A model of home-based care for people with disabilities : Better practice in rural Thailand
- Wanaratwichit, Civilaiz, Hills, Danny, Cruickshank, Mary, Newman, Barbara
- Authors: Wanaratwichit, Civilaiz , Hills, Danny , Cruickshank, Mary , Newman, Barbara
- Date: 2015
- Type: Text , Journal article
- Relation: Asia Pacific Journal of Health Management Vol. 10, no. 2 (2015), p. 44-51
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- Description:
Background and objective: People with disabilities living in rural areas often require considerable support to meet their complex needs. This study investigated a best practice model in home-based care for people with disabilities in rural Thailand.
Design and Setting: A case study method was adopted to investigate a best practice model of home-based care for people with disabilities in Nakhonthai District, Phitsanulok Province, Thailand. Data were collected from 30 participants through in-depth interviews, focus groups, direct observation and document analysis. Content and thematic analyses were conducted for qualitative data. The Wilcoxon Signed-Rank test was used for the outcome measurement of activities of daily living (ADL) scores.
Results: This model of home-based care for people with disabilities, as an integrated network model, brings together the community, health professionals and other organisations. The role of trained community health volunteers was mainly to deliver home-based personal care for people with disabilities, while health professionals focused mainly on controlling the quality of care, managing the knowledge and skills of volunteers, and co-ordinating the network. The difference between ADL scores before and after the implementation of the model (n=20) was statistically significant (p<0.01). Conclusion: This best practice model of home-based care for people with disabilities in rural Thailand shifts responsibility in the main service decisions from professionals to the community and other stakeholders and engages and empowered all stakeholders in the provision, co-ordination and management of care.
- Authors: Wanaratwichit, Civilaiz , Hills, Danny , Cruickshank, Mary , Newman, Barbara
- Date: 2015
- Type: Text , Journal article
- Relation: Asia Pacific Journal of Health Management Vol. 10, no. 2 (2015), p. 44-51
- Full Text:
- Reviewed:
- Description:
Background and objective: People with disabilities living in rural areas often require considerable support to meet their complex needs. This study investigated a best practice model in home-based care for people with disabilities in rural Thailand.
Design and Setting: A case study method was adopted to investigate a best practice model of home-based care for people with disabilities in Nakhonthai District, Phitsanulok Province, Thailand. Data were collected from 30 participants through in-depth interviews, focus groups, direct observation and document analysis. Content and thematic analyses were conducted for qualitative data. The Wilcoxon Signed-Rank test was used for the outcome measurement of activities of daily living (ADL) scores.
Results: This model of home-based care for people with disabilities, as an integrated network model, brings together the community, health professionals and other organisations. The role of trained community health volunteers was mainly to deliver home-based personal care for people with disabilities, while health professionals focused mainly on controlling the quality of care, managing the knowledge and skills of volunteers, and co-ordinating the network. The difference between ADL scores before and after the implementation of the model (n=20) was statistically significant (p<0.01). Conclusion: This best practice model of home-based care for people with disabilities in rural Thailand shifts responsibility in the main service decisions from professionals to the community and other stakeholders and engages and empowered all stakeholders in the provision, co-ordination and management of care.
An exploratory study of factors influencing pakistani physicians' retention and resettlement career decisions
- Arif, Muhammad, Fraser, John, Cruickshank, Mary
- Authors: Arif, Muhammad , Fraser, John , Cruickshank, Mary
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Ayub Medical College, Abbottabad : JAMC Vol. 34 , no. 3 (2022), p. S649-S659
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- Description: Background: The recruitment, retention and migration of health workers is a global phenomenon. The literature shows push factors associated with leaving rural areas and developing countries in general are explored in depth. However importantly, some health workers behave differently and decide to stay in or return to a developing country. Less is known about the reasons/ pull factors of this groups' decision making. Methods: This paper aims to explore the perceptions of Pakistani physicians regarding their career decisions to remain in their country, or resettle back after working abroad for some time. Thirteen Pakistani physicians were interviewed via telephones who were working in Pakistan and Australia. Results: The motivation for Pakistani physicians to remain or resettle back into their country stems from the perceived better quality of life in Pakistan compared to the better standard of life overseas. Other reasons include a perceived differentiation between locals and non-locals abroad and the availability of a permanent job in Pakistan. Conclusion: The main factors that contributed to Pakistani physicians' retention and resettlement decisions were mostly personal and family or societal factors and there was a minimal role for professional or health system related factors in their career decisions, except for the availability of permanent jobs in Pakistan.
