质量至关重要,特别是通过患者满意度。
    方法:对查mu和克什米尔的277名参与者进行了横断面调查,利用半结构化问卷和PSQ-18。使用SPSS(v25)进行数据分析,包括卡方检验和描述性分析。
    结果:在277名参与者中,70.8%的人对医疗服务表示高度满意。大多数人(70%)同意医生对医学检查的解释很好。此外,70%的人强烈同意他们的医生办公室装备精良。不满意因素明显较低。发现年龄与饮酒之间存在显着关联(p=0.041),性别和饮酒(p=0.007),性别和烟草使用(p=0.032),教育水平和疫苗接种(p=0.001)。
    结论:该研究强调了大流行期间患者的高满意度。改善初级卫生保健和社区中心的可及性和质量对于有效满足患者需求至关重要。
    BACKGROUND: Amidst the challenges posed by Covid-19, assessing healthcare quality in India is crucial, particularly through patient satisfaction levels.
    METHODS: A cross-sectional survey of 277 participants in Jammu and Kashmir was conducted, utilizing a semi-structured questionnaire and PSQ-18. Data analysis was performed using SPSS (v25) including Chi-Square tests and Descriptive analysis.
    RESULTS: Out of 277 participants, 70.8% expressed high satisfaction with medical care. Majority (70%) agreed that doctors explained medical tests well. Additionally, 70% strongly agreed that their doctor\'s office was well-equipped. Dissatisfaction factors were notably low. Significant associations were found between age and alcohol use (p = 0.041), gender and alcohol use (p = 0.007), gender and tobacco use (p = 0.032), and education level and vaccination (p = 0.001).
    CONCLUSIONS: The study highlights high patient satisfaction during the pandemic. Improving accessibility and quality of primary healthcare and community centres is essential to meet patient needs effectively.
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  • 文章类型: Journal Article
    背景:全球,文化和语言多样化(CALD)的人口正在增加,预计到2050年将达到4.05亿。由于文化原因,为CALD人群提供紧急护理可能会很复杂,社会,语言因素。文化的程度,社会,目前尚不清楚背景因素对来自CALD背景的患者在整个急诊护理过程中的护理交付的影响。使用系统的方法,这篇综述旨在绘制现有证据,为来自CALD背景的患者提供紧急医疗服务,并使用社会生态框架提供更广泛的文化视角。社会,以及情境对急诊护理服务的影响。
    方法:将使用JoannaBriggsInstitute(JBI)范围审查方法来指导本次审查。人口是来自CALD背景的患者,他们接受了护理,并提供了直接护理的急诊护理临床医生。该概念是从CALD背景向患者提供医疗保健。背景是紧急护理。这项审查将包括定量,定性,和混合方法研究从2012年1月1日起以英文发表。搜索将在CINAHL(EBSCO)的数据库中进行,MEDLINE(Ovid),Embase(Elsevier),Socindex(EBSCO),Scopus(Elsevier),和谷歌学者的网络搜索。PRISMA(系统审查和荟萃分析的首选报告项目)流程图将用于介绍搜索决策过程。所有包含的文章将使用混合方法评估工具(MMAT)进行评估。数据将以表格形式呈现,并附有文献的叙述性综合。
    结论:尽管来自CALD背景的患者越来越多地使用急诊护理服务,在急诊护理背景(ED和院前设置)中,没有对来自CALD背景的患者的医疗保健交付进行全面审查,包括考虑文化,社会,和上下文的影响。此范围审查的结果可用于为未来的研究和策略提供信息,这些研究和策略旨在为需要紧急护理的来自CALD背景的人提供护理服务和经验。
    背景:此范围审查已在OpenScienceFrameworkhttps://doi.org/10.17605/OSF中注册。IO/HTMKQ。
    BACKGROUND: Worldwide, the culturally and linguistically diverse (CALD) population is increasing, and is predicted to reach 405 million by 2050. The delivery of emergency care for the CALD population can be complex due to cultural, social, and language factors. The extent to which cultural, social, and contextual factors influence care delivery to patients from CALD backgrounds throughout their emergency care journey is unclear. Using a systematic approach, this review aims to map the existing evidence regarding emergency healthcare delivery for patients from CALD backgrounds and uses a social ecological framework to provide a broader perspective on cultural, social, and contextual influence on emergency care delivery.
