Regular Health Care Services Research Articles

Community People Preparedness and Response on Prevention and Control of COVID-19 Best Practice in Bangladesh

Purpose: The major objectives of the study were to assess the knowledge, attitude & practice (KAP) towards community preparedness and response on prevention of COVID-19 among the community people. Method: A sample survey was conducted to collect data from people admitted to a district-level tertiary hospital for the treatment of various health complications during the COVID-19 pandemic. A total of 300 randomly selected patients and their attendants were interviewed in the hospital setting. Results: The mean knowledge score was 18.73 out of 24 and the main sources of information were TV (86.5%), radio (13%), newspaper (13%), social media (13.5%), friends/relatives (14%), formal healthcare providers (6%) and religious leaders (3%). Knowledge was significantly poor among aged people, women, less educated, and less earning. The majority of the participants (79%) suggested wearing facemasks as effective tools to prevent COVID-19 from spreading, whereas 56% mentioned maintaining physical or social distance as crucial to prevent the infection. We found strong relationship between monthly total family expenses and wearing of facemasks by gender to prevent the COVID-19 (x2= 18.405; Cramer’s V= .17, df = 8; sig; P= < .018). Similarly maintaining physical/social distance to prevent COVID-19 is also related to respondents’ economic strata (x2= 43.741; Cramer’s V= .14, df = 20; Sig; P= < .002). Conclusions: Awareness program on COVID-19 is very important to prevent the spread of the deadly virus. Effective communication intervention with increasing treatment facilities is essential for the prevention and control of COVID-19. Government and development agencies should prioritize the COVID-19 response program with regular health care services.

Episodes of care in a primary care walk-in clinic at a refugee camp in Germany \u2013 a retrospective data analysis

BackgroundFrom 2015 to 2016 Germany faced an influx of 1.16 million asylum seekers. In the state of Hamburg Primary Care walk-in clinics (PCWC) were commissioned at refugee camps because the high number of residents (57,000 individuals) could not be provided with access to regular healthcare services. Our study aims were (1) to describe the utilization of a PCWC by camp residents, (2) to compare episodes of continuous care with shorter care episodes and (3) to analyse which diagnoses predict episodes of continuous care in this setting.MethodsA retrospective longitudinal observational study was conducted by reviewing all anonymized electronic medical records of a PCWC that operated from 4th November 2015 to 22nd July 2016 at a refugee camp in Hamburg. Episodes of care (EOC) were extracted based on the international classification of primary care-2nd edition (ICPC-2). Outcome parameters were episode duration, principal diagnoses, and medical procedures.ResultsWe analysed 5547 consultations of 1467 patients and extracted 4006 EOC. Mean patient age was 22.7 ± 14.8 years, 37.3% were female. Most common diagnoses were infections (44.7%), non-communicable diseases (22.2%), non-definitive diagnoses describing symptoms (22.0%), and injuries (5.7%). Most patients (52.4%) had only single encounters, whereas 19.8% had at least one EOC with a duration of ≥ 28 days (defined as continuous care). Several procedures were more prevalent in EOC with continuous care: Blood tests (5.2 times higher), administrative procedures (4.3), imaging (3.1) and referrals to secondary care providers (3.0). Twenty prevalent ICPC-2-diagnosis groups were associated with continuous care. The strongest associations were endocrine/metabolic system and nutritional disorders (hazard ratio 5.538, p < 0.001), dermatitis/atopic eczema (4.279, p < 0.001) and psychological disorders (4.056, p < 0.001).ConclusionA wide spectrum of acute and chronic health conditions could be treated at a GP-led PCWC with few referrals or use of medical resources. But we also observed episodes of continuous care with more use of medical resources and referrals. Therefore, we conclude that principles of primary care like continuity of care, coordination of care and management of symptomatic complaints could complement future healthcare concepts for refugee camps.

Patient satisfaction & use of health care: a cross-sectional study of asylum seekers in the Freiburg initial reception centre

BackgroundIn response to a high number of incoming asylum seekers and refugees (AS&R) in Germany, initial reception centres were established to provide immediate shelter, food and health support. This study evaluates the satisfaction with and use of the health care available at the Freiburg initial reception centre (FIRC) where an integrated health care facility (ICF) was set up in 2015.MethodsWe assessed use and satisfaction with health services available to resident AS&R within and outside the FIRC in a cross-sectional design. Data were collected in 2017 using a questionnaire with both open and closed ended items.ResultsThe majority of 102 included participants were young (mean age 24.2; 95%CI 22.9–25.5, range 18–43) males (93%), from Sub-Saharan Africa (92%). High use frequencies were reported from returning patients of the ICF; with 56% fortnightly use and 19% daily use reported. The summary of satisfaction scores indicated that 84% (CI95 76–89%) of respondents were satisfied with the ICF. Multivariate analysis showed female gender and non-English speaking as risk factors for low satisfaction. Outside the FIRC, the satisfaction scores indicated that 60% of participants (95%CI 50–69%) were satisfied with the health care received.ConclusionOur study shows that AS&R residing in the FIRC are generally satisfied with the services at the ICF, though strategies to enhance care for females and non-English speakers should be implemented. Satisfaction with health care outside of the FIRC was not as high, indicating the need to improve quality of care and linkage to regular health care services.

