Need For Services Research Articles

Access to specialized health care services among older Canadians.

Canada is experiencing rapid population aging, which has a wide range of implications, including an increased need for health care services. However, very few studies have examined use of specialized health care services (e.g., visits to medical specialists, non-emergency tests, and surgeries) among older Canadians. Data from the Canadian Health Survey on Seniors - 2019/2020 were used to examine specialized health care service use among older Canadians. Latent class analysis was calibrated using a nationally representative sample of 39,047 Canadians aged 65 years or older to identify distinct patterns of need factors related to health care service use. Multivariable logistic regression, stratified by gender, was used to examine the association of predisposing characteristics, enabling resources, and need factors with specialized health care service use. In 2019/2020, an estimated 2.6 million older Canadians (43.4%) visited medical specialists, 1.4 million (23.2%) got non-emergency tests, and 0.6 million (10.4%) had non-emergency surgeries. Among those, 15.6% reported experiencing difficulties accessing services. Women were less likely than men to have visited medical specialists and have received non-emergency tests. Lower education was consistently associated with lower odds of specialized health care service use. Individuals in the multimorbidity, high stress-multimorbidity-disability, and poor physical and mental health classes were more likely than those in the comparatively healthy class to use specialized health care services and to experience difficulties accessing them. Findings of this study highlight gender differences and the importance of considering multidimensional need factors - ranging from physical health to mental health to psychosocial factors - in examining use of specialized health care services.

Insurance Coverage for Gender-Affirming Voice and Communication Services: An In-Depth Analysis in a Midwestern U.S. State

Purpose: The aim of this study was to explore the gap between the need for gender-affirming voice and communication services (GAVCS) and insurance coverage within one state. Method: An electronic, cross-sectional survey of transgender/gender-diverse (TGD) adults assessed the incidence of insurance and cost barriers to GAVCS. Then, policies from 22 major insurers were reviewed using a web-based search and telephone inquiries. Finally, a tool was developed for clinicians to share available coverage for GAVCS by insurer. Results: Over half (53%) of 115 respondents reported vocal incongruence, but only 19.1% had pursued GAVCS. Of those who had not, 57% reported cost and/or insurance coverage were barriers (most of whom were commercially insured). Less than half of major Ohio insurance plans mentioned GAVCS coverage, and of those who did, less than half would consider covering it on a case-by-case basis. Creation of a tool that explained coverage across insurance companies was helpful, but challenging and labor-intensive. Conclusions: TGD individuals often experience a mismatch between their gender identity and societal perceptions of their voice, which can worsen dysphoria and compromise safety. GAVCS align voice with gender identity but are inconsistently covered by health insurance and can be costly, particularly for individuals who face socioeconomic marginalization. Inconsistent transparency in communicating coverage criteria further exacerbates access to GAVCS. Poor insurance coverage of GAVCS is an important barrier to accessing this evidence-based care, and more transparency and consistency in coverage is critical.

Pekan Sagu Innovation Regains the Public Service Moment of Truth

The digital era has influenced public service innovation. Many districts/cities in Indonesia use digital service innovation to overcome the maladministration problem in civil registration services, however, Seluma regency government has chosen to maintain physical moment of truth through the Pekan Sagu innovation. This innovation is in the form of increasing service hours on Saturdays and Sundays through door-todoor service. The researcher chose a qualitative paradigm in order to reveal the natural conditions of the unit of analysis with a case study design. Primary and secondary data were collected through interviews, observation, and documentation studies, with triangulation of sources, time, and methods. The research results show that Pekan Sagu has the dimensions of compatibility, complexity, trialability and observability. This innovation maintains the public service moment of truth which is actually the weak point of previous problems of public service because of maladministration. A direct in-touch service policy with an extension of service time can be a short-term solution to overcome some target groups’ problem who are not yet technologically literate, however, the government still has to educate citizens and prepare the need for digital-based services to meet the demands of long-term civil registration services.
 Keywords: innovation, public service

Socialines paslaugas teikiančių įstaigų biudžeto sudarymas ir analizė: globos namų atvejis