    METHODS: The Joanna Briggs Institute (JBI) scoping review methodology will be used to guide this review. The population is patients from CALD backgrounds who received care and emergency care clinicians who provided direct care. The concept is healthcare delivery to patients from CALD backgrounds. The context is emergency care. This review will include quantitative, qualitative, and mixed-methods studies published in English from January 1, 2012, onwards. Searches will be conducted in the databases of CINAHL (EBSCO), MEDLINE (Ovid), Embase (Elsevier), SocINDEX (EBSCO), Scopus (Elsevier), and a web search of Google Scholar. A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flow diagram will be used to present the search decision process. All included articles will be appraised using the Mixed Methods Appraisal Tool (MMAT). Data will be presented in tabular form and accompanied by a narrative synthesis of the literature.
    CONCLUSIONS: Despite the increased use of emergency care service by patients from CALD backgrounds, there has been no comprehensive review of healthcare delivery to patients from CALD backgrounds in the emergency care context (ED and prehospital settings) that includes consideration of cultural, social, and contextual influences. The results of this scoping review may be used to inform future research and strategies that aim to enhance care delivery and experiences for people from CALD backgrounds who require emergency care.
    BACKGROUND: This scoping review has been registered in the Open Science Framework https://doi.org/10.17605/OSF.IO/HTMKQ.
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  • 文章类型: Journal Article
    背景:尽管美国预防服务工作组建议对成年人进行不健康的饮酒筛查,在初级保健中,酒精筛查的实施仍然不够理想.
    方法:实施前和实施后的研究设计,从2021年10月至2022年6月,在印第安纳波利斯的一家为少数民族和贫困成年人服务的大型初级保健诊所,使用敏捷实施过程来增加对成年患者不健康饮酒的筛查。
    结果:与0%的基线筛查率相比,使用酒精使用障碍识别测试-消费工具(AUDIT-C),敏捷的实施过程增加并持续超过80%的酒精使用筛查率。
    结论:使用敏捷实施过程,我们成功实施了基于证据的建议,以筛查初级保健中的不健康饮酒.
    BACKGROUND: Despite the United States Preventive Services Task Force recommendation to screen adults for unhealthy alcohol use, the implementation of alcohol screening in primary care remains suboptimal.
    METHODS: A pre and post-implementation study design that used Agile implementation process to increase screening for unhealthy alcohol use in adult patients from October 2021 to June 2022 at a large primary care clinic serving minority and underprivileged adults in Indianapolis.
    RESULTS: In comparison to a baseline screening rate of 0%, the agile implementation process increased and sustained screening rates above 80% for alcohol use using the Alcohol Use Disorders Identification Test - Consumption tool (AUDIT-C).
    CONCLUSIONS: Using the agile implementation process, we were able to successfully implement evidence-based recommendations to screen for unhealthy alcohol use in primary care.
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  • 文章类型: Journal Article
    为了研究多囊卵巢综合征(PCOS)对工作相关损害的影响,并探讨与种族的关系,心理健康,和医疗保健服务指数。
    一项基于互联网的横断面调查。
    2022年8月至2022年10月期间患有PCOS的北美女性。
    自我报告诊断为PCOS的个体。
    不适用。
    主要结果是由于PCOS导致的误工。次要结果包括休假,对工作质量的影响,以及由于PCOS而被推迟工作的感觉。
    在1,105名受访者中,1,058例报告由医生诊断为PCOS。在这个群体中,50.4%的人报告因为PCOS而缺工,72%的人认为PCOS影响了他们的工作质量,51.5%的人感到工作受到PCOS的阻碍。多变量分析显示,由于PCOS而缺工与黑人种族独立相关,缺乏保险,需要多个医生进行PCOS诊断,需要≥3名医生进行当前护理,对护理的满意度下降,还有焦虑和抑郁的症状.
