Determine Health Care Providers Research Articles

Health Care Providers’ Perceptions of Quality, Acceptance, and Satisfaction With Telebehavioral Health Services During the COVID-19 Pandemic: Survey-Based Study

BackgroundDue to rapidly increasing rates of COVID-19 across the country, system-wide changes were needed to protect the health and safety of health care providers and consumers alike. Technology-based care has received buy-in from all participants, and the need for technological assistance has been prioritized.ObjectiveThe objective of this study was to determine the initial perceptions and experiences of interprofessional behavioral health providers about shifting from traditional face-to-face care to virtual technologies (telephonic and televideo) during the COVID-19 pandemic.MethodsA survey-based study was performed at a large, integrated medical health care system in West-Central Florida that rapidly implemented primary care provision via telephone and televideo as of March 18, 2020. A 23-item anonymous survey based on a 7-point Likert scale was developed to determine health care providers’ perceptions about telephonic and televideo care. The survey took 10 minutes to complete and was administered to 280 professionals between April 27 and May 11, 2020.ResultsIn all, 170 respondents completed the survey in entirety, among which 78.8% (134/170) of the respondents were female and primarily aged 36-55 years (89/170, 52.4%). A majority of the respondents were outpatient-based providers (159/170, 93.5%), including psychiatrists, therapists, counselors, and advanced practice nurses. Most of them (144/170, 84.7%) had used televideo for less than 1 year; they felt comfortable and satisfied with either telephonic or televideo mode and that they were able to meet the patients’ needs.ConclusionsOur survey findings suggest that health care providers valued televideo visits equally or preferred them more than telephonic visits in the domains of quality of care, technology performance, satisfaction of technology, and user acceptance.

Screening and Intervention Practices for Alcohol Use by Pregnant Women and Women of Childbearing Age: Results of a Canadian Survey.

To determine health care providers' familiarity with and use of the Society of Obstetricians and Gynaecologists of Canada's (SOGC's) 2010 Alcohol Use and Pregnancy Consensus Clinical Guidelines and to identify barriers and enablers that affected guideline uptake. We conducted an online pan-Canadian survey of midwives, obstetricians, family physicians, and nurses. The survey was divided into five sections: knowledge, SOGC guidelines, screening and intervention practices, attitudes and beliefs, and demographic information. Just over half of the 588 respondents who provided care to pregnant women or to women of childbearing age were familiar with and used the guidelines. Most respondents screened for alcohol use by asking women about alcohol consumption, but relatively few used a screening questionnaire. Approximately two-thirds of respondents provided brief intervention and referral to harm reduction or treatment services. Enablers of guideline adherence included knowledge about the risks of alcohol in pregnancy, perceived responsibility to identify and address at-risk drinking, and a belief that women are motivated to reduce their alcohol consumption if pregnant or planning to become pregnant. Lack of confidence in ability to use screening questionnaires and to provide brief intervention, as well as a lack of belief in the effectiveness of both practices, were barriers to use. Strategies are needed to improve familiarity with and uptake of the Alcohol Use and Pregnancy Consensus Clinical Guidelines. Particular attention should be given to education and training regarding the use of validated screening questionnaires and brief intervention practices.

Assessing uptake of national HIV screening and testing guidance—Part 2: Knowledge, comfort and practice

The Public Health Agency of Canada's (PHAC) HIV Screening and Testing Guide (the Guide) provides guidance to health care providers regarding who, when and how often to screen for HIV. HIV screening and testing is important in meeting the Joint United Nations Programme on HIV/AIDS' (UNAIDS) 90-90-90 targets towards HIV elimination. To determine health care providers' levels of knowledge about and comfort with aspects of HIV testing, and to determine whether their HIV testing practices are consistent with the recommendations in the Guide. An open, anonymous online survey that included questions on knowledge, comfort and HIV testing practices was developed with stakeholders, validated and pre-tested. It was then disseminated to a convenience sample of health care providers across Canada between June and August 2016. A total of 1,075 participants representing all Canadian provinces and territories responded to the survey, with the majority being nurses (54%) and physicians (12%). Overall, knowledge related to HIV testing was substantial, but 37% of respondents underestimated the percentage of people living with HIV in Canada who are unaware of their HIV status and only 32% of respondents knew that HIV patients are frequently symptomatic during the acute infection. Most participants were comfortable with HIV testing and approximately 50% reported offering HIV testing regularly. Although overall knowledge and practice were consistent with PHAC's HIV Screening and Testing Guide, some health care providers may underestimate the magnitude of undiagnosed HIV cases in Canada and may misinterpret the symptoms of acute HIV infection. While the amplitude of these results need to be interpreted in light of the convenience sample, addressing these knowledge gaps may facilitate earlier diagnosis of HIV among those who are unaware of their HIV status.