One of the main functions of social protection is the provision of social services to peoplewho need them. In today's society, the need for social services tends to increase and needs to beadequately funded. However, the issues of the management and financing of these services have notbeen sufficiently investigated. In order to fill this gap, this article examines the financing arrangementsfor social services. It also analyses and evaluates the preparation and implementation of the budget ofthe institution providing such services. The object of the study is the budget for 2020-2022 of one of theinstitutions providing social services – care homes. The aim of the study: after examining the nature ofsocial services and the arrangements for their management and financing, to assess the arrangementsfor preparing the budget of the care home and to analyse it budget for the period 2020-2022. The studyfound that the projected revenue and cost budget of the care home is quite different from the actualrevenue and cost of the institution. The study identified the reasons for these variances and madesuggestions for improving the preparation of the budget project with a view to reducing the variancesbetween planned and actual amounts in future.

Community Preferences for the Care of Older People at the End of Life: How Important is the Disease Context?

Population preferences for care at the end of life can inform palliative care policy and direction. Research investigating preferences for care at the end of life has focused predominantly on the context of advanced cancer, with relatively little attention to other life-limiting illnesses that are common causes of death. We aimed to investigate preferences for the care of older people at the end of life in three different disease contexts. The purpose was to understand if population preferences for care in the last 3 weeks of life would differ for patients dying from cancer, heart failure or dementia. Three discrete choice experiments were conducted in Australia with a general population sample using similar methods but different end-of-life disease contexts. Some attributes were common across the three experiments and others differed to accommodate the specific disease context. Each survey was completed by a different panel sample aged ≥45years (cancer, n=1548; dementia, n=1549; heart failure, n=1003). Analysis was by separate mixed logit models. The most important attributes across all three surveys were costs to the patient and family, patient symptoms and informal carer stress. The probability of choosing an alternative was lowest (0.18-0.29) when any one of these attributes was at the least favourable level, holding other attributes constant across alternatives. The cancer survey explored symptoms more specifically and found patient anxiety with a higher relative importance score than the symptom attribute of pain. Dementia was the only context where most respondents preferred to not have a medical intervention to prolong life; the probability of choosing an alternative with a feeding tube was 0.40 (95% confidence interval 0.36-0.43). This study suggests a need for affordable services that focus on improving patient and carer well-being irrespective of the location of care, and this message is consistent across different disease contexts, including cancer, heart failure and dementia. It also suggests some different considerations in the context of people dying from dementia where medical intervention to prolong life was less desirable.

Food insecurity and associated health and social determinants among older adults in Ghana: Analysis of the WHO’s study on global AGEing and adult health (SAGE), 2014–2015

This study was conducted to assess the prevalence and factors associated with Food Insecurity (FI) and further quantify its association with unmet need for health services and health-related outcomes among older adults aged 50 years and above in Ghana. The Ghana Study on Global AGEing and Adult Health was used. Body Mass Index (BMI), depressive episodes, functional difficulties (FD), low Quality of Life (QoL), memory decline, and Unmet Needs of Health Services (UNHS) are the the study outcomes. Ordinary Least Square, and Poisson regression analysis modified with Mahalanobis distance matching within propensity score caliper weights were employed. Stata 16.1 was used to perform analysis and a p-value < 0.05 was deemed significant. The prevalence of FI among older adults aged 50 years or older in Ghana was approximately 28 %(95 %CI = 24.5–31.7) and was strongly associated with lower educational attainment and social support. The prevalence ratio of depression, FD, low QoL and UNHS among older adults who experienced FI were; 3.43(95 %CI = 2.25–5.21), 1.18(95 %CI = 1.12–1.23), 2.01(95 %CI = 1.54–2.62), and 1.46(95 %CI = 1.01–2.11). Memory significantly decreased by 85 percentage points% among food insecure older adults [aβ(95 %CI) = −0.85(−1.62–−0.07)]. Older adults with relatively higher educational attainment and social support are less likely to suffer FI and associated limited health and poor social well-being. In the national quest to achieve SDG 2, these health and social determinants of FI among older adults should be considered in the implementation of the national ageing policy to improve the health and well-being of older adults in Ghana.

