Professional Health Care Providers Research Articles

The Influences of Open Access of Online Health Information on Patient Compliance to Professional Healthcare Providers Prescription in Kasangati Town Council, Wakiso District Uganda

Globally the health sector has witnessed disruptive transformation of how information is; generated, analyzed and shared using Information Communication Technologies (ICT). There is limited understanding on how patient’s access of online health information influences their desire to seek professional healthcare services or their adherence to professional healthcare service providers prescription/advise. Thus, the aim of this study was to investigate the influence that online health information has on patients’ compliance to professional healthcare service provider’s case management plans in Kasangati Town Council, Wakiso District, Uganda. Results show that, availability of internet, accessibility and availability of information and desire to gain deeper understanding are some of key factors that influence patients to access online health information. The study further revealed that access to online health information reinforces patient desired to seek professional care services and adhere to a case management plan provided by the health workers in addition to improving patient awareness and participation in management of their health.

Factors that Promote a Positive Childbearing Experience: A Qualitative Study.

Experiences of pregnancy and birth are important and have long-term impacts on the well-being of women and their families. Perinatal services should aim for care that promotes a positive childbearing experience, as well as optimizing health outcomes for the woman and newborn. This study aimed to understand the health system factors that promote a positive childbearing experience. Women who had a positive experience and had given birth in Australia in the previous 12 months were recruited for individual semistructured interviews. The interview guide focused on health system factors that participants credited with contributing to their positive experience of perinatal care. Interviews were conducted until data saturation was reached. Qualitative data were transcribed verbatim and analyzed using inductive thematic analysis. Data from 36 interviews were thematically analyzed, and 4 major themes were generated: health care provider attributes, health system attributes, communication and decision-making, and experience of care. The salient factors that promoted positive experiences included care that was respectful and individualized with effective communication, access to midwifery continuity of care models, and good integration between services. Competent and professional health care providers who facilitated shared decision-making were also essential. Although women often sought out care that promoted physiologic birth, they emphasized that the way they were cared for was more important than fulfilling specific birth aspirations. Quality maternity care has the capacity to support a woman's confidence in her own abilities and promote a positive, and sometimes transformative, childbearing experience.

Knowledge Attitude and Practices of Healthcare Service Providers About Minimum Service Delivery Standards

Worldwide Health care services are provided and regulated as well as monitored by applying standard regimens. It is pivotal for patient health, safety and efficient treatment and health services provision. Objective: To assess the knowledge, attitude and Practices of healthcare service providers about Minimum Service Delivery Standards. Methods: It is a cross sectional study in which questionnaire was developed to study minimum service delivery provision towards patients by professional health care providers. A complete Performa was filled by interviewing doctors (MBBS), dentists, nurses, dispensers and para medical staff working at BHUs and RHCs. The data was collected after informed consent following ethical considerations and guidelines by University of Lahore. The data was entered and analyzed using SPSS version 22. Results: The results show the good knowledge of HCPs was resounded in lowest parameter of 1.5% while poor knowledge was scored 95.5%. The attitude of HCPs toward was recorded the positive attitude 58.3% neutral 40.2% while negative attitude 1.5%. the Practices of MSDS at health facility was scored good Practices 4.9% Satisfactory Practices was recorded 0.4% while poor Practices of MSDS was recorded 94.7%. Conclusion: Using MSDS parameter the one can create a better environment of health care to patients. The medical and para medical staff should meet all standards assured in the current study to make a better place for the sake of health and treatment.

YouTube as a source of (mis)information on allergic rhinitis

BackgroundAllergic rhinitis is a very common chronic condition that affects nearly one-quarter of the adult population worldwide. The optimal management of allergic rhinitis includes useful information on several aspects of the condition. Social media and online platforms are increasingly being used to obtain health-related information. ObjectiveThe study aimed to evaluate and evaluate the popularity and usefulness of YouTube videos on allergic rhinitis. MethodsOut of 225 screened videos, 86 met the inclusion criteria. A scoring scheme was designed to evaluate and rate the content of the extracted data. Data on views, likes, dislikes, and comments were extracted, and data on the source of uploader, duration, and content quality were recorded. ResultsA total of 43% of the videos were classified as useful, 36% as misleading, and 21% as neither useful nor misleading. Although professional health care providers uploaded two-thirds of the videos, they accounted for only 24.4% of the total videos. Videos uploaded by television shows and YouTube channels had by far the most user interaction, accounting for 66.9% of the total likes, 66.8% of the total dislikes, and 54.0% of the total comments. This source alone accounted for 23.4% of the total views, but for 48% of the total misleading videos. ConclusionThe usefulness of YouTube videos on allergic rhinitis is varying and less than half of the videos provided useful information. If the proper conditions are met, selected YouTube videos on allergic rhinitis can be used as a source of information for patient education.