Oral Health Care Guidelines, Training, and Resources among Stroke Care Providers.

During a stroke, the mouth tends to become an unhealthy place and may give rise to various life-threatening conditions. To this end, there have been repeated calls to incorporate oral hygiene guidelines and practices for hospitalized stroke patients to prevent aspiration pneumonia and improve patients' oral health. The objective of the study was to determine health care providers' practices of oral health care among patients hospitalized after an occurrence of stroke and to determine health care providers' background and work environment effect on these practices. A cross-sectional study was conducted among stroke care providers in 13 public hospitals in Malaysia. The questionnaires distributed were self-administered, where nursing staff provided details of their oral health care practices for stroke patients. Information on the background of health care providers and work environment was also collected. Overall, a total of 780 responses from the registered nurses were obtained. Almost half of the respondents (48.1%) reported that they recommended toothbrushing twice or more per day to stroke patients. Two-thirds (64.7%) reported that they performed daily mouthwashing on their patient, while less than half (38.8%) reported daily oral hygiene assistance. Result of the analysis revealed that oral hygiene practices were significantly associated with having working wards ( P < 0.05), level of qualification ( P < 0.05), having oral health care guidelines ( P < 0.001), specific resources ( P < 0.05), and attending previous training in oral care ( P < 0.001). Provision of oral hygiene practices for hospitalized stroke patients is important. A lack of oral health care guidelines, support from dental professionals, specific resources, training, and assistance in daily oral care for patients is evident and detrimental to oral hygiene practices. The current findings have significant implications for new initiatives to support health care providers, particularly the registered nurses performing oral health care for hospitalized stroke patients. Knowledge Transfer Statement: This study may provide a basis of information for improving the delivery of oral health care to stroke patients. Enhancement in the training and improvement in the existing guidelines and resources is pivotal for the provision of better oral health care for the potential benefits to these patients, including their improved quality of life and disease prevention.

Utilizers Satisfaction with Health Care Services Provided by New Damietta General Health Center

Utilizers’ satisfaction is a multifaceted and a very challenging outcome to define. Patient expectations of care and attitudes greatly contribute to satisfaction. Other psychosocial factors, including pain and depression, are also known to contribute to utilizer’s satisfaction scores. Objectives: Were to assess the utilizers’ satisfaction with health care services provided by New Damietta Health Center and to determine health care providers’ opinions about the causes of the users satisfaction from their points of view and how to improve it. Methods: A cross sectional study was conducted on the attendants of New Damietta General Health Center. The study included 130 health care utilizers and 49 health care providers from first of April to end of June 2014. Data collection was performed by an interview questionnaire. Results: The results showed that out of 130 health care utilizers, 96 (73.8%) were females, 91 (70.0%) were in the age group 19-45 years, and the overall rating of services as reported by the users was 62.46%. About half (46.2%) of the respondents reported that they had a good care at the center. While, a minority (3.8%) recorded that the center's services were poor. The users illustrated that the health care services and health care providers were the best items in the center, 53.9% and 46.0%, respectively. The cheap services were considered the commonest cause of satisfaction as reported by 47.9% of females and 53.0% of males. While, drug deficiency was the commonest cause of dissatisfaction as mentioned by 73.0% of females and 55.9% of males. Conclusion: The majority of our respondents were relatively satisfied regarding different aspects of care. However, still there are many efforts (e.g. drug adequacy) needed for improvement of patient satisfaction. Recommendation: Health authorities should paid attention to overcome causes related to utilizers’ dissatisfaction as drug unavailability.

