Experiences Of Health Services Research Articles

Pilot of a multicomponent program for people with dementia and their care partners: Health services staff expectations, experiences and observations.

There is increased recognition of the need to improve post-diagnostic pathways for people with dementia and their care partners living in the community to access rehabilitation services to support independence and wellbeing. However, there is minimal evidence on implementing rehabilitation services for this population. The study aimed to present the expectations and experiences of allied health staff involved in piloting the Sustainable Personalised Interventions for Cognition, Care and Engagement (SPICE) program based at an outpatient clinic of a public rehabilitation hospital. Over twelve weeks, the program combines small group and dyadic evidence-based interventions including cognitive stimulation therapy, occupational therapy, physical activity, care partner education, and dietetics. A qualitative exploratory methodology was used with pre- and post-program interviews conducted with ten allied health staff. Questions were designed to elicit the expected and actual benefits and challenges of the initial implementation of the multicomponent program. The multidisciplinary team were motivated by the potential for the SPICE program to meet an important service gap, and confident people with dementia and their care partners would benefit. Staff reported enjoyment, satisfaction, and confidence in delivering the program, and believed the multiple components had synergistic effects on participants, particularly regarding social connection and functional engagement. While staff had pre-program concerns regarding retention, participant fatigue, and managing challenging situations, these were not realised. At times, staff observed program intensity to cause unintended stress for some care partners. Resourcing and strategies to ensure sustainability were identified as important by staff, as well as the need for ongoing support to participants post-program. Overall, the SPICE program exceeded expectations and was rewarding for staff. Further work to refine and evaluate the program is necessary to support its potential to continue providing dementia rehabilitation to promote the independence and wellbeing of people with dementia and care partners living in the community.

A Systemic Review on the Awareness, Adoption, and Utilization of Digital Health in the Kingdom of Saudi Arabia

Abstract This study, grounded in existing literature, aims to establish a framework and derive conclusions regarding the awareness, acceptance, and utilization of digital medical and health services in Saudi Arabia. It sets the foundation for subsequent research phases to assess the impact of digital health adoption, evaluate the performance of these services, and provide governance insights. Metrics of adoption and acceptance are essential in determining the effectiveness and delivery of e-health services. The significance of this study lies in validating the acceptance and utilization of digital health services by diverse stakeholders, including patients, healthcare professionals, cloud service providers, and health systems, which will aid in future evaluations of performance and governance in digital healthcare. A systematic review was conducted, drawing on literature from various databases, to assess the levels of awareness, acceptance, and utilization of e-health services. Data were sourced from journal articles in databases such as Google Scholar, PubMed, PubMed Central, CINAHL, and MEDLINE, focusing on segments such as telecare, telehealth, telemedicine, and mobile and digital health under the information and communication technology domain. This comprehensive review evaluates the awareness, adoption rate, utilization, and user experience of digital health services in Saudi Arabia.

Tikanga Māori in the Context of Inpatient Whakatahe (Miscarriage): A Quality Improvement Project