Movement disorders in COVID-19 times: impact on care in movement disorders and Parkinson disease.

The purpose of this review is to outline the impact of the COVID-19 pandemic on movement disorder holistic care, particularly in the care of people with Parkinson disease (PWP). As the pandemic unfolds, a flurry of literature was published regarding the impact of COVID-19 on people with Parkinson disease including the direct impact of infection, availability of ambulatory care, loss of community-based team care, and acceptability of telemedicine. COVID-19 has impacted the care of PWP in numerous ways. Recognizing infection in PWP poses challenges. Specific long-term complications, including emerging reports of long COVID syndrome is a growing concern. Caregivers and PWP have also been impacted by COVID-19 social isolation restrictions, with radical changes to the structure of social networks and support systems globally. In a matter of weeks, the global community saw an incredible uptake in telemedicine, which brought benefits and pitfalls. As PWP adapted to virtual platforms and the changing architecture of care delivery, the pandemic amplified many preexisting inequities amongst populations and countries, exposing a new 'digital divide'.

Mental Health Status of High School Students in Khartoum State, Sudan During the COVID-19 Pandemic: A Cross-Sectional Study

AimsThis study sought to assess mental health status of high school students in Khartoum State, to evaluate the participants’ adherence to COVID-19 preventive measures and to identify factors associated with commitment to COVID-19 guidelines and mental health status during the COVID-19 pandemic.MethodsThis was a descriptive, cross-sectional and institution-based study. 364 post-primary students in 10 schools were selected by multistage stratified cluster sampling. Mental health status was evaluated using the General Health Questionnaire (GHQ-12). Chi-square testing was used to identify influencing factors of mental health status and commitment to practicing COVID-19 preventive measures.ResultsA median commitment score of 2/5 was achieved. 70.8% of students in this study demonstrated low commitment (< 50%) to practicing COVID-19 preventive guidelines. Commitment to COVID-19 preventive measures was significantly associated with gender (p = 0.047), academic year (p = 0.033) and post-primary schools attended by the participants (p < 0.001). 36.5% of the participants’ GHQ-12 scores demonstrated severe psychological distress (GHQ-12 > 20/36). A mean GHQ-12 score of 18.4 and median of 19 was achieved, indicating moderate to severe psychological distress. GHQ-12 scores were significantly associated with incidence of COVID-19 infection among family members (p = 0.016).ConclusionOver one-third of high school students in Khartoum State demonstrated moderate to severe psychological distress as a result of the COVID-19 pandemic, which was significantly associated with first-degree family members having a confirmed COVID-19 diagnosis. Commitment to preventive measures set by the General Directorate of Global Health was significantly associated with gender and academic year. A lesser psychological impact could be achieved through timely health education, expression of confidence in professional healthcare providers and perception of sound health status, together with consistent public health campaigning.

Assessment of factors affecting attitudes and knowledge of pregnant women about COVID-19 vaccination