Impacts of health care providers’ characteristics on their assessment regarding the adequacy of adolescent sexual and reproductive health services in Swaziland

Background: At the present time, there are more than a billion of adolescents living in the developing countries. As they grow up, their circumstances and situations are quite different from that of their parents and their health care providers as well, with greater access to formal education, increasing need of technological skills such as computer, the more advanced cellular phones and internet literacy, and more exposure to new ideas through media, telecommunications and other avenues. These lead to change of environment and other factors that might influence adolescents towards taking decisions in regard to their sexual and reproductive health. On the other hand, it also raises curiosity to the health care providers as they expect them to go through their path of experiences hence that does not happen in most cases. Objective: This study sought to assess the adequacy of adolescent sexual and reproductive health services from the health care providers’ perspective, to determine health care providers’ characteristics associated with their assessment regarding the adequacy of adolescent sexual and reproductive health services as well as to determine factors and perceived barriers to the provision of adolescent sexual and reproductive health services. Methods: A cross-sectional survey was conducted among 196 health care providers in 5 purposively selected healthcare facilities using self-administered, pre-tested structured questionnaires. Descriptive statistics, bivariate statistics; independent-samples t-test and one-way ANOVA, Pearson correlation and multiple regression analysis were conducted to drive impacts and associations of health care providers’ assessment regarding adequacy of adolescent sexual and reproductive health services. Results: The majority of respondents were nurses (87%), followed by physicians and nurse assistants (7% and 6%, respectively). Bivariate results showed that level of education on health care providers’ assessment regarding the adequacy of adolescent sexual and reproductive health services was statistically significant (p = 0.03). The results were also found statistically significant (p = 0.01) on health care providers’ specialty on their assessment regarding adequacy of adolescent sexual and reproductive health services. There was a statistically significant weak positive correlation (r = 0.141, p = 0.039) between health care providers’ perceptions on their assessment regarding adequacy of adolescent sexual and reproductive health services in Swaziland. When a multiple regression analysis was conducted, nurse practitioners and obstetrician among the other groups were statistically significant at (p = 0.012 and p = 0.036, respectively). Another significant predictor of the outcome variable was religion, the Roman Catholic group was statistically significant (p = 0.019) when compared to the other religious groups. Multiple regression analysis results showed 6% of the variances in healthcare providers’ assessment regarding adequacy of adolescent sexual and reproductive health services were explained by specialty and religion. Conclusion: There is a need to improve the curriculum of health care providers in Swaziland in order to address issues of adolescent sexual and reproductive health services. There is also a need to further health care providers training so that they can be able to specialize in different field.

Health care providers’ attitudes towards termination of pregnancy: A qualitative study in Western Nigeria

Background: Despite restrictive abortion law in Nigeria, women still seek abortion services. Restrictive policies on abortion make it difficult for safe and legal abortion to be obtained. Hence, abortion is provided on clandestine basis in some private health facilities, and where the cost of such service is prohibitory, women resort to unsafe methods, including visiting quacks and self medication, resulting in severe complications including death. In Nigeria, little is known about the personal and professional attitudes of individuals who are currently providing abortion services. Exploring the factors which determine health care providers’ involvement in or disengagement from abortion services may facilitate improvement in the planning and provision of future services. Methods: Data were collected using qualitative research methods. Thirty-six in-depth interviews and one focus group discussion were conducted between January 2010 and July 2010 with health care providers who were involved in a range of abortion services provision in theWestern Nigeria. Data were analysed using a thematic analysis approach. Results: Complex patterns of service delivery were prevalent throughout many of the health care facilities. Fragmented levels of service provision operated in order to accommodate health care providers’ willingness to be involved in different aspects of abortion provision. Closely linked with this was the urgent need expressed by many providers for liberalization of abortion laws inNigeriain order to create a supportive environment for both clients and providers. Almost all providers were concerned about the numerous difficulties women faced in seeking an abortion and their general quality of care. An overriding concern was poor pre and post abortion counselling including contraceptive counselling and provision. Conclusion: This is the first known qualitative study undertaken in Nigeria exploring providers’ attitudes towards abortion and it adds to the body of information addressing the barriers to safe abortion services. In order to provide an enabling environment and sustain a pool of abortion service providers, a drastic change in Nigerian abortion laws is mandatory, after which policies that both attract prospective abortion service providers and retain existing ones can be developed.