In Aotearoa New Zealand, it is estimated that one in four women experience a pregnancy that ends in whakatahe (miscarriage). A surgical procedure and hospital inpatient stay is sometimes required. In this highly medicalised context, the cultural needs of wāhine (women) Māori are often overlooked. Due to the lack of awareness of tikanga Māori (traditional cultural practices) amongst nursing staff, a quality improvement project was initiated in 2023 in a ward setting of a tertiary hospital. The aim was to incorporate tikanga principles into clinical practice for the management of miscarriage of pregnancy less than 21 weeks’ gestation. A kaupapa Māori approach informed the project design. Data collected during the project included a review of hospital policies and guidelines, a review of literature and other publications that addressed tikanga Māori principles during birthing and miscarriage, and consultation with Māori midwives. Using Te Whare Tapa Whā as a framework, the findings from these sources applied relevant tikanga principles to the clinical context of nurses caring for wāhine Māori and their whānau (extended family). A subsequent study day for nurses has increased their knowledge and confidence to incorporate tikanga Māori into their everyday practice, leading to observable changes. This outcome points to the need to invest in the education, knowledge and confidence of nurses in the use of tikanga Māori in ways that support wāhine Māori and whānau during a time of loss and grief. When nurses understand and know how to apply Te Whare Tapa Whā to their practice, it is possible to improve the experience of health services for wāhine Māori. Te Reo Māori Translation Ko ngā tikanga Māori ka pā mō te whakatahe ohorere o te tūroro: He kōkiri Whakapiki Kounga Ngā Ariā Matua E whakapaetia ana, kotahi wahine i roto i te whā i Aotearoa ka rongo i te pōuri o te whakatahe e mutu ai tētahi o ōna hapūtanga (miscarriage). Mō ētahi me haere tētahi mahi poka tinana, me noho hoki hei tūroro i te hōhipera mō tētahi wā. I roto i tēnei horopaki hōhipera nei, he rite tonu te wareware o ngā hiahia ahurea o te wāhine Māori. Nā te kore hoki o ngā tapuhi e mārama ki ngā tikanga Māori, i whakarewaina tētahi kōkiri whakapiki kounga i te tau 2023 i tētahi mātūtū (ward) o tētahi hōhipera taurima matatini. Ko te whāinga ia kia whakaurua ngā mātāpono i takea mai i ngā tikanga Māori ki roto i ngā mahi tiaki tūroro ki ngā mahi āwhina i te wahine mō ngā whakatahe hapū, i ngā wiki i mua i te wiki 21. I riro nā tētahi ara kaupapa Māori i ārahi te hoahoa kōkiri. Ko ngā raraunga i kohia i roto i te kōkiri ko tētahi arotake o ngā kaupapahere me ngā aratohu hōhipera, he arotakenga o ngā tuhinga me ērā atu pukapuka mō ngā mātāpono i takea mai i ngā tikanga Māori i roto i te whakawhānau me te whakatahe, me te torotoro i ngā whakaaro o ngā kaiwhakawhānau Māori. I whakamahia Te Whare Tapa Whā hei anga, ā, i hoatu ngā mātāpono tikanga hāngai ki te horopaki tiaki tūroro o ngā tapuhi e tautiaki nei i ngā wāhine Māori me ō rātou whānau. Nā tētahi rā wānanga i muri mai i piki ake ai te mōhiotanga me te māia o ngā tapuhi mō te kawe i ngā tikanga Māori ki roto i ā rātou mahi o ia rā, me te piki anō o ngā rerekētanga ka taea te kite. Ka puta i konei te whakaaro me tāpae rawa ki te akoranga, ki te mōhiotanga me te māia ki ngā tikanga Māori, i runga anō i te kimi tikanga tautoko wāhine Māori me ō rātou whānau i te wā o te mate me te pōuri nui. Ina mātau ngā tapuhi ki te hoatutanga o Te Whare Tapa Whā i roto i ā rātou mahi, ka taea te whakapiki ngā wheako o ngā wāhine Māori i roto i ngā ratonga hauora. Ngā kupu matua Tikanga; Māori; whakatahe; whakapiki kounga; mahi tapuhi; hōhipera; haumaru ahurea

Hjerteinfarkt og posttraumatisk stressreaksjon: en kvalitativ studie

An increasing number of people survive myocardial infarction, and research suggests that psychological difficulties are prevalent among heart patients. The aim of the study was to examine the participants’ psychological reactions to myocardial infarction. The study was based on 27 semi-structured interviews. Three central themes emerged: 1) experiences of myocardial infarction and subsequent psychological reactions, 2) experiences of health services, particularly rehabilitation and 3) the significance of health information. The results indicate widespread psychological difficulties among the participants. Several describe the infarction as a traumatic event with stress-related symptoms. The participants’ experiences of their encounters with the health services varied, and they described various factors associated with hospitalisation and rehabilitation as protective or stressful. Lack of health information was found to be stressful, and created uncertainty and unpredictability for the participants. The findings suggest that the participants have psychological reactions following a myocardial infarction. These difficulties impose limitations on daily life activities, and many require more psychological support and better tailored health information than what is currently provided . Keywords: Myocardial infarction, PTSD, anxiety, depression, qualitative study, rehabilitation

Patient Reported Outcome Measures in cancer care: a hybrid effectiveness-Implementation trial to optimise Symptom control and health service Experience (PROMISE)–protocol for a randomised controlled trial of electronic self-reporting of symptoms versus usual care during and following treatment in patients with cancer

IntroductionRoutine collection of patient-reported outcome measures (PROMs) has the potential to inform and improve cancer care. It is now feasible for patients to complete PROMs electronically (ePROMs) providing information about...

Challenges and opportunities of sustained public involvement in maternal health research: a practice case study with reflections from researchers and public contributors

It is widely agreed that collaboration with people with lived experience of specific health conditions or health services is both a moral imperative and a utility to improve research quality, validity and impact. However, there is little agreement about how to practise public involvement. In this article, we describe the formation and work of the Nottingham Maternity Research Network, an ongoing research reference panel that supports public involvement in maternal health research. Drawing on nine years’ experience, researchers and public contributors reflect together on the key issues to consider when co-producing research with maternity service users: first, pragmatic considerations, and second, creating a safe space for drawing on intimate and sometimes traumatic experiences. We argue that a sustained model of public involvement and engagement – that is, a standing group rather than a series of project-based, time-limited opportunities for involvement – brings opportunities to build trust and to develop a community that is supportive and inclusive. However, the sustained model of public involvement also brings practical challenges.