The aim of this study was to analyse knowledge and attitudes of pregnant women about Coronavirus disease (COVID-19) and its vaccine. Pregnant women who attended outpatient maternal care between October 2020 and March 2021 were invited to participate in this cross-sectional survey study. To identify the effect of baseline characteristics of participants on their vaccination decision, the pregnant women were divided into two groups as accepting or rejecting the COVID-19 vaccine. The Multiparity rate was significantly higher in the rejection group (73.8 vs. 42.3, p = .001). Education level and rate of employment in the professional health sector were significantly higher in the acceptance group (p = .001 and p = .008). A total of 103 (26.4%) pregnant women from the acceptance group, and 23 (10.9%) from the rejection group had a history of the death of relatives and acquaintances from COVID-19 (p = .001). The present study demonstrated that nulliparous status, higher education level, working as a professional healthcare provider and incidence of death in relatives due to COVID-19 significantly rise pregnant women’s acceptance of the COVID-19 vaccine. Considering the overall acceptance rate of 65%, improved vaccination programmes using all types of information sources need to be the main task to block the COVID-19 pandemic. IMPACT STATEMENT What is already known on this subject? There are previous studies that evaluated the attitudes and beliefs about several vaccine types among pregnant women. An important part of tackling the COVID-19 pandemic is the success of the COVID-19 vaccination program in pregnant women. In this respect, it is important to know the attitudes of pregnant women regarding COVID-19 vaccination. What do the results of this study add? The baseline characteristics of pregnant women with or without acceptance of COVID-19 vaccination were similar regarding COVID-19 infection. The rates of being not multiparous and a health worker were higher in women with acceptance of COVID-19 vaccination. The rate of loss of relatives was also higher in women with acceptance of COVID-19 vaccination. In women without acceptance of COVID-19 vaccination, the major drawback was related to the possibility of harm to their baby’s and own health. What are the implications of these findings for clinical practice and/or further research? In pregnant women, the attitude to COVID-19 vaccination may be modifiable by the design of focussed information media with respect to their education, occupation, and parity. Longitudinal studies are needed to determine whether this approach can effectively increase the rate of COVID-19 vaccination in pregnant women.

Identifying health care access barriers in southern rural Ecuador

BackgroundAccess to professional health care providers in Loja Province, Ecuador can be difficult for many citizens. The Health Care Access Barrier Model (HCAB) was established to provide a framework for classification, analysis, and reporting of modifiable health care access barriers. This study uses the HCAB Model to identify barriers and themes impacting access to health care access in southern rural Ecuador.MethodsThe research team interviewed 22 participants and completed 15 participant observation studies in the study area. Interviews and a single focus group session of artisans were recorded and transcribed from Spanish to English, and thematic analysis was performed.ResultsThe thematic analysis found financial, structural, and cognitive health care access barriers. Cost of medications, transportation, missed responsibilities at work and home, difficulty scheduling appointments, and misconceptions in health literacy were the predominant themes contributing to health care access. These pressure points provide insight on where actions may be taken to alleviate access barriers.ConclusionModifiable health care access barriers outlined in the HCAB are evident in the study area. Further research and implementation of programs to resolve these barriers, such as the creation of health care subcenters and/or mobile clinic, insurance coverage of specialized care, increasing availability and accessibility to affordable transportation, improving roadways, introduction of a 24/7 call center to schedule medical visits, monetary incentive for primary care physicians to practice in rural and underserved areas, provision of affordable work equipment, and emphasizing the improvement of health care literacy through education, may diminish current barriers, identify additional barriers, and improve overall health in the rural area of Loja, Ecuador and similar rural regions around the world.

Public Health Detailing on Sexual Health Care in San Francisco: Learnings From Real-World Implementation.

Public health detailing is an intervention in which a public health professional visits health care providers to educate them about evidence-based approaches to improve health. The San Francisco Department of Public Health conducted a public health detailing program from 2016 to 2018 to improve sexual health care and preexposure prophylaxis services in the city. We conducted a mixed-methods study to understand the implementation of detailing and explore examples of changes to clinicians' clinical behaviors. We surveyed 203 clinicians, conducted 60-minute qualitative interviews with 7 clinicians and 4 detailers, and analyzed tracking forms. We used descriptive statistics to assess associations in the surveys. We used qualitative thematic analysis to understand facilitators and barriers to detailing and identify ways to improve the process and identify its potential benefits. In interviews, both clinicians and detailers had a favorable view of detailing as a tool to connect health department expertise to clinicians. Detailers cited challenges such as limited clinic time, provider turnover, and policies that limit their access to clinicians. These challenges may attenuate the real-world benefits of detailing. Clinicians offered examples of how detailing altered their behaviors, such as taking sexual health histories, building knowledge and confidence about sexual health, and using health department services. Matched surveys (n = 21) showed preliminary changes to prescribing preexposure prophylaxis. Public health detailing is a promising approach to increase clinicians' knowledge and confidence to offer sexual health care services, build buy-in, and support connection to health departments. Detailing programs require sufficient investment and staff support to build lasting and collaborative relationships between clinicians and public health departments and to assess the impact of the intervention.

Understanding Caregiving and Caregivers: Supporting Children and Youth With Special Health Care Needs at Home.