Association of concussion/brain injury symptoms and diagnosis with mental and social well-being in 2020 National Health Interview Survey (NHIS) children

ABSTRACT Background Population-based data regarding the associations between prior concussion or brain injury symptoms/diagnosis and mental/social well-being is lacking for U.S. children. Methods Associations between prior concussion or brain injury symptoms/diagnosis (reported by parents of children ages 5–17 from the 2020 National Health Interview Survey) and current mental/social well-being were determined in multivariable models. Results Amongst 2020 US children, 8.7% and 5.3% had previous symptoms and diagnosis of concussion/brain injury, respectively. 23% of children with symptoms were never checked for a concussion/brain injury, with younger children at higher risk of not getting checked after symptomatic head trauma. Prior concussion or brain injury symptoms/diagnosis was associated with a higher likelihood of current depressive symptoms (odds ratio [OR] = 1.60; 95% CI = 1.21–2.14; p < 0.001), anxiety (OR = 2.07; 95% CI = 1.52–2.82; p < 0.001), difficulty making friends (OR = 1.57; 95% = 1.06–2.33; p = 0.03), use of medications for mental/social/behavioral issues (OR = 1.69; CI = 1.21–2.36; p = 0.002), and mental health therapy/counseling (OR = 1.52; 95% CI = 1.13–2.04; p = 0.006). Conclusion U.S. children with prior concussion or brain injury symptoms/diagnosis have a higher rate of mental and social disturbances and a more frequent need for mental health services. Nearly one-quarter of children with significant symptoms after head trauma are never checked for a concussion/brain injury; routine concussion evaluation after head trauma should be emphasized especially in younger children.

Occupations and occupational therapy practice with Chinese older adults living with life-limiting illnesses in Singapore: A focus group study.

While Singapore is rapidly ageing and the need for palliative care services is projected to rise, there has been limited exploration of the occupations of Chinese older adults with life-limiting conditions. This study is the third in a series of three studies aimed to address this issue. This study also sought to discuss future directions for occupational therapy practice with Chinese older adults living with life-limiting illnesses in Singapore. The study adopted a qualitative exploratory design using focus groups. Participants were recruited using convenience and snowball sampling. Inclusion criteria were occupational therapists who had attained full registration status with the Allied Health Professionals Council in Singapore, had two or more years of practice as an occupational therapist, and had a current or recent palliative care caseload. Three focus groups with 16 participants were conducted, and three themes were constructed from the data through reflexive thematic analysis. Reflections on culture and occupations is about the impact of a collectivist culture on occupations, such as tensions new caregivers experience between keeping clients safe and respecting clients' choices. It also highlights that there will always be individual differences within any cultural group. Challenges of occupational therapy practice in palliative care describe the need for therapists to be comfortable with rest and ethical tensions participants faced with billing for sessions that mainly involved time spent conversing with clients and when clients and caregivers' goals differed. Finally, Moving forward is about the importance of having mentors and the learning needs of occupational therapists in palliative care. Occupational therapists experienced in providing services to palliative care clients in Singapore emphasised the collectivist nature of Singaporean Chinese families and contributed more information to its possible impact on occupations and occupational therapy practice and made suggestions for future practice.

Demand analysis of health care services for community-dwelling breast cancer survivors based on the Kano model: A cross-sectional study

ObjectivesProviding satisfactory healthcare services for breast cancer survivors can effectively reduce their burden and the pressure on medical resources. The aim of this study was to explore health care service demands for community-dwelling breast cancer survivors using the Kano model. MethodsA cross-sectional survey was conducted from January to March 2023 among breast cancer survivors discharged from a tertiary cancer hospital. Participants were asked to fill out a self-designed questionnaire involving the Kano model, which helped to categorize and prioritize the attributes of healthcare services. The questionnaire included 30 health care services. Additionally, their social demographic characteristics were collected during the survey. ResultsA total of 296 valid questionnaires were collected, and demand attributes of the 30 health care services were evaluated. The findings revealed that one of 30 services was classified as “must-be attributes” (body image management), 13 as “one-dimensional attributes” (focused on medical security support, health management, and health counseling), 3 as “attractive attributes” (focused on communication needs and telehealth services), and 11 as “indifferent attributes” (mainly in the area of psycho-social services). ConclusionsBreast cancer survivors in the community have different levels of need for various health care services. It’s crucial for healthcare providers to identify these needs and devise effective strategies to deliver the appropriate services. Services with must-be and one-dimensional attributes should be given priority, and efforts should be made to provide services with attractive attributes, hence improving the quality of life of breast cancer survivors.