Experiences of health services for adults with cerebral palsy, their support people, and service providers.

https://onlinelibrary.wiley.com/doi/full/10.1111/dmcn.16037

Evaluating the impact of the Health Access for Refugees Project on people who are refugees or seeking asylum in Northern England.

Evidence demonstrates that people who are seeking asylum and refugees face individual, institutional and system-level barriers when accessing health services. Health Access for Refugees' Project (HARP) is a UK initiative increasing access to health care within this community through a series of interventions. This study explored the impact of HARP on health service access, experiences and outcomes for clients, and how volunteers and staff addressed institutional and system-level barriers. In summer 2020, we conducted qualitative telephone interviews with four HARP clients, eight clients who became volunteers, seven further volunteers and three staff members. The educational aspect of the interventions supported clients navigating the complex UK health care system while promoting independence in accessing health care. Advocacy by volunteers and staff was important in challenging barriers at individual and institutional levels. Staff challenged the asylum system, by improving information around entitlement to health care and addressing barriers to registering with a General Practitioner (GP). Interventions such as those provided by HARP can address different levels of barriers to support people accessing health care provision. This can be achieved through training health professionals and working with peers to support access to care and to develop self-advocacy. However, stable long-term funding is essential to ensure the sustainability of these initiative.

Health Service Experiences of War-injured Immigrant Populations in Canada in 2023

Health Service Experiences of War-injured Immigrant Populations in Canada in 2023

Exploring black women's experiences of mental health services: a literature review.

The prevalence of mental health issues among black women is high, but they are underrepresented among mental health service users. This article details a systematised review of the literature that explored black women's perceptions and experiences of, and barriers to, engaging with mental health services. A total of 16 articles from the UK and North America were included in the review. Four main themes were identified as presenting barriers to black women's engagement with services: mistrust; sociocultural factors; lack of awareness; and practical barriers. The intersection of gender and race was evident in the 'strong black woman' ideal, which may have hindered their recognition and disclosure of mental health conditions, as well as in practical barriers such as costs and caring responsibilities. Historical and cultural perceptions of mental health issues and healthcare services, alongside their previous negative experiences of services, may prevent many black women from accessing essential support. Nurses and other healthcare professionals have an important role in engendering trust, challenging racism and promoting positive mental health.

Listening to the Perspectives of Black Women on Perinatal Health Disparities: Reversing the Tide and Improving Outcomes.

Pregnancy-related health in the USA fares worse than similarly resourced countries and the gap continues to widen. This trend however is disproportionately experienced by women of color. We have come to understand that this is due to the systems and structures that perpetuate racism. Despite our awareness of this, the voices of the community impacted by these systems have been largely left out of research. The authors aimed to utilize participatory research methods within a qualitative design to askBlack pregnant and parenting women about their lived experiences of pregnancy and perinatal health services. Over three focus groups, the authors gathered information from 12 participants. Participants were Black women currently pregnant or pregnant in the last year, ages 22-37years old. Participants shared their experiences and views on racial disparities within perinatal health care. Our analytic goal was to explore the questions: "What are Black women talking about in relation to perinatal health"; "Where do Black women get information about perinatal health disparities?"; and "How do Black women feel when they hear or talk about perinatal health risks?". In general, participants felt that the burden to understand their pregnancy risks and options was theirs alone to carry. This resulted in their utilization of and reliance on the internet, social supports, and holistic providers such as doulas for information about how to reduce their risk for maternal morbidity and mortality. Results demonstrate patients' receptivity to frank conversation about perinatal health disparities, and their willingness to partner with their providers to reduce risks in pregnancy. While interventions to reduce perinatal health risks must be systemic, they cannot move forward without including the voices of and partnering with the community they hope to positively impact.