Caregiving encompasses the nurturing, tasks, resources, and services that meet the day-to-day needs of children and youth with special health care needs (CYSHCN) at home. Many gaps exist in the strategies currently offered by the health care system to meet the caregiving needs of CYSHCN. The work of family caregivers of CYSHCN is known to be extensive, but it is so poorly understood that it has been described as "invisible". This invisibility leads to poor communication and gaps in understanding between professional health care providers and family caregivers. To address these gaps, health care researchers must work with family caregivers to incorporate their expertise on caregiving and create meaningful and sustainable research partnerships. A growing body of research is attempting to remedy the problem of caregiving invisibility and lay better foundations for successful integration between health care settings, family caregiving, professional caregiving, and community supports for families of CYSHCN. We identify high-priority gaps in CYSHCN caregiving research and propose research questions that are designed to accelerate growth in evidence-based understanding of the work of family caregivers of CYSHCN and how best to support them.

Parental Decision-making: Intersections of Hope, Communication, Relationships, and Emotions

<h3>Category/Date</h3> Research Poster presented at NAPNAP's 42^nd National Conference on Pediatric Health Care, March 24^th, 2021. https://napnap21.org/community/#/home <h3>Background</h3> Children born with complex life-threatening chronic conditions (CLTCs) often require highly complex care and decision-making. Previous research has documented that decisions about healthcare treatment can be intimately connected with personal perceptions and interpretations of information, communication, and parent empowerment. Parents of children born with CLTCs often experience an uncertain trajectory in which hope plays a critical, but largely unexplored, role in their decision-making. <h3>Purpose</h3> This qualitative descriptive study aimed to explore how parental and provider hope may influence decision-making and care for a child born with a CLTC. <h3>Methods</h3> This was a Duke University IRB approved study. Data collection for each case was derived from qualitative semi-structured interviews occurring at least monthly until one year after study enrollment, unless death of the child intervened. Interview questions targeted parental and provider perceptions of previous or anticipated decisions, experience caring for the infant, and how provision of care had been affected by decisions made. We utilized a subset of 193 interviews with parents and healthcare providers responsible for the care of 10 infants with complex congenital heart diseases (cases), selected from a large prospective longitudinal study on parent and provider decision-making for 35 infants with CLTCs. Enrollment of infants with complex congenital heart disease began at birth for those with a prenatal diagnosis, or otherwise at time at diagnosis. Each case consisted of an infant, at least one parent, and at least three providers (e.g. attending physician, nurse, nurse practitioner). Transcripts were uploaded to and analyzed in NVivo 12 and a codebook was defined. Generated themes illustrated the intersection of hope with the dynamics of communication, relationships, and emotions that in turn influence decision-making. <h3>Results</h3> Through our analysis, we developed a central framework of the effects of hope on decision-making through the influence of three factors: emotions, relationships, and communication. The linkages between these concepts are integral, yet fluid and nonlinear. Overall, parental hope remained strong over the course of the study, and played a pivotal role in parents' decision making despite changes in relationships with providers and other adults, fluctuating emotions, and both positive and negative perceptions of communication. Both parents and professional health care providers express a range of emotions which impact communication, that appear to be strongly linked to hope and decision-making. Additionally, relationships as well as communication between parents and provider both appeared responsible for and responsive to changes in hope which impacted parental and provider decision making for the child with CLTCs. <h3>Discussion/conclusion</h3> Multiple barriers exist to parent-provider communication, including structural (e.g. rotating providers) as well as regarding parental characteristics (e.g. education, age, medical insurance) and opinions and judgements placed on parents by providers. Parents of children with CLTCs benefit from emotional and practical support, trusting relationships with providers, agency in and information about their child's care. To support these needs, it is crucial that healthcare providers receive training to become comfortable having difficult, trusting, and honest conversations with parents and be mindful of parents' own needs and responsibilities.

Impact of COVID-19 Pandemic on (Health) Care Situation of People with Parkinson's Disease in Germany (Care4PD).