    多囊卵巢综合征显著影响就业相关生产力。种族等因素,心理健康,医疗保健服务似乎在这种影响的程度中起着至关重要的作用。
    UNASSIGNED: To study the impact of polycystic ovary syndrome (PCOS) on work-related impairments and explore relationships with race, mental health, and healthcare delivery indices.
    UNASSIGNED: A cross-sectional internet-based survey.
    UNASSIGNED: North American women with PCOS between August 2022 and October 2022.
    UNASSIGNED: Individuals with a self-reported diagnosis of PCOS.
    UNASSIGNED: Not applicable.
    UNASSIGNED: The primary outcome was missed work because of PCOS. The secondary outcomes included leave from work, impacts on the quality of work, and feelings of being held back at work because of PCOS.
    UNASSIGNED: Of 1,105 respondents, 1,058 reported having PCOS diagnosed by a physician. Of this group, 50.4% reported missing work because of PCOS, 72% felt that PCOS impacted the quality of their work, and 51.5% felt held back at work by PCOS. Multivariate analyses revealed that missing work because of PCOS was independently associated with black race, lack of insurance, requiring multiple doctors for a PCOS diagnosis, needing ≥3 doctors for current care, decreased satisfaction with care, and symptoms of anxiety and depression.
    UNASSIGNED: Polycystic ovary syndrome significantly impacts employment-related productivity. Factors such as race, mental health, and healthcare delivery appear to play a crucial role in the extent of this impact.
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  • 文章类型: Journal Article
    尽管对2019年冠状病毒病(COVID-19)对患者医疗保健观念的影响知之甚少,提高理解可以指导医疗保健提供者充分解决患者的担忧。这项横断面研究调查了COVID-19引起的恐惧如何影响肾结石患者的认知,决策,以及对护理服务的偏好。
    利用对COVID-19量表(FCV-19S)的有效恐惧,在部分COVID-19大流行期间,在一家结石诊所对患者进行了调查,03/2021-04/2022。单因素方差分析(ANOVA)卡方检验,和多项逻辑回归评估了社会人口统计对反应的影响。
    完成了两百四次调查。平均年龄58±16岁,112名(54.9%)为女性。平均FCV-19S为14.8±5.8点(范围,7-33).女性和非高加索种族与较高的恐惧得分相关(分别为P<0.01和P=0.01)。预防结石的努力与恐惧无关(P=0.38)。自我评估的健康状况较差与预防结石的努力增加有关(P=0.04)。据报道,89%的患者倾向于亲自护理。寻求护理的意愿因年龄和教育而异,中年患者寻求治疗的可能性降低(P=0.04),受教育程度增加(P=0.01)。
    COVID-19大流行期间的恐惧在肾结石患者中变化很大,女性和非高加索人的恐惧得分更高。在大流行期间寻求护理的意愿随年龄而变化,教育水平,症状严重程度,COVID-19恐惧,目前的石头状态,和健康状况。在COVID-19期间,结石患者更喜欢面对面医疗,而不是远程医疗。未来的研究需要进一步评估这些健康差异,恐惧的差异,以及寻求与石头相关的医疗保健的安慰,以帮助我们更好地告知卫生政策制定者并提供以患者为中心的护理。
    UNASSIGNED: Although minimal is known about coronavirus disease 2019 (COVID-19)\'s impact on patient healthcare perceptions, improved understanding can guide healthcare providers to adequately address patient concerns. This cross-sectional study investigated how fear induced by COVID-19 impacted nephrolithiasis patients\' perceptions, decision-making, and preferences for care delivery.
    UNASSIGNED: Utilizing the validated Fear of COVID-19 Scale (FCV-19S), patients were surveyed at a single stone clinic during part of the COVID-19 pandemic, 03/2021-04/2022. One-way analysis of variance (ANOVA), Chi-square tests, and multinomial logistic regression evaluated the effect of sociodemographics on responses.