Equity and unmet need of non-communicable diseases services in Saudi Arabia using a National Household Survey (2019).

Saudi Arabia is implementing a comprehensive health system transformation in health services provision, governance, and financing. Given the high burden of non-communicable diseases (NCD), a key objective of the transformation is to integrate NCD prevention and treatment into primary care. The study objectives were to assess primary care service use for treatment of NCDs, to quantify existing inequities in preventive services utilization, and to identify regional and sociodemographic factors associated with these inequities. Using the 2019 Kingdom of Saudi Arabia World Health Survey, multivariable logistic regression models were conducted to identify predictors of utilization of primary care services for NCD prevention and treatment, unmet need among those with a diagnosis of diabetes, hypertension, or dyslipidemia, and unmet need in breast and cervical cancer screening. Among those with an NCD diagnosis, living in a high-income household was associated with a lower probability of having an unmet need compared to those in low-income households. Furthermore, rural residents were less likely to have an unmet need compared to urban residents (OR 0.58, p=0.029). Individuals without a perceived need for healthcare within the last 12 months had three times the probability of unmet need in comparison to those with such a perceived need (p<0.001). Women in all regions had a lower probability of ever having a mammogram compared to women in the central regions around Riyadh. Women with an education above a secondary level had five times the odds of undergoing cervical cancer screening and three times the likelihood of ever having a mammogram (P=0.012, p=0.02) than other women. Compared to women in low-income households, those in middle (OR 1.99, P=0.026), upper middle (OR 3.47, p<0.001), or high-income households (OR 2.59, p<0.001) had a higher probability of having had cervical cancer screening. Inequities in NCD treatment and prevention services' utilization in Saudi Arabia are strongly associated with region of living, population density, wealth, income, education and perceived need for health care. More research is needed to better understand the extent of unmet primary care needs for NCD and how to address the underlying contributing factors to access inequities.

Determinants of postpartum depression among women in Kampong Chhnang Province, Cambodia

ObjectiveThis study aimed to identify the prevalence of postpartum depression (PPD) and the factors associated with PPD in Kampong Chhnang Province, Cambodia. Study designA cross-sectional study. ParticipantsThis study included 440 Cambodian women at 6–8 weeks postpartum who visited health centers between July and September 2021. Materials and methodsData were collected through face-to-face interviews by midwives and nurses using a structured questionnaire. The Edinburgh Postnatal Depression Scale (EPDS) in the Khmer language was used to screen for PPD, and suspected PPD was defined as a total EPDS score ≥ 10. Logistic regression analyses were performed to identify the factors associated with suspected PPD. FindingsThe average age of participants was 28.6 years old. The prevalence of suspected-PPD was 30.2 % (n = 133). Factors associated with suspected PPD were income dissatisfaction (adjusted odds ratio (AOR) = 2.66, 95 % confidence interval (CI) 1.27–5.56, P = 0.010), unintended pregnancy (AOR = 1.99, 95 % CI 1.10–3.61, P = 0.023), and a partner employed as a manual laborer (AOR = 3.85, 95 % CI 1.11–13.33, P = 0.034), farmer (AOR = 3.69, 95 % CI 1.11–12.31, P = 0.034), and factory worker (AOR = 5.43, 95 % CI 1.38–21.41, P = 0.016). In addition, poor relationship with partners (AOR = 2.14, 95 % CI 1.17–3.94, P = 0.014), poor relationship with mother-in-law (AOR = 3.51, 95 % CI 1.70–7.21, P < 0.001), and a history of depression before pregnancy (AOR = 6.34, 95 % CI 1.59–25.34, P = 0.009) were significantly associated with suspected-PPD. Key conclusions and implications for practiceThis study highlighted the need for mental health services in primary healthcare settings. Mental health training for healthcare workers, particularly primary-level nurses, should be prioritized and strengthened. Further clinical study on EPDS validation should be carried out to justify the appropriate cut-off EPDS score for Cambodian women. The EPDS should be integrated into routine PNC services to identify women with suspected-PPD. Education on PPD should be provided not only to the nurses and midwives, but also to the women and their families to support the mental health of pregnant and postpartum women.