The Care4PD study examined the impact of the COVID-19 pandemic on the care situation of people (PwP) with Parkinson’s disease in Germany. A comprehensive, nationwide, anonymous questionnaire for PwP was distributed by the members’ journal of the German Parkinson’s Disease Association and in several PD specialized in- and outpatient institutions. PwP subjectively evaluated their general care situation and individual impairments during the pandemic. We analyzed 1269 eligible out of 1437 returned questionnaires (88.3%) and compared PwP with (p-LTC) and without (np-LTC) professional long-term care. Both groups rated the general pandemic-related consequences as being rather mild to moderate (e.g., worsening of symptom or concerns). However, familial/social contact restrictions were indicated as most compromising, whereas access to outpatient professional health care providers was less affected. PwP with professional LTC reported more impairment than those without. COVID-19 vaccination rates and acceptance were generally high (p-LTC: 64.3%, np-LTC: 52.3%) at the time of the study, but realization of sanitary measures—especially wearing masks as a patient during care sessions—still needs to be improved. Technical options for telemedicine were principally available but only rarely used. Altogether, during the COVID-19 pandemic, PwP in Germany seemed to have a relatively stable health care access, at least in outpatient settings, while mainly social isolation compromised them. The p-LTC group was more impaired in everyday live compared with the np-LTC group.

Crossroads of parental decision making: Intersections of hope, communication, relationships, and emotions.

Parents of children born with complex life-threatening chronic conditions (CLTCs) experience an uncertain trajectory that requires critical decision making. Along this trajectory, hope plays an influential but largely unexplored role; therefore, this qualitative descriptive study explores how parent and provider hope may influence decision making and care of a child born with CLTCs. A total of 193 interviews from 46 individuals (parents, nurses, physicians, and nurse practitioners) responsible for the care of 11 infants with complex congenital heart disease (CCHD) were analyzed to understand how hope features in experiences related to communication, relationships, and emotions that influence decision making. Overall, parental hope remained strong and played a pivotal role in parental decision making. Parents and professional healthcare providers expressed a range of emotions that appeared to be integrally linked to hope and affected decision making. Providers and parents brought their own judgments, perceptions, and measure of hope to relationships, when there was common ground for expressing, and having, hope, shared decision making was more productive and they developed more effective relationships and communication. Relationships between parents and providers were particularly influenced by and contributory to hope. Communication between parents and providers was also responsible for and responsive to hope.

Effects of helping relationships on health-promoting lifestyles among patients with chronic kidney disease: A randomized controlled trial

BackgroundHealthy behaviors can slow the progression of chronic kidney disease. Professional healthcare providers deliver education, physical exercise programs, motivation consultations, and stage-tailored strategies for improving health behaviors, but their effectiveness reported mixed. The helping relationships of significant others based on the transtheoretical model have been shown to be beneficial in facilitating and practicing health-promoting behaviors. However, few studies have examined the effects of helping relationships on health-promoting behaviors among patients with chronic kidney disease. ObjectivesThe aim of this study was to examine the effects of the intervention strategies of significant others in their helping relationships with patients to advance stages of exercise and diet behaviors, and to improve health-promoting lifestyles. DesignA randomized controlled study. SettingsTwo outpatient nephrology clinics in southern Taiwan. ParticipantsSixty participants in each of the two groups. MethodsPatients were randomly assigned to either the intervention group (n = 60) whose significant others received strategies for helping relationships for 12 months, or the control group (n = 60). The Stage of Change of Exercise and Diet Behaviors, and Health Promoting Lifestyle Profile-II Chinese version were assessed at baseline and 3, 6, 9, and 12 months after receiving the helping relationship interventions tailored to stage of change from significant others. ResultsGeneralized estimating equation analyzes revealed that the intervention group, when compared to the control group, had significantly advanced stages of change in exercise and diet, and improvement in health-promoting lifestyle over time. Adult children and spouses were the most common significant others to help patients practice healthy behaviors, compared to previous studies where professional healthcare providers were the significant others. ConclusionsIndividualized plans for healthy behaviors should take into consideration patients’ readiness for adopting stage-tailored strategies of helping relationships of significant others to adhere to the health-promoting lifestyle. To promote a healthier lifestyle, significant others, such as spouses and adult children, should be included in treatment programs.