- Authors: Arif, Muhammad , Fraser, John , Cruickshank, Mary
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Ayub Medical College, Abbottabad : JAMC Vol. 34 , no. 3 (2022), p. S649-S659
- Full Text:
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- Description: Background: The recruitment, retention and migration of health workers is a global phenomenon. The literature shows push factors associated with leaving rural areas and developing countries in general are explored in depth. However importantly, some health workers behave differently and decide to stay in or return to a developing country. Less is known about the reasons/ pull factors of this groups' decision making. Methods: This paper aims to explore the perceptions of Pakistani physicians regarding their career decisions to remain in their country, or resettle back after working abroad for some time. Thirteen Pakistani physicians were interviewed via telephones who were working in Pakistan and Australia. Results: The motivation for Pakistani physicians to remain or resettle back into their country stems from the perceived better quality of life in Pakistan compared to the better standard of life overseas. Other reasons include a perceived differentiation between locals and non-locals abroad and the availability of a permanent job in Pakistan. Conclusion: The main factors that contributed to Pakistani physicians' retention and resettlement decisions were mostly personal and family or societal factors and there was a minimal role for professional or health system related factors in their career decisions, except for the availability of permanent jobs in Pakistan.
An integrative review of enablement in primary health care
- Frost, Jane, Currie, Marian, Cruickshank, Mary
- Authors: Frost, Jane , Currie, Marian , Cruickshank, Mary
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Primary Care & Community Health Vol. 6, no. 4 (2015), p. 264-278
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- Description: Objectives: To review how enablement is conceptualized and practiced in primary health care and to explore the factors that influence patient enablement in this setting. Method: A narrative integrative literature review was undertaken. Results: Twenty-four articles specifically relating to enablement in primary health care were identified. Three literature reviews, 4 qualitative studies, and 17 quantitative studies were included in the analysis. Conclusions: In the primary health care setting, the concept of enablement is well defined as an outcome measure of quality. The literature exploring the practice of enablement is sparse, but 2 randomized controlled trials suggest enablement is linked to better outcomes for patients with asthma and diabetes. Primary factors influencing enablement included the practitioners’ open communication style, the degree to which the practitioner is patient centered, and longer consultations. Other factors found to be associated with enablement were the presenting health issue, general state of health, ethnicity, the patient’s own coping strategies and degree of independence, and socioeconomic status. The association between enablement and patients’ expectations and satisfaction is less clear. The majority of research on enablement was carried out among general practitioners. Further research into the degree to which patients are enabled by a wider range of health care providers is needed. Additional qualitative research would provide a deeper understanding of the attributes of enablement in the primary health care setting.
- Authors: Frost, Jane , Currie, Marian , Cruickshank, Mary
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Primary Care & Community Health Vol. 6, no. 4 (2015), p. 264-278
- Full Text:
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- Description: Objectives: To review how enablement is conceptualized and practiced in primary health care and to explore the factors that influence patient enablement in this setting. Method: A narrative integrative literature review was undertaken. Results: Twenty-four articles specifically relating to enablement in primary health care were identified. Three literature reviews, 4 qualitative studies, and 17 quantitative studies were included in the analysis. Conclusions: In the primary health care setting, the concept of enablement is well defined as an outcome measure of quality. The literature exploring the practice of enablement is sparse, but 2 randomized controlled trials suggest enablement is linked to better outcomes for patients with asthma and diabetes. Primary factors influencing enablement included the practitioners’ open communication style, the degree to which the practitioner is patient centered, and longer consultations. Other factors found to be associated with enablement were the presenting health issue, general state of health, ethnicity, the patient’s own coping strategies and degree of independence, and socioeconomic status. The association between enablement and patients’ expectations and satisfaction is less clear. The majority of research on enablement was carried out among general practitioners. Further research into the degree to which patients are enabled by a wider range of health care providers is needed. Additional qualitative research would provide a deeper understanding of the attributes of enablement in the primary health care setting.