Transition self-assessment tool: The development and field testing of a statewide assessment of pre-employment transition services

BACKGROUND: Under the Workforce Innovation and Opportunity Act of 2014 (WIOA), vocational rehabilitation (VR) agencies are required to evaluate their students’ need for pre-employment transition services and use this information to inform their goals, priorities and strategies. OBJECTIVE: This manuscript presents the development and field testing of the Transition Self-Assessment Tool (TSAT), a web-based instrument designed to support VR agencies’ evaluation and strategic planning initiatives by measuring the availability, accessibility, and coordination of school-based transition services. METHOD: Our methods describe the TSAT development procedures and the methods of conducting a TSAT field test. RESULTS: Findings suggest high schools offer a broad array of career-related services for their students. However, not all potentially eligible students with disabilities have access to those services and when these services are provided, they are frequently delivered without coordination with VR. Additionally, data show more services are available, accessed, and coordinated in high schools participating in a statewide transition program. CONCLUSION: Results from the TSAT field test suggest it is feasible to conduct a statewide needs assessment of school-based transition services using this instrument. Furthermore, the findings from the TSAT align with prior knowledge about school-based transition services, and can be used to inform a state’s goals, priorities and strategies.

Soulspace: Integrated youth mental health care in Berlin, Germany-An introduction to the program and a description of its users.

A substantial gap between young people's need for mental health care services and their actual access to such services led worldwide organizations (e.g., the WHO) to recommend the implementation of early intervention programs and youth mental health services. Some countries around the world have established structures to meet this recommendation. In this paper, we describe soulspace as the first integrated youth mental health service for young people aged between 15 and 35 years in Berlin, Germany. We introduce soulspace as easily accessible mental health care for young people, and we characterize soulspace along the lines of the internationally established eight key principles of integrated youth mental health services (Killackey, et al., 2020, World Economic Forum). Soulspace is a cooperation between clinical outpatient units of psychiatric clinics for adolescents and young adults as well as a community-based counselling service. It provides initial contact, counselling, diagnostics, and treatment. Our analyses of the pathways to soulspace and the characteristics of the soulspace users suggest that the low threshold is a facilitator to help finding for young people in comparison to more conventional early intervention models. That is, having transferred the early intervention center in a youth-facing counselling service as was done in soulspace seems to have reduced the threshold to seek help for families and for young people in need for support. In summary, with soulspace, an easily accessible mental health care service was established that integrates counselling and specialized psychiatric treatment if needed.

Health-related quality of life, needs, and concerns among cancer survivors referred to rehabilitation in primary healthcare setting.

There is a growing need for rehabilitation services beyond hospitals. This study aims to describe challenges faced by cancer survivors (CSs) referred for rehabilitation in primary healthcare, employing standardized scales measuring health-related quality of life (HRQOL) and open-ended questions. Furthermore, the study explores the applicability of patient-reported outcomes (PROs) in comprehensively understanding challenges encountered by CSs. This cross-sectional study involves CSs referred for cancer rehabilitation in a primary healthcare setting, including those participating in PROs as a part of routine practice. HRQOL was assessed using the Functional Assessment of Cancer Therapy-General (FACT-G). The International Classification of Functioning, Disability and Health (ICF) framed the analysis of responses to open-ended questions 'what concerns you the most?' and 'what matters to you?' Results: FACT-G showed the lowest scores for functional well-being (14.4) and emotional well-being (16.6), with higher scores for physical well-being (18.9) and social/family well-being (21.1). Responses to open-ended questions unveiled worries about everyday life and how cancer will impact family well-being presently and in the future. Furthermore, CSs reported a need to maintain normality and proactively address the challenges posed by the disease. CSs referred for rehabilitation in primary healthcare experience comprehensive challenges necessitating a holistic rehabilitation approach. This includes interventions supporting CSs in dealing with uncertainty, regaining a sense of control, and addressing family well-being concerns. When using PROs for need assessment, the combination of validated HRQOL scales and open-ended questions is crucial for an in-depth understanding of CSs' challenges.