    UNASSIGNED: Two hundred and four surveys were completed. Mean age was 58±16 years, and 112 (54.9%) were women. Mean FCV-19S was 14.8±5.8 points (range, 7-33). Women and non-Caucasian races were associated with higher fear scores (P<0.01 and P=0.01 respectively). Stone prevention effort was not associated with fear (P=0.38). Poorer self-assessed health status was associated with increased stone prevention efforts (P=0.04). Preference for in-person care was reported in 89% of patients. Willingness to seek care varied by age and education, with decreased likelihood to seek care for middle-aged patients (P=0.04) and increased education (P=0.01).
    UNASSIGNED: Perceived fear during the COVID-19 pandemic was highly variable in nephrolithiasis patients, with higher fear scores in women and non-Caucasians. Willingness to seek care during the pandemic varied with age, education level, symptom severity, COVID-19 fear, current stone status, and health status. Stone patients greatly preferred in-person medical care over telemedicine during COVID-19. Future studies are needed to further evaluate these health disparities, discrepancies in fear, and comfort in seeking stone-related healthcare to help us better inform health policymakers and provide patient-centered care.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    本研究旨在探讨医疗保健专业人员如何看待法语提供的家庭儿科癌症护理。
    使用对22名医疗保健专业人员的半定向个人访谈进行了定性描述性研究。研究小组的两名成员独立对转录访谈进行了主题分析。
    小儿癌症护理在魁北克很容易用法语提供,但在安大略省获得法语服务的机会有限。本文讨论了这种缺乏途径的可能原因和影响以及潜在的解决方案。
    应考虑本研究中汇编的观点,以帮助提供高质量的法语家庭儿科癌症护理。
    UNASSIGNED: This study aims to explore how healthcare professionals perceive home-based pediatric cancer care provided in French.
    UNASSIGNED: A qualitative descriptive study was conducted using semi-directed individual interviews of 22 healthcare professionals. A thematic analysis of the transcribed interviews was carried out independently by two members of the research team.
    UNASSIGNED: Pediatric cancer care is readily available in French in Quebec, but access to French-language services in Ontario is limited. The possible causes and effects of this lack of access and potential solutions are discussed in this paper.
    UNASSIGNED: The perceptions compiled in this study should be taken into account to help provide quality home-based pediatric cancer care in French.
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  • 文章类型: Journal Article
    背景:尽管基于社区的健康规划和服务(CHPS)政策自1990年代中期在加纳成立以来取得了成功,有关SefwiWiawso市政CHPS设施的实施和使用的数据很少。我们评估了SefwiWiawso市的医疗保健服务和影响CHPS使用的因素。
    方法:于2020年9月至10月在SefwiWiawo市进行了一项基于社区的分析性横断面研究。该研究的受访者是通过多阶段抽样招募的。收集了有关其社会人口特征的信息,通过使用结构化的预测试问卷进行访谈,了解和使用CHPS设施。使用单变量和多变量逻辑回归评估影响CHPS设施使用的因素,以产生具有95%置信区间(CI)的粗比值比和调整后的比值比(OR)。P≤0.05被认为具有统计学意义。
    结果:共招募了483名调查对象。被调查者平均年龄为43.0±16.3岁,超过70%是女性或与伴侣结婚/同居。大多数受访者(88.2%)了解CHPS概念,超过一半(53.4%)在CHPS设施中获得医疗保健。大多数受访者对卫生服务质量(>65%)和工作人员态度(77.2%)的评价非常积极。影响CHPS设施使用的重要因素是:了解CHPS概念(AOR6.57,95%CI1.57-27.43;p=0.01),车辆到达设施的等待时间更长,以及在提供护理之前在设施的等待时间更短。等待30-60分钟(AOR2.76,95%CI1.08-7.07;p=0.01)或超过一小时(AOR10.91,95%CI3.71-32.06;p=0.01)的人,而在接受护理前在CHPS机构等待少于30分钟(AOR5.74,95%CI1.28-25.67;p=0.03)或30-60分钟(AOR2.60,95%CI0.57-11.78;p=0.03)的患者更有可能在CHPS机构获得护理。
    结论:知识,在该人群中,CHPS设施的医疗保健服务使用率很高。旨在减少CHPS设施等待时间的干预措施可以大大增加这些设施对医疗保健服务的使用。
    BACKGROUND: In spite of the successes of the community-based health planning and services (CHPS) policy since its inception in the mid-1990s in Ghana, data pertaining to the implementation and use of CHPS facilities in Sefwi Wiawso Municipal is scant. We assessed access to healthcare delivery and factors influencing the use of CHPS in Sefwi Wiawso Municipal.
