Expectations Of Health Care Professionals Research Articles

Point-of-Care Testing in Diabetes Management: What Role Does It Play?

Diabetes is a multisystem disease requiring complex management provided by a variety health care professionals (HCPs). Comprehensive care of patients with diabetes requires frequent testing of hemoglobin A1c (A1C),and research indicates that use of point-of-care testing (POCT) can affect patients' A1C results in the shortterm. The purpose of this qualitative study was to explore the ideas, opinions, and expectations of HCPs and patients with diabetes about the potential role of POCT, including its impact on patient-provider interactions, patient care, and issues of implementation.In-depth interviews, which were audiotaped and transcribed verbatim, were conducted with key stakeholders. The analysis used immersion and crystalization strategies. Thirty-seven interviews were conducted: seven with endocrinologists and internists, seven with family physicians, eight with diabetes educators, seven with family practice nurses, and eight with patients with diabetes.Two major themes emerged from the data analysis: 1) the impact of POCT on the clinical encounter and the care of patients, and 2) the POCT machine, including accuracy and the cost of incorporating the machine into clinical practice. The analysis revealed strong similarities across all groups of HCPs, and patients also expressed similar concerns.This study illuminates perceptions of HCPs and patients regarding the impact of POCT on diabetes management. POCT was viewed as having many benefits in the clinical care of patients with diabetes, including face-to-face encounters that offer immediate feedback, proactive patient education,increased collaboration between patients and providers, and improved patient adherence. However, logistical issues, such as the machine's accuracy and cost factors, could be significant barriers to implementation

Young adults' perceptions of living with chronic inflammatory bowel disease.

King's (1981, 1995b) Theory of Goal Attainment provided the theoretical framework for this qualitative, descriptive study exploring the perceptions of five young adults living with chronic inflammatory bowel disease (IBD). Through in-depth interviews, the participants had the opportunity to share their perceptions of what mattered most as they lived the experiences of this illness. The uniqueness and individuality of perceptions, the challenges of chronic bowel disease, recommendations for the future, and participants' expectations of healthcare professionals were explored. Persons with chronic IBD are faced with many life-disrupting challenges that profoundly affect their personal, interpersonal, and social systems. This research study supported the premise that understanding the patient's perspective and reaching perceptual accuracy through human-to-human interaction is critical to healthcare outcomes and achievement of the young adult's health goals.

Quality of Life: Issues for Persons with Neuromuscular Diseases

Improving quality of life has always been a goal of rehabilitation medicine. However, health care providers often do not know much about the quality of life of individuals with neuromuscular diseases, nor what factors are critical to achieving a good quality of life. Lack of knowledge about subjective quality of life factors can negatively influence expectations and selection of treatments. In the most glaring cases, a physician's subjective but incorrect assessment of a disabled individuals' quality of life may prevent life-sustaining interventions. As a group, the quality of life of individuals with NMD is not much different than nondisabled controls and is substantially better than presumed by the general public and, often times, by health care workers. Nevertheless, their quality of life is reduced in certain areas. Surprisingly, level of disability is not a critical factor that significantly alters life satisfaction. Presumably, this is because physical functioning has been adequately managed. The greatest problems that individuals with neuromuscular disease identified were: lack of information about the disease and services; poor coordination of services; negative attitudes; and a diminished expectation of their potential. In addition, people with severe disabilities had significant problems obtaining, financing, and managing personal care attendants. Factors related to a good quality of life were related to perceived control, perceived health status, but not disability. The more that people could do for themselves, either on their own or with personal care assistants, assistive devices, and use of technology, the better their quality of life.