Experience with introducing peer trainers into mental health education

ABSTRACT People who have experienced mental health problems often encounter stigmatisation, mainly by professional mental health care providers. Therefore, involvement of experts by experience in courses taught at a higher education institution that provides training for future healthcare professionals aims at destigmatising mental illnesses. Peer trainers have a lived mental health problems experience who take on the role of trainers to present the latest mental health care trends and theories and introduce recovery elements into the educational process. The data on which the article is based were gathered over a period of three years from focus groups involving 2nd year students of the bachelor’s degree programme of ‘Clinical Social Worker’. The results obtained clearly show the destigmatising effect of this type of teaching: what has proven to be crucial in this regard was, on the one hand, the experience of former patients, and on the other hand, a counterweight to the often-one-sided information prevalent in professional literature on mental health available in the Czech Republic. The teaching reinforced the students’ ability to work in a multidisciplinary team together with a peer support worker and also undermined any prejudice they may have had towards people with mental health problems.

Flexible protocols and paused audio recorders: The limitations and possibilities for technologies of care in two global mental health interventions

Lay-counselors have become a key human resource in the field of global mental health, aiming to address the estimated one-million-person shortage of mental healthcare providers. However, the role of lay-counselors is ambiguous and in tension: their role is quasi-professional, with specific training and skills that set them apart within communities, yet their role is also defined in contrast to professional mental healthcare providers. We explore how these tensions manifest through the material technologies for protocolizing and evaluating lay-counselor roles. We draw on our ethnographic fieldwork within two global mental health interventions that represent different ends of the spectrum of lay-counselor involvement, in order to explore the possibilities and limitations of such material technologies. Thinking Healthy Program-Peer delivered is a cognitive behavioral therapy-based intervention for women with perinatal depression delivered in Goa, India, and Tuko Pamoja (Swahili: “We are Together”) is a family therapy intervention to improve mental health and family functioning in Eldoret, Kenya. First, we explore how intervention manuals – the step-by-step protocols that guide therapy delivery – can both constrain counselors to a script and enable their novel contributions to therapeutic encounters. Then, we examine assessment tools used to evaluate interventions writ large and lay-counselors specifically. We describe how, even where lay-counselors are encouraged to bring their own expertise into therapy delivery, this expertise is not often reflected in evaluation tools. Instead, the focus tends toward fidelity checklists, which require adherence to the manualized intervention and can penalize counselors for “going off book.” Even though lay-counselors are often recruited specifically because of their existing roles and “local expertise,” we argue that the material technologies of interventions can at times limit how their expertise is enabled and valued. We offer recommendations for global mental health programs to facilitate greater recognition and valuing of lay-counselor expertise.

Wellbeing, symptoms of trauma, and personal resources in Palestinian professional helpers: a cross-sectional quantitative survey

BackgroundProfessional helpers working in adverse circumstances are at risk of developing psychosocial stress and signs of primary and secondary trauma (eg, anxiety and hyperarousal). We used modelling to investigate whether and to what extent personal resources (ie, post-traumatic growth, sense of coherence, and wellbeing) of Palestinian helpers affected their experience of psychological distress and trauma symptoms. MethodsEligible participants were professional health-care providers working in Gaza and the West Bank, occupied Palestinian territory, between June and October, 2018. We used the following quantitative measures: WHO Well Being Index (WHO-5), General Health Questionnaire (GHQ-12), Impact of Event Scale (IES-13), Sense of Coherence Scale (SOC-3), and Post-traumatic Growth Index (PTGI-10). Data were analysed by multivariate structural equation modelling with latent and empirical indicators to test the fit of these constructs to the empirical data. The model was specified to evaluate whether and to what extent mental resources may be interpreted as a set of protective factors mitigating risk factors. The study was approved by the ethics board of the University of Milano-Bicocca, Milan, Italy. Written consent was obtained from participants. Findings181 participants were enrolled, ranging in age from 18 to 65 years (mean 31·1, SD 8·7). 135 (75%) were men. The mean GHQ-12 score was 17·7 (SD 7·5), revealing a medium to high degree of psychological trauma. 60 (33%) participants reported low mood (although not necessarily depression) on WHO-5. The structural model showed an excellent fit (χ2 [24] 31·8, p=0·132, root mean square error of approximation 0·043, 90% CI 0·019–0·077). Stronger personal resources were associated with lower levels of both psychological distress (β=–0·25, p<0·01) and trauma (β=–0·16, p<0·01). Personal resources were especially associated with reduced levels of anxiety (β=–0·23, p<0·01) and intrusion symptoms (β=–0·22, p<0·01). InterpretationOur integrated model showed that, despite heavy psychological burden, perceptions of post-traumatic growth, coherence, and wellbeing are associated with reduced psychological distress. Targeted training of health-care providers focused on self-awareness of their personal skills and survival resources could improve their psychological health. The study was limited by the cross-sectional research design, and the outcomes of the structural model should be read in terms of probabilistic associations rather than cause-effect relationships. A second limitation concerns the kind of data collected. All the research instruments yielded self-reported quantitative scores, meaning that the standardised β weights in the model could potentially be an artifact of common method variance (ie, attributable to the measurement method rather than to the constructs themselves. FundingNone.