    METHODS: An analytical community-based cross-sectional study was conducted in the Sefwi Wiawo Municipal from September to October 2020. Respondents for the study were recruited through multi-stage sampling. Information was collected on their socio-demographic characteristics, knowledge and use of CHPS facilities through interviews using a structured pre-tested questionnaire. Factors influencing the use of CHPS facilities were assessed using univariable and multivariable logistic regression to generate crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs). P ≤ 0.05 was considered statistically significant.
    RESULTS: A total of 483 respondents were recruited for the study. The mean age of the respondents was 43.0 ± 16.3 years, and over 70% were females or married/cohabiting with their partners. Most respondents (88.2%) knew about the CHPS concept and more than half (53.4%) accessed healthcare in the CHPS facilities. Most respondents rated the quality of health services (> 65%) and staff attitude (77.2%) very positively. Significant factors influencing the use of the CHPS facilities were; knowledge of the CHPS concept (AOR 6.57, 95% CI 1.57-27.43; p = 0.01), longer waiting time for a vehicle to the facility, and shorter waiting time at the facility before being provided with care. People who waited for 30-60 min (AOR 2.76, 95% CI 1.08-7.07; p = 0.01) or over an hour (AOR 10.91, 95% CI 3.71-32.06; p = 0.01) before getting a vehicle to the facility, while patients who waited for less than 30 min (AOR 5.74, 95% CI 1.28-25.67; p = 0.03) or 30-60 min (AOR 2.60, 95% CI 0.57-11.78; p = 0.03) at the CHPS facility before receiving care were more likely to access care at the CHPS facilities.
    CONCLUSIONS: Knowledge, and use of healthcare services at the CHPS facilities were high in this population. Interventions aimed at reducing waiting time at the CHPS facilities could greatly increase use of healthcare services at these facilities.
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  • 文章类型: Journal Article
    这项研究调查了印度东北部COVID-19幸存者的患者满意度,出于幸存者独特的长期医疗保健需求以及患者满意度在评估和提高医疗保健质量方面的关键作用。通过关注这个开发不足的地区,该研究旨在发现可以指导在类似情况下改善以患者为中心的护理和医疗服务提供的见解。
    使用简单随机抽样技术进行研究。数据是通过电话采访使用半结构化问卷收集的,包括患者满意度问卷-18(PSQ-18)进行分析。PSQ-18产生了七个代表患者满意度不同维度的子量表得分。采用SPSS软件进行统计分析,总结社会人口学特征,病史,和患者满意度,同时采用描述性和推断性统计数据。
    结果表明,对COVID-19疫苗的接受度很高,大多数参与者都接受了两种剂量。患者对医疗服务的满意度总体上是积极的,特别是在与医患沟通和医疗质量相关的方面。然而,人们对护理的可负担性和及时性感到担忧。各州的地区差异,以及教育和收入等因素,显著影响患者满意度。
    该研究显示,印度东北部的患者满意度总体良好。然而,医疗保健负担能力和及时性方面的挑战仍然存在,受地区差异和社会经济因素的影响。需要有针对性的干预措施来改善该地区的医疗保健。
    UNASSIGNED: This study investigates patient satisfaction among COVID-19 survivors in Northeast India, motivated by the unique long-term healthcare needs of survivors and the critical role of patient satisfaction in assessing and enhancing healthcare quality. By focusing on this underexplored region, the research aims to uncover insights that can guide improvements in patient-centered care and healthcare service delivery in similar contexts.