Caregivers’ Perceptions of Do Not Resuscitate Orders: A Qualitative Study in Rural Southwestern Kenya

The need for palliative care services has increased with the rise of patients with terminal illnesses. Unfortunately, there is a need for more research in palliative care, especially on end-of-life care. Conversations during that period present an ethical and cultural challenge in both collectivistic and individualistic societies. Worldwide, the laws regulating Do Not Resuscitate orders differ from country to country. The perceptions also vary from society to society. Studies have shown the need to involve families in this era of rising advocacy for patient-centered care. Caregivers have an essential role in decision-making and are involved in end-of-life decisions. This study aimed to describe caregivers' perceptions of Do Not Resuscitate orders. The study used a qualitative approach and phenomenological research design. It involved eighteen caregivers of patients receiving palliative care. The sampling procedure was non-probability purposive. Data was collected using in-depth interviews and analyzed using thematic analysis. Overall, two themes emerged from the findings. The first theme was a lack of awareness of the Do Not Resuscitate orders and the resuscitation techniques, and the second theme was subjective perceptions based on caregivers' beliefs and emotional responses. Caregivers need counseling, preparation, and education on Do Not Resuscitate orders and resuscitation methods to improve Do Not Resuscitate discussions. Healthcare providers need to be empowered to hold those discussions.

Clinical features and Surgical Outcomes of Thyroid Goitre Presenting to Ear, Nose and Throat Department of Queen Elizabeth Central Hospital, Blantyre, Malawi.

In Malawi there is a perception that goitre is common and causes significant public health and economic burdens. The purpose of this study was to assess the demographic distribution, clinical presentation, investigations, management, outcomes and complications of goitre seen at Queen Elizabeth Central Hospital (QECH), Blantyre, Malawi. A single hospital-based descriptive retrospective study from January 2017 to December 2018 for all patients presenting with goitre. Out of 9073 patients who presented to ENT department, 105 patients presented with goitre representing 1% of all patients seen during the study period. The Male: Female ratio was 1:25. The mean symptom duration with goitre was 4 years (SD +/- 6.4). Thyroid function test results were available in 54 patients and out of these, 53(98%) patients were euthyroid. Ultrasound scan (USS) reports were available in 44 patients, of these 32(73%) were multinodular goitres. In 70 cases, pathology results were available and showed that 20% were thyroid cancers and that papillary thyroid carcinoma was the commonest cancer (64%). Two recurrent laryngeal nerve injuries were recorded in 79 surgical procedures representing 2.5% of patients (6.3% overall complication rate). Inpatient stay ranged from 2 days to 49 days (median 3 days). Goitre at our centre is more common in women than in men. One in five patients in this cohort had thyroid cancers. This prevalence is higher than other areas in the world highlighting the need for cytology services on every patient before surgery and histology services after surgery. Recurrent laryngeal nerve injury and other complications were infrequent demonstrating local high safety of thyroid surgery, despite late presentation to the ENT department.

IDEAL: Maintaining PHC-focused training in a MBChB programme through a COVID-induced innovation.

Responding to the need for authentic clinical training for students in the context of coronavirus disease 2019 (COVID-19), the Stellenbosch University Faculty of Medicine and Health Sciences developed an innovative 12-week longitudinal, integrated rotation for pre-final-year medical students, the Integrated Distributed Engagement to Advance Learning (IDEAL) rotation. This saw 252 students being placed across 30 primary and secondary healthcare facilities in the Western and Northern Cape provinces. With a focus on service learning, the rotation was built on experiences and research of members of the planning team, as well as partnership relationships developed over an extended period. The focus of student learning was on clinical reasoning through being exposed to undifferentiated patient encounters and the development of practical clinical skills. Students on the distributed platform were supported by clinicians on site, alongside whom they worked, and by a set of online supports, in the form of resources placed on the learning management systems, learning facilitators to whom patient studies were submitted and wellness supporters. Important innovations of the rotation included extensive distribution of clinical training, responsiveness to health service need, co-creation of the module with students, the roles of learning facilitators and wellness supporters, the use of mobile apps and the integration of previously siloed learning outcomes. The IDEAL rotation was seen to be so beneficial as a learning experience that it has been incorporated into the medical degree on an ongoing basis.Contribution: Longitudinal exposure of students to undifferentiated patients in a primary health care context allows for integrated, self-regulated learning. This provides excellent opportunities for medical students, with support, to develop both clinical reasoning and practical skills.