Experiences of central child health services teams regarding a special governmental investment in child health services

BackgroundHistorically marked by a high infant mortality rate, Sweden’s healthcare reforms have successively led to a robust, decentralized universal child health system covering over 97% of the population 0–5 years. However, inequities in health have become an increasing problem and the public health law explicitly states that health inequities should be reduced, resulting in various government initiatives. This study examines the experiences of Central Child Health Services (CCHS) teams during the implementation of the Child Health Services Accessibility Agreement between the State and the regions starting in 2017. The agreement aimed to enhance child health service accessibility, especially in socio-economically disadvantaged areas, but broadly stated guidelines and the short-term nature of funding have raised questions about its effectiveness. The aim of this study was to understand the experiences of CCHC teams in implementing the Child Health Services Accessibility Agreement, focusing on investment decisions, implementation efforts, as well as facilitators and barriers to using the funds effectively.MethodsCCHC teams were purposefully sampled and invited via email for interviews, with follow-ups for non-respondents. Conducted from January to October 2023, the interviews were held digitally and recorded with individuals familiar with the agreement’s implementation within these teams. Both authors analyzed the transcripts thematically, applying Braun and Clarke’s framework. Participants represented a cross-section of Sweden’s varied healthcare regions.ResultsThree main themes emerged from the thematic analysis: “Easy come, easy go,” highlighting funding uncertainties; “What are we supposed to do?” expressing dilemmas over project prioritization and partner collaboration; and “Building castles on sand,” focusing on the challenges of staff retention and foundational program stability. Respective subthemes addressed issues like fund allocation timing, strategic decision-making, and the practical difficulties of implementing extended home visiting programs, particularly in collaboration with social services.ConclusionsThis study uncovered the challenges faced in implementing the Child Health Services Accessibility Agreement across different regions in Sweden. These obstacles underline the need for precise guidelines regarding the use of funds, stable financing for long-term project sustainability, and strong foundational support to ensure effective interprofessional collaboration and infrastructure development for equitable service delivery in child health services.

Experiences of health services for adults with cerebral palsy, their support people, and service providers.

To explore the experiences of health services among adults with cerebral palsy (CP) in Ireland, from the perspectives of adults with CP, their support people, and service providers. A qualitative descriptive study design was used. In-depth semi-structured interviews were conducted between March and August 2021 with adults with CP, people who supported them, and health professionals. Thematic analysis was used to evaluate the data. Twenty-one adults with CP, seven support people (family carer[s], spouse or partner, or friend), and 15 service providers participated in the study. Adults had a mean age of 38 years 5 months (range 22-58 years) and were classified in Gross Motor Function Classification System levels I to V. Five themes were identified from the data: (1) access challenges in adult services; (2) knowledge and understanding of CP; (3) support people's role and care burden; (4) communication and interaction in adult services; and (5) health system challenges. Adults with CP in Ireland face multiple challenges accessing the health services they need. Services were reported to be inadequate, with limited resources and understanding of CP. Participants highlighted a need for system-level interventions, including enhanced training for health professionals to effectively meet the needs of adults with CP.

Community perception and experience of health services in the midst of an earthquake and COVID-19 pandemic: A phenomenological study

Indonesia is located on the Pacific Ring of Fire with various disasters occurring frequently and causing tremendous impacts. Recently, Mamuju Regency in West Sulawesi was hit by an earthquake during the COVID-19 pandemic, making primary health care (PHC) a major community health care provider facing several issues. This study aims to explore the challenges and supporting factors of the recovery of PHC after the earthquake during the COVID-19 pandemic using a descriptive phenomenology grounded in Edmund Husserl's philosophy. The Bamboo PHC (Puskesmas Bambu) was selected as the only PHC in Mamuju which was most affected by the earthquake. A focus group discussion method was conducted by involving 15 participants selected using purposive sampling and divided into three groups (health workers, health cadres, and community members). As a result, the community members acknowledged that the Bamboo PHC services programs in general were favorable before the pandemic, there were several basic and superior health service programs that the community felt were valuable. Yet, the COVID-19 pandemic worsened the situation and the use of healthcare facilities decreased. Coupled with the occurrence of natural disasters in vulnerable areas, it is increasingly causing fatalities. Therefore, disaster preparedness and community empowerment are the key to successful disaster management.

What supports the emotional well-being of peer workers in an NHS mental health service?

Purpose This study aims to explore the experiences of peers working in a range of roles within a single NHS mental health service. This study also aims to provide evidence of the impact of existing support, organisational structure and culture around peer working and provide recommendations for a Good Practice Guide for Peer Working. Peer roles require lived experience of mental health conditions and/or services. While the impact on them of using their own lived experience is not fully understood, anecdotal evidence suggests that peer workers may experience a greater emotional impact than other mental health workers. Burnout and retention are particular concerns. Design/methodology/approach This was a two-stage study using focus groups and reflexive thematic analysis in Stage 1. The key themes formed the basis of the Stage 2 workshop, which provided recommendations for a Good Practice Guide. The study team consisted of peer researchers with lived experience, supported by a Lived Experience Advisory Panel. Findings There is a perceived lack of support and an increased peer burden for peer workers. Recommendations included relevant ongoing training and development; support and supervision; and organisational cultural change. Originality/value Working within a peer-led co-production framework, this study contributes to the development of the evidence base for peer emotional labour. Based on the findings, a Good Practice Guide for Peer Working is being developed to promote good practice for the development of future peer worker roles.