    UNASSIGNED: The study was conducted using a Simple Random Sampling technique. Data were collected through telephone interviews using a semi-structured questionnaire, including the Patient Satisfaction Questionnaire-18 (PSQ-18) for analysis. The PSQ-18 yielded seven subscale scores representing different dimensions of patient satisfaction. Statistical analysis using SPSS software was conducted to summarize socio-demographic characteristics, medical history, and patient satisfaction levels, employing both descriptive and inferential statistics.
    UNASSIGNED: The results indicated a high acceptance of COVID-19 vaccination, with the majority of participants having received both doses. Patient satisfaction with healthcare services is generally positive, particularly in aspects related to doctor-patient communication and medical care quality. However, there are notable concerns regarding the affordability and timeliness of care. Regional variations across states, as well as factors like education and income, significantly influence patient satisfaction levels.
    UNASSIGNED: The study revealed generally good patient satisfaction levels in Northeast India. However, challenges in healthcare affordability and timeliness persist, influenced by regional disparities and socio-economic factors. Targeted interventions are needed to improve healthcare in the region.
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  • 文章类型: Journal Article
    背景了解新的循证临床干预如何以及何时成为标准实践对于确保医疗保健与最新知识保持一致至关重要。然而,需要严格的方法来确定新的临床实践何时标准化到护理标准。为了解决这个差距,这项研究定性地探讨了如何,when,以及为什么临床实践变化在医疗机构内变得正常化。方法我们使用目的抽样来招募在不同健康环境中从事实施科学工作的临床领导者。注册参与者完成了半结构化访谈。定性数据分析以标准化过程理论(NPT)框架的修订版为指导,以确定突出的主题。已确定的规范化策略已映射到实施变更专家建议(ERIC)项目。结果共有17人接受了访谈。参与者描述了确定新临床实践何时成为新常态的四个关键信号:1)整合到现有工作流程中;2)在整个组织单位中扩展;3)员工的购买和所有权;4)无需持续监控的维持。参与者确定了使新的临床干预措施正常化的重要策略:1)采取患者方法;2)获得员工的支持和所有权;3)对正常化的进展进行持续测量。结论这些结果提供了对指标的有价值的见解,这些指标表示新的临床实践何时变得正常化,以及为促进这一过渡而采用的策略。这些发现可以为未来的研究提供信息,以开发实施领导者可以用来系统地测量临床变更过程的工具。
    UNASSIGNED: Understanding how and when a new evidence-based clinical intervention becomes standard practice is crucial to ensure that healthcare is delivered in alignment with the most up-to-date knowledge. However, rigorous methods are needed to determine when a new clinical practice becomes normalized to the standard of care. To address this gap, this study qualitatively explores how, when, and why a clinical practice change becomes normalized within healthcare organizations.
    UNASSIGNED: We used purposive sampling to recruit clinical leaders who worked in implementation science across diverse health contexts. Enrolled participants completed semi-structured interviews. Qualitative data analysis was guided by a modified version of the Normalization Process Theory (NPT) framework to identify salient themes. Identified normalization strategies were mapped to the Expert Recommendations for Implementation Change (ERIC) project.
    UNASSIGNED: A total of 17 individuals were interviewed. Participants described four key signals for identifying when a novel clinical practice becomes the new normal: 1) integration into existing workflows; 2) scaling across the entire organizational unit; 3) staff buy-in and ownership; and 4) sustainment without ongoing monitoring. Participants identified salient strategies to normalize new clinical interventions: 1) taking a patient approach; 2) gaining staff buy-in and ownership; and 3) conducting ongoing measurement of progress towards normalization.
    UNASSIGNED: The results offer valuable insight into the indicators that signify when a novel clinical practice becomes normalized, and the strategies employed to facilitate this transition. These findings can inform future research to develop instruments that implementation leaders can use to systematically measure the clinical change process.
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