Analysis Of The Application Of Electronic Medical Record In RUMKITAL Dr. Mintohardjo With The Measures Of Effectiveness Method

The phenomenon of the industrial revolution 4.0 accompanied by the rapid development of information technology has had a positive impact on the development of hospital management information systems. Currently, manual medical records are deemed no longer effective in relation to the community's need for quality, fast, precise, accurate and complete health services. Electronic Medical Record enables service providers to track patient data more quickly, identify visits, prevent and screen, help diagnose and manage disease so as to improve the quality of health services. This research was conducted to measure the effectiveness of the application of the Electronic Medical Record in Rumkital Dr. Mintohardjo by measuring the data input component, data integration and data security is assessed from the Usability, Flexibility and Efficiency of each component. Data collection was obtained from interviews and questionnaires from informants and respondents, namely officials and health workers at Dr. Rumkital. Mintohardjo regarding the application of Electronic Medical Records. The data obtained were then processed using the Measures of Effectiveness (MoE) method to measure the effectiveness of the application of the Electronic Medical Record. The hypothesis of this research is that the more effective the application of the Electronic Medical Record, the higher the quality of health services at Dr. Hospital. Mintohardjo and proven through data processing using the Measures of Effectiveness method. This study found the results that the effectiveness of the application of the Electronic Medical Record in Rumkital Dr. Mintohardjo has an MoE value of 0.676, it is included in the effective category.&#x0D; &#x0D; Keywords Electronic Medical Record, Measures Of Effectiveness, Rumkital Dr Mintoharjo

A vision to enhance self-regulation in children: The promise of pediatric hypnosis

ABSTRACT Pediatric hypnosis practices are a valuable tool for enhancing emotional self-regulation and promoting resilience. Hypnotically informed materials, toys, and language are simple ways to encourage relaxation and stress management. By learning hypnosis skills such as becoming imaginatively absorbed in imagery, “belly breathing,” and using simple toys to promote muscle relaxation, children can access natural and novel ways to navigate life’s challenges. An example of these hypnotically informed materials and skills training exercises can be found in Comfort Kits (developed by Dr. Karen Olness circa 1996 and widely distributed by Drs. Culbert and Olness since 2004, used by thousands of children in hospitals and in community settings following natural disasters and wars. Extending this supportive tool and self-hypnosis training into schools presents an opportunity to introduce children to self-directed stress management skills in a practical and convenient manner. Training children to use hypnotically informed self-regulation skills begins to fill the gap between the need for mental health services and available resources. By incorporating hypnotically informed stress management training and self-hypnosis practices into schools, we can equip children with essential tools for improved mental well-being, particularly when they need psychological first aid. Using hypnotic practices and skills can help children manage difficult experiences and develop a sense of comfort and control. Next steps include looking at the feasibility and efficacy of positioning self-directed self-regulation practices (like those found in Comfort Kits and used by clinicians trained in therapeutic pediatric hypnosis) in schools, including through consultation with experts in curriculum development and assessment.

Digitalization in the Russian healthcare: barriers to digital maturity

Over the last 20 years a significant progress has been made in the use of digital technologies in the Russian healthcare: a widespread introduction of health information systems (HIS), work with big data, and use of artificial intelligence. Hopes are pinned on IT technologies; it is expected that they will simplify healthcare activities, as well as take the quality of medical care to a new level. Ultimately, it will contribute to a better quality of life for the population. However, certain internal and external factors slow the advance of digital technologies, creating barriers to digital maturity in healthcare. Imperfection of the legal and regulatory framework and insufficient funding of healthcare and innovation have a negative impact on the rate of development and translation of new technologies into medicine. The article considers a low level of digital literacy among health care providers and low level of motivation to make changes in organizational processes as a serious barrier to e-health promotion. Modern Russian research on this topic has identified significant gaps in basic digital skills among health professionals. At the same time, a low level of digital knowledge and patients’ trust create a low demand for e-health product development, and thus cannot act as an additional driver of IT developments. Health digitalization is an absolute trend in the current development of healthcare in our country, and in view of modern social and demographic trends, the need for medical services will only increase. Introduction of digital technologies into practice should contribute to better quality of and higher access to medical services, therefore health digitalization is a timely and logical stage of medicine development in Russia.