Household’s Choice of Healthcare Provider in Kenya

Abstract People respond in different manners to various injuries or illnesses. Factors that influence response to illness or injuries are usually categorized into enabling factors, predisposing factors and perceived factors. These responses are self-treatment, seeking healthcare services from professional healthcare providers (private, public and mission healthcare facilities), seeking treatment from traditional healers and not seeking treatment at all. Despite an increase in the utilization rate of healthcare facilities, there is still a high prevalence of self-treatment among households in Kenya. This article, therefore, aims to examine the factors that influence household’s choice of the healthcare provider by making use of national household survey data subjected to multinomial probit regression analysis. The article evidences that severity of illness, wealth, health insurance, distance, employment status, education as well as place of residence influences household’s choice of healthcare provider. This implies that government should institute policies aimed at creating employment opportunities, promoting education, construction of additional healthcare facilities and encouraging more households to have health insurance covers.

Accessing community dementia care services in Ireland: Emotional barriers for caregivers.

Despite the benefits of utilising community-based care services (CBS) for people with dementia and their caregiver being well established, people with dementia and caregivers use fewer services in comparison to other people in need of care. While societal, cultural and logistical factors effecting caregiver use of CBS are frequently studied, research of internal emotional barriers, mental limitations created by one's own self that prevents open communication of thoughts and feelings, and their effect on CBS use is limited. This paper explores internal emotional barriers on caregivers' use of CBS within the Irish Healthcare System. Professional Healthcare Providers were also interviewed as a preliminary indicator of their awareness of these internal emotional barriers and their impact on caregivers' use of CBS. Using interpretive description methodology, interviews with 20 caregivers and fourteen dementia professional healthcare providers were transcribed and a thematic analysis methodology applied to illuminate themes/patterns within participants' subjective perceptions of caregivers emotional barriers to using CBS. Four themes emerge: reluctance to question general practitioner (GP) authority; embarrassment during level of care requirement reviews; sense of obligation to provide all care; and fear of stigma. Caregivers interviewed were reluctant to communicate concerns with professional healthcare providers (PHPs), thereby reducing the PHP's awareness of these barriers and delaying/preventing use of CBS. As key gatekeepers within the care pathway, GPs should address the uneven power dynamic with the caregiver through user-centred models of care, which actively encourage open dialogue, and receive training to identify the indicative behaviours of internal emotional barriers and empower the caregiver to communicate their feelings/concerns directly.

Practice and Acceptability of Yoga Among Pregnant Women in India: A Cross-Sectional Survey.

The practice of yoga is beneficial during pregnancy, but we do not know what proportion of pregnant women in India practice yoga. To address this research gap, we conducted a study to address following research questions: (1) What proportion of pregnant women in rural Maharashtra practice yoga? (2) Which sociodemographic factors are associated with the practice of yoga among these women? and (3) What is the perceived acceptability of integrating yoga-based intervention into routine antenatal care? A consecutive sample of pregnant women attending the antenatal clinic of a tertiary care hospital, who could fluently communicate in Marathi and who did not have any serious physical illness or cognitive impairment, were included in this cross-sectional survey. A total of 228 subjects were included in our study. Yoga was practiced by 38 of them (16.7%, 95% confidence interval 12.1-22.1) during the current pregnancy. Older age, higher education, and being a professional (teacher, healthcare provider, or bank official) were associated with practice of yoga. More than half of the participants (53.9%) thought that yoga should be included as part of their antenatal care; this perceived acceptability of yoga was not associated with any of the sociodemographic factors except for the participants' occupation. This study provides information about the prevalence and sociodemographic factors associated with the practice of yoga among pregnant women in a rural setting in India. It also explores the perceived acceptability of yoga-based interventions among this group. Findings from this study can inform design of future studies to evaluate the effect of yoga-based interventions during pregnancy.