Family Presence During Invasive Procedures at the Emergency Department

Family presence (FP) during invasive procedures (IPs) in children remains controversial among pediatric emergency department (PED) staff. The authors aimed to determine health care providers' attitudes toward FP during IPs in Spain, to learn whether parents are given the option of being present during different IPs, and to study which factors influence the providers' opinions. Observational study. Physicians and nurses were asked to answer a questionnaire, which was sent to 43 PEDs and was available at the Spanish Pediatric Emergency Society Web site. We obtained 222 questionnaires from 36 Spanish hospitals. A total of 65.8% of the surveys were answered by physicians (66.4% pediatricians) and 34.2% by nurses. The median age of the respondents was 32 years, and 69.2% were women. Parents were given the option of being present during blood sampling (36.4%), intravenous line placement (32.7%), urethral catheterization (32.1%), lumbar puncture (13.5%), and resuscitation (1%). More than 60% of providers approved of FP during blood sampling, sutures, intravenous line placement, and urethral catheterization; however, only 10.8% of providers encourages FP during resuscitation. Against FP, health care staff argue procedural invasiveness (75.6%), parents' anxiety (87.6%), and worsened performance of the procedure (66%). Commonly expressed advantages were reducing patient distress (72.9%) and parent anxiety (62.3%). Physicians, especially the older ones, are more likely to encourage FP than nurses for some IPs. The PED staff tend to prefer parents not to be present during IPs as the level of invasiveness increases. Family presence is not common in Spanish PEDs. Older physicians are more likely to support FP than nurses.

Health care providers' attitudes towards termination of pregnancy: A qualitative study in South Africa

BackgroundDespite changes to the abortion legislation in South Africa in 1996, barriers to women accessing abortion services still exist including provider opposition to abortions and a shortage of trained and willing abortion care providers. The dearth of abortion providers undermines the availability of safe, legal abortion, and has serious implications for women's access to abortion services and health service planning.In South Africa, little is known about the personal and professional attitudes of individuals who are currently working in abortion service provision. Exploring the factors which determine health care providers' involvement or disengagement in abortion services may facilitate improvement in the planning and provision of future services.MethodsQualitative research methods were used to collect data. Thirty four in-depth interviews and one focus group discussion were conducted during 2006 and 2007 with health care providers who were involved in a range of abortion provision in the Western Cape Province, South Africa. Data were analysed using a thematic analysis approach.ResultsComplex patterns of service delivery were prevalent throughout many of the health care facilities, and fragmented levels of service provision operated in order to accommodate health care providers' willingness to be involved in different aspects of abortion provision. Related to this was the need expressed by many providers for dedicated, stand-alone abortion clinics thereby creating a more supportive environment for both clients and providers. Almost all providers were concerned about the numerous difficulties women faced in seeking an abortion and their general quality of care. An overriding concern was poor pre and post abortion counselling including contraceptive counselling and provision.ConclusionThis is the first known qualitative study undertaken in South Africa exploring providers' attitudes towards abortion and adds to the body of information addressing the barriers to safe abortion services. In order to sustain a pool of abortion providers, programmes which both attract prospective abortion providers, and retain existing providers, needs to be developed and financial compensation for abortion care providers needs to be considered.

Health care providers' perceptions of spirituality while caring for veterans.

To determine health care providers' views on spirituality, its role in the health of patients, and barriers to discussing spiritual issues with patients, the author convened five focus groups at two Veterans Administration Medical Centers. Participants were nurses, physicians, social workers, psychologists, and chaplains. Common themes included (a) the lack of education for professionals regarding how to address patients' spiritual needs; and (b) systems-related issues, including communication systems that do not function well, how spiritual needs are addressed on admission, support or lack thereof by hospital administrators, and lack of support for the spiritual needs of staff. The aging and illnesses of many current veterans plus the escalated potential of war highlight the importance of addressing veterans' spiritual needs.