Understanding the Retrospective and Current Health Care Needs and Service Experiences of Adult Survivors of Minor Sex Trafficking

Minor sex trafficking is an urgent public health problem, but we lack data about how such experiences impact health and health care access. Utilizing data collected from in-depth interviews with 35 adult survivors of minor sex trafficking across the U.S. we explored the physical and psychological healthcare access and healthcare experiences of adult survivors of minor sex trafficking. Negative healthcare experiences before, during, and following sex trafficking foster a lack of trust and confidence in healthcare systems as adults. Recommendations are provided to help overcome barriers to meeting healthcare needs and improving health care experiences for survivors of minor sex trafficking.

Client perspectives on creating supportive sexual health environments for people with persistent anxiety: a qualitative study

ObjectivesWe sought to explore sexual health service clients’ perspectives, preferences and suggestions for how to better address or alleviate anxiety among clients of sexual health services (eg, sexually transmitted infection...

Men’s Satisfaction with General Health Services is Associated with Future Use of HIV Testing in Malawi: A Community-Representative Survey

Across sub-Saharan Africa, men are less likely to know their HIV status than women, leading to later treatment initiation. Little is known about how experiences with general health services affect men’s use of HIV testing. We used data from a 2019 community-representative survey of men in Malawi to understand frequency and cause of men’s negative health service experiences (defined as men reporting they “would not recommend” a facility) and their association with future HIV testing. We conducted univariable and multivariable logistic regressions to determine which aspects of health facility visits were associated with would-not-recommend experiences and to determine if would-not-recommend experiences 12–24 months prior to the survey were associated with HIV testing in the 12 months prior to the survey. Among 1,098 men eligible for HIV testing in the 12 months prior to the survey, median age was 34 years; 9% of men reported at least one would-not-recommend experience, which did not differ by sociodemographics, gender norm beliefs, or HIV stigma beliefs. The factors most strongly associated with would-not-recommend experiences were cost (aOR 5.8, 95%CI 2.9–11.4), cleanliness (aOR 4.2, 95%CI 1.8–9.9), medicine availability (aOR 3.3, 95%CI 1.7–6.4), and wait times (aOR 2.7, 95%CI 1.5-5.0). Reporting a would-not-recommend experience 12–24 months ago was associated with a 59% decrease in likelihood of testing for HIV in the last 12 months (aOR 0.41; 95% CI:0.17–0.96). Dissatisfaction with general health services was strongly associated with reduced HIV testing. Coverage of high-priority screening services like HIV testing may benefit from improving overall health system quality.

Sexual health services for adolescents on Reunion Island: results from a descriptive interview-based study

ObjectivesTo describe the experiences of sexual health services available for adolescents aged 15–19 years on Reunion Island.DesignA qualitative descriptive study was conducted from 3 December 2022 to 24 October 2023....

Adolescent boys’ experiences of mental health and school health services - an interview study from Norway

BackgroundMental health problems among adolescents is a global challenge. During the transition to adolescence, physiological, psychological, and social changes occur, leading to increased vulnerability. Thus, adolescent boys are less likely to seek help for mental health problems, which makes them an undetected group. The aim of this study was to gain a deeper understanding of adolescent boys’ experiences of mental health and school health service.MethodsAn inductive, qualitative design was chosen using three focus group interviews and three individual interviews. The study included 18 adolescent boys in 7th grade, in a school located in a medium-sized municipality in Norway. The interviews were analysed with qualitative content analysis. The consolidated criteria for reporting qualitative research (COREQ) were followed in this study.ResultsThe overall theme “barriers towards seeking help”, and three categories— navigating stigma and privacy concerns; perceptions of self-responsibility; and lacking knowledge of mental health problems and help-seeking—described the adolescent boys experiences. The awareness and willingness to seek help were present, but there are barriers preventing the adolescent boys from acting on that willingness.ConclusionsLack of knowledge and a non-permissive culture for mental health problems among adolescents contributes to decreased help-seeking behaviour among adolescent boys. The school health service is the most related health service for adolescents and should focus on being available and strengthening empowerment and mental health literacy through the development and implementation of interventions to promote mental health.