Models and interventions to promote and support engagement of first nations women with maternal and child health services : an integrative literature review
- Austin, Catherine, Hills, Danny, Cruickshank, Mary
- Authors: Austin, Catherine , Hills, Danny , Cruickshank, Mary
- Date: 2022
- Type: Text , Journal article
- Relation: Children Vol. 9, no. 5 (2022), p.
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- Description: Background: Studies show that participation in maternal and child health (MCH) services improves health outcomes for First Nations families. However, accessing MCH services can be associated with fear, anxiety, and low attendance at subsequent appointments. Objective: To identify the existing knowledge of models/interventions that support engagement of First Nations women with MCH services in the child’s first five years. Methods: An integrative review was undertaken of full-text, peer-reviewed journal articles and grey literature, which were analysed to identify barriers and enabling factors that influenced the engagement of First Nations families with MCH services. Results: Enabling factors that influenced the engagement with MCH services included service models/interventions that are timely and appropriate, and effective integrated community-based services that are flexible, holistic, culturally strong, and encourage earlier identification of risk and further assessment, intervention, referral, and support from the antenatal period to the child’s fifth birthday. Barriers to engagement included inefficient communication, lack of understanding, cultural differences between the client and the provider, poor continuity of care, limited flexibility of service delivery to meet individual needs, and a health care model that does not recognise the importance of the social determinants of health and wellbeing. Discussion: Timely, effective, holistic engagement with First Nations women during their child’s first 2000 days, which respects their culture and facilitates genuine partnerships built on co-design and shared decision making with the indigenous community, needs to be an essential part of the MCH service model if health care providers seek to practise within First Nations communities. Conclusion: Improving engagement with MCH services is important for First Nations families, the nursing practice, and public health. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
- Authors: Austin, Catherine , Hills, Danny , Cruickshank, Mary
- Date: 2022
- Type: Text , Journal article
- Relation: Children Vol. 9, no. 5 (2022), p.
- Full Text:
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- Description: Background: Studies show that participation in maternal and child health (MCH) services improves health outcomes for First Nations families. However, accessing MCH services can be associated with fear, anxiety, and low attendance at subsequent appointments. Objective: To identify the existing knowledge of models/interventions that support engagement of First Nations women with MCH services in the child’s first five years. Methods: An integrative review was undertaken of full-text, peer-reviewed journal articles and grey literature, which were analysed to identify barriers and enabling factors that influenced the engagement of First Nations families with MCH services. Results: Enabling factors that influenced the engagement with MCH services included service models/interventions that are timely and appropriate, and effective integrated community-based services that are flexible, holistic, culturally strong, and encourage earlier identification of risk and further assessment, intervention, referral, and support from the antenatal period to the child’s fifth birthday. Barriers to engagement included inefficient communication, lack of understanding, cultural differences between the client and the provider, poor continuity of care, limited flexibility of service delivery to meet individual needs, and a health care model that does not recognise the importance of the social determinants of health and wellbeing. Discussion: Timely, effective, holistic engagement with First Nations women during their child’s first 2000 days, which respects their culture and facilitates genuine partnerships built on co-design and shared decision making with the indigenous community, needs to be an essential part of the MCH service model if health care providers seek to practise within First Nations communities. Conclusion: Improving engagement with MCH services is important for First Nations families, the nursing practