Paradigms in health care and its relationship to the nursing theories: an analytical test

DANTAS, Rodrigo Assis Neves; NÓBREGA, Walkíria Gomes da; MORAIS FILHO, Luiz Alves; MACÊDO, Eurides Araújo Bezerra de ; FONSECA , Patrícia de Cássia Bezerra; ENDERS, Bertha Cruz; MENEZES, Rejane Maria Paiva de; TORRES , Gilson de Vasconcelos. Paradigms in health care and its relationship to the nursing theories: an analytical test . Revista de Enfermagem UFPE on line. v.4,n.2, p.16-24.abr/jun. 2010. Disponível em < http://www.ufpe.br/revistaenfermagem/index.php/revista>.

Effect of Wealth on Health Care Seeking Behavior And Out of Pocket Health Expenditure in Malawi

Thesis (Master's)--University of Washington, 2016-06

Chinese Migrant Workers in Kenya: Their Health Status and Access to Health Care

Thesis (Master's)--University of Washington, 2016-06

Whistleblowing process in Finnish health care

Wrongdoing in health care is harmful action that jeopardizes patient safety and can be targeted at the patient or employees. Wrongdoing can vary from illegal, unethical or unprofessional action to inappropriate behavior in the workplace. Whistleblowing can be considered as a process where wrongdoing is suspected or oberved in health care by health care professionals and disclosed to the party that can influence the wrongful action. Whistleblowing causes severe harm to the whistleblower and to the object of whistleblowing complaint, to their personnel life and working community. The aim of this study was to analyze whistleblowing process in Finnish health care. The overall goal is to raise concern about wrongdoing and whistleblowing in Finnish health care. In this cross-sectional descriptive study the data were collected (n = 397) with probability sampling from health care professionals and members of The Union of Health and Social Care Professionals in Finland Tehy. The data were collected with questionnaire: “Whistleblowing -väärinkäytösten paljastaminen terveydenhuollossa” developed for this study and by using Webropol questionnaire -software during 26.6.-17.7.2015. The data were analyzed statistically. According to the results of this study health care professionals had suspected (67 %) and observed (66 %) wrongdoing in health care, more often than once a month (30%). Mostly were suspected (37 %) and observed (36%) inadequacy of the personnel and least violence toward the patient (3 %). Wrongdoing was whistle blown (suspected 29 %, observed 40 %) primarily inside the organization to the closest supervisor (76 %), face-to-face (88 %). Mostly the whistle was blown on nurses’ wrongdoing (58 %). Whistleblowing act didn’t end the wrongdoing (52 %) and whistleblowing had negative consequences to the whistleblower such as discrimination by the manager (35 %). Respondents with work experience less than ten years (62 %), working in temporary position (75 %) or in management position (88 %) were, more unwilling to blow the whistle. Whistleblowing should be conducted internally, to the closest manager in writing and anonymously. Wrongdoing should be dealt between the parties involved, and written warning should ensue from wrongdoing. According to the results of this study whistleblowing on wrongdoing in health care causes negative consequences to the whistleblower. In future, attention in health care should be paid to preventing wrongdoing and enhancing whistleblowing in order to decrease wrongdoing and lessen the consequences that whistleblowers face after blowing the whistle.

The role of emotions in value creation for families in pediatric health care

The purpose of this study was to analyze emotions related to a child’s critical illness from the perspective of the family and discuss the link those emotions might form with value creation. High quality service is of paramount importance in hospital care, especially when a child is diagnosed with critical illness. Through the analysis of patient family emotions and their triggers, the study was aiming to deepen the understanding of value creation for customer. Therefore, the research sought to find answers to the following three sub-questions: 1. What are the emotions experienced? 2. What triggers them? 3. How are the emotions linked to amelioration or aggravation of value for patient and family? The theoretical background of this research is built on two core concepts: emotions and value creation. As both concepts are wide and multifaceted, the research concentrates on viewing emotions from the applicable cognitive angle, identifying and categorizing emotions in a general level. Value creation is studied from the service perspective, discussing the possible relations between emotions and value creation. Moreover, the suitability of views regarding customer value co-creation to health care encounters is analyzed. Qualitative approach was selected as the most appropriate methodology for conducting the empirical research. The empirical data was collected from public blogs, for which a total of 18 blogs were reviewed. Five blogs were selected for the analysis, which had the intent of identifying the emotions experienced by patient families and deepening the knowledge of their role in value creation during health care service encounters. The empirical study of this research discovered a wide range of positive and negative emotions, which denotes that a severe life situation does not prevent the feeling of positive emotions. Furthermore, by combining the empirical findings to the theoretical background, this study concludes that recognizing and treating the patient family as a partner and value creator is essential. The high quality technical aspect of care is vital, but it is not the sole attribute for service quality, as the interpersonal communication plays a large role in the customer’s overall assessment of the health care performance. The patients and their families largely evaluate the service encounter based on their perceptions, thus emotions play a significant role. Depending on the service experience, value maybe created or destructed. Hence, this study posits emotion at the core of the service encounter, indicating towards the importance of active assessment of customer perceptions and the recognition of the emotional states

Paradigms in health care and its relationship to the nursing theories: an analytical test

DANTAS, Rodrigo Assis Neves; NÓBREGA, Walkíria Gomes da; MORAIS FILHO, Luiz Alves; MACÊDO, Eurides Araújo Bezerra de ; FONSECA , Patrícia de Cássia Bezerra; ENDERS, Bertha Cruz; MENEZES, Rejane Maria Paiva de; TORRES , Gilson de Vasconcelos. Paradigms in health care and its relationship to the nursing theories: an analytical test . Revista de Enfermagem UFPE on line. v.4,n.2, p.16-24.abr/jun. 2010. Disponível em < http://www.ufpe.br/revistaenfermagem/index.php/revista>.

Whistleblowing process in Finnish health care

Wrongdoing in health care is harmful action that jeopardizes patient safety and can be targeted at the patient or employees. Wrongdoing can vary from illegal, unethical or unprofessional action to inappropriate behavior in the workplace. Whistleblowing can be considered as a process where wrongdoing is suspected or oberved in health care by health care professionals and disclosed to the party that can influence the wrongful action. Whistleblowing causes severe harm to the whistleblower and to the object of whistleblowing complaint, to their personnel life and working community. The aim of this study was to analyze whistleblowing process in Finnish health care. The overall goal is to raise concern about wrongdoing and whistleblowing in Finnish health care. In this cross-sectional descriptive study the data were collected (n = 397) with probability sampling from health care professionals and members of The Union of Health and Social Care Professionals in Finland Tehy. The data were collected with questionnaire: “Whistleblowing -väärinkäytösten paljastaminen terveydenhuollossa” developed for this study and by using Webropol questionnaire -software during 26.6.-17.7.2015. The data were analyzed statistically. According to the results of this study health care professionals had suspected (67 %) and observed (66 %) wrongdoing in health care, more often than once a month (30%). Mostly were suspected (37 %) and observed (36%) inadequacy of the personnel and least violence toward the patient (3 %). Wrongdoing was whistle blown (suspected 29 %, observed 40 %) primarily inside the organization to the closest supervisor (76 %), face-to-face (88 %). Mostly the whistle was blown on nurses’ wrongdoing (58 %). Whistleblowing act didn’t end the wrongdoing (52 %) and whistleblowing had negative consequences to the whistleblower such as discrimination by the manager (35 %). Respondents with work experience less than ten years (62 %), working in temporary position (75 %) or in management position (88 %) were, more unwilling to blow the whistle. Whistleblowing should be conducted internally, to the closest manager in writing and anonymously. Wrongdoing should be dealt between the parties involved, and written warning should ensue from wrongdoing. According to the results of this study whistleblowing on wrongdoing in health care causes negative consequences to the whistleblower. In future, attention in health care should be paid to preventing wrongdoing and enhancing whistleblowing in order to decrease wrongdoing and lessen the consequences that whistleblowers face after blowing the whistle.

The importance of environmental sustainability in public procurement of medical devices in health care sector

The aim of this thesis was to examine the role of environmental sustainability in the procurement of medical devices in health care sector. Current literature is mainly focused on other product groups and medical devices have been left without sufficient attention. Nevertheless, EU has recently developed green public procurement criteria for medical devices (EU GPP criteria for health care EEE) in order to support and offer guidelines for purchasers in hospitals. In this study, the criteria were used as a framework in order to examine the most significant environmental aspects for medical devices. The empirical research was executed in Finnish public hospitals with mixed method approach; quantitative data was collected by a survey and qualitative data was collected by interviews held for procurement specialists. The focus was on understanding the importance of environmental sustainability in the procurement of medical devices and which environmentally sustainable features would be the most significant. Of interest was also the medical device supplier view and how they could take environmental sustainability into consideration.

The Political and Social Dynamics of Poverty, Poor Relief and Health Care in Early-Modern Portugal

By the end of the fifteenth century most European countries had witnessed a profound reformation of their poor relief and health care policies. As this book demonstrates, Portugal was among them and actively participated in such reforms. Providing the first English language monograph on this topic, Laurinda Abreu examines the Portuguese experience and places it within the broader European context. She shows that, in line with much that was happening throughout the rest of Europe, Portugal had not only set up a systematic reform of the hospitals but had also developed new formal arrangements for charitable and welfare provision that responded to the changing socioeconomic framework, the nature of poverty and the concerns of political powers. The defining element of the Portuguese experience was the dominant role played by a new lay confraternity, the confraternity of the Misericórdia, created under the auspices of King D. Manuel I in 1498. By the time of the king's death in 1521 there were more than 70 Misericórdias in Portugal and its empire, and by 1640, more than 300. All of them were run according to a unified set of rules and principles with identical social objectives. Based upon a wealth of primary source documentation, this book reveals how the sixteenth-century Portuguese crown succeeded in implementing a national poor relief and health care structure, with the support of the Papacy and local elites, and funded principally through pious donations. This process strengthened the authority of the royal government at a time which coincided with the emergence of the early modern state. In so doing, the book establishes poor relief and public health alongside military, diplomatic and administrative authorities, as the pillars of centralisation of royal power.

Health planning & health services research /

Description based on: Oct. 16, 1979.

Impact of cost sharing on utilization of primary health care Services: providers versus household perspectives

This study is set to match and compare results of the analysis of impacts of cost sharing on households with those on health-care providers in two selected districts in Tanzania. The setting is intended to establish and compare concurrently the impact of cost sharing on health-care utilization as viewed from both the providers and beneficiary households. The findings of the study indicate that quality of primary health care has improved as a result of the introduction of cost sharing. Attendance and hence utilization in health facilities has also increased. Mortality rate, at least for one district has not worsened. By implication then, cost sharing appears to have a positive impact on the provision of primary health care, except for a few cases that fail to consult because of the fees. An appropriately managed exemption facility is likely to eliminate the negative impact.

Representativeness, legitimacy and power in public involvement in health-care management

Public participation in health-service management is an increasingly prominent policy internationally. Frequently, though, academic studies have found it marginalized by health professionals who, keen to retain control over decision-making, undermine the legitimacy of involved members of the public, in particular by questioning their representativeness. This paper examines this negotiation of representative legitimacy between staff and involved users by drawing on a qualitative study of service-user involvement in pilot cancer-genetics services recently introduced in England, using interviews, participant observation and documentary analysis. In contrast to the findings of much of the literature, health professionals identified some degree of representative legitimacy in the contributions made by users. However, the ways in which staff and users constructed representativeness diverged significantly. Where staff valued the identities of users as biomedical and lay subjects, users themselves described the legitimacy of their contribution in more expansive terms of knowledge and citizenship. My analysis seeks to show how disputes over representativeness relate not just to a struggle for power according to contrasting group interests, but also to a substantive divergence in understanding of the nature of representativeness in the context of state-orchestrated efforts to increase public participation. This divergence might suggest problems with the enactment of such aspirations in practice; alternatively, however, contestation of representative legitimacy might be understood as reflecting ambiguities in policy-level objectives for participation, which secure implementation by accommodating the divergent constructions of those charged with putting initiatives into practice.

The Prevalence of Depression among patients and its detection by Primary Health Care Workers at Matawale Health Centre (Zomba)

Background Little information is available on the prevalence of depression in Malawi in primary health care settings and yet there is increased number of cases of depression presenting at tertiary level in severe form. Aim The aim of the study was to determine the prevalence of depression among patients and its detection by health care workers at a primary health care clinic in Zomba. Methods A cross-sectional survey was done among patients attending outpatient department at Matawale Health Centre, in Zomba from 1st July 2009 through to 31st July 2009. A total of 350 adults were randomly selected using systematic sampling. The “Self Reporting Questionnaire”, a questionnaire measuring social demographic factors and the Structured Clinical Interview for DSM-IV Axis I disorders Non-Patient Version (SCID-NP) were administered verbally to the participants. Findings The prevalence of depression among the patients attending the outpatients department was found to be 30.3% while detection rate of depression by clinician was 0%. Conclusion The results revealed the magnitude of depression which is prevalent in the primary health care clinic that goes undiagnosed and unmanaged. It is therefore recommended that primary health care providers do thorough assessments to address common mental disorders especially depression and they should be educated to recognise and manage depression appropriately at primary care level.

A cross-sectional survey of 5-year-old children with non-syndromic unilateral cleft lip and palate:the Cleft Care UK study. Part 1: background and methodology

OBJECTIVES: We describe the methodology for a major study investigating the impact of reconfigured cleft care in the United Kingdom (UK) 15 years after an initial survey, detailed in the Clinical Standards Advisory Group (CSAG) report in 1998, had informed government recommendations on centralization. SETTING AND SAMPLE POPULATION: This is a UK multicentre cross-sectional study of 5-year-olds born with non-syndromic unilateral cleft lip and palate. Children born between 1 April 2005 and 31 March 2007 were seen in cleft centre audit clinics. MATERIALS AND METHODS: Consent was obtained for the collection of routine clinical measures (speech recordings, hearing, photographs, models, oral health, psychosocial factors) and anthropometric measures (height, weight, head circumference). The methodology for each clinical measure followed those of the earlier survey as closely as possible. RESULTS: We identified 359 eligible children and recruited 268 (74.7%) to the study. Eleven separate records for each child were collected at the audit clinics. In total, 2666 (90.4%) were collected from a potential 2948 records. The response rates for the self-reported questionnaires, completed at home, were 52.6% for the Health and Lifestyle Questionnaire and 52.2% for the Satisfaction with Service Questionnaire. CONCLUSIONS: Response rates and measures were similar to those achieved in the previous survey. There are practical, administrative and methodological challenges in repeating cross-sectional surveys 15 years apart and producing comparable data.

Quality of life and chronic disease in patients receiving primary health care

Problem Statement: Chronic disease entails physical, psychological and social issues with a decrease in the quality of life. The assessment of QoL has been applied as indicator in patients with chronic diseases. Research Questions: What is the quality of life in patients with chronic disease? What are the socio-demographic variables that influence the quality of life in patients? Purpose: To assess the quality of life in patients suffering from chronic disease and identify socio-demographic variables which influence the quality of life of patients suffering from chronic disease. Research Methods: We conducted a cross-sectional analytical study using a sample composed of 228 users (134 females) from a Family Health Unit in the municipality of Viseu. Data collection was made by means of a questionnaire, consisting of sociodemographic variables, the SF-12 scale and the existence of chronic disease was assessed through the questions – “Do you currently suffer from any chronic disease?”; “If so, which one(s)?”. Findings: The most common chronic diseases were hypertension (59.9%). Female patients with a chronic disease reported worse physical functioning, role-physical and role-emotional; increased bodily pain and better quality of life regarding general health. Male patients showed worse role-physical, increased bodily pain and vitality. Sociodemographic variables which were associated with quality of life were area of residence, academic qualifications and work situation. Conclusion: Chronic disease affects quality of life negatively. Quality of life in both patients groups was associated with socio-demographic variables. Health-related quality of life is an essential issue and should be considered as a priority in health policies.