Promoting the application of implementation research in the field of public health in China

With the rapid development of medical practice, evidence-based medicine combines the best evidence, clinical experience and patient value, the role of evidence-based public health in public health has become increasingly prominent. However, only about half of the evidence-based medical evidence can be truly translated into regular health care services, and the conversion process takes a long time. In order to bridge the gap between best evidence and clinical or public health applications, implementation research emerged as a new discipline. This paper introduce the background, development, theory and methods of implementation research, and discusses it's application and challenges of implementing scientific in the field of public health in China.

Barriers to Using a Nationwide Skin Cancer Screening Program: Findings from Germany

Background: In 2008, a nationwide standardized and systematic skin cancer screening (SCS) service, which is globally unique, was implemented in Germany. We aimed to provide current data on SCS use, to explore barriers to SCS usage, and to identify population groups with lower rates of SCS use. Methods: We analyzed data from 2,635 participants (18-45 years) in the National Cancer Aid Monitoring on Sunbed Use. Data on SCS use, barriers to SCS, and sociodemographic characteristics were obtained. Chi-square tests and logistic regression analyses were performed to analyze the data. Data was weighted by age, sex, educational level, and federal state. Results: In total, 39.0% of participants reported having been screened for skin cancer at least once in their lifetime. The subjective importance of different barriers varied depending on the participants' educational level. SCS use was negatively associated with male sex (odds ratio (OR) = 0.63, p < 0.001), low level of education (OR = 0.83, not significant), immigrant background (OR = 0.63; p < 0.001), and having no employment. Conclusion: Although the SCS is part of the regular healthcare services offered in Germany, our data showed lower usage among certain population groups. Barriers relevant for these groups should be considered when developing measures to increase SCS use.

“Safety at Home”: Experiences From Testing of Video Communication Between Patients and Home Health Care Personnel

The implementation of welfare technology in Norwegian municipals is a governmental priority, but there is little research on transfer of technological solutions into regular health care services. The aim of the project “Safety at home” was to test and evaluate the use of video communication between patients and health care personnel. There were two test periods, with the initial phase focusing on patients with chronic obstructive pulmonary disease (COPD). The second phase focused on patients who most likely would benefit from video communication. Nine patients tested the equipment, and they were interviewed afterward. In addition, nursing personnel evaluated the project through focus group interviews. The results identified that the equipment was user friendly and contributed to the patients’ feelings of safety. However, there were concerns about video calls replacing the “human touch” of home visits. The personnel also experienced that the technological solution had limitations, and new tasks added to their workload. The choice of focusing on COPD patients was considered a disadvantage, and we recommend that future projects should not be restricted by diagnosis and should target the most eligible candidates.

P096 HIV testing in tertiary healthcare settings – staff beliefs and concerns

IntroductionUndiagnosed HIV remains a problem in the UK. Locally, we have an extremely high prevalence of HIV (>8:1000). BASHH, BHIVA and NICE recommend routine HIV testing in medical admissions in...

Moving the self-esteem of people with epilepsy by supportive group: a clinical trial.

People with epilepsy (PWE) face physical and mental illness, and social stigma, which affect their self-esteem and quality of life. The purpose of this study was to examine the effects of a support group on the self-esteem of PWE. A Quasi-experimental study was performed on 120 PWE in the Epilepsy Clinic at Srinagarind Hospital. The experimental group (N=60) attended the support group before receiving regular health care services. The control group (N=60) received only regular healthcare services. Data was collected by using the Rosenberg self-esteem scale scoring before and after the experiment. The score was analyzed by using a paired t-test and an independent t-test. The study showed that before the experiment, the self-esteem score of the control group was significantly higher than the experimental group. After the experiment, the scores of the control group and the experimental group showed a significant statistical difference. The score in the control group was significantly lower than the experimental group, while the score in the experimental group was significantly higher than before the experiment. The support group improves the self-esteem of PWE. Medical personnel should set up a support group for PWE to enhance their self-esteem.

Efficacy of lifestyle interventions in physical health management of patients with severe mental illness

Awareness of the importance of maintaining physical health for patients with severe mental illnesses has recently been on the increase. Although there are several elements contributing to poor physical health among these patients as compared with the general population, risk factors for cardiovascular disease such as smoking, diabetes mellitus, hypertension, dyslipidemia, metabolic syndrome, and obesity are of particular significance due to their relationship with mortality and morbidity. These patients present higher vulnerability to cardiovascular risk factors based on several issues, such as genetic predisposition to certain pathologies, poor eating habits and sedentary lifestyles, high proportions of smokers and drug abusers, less access to regular health care services, and potential adverse events during pharmacological treatment. Nevertheless, there is ample scientific evidence supporting the benefits of lifestyle interventions based on diet and exercise designed to minimize and reduce the negative impact of these risk factors on the physical health of patients with severe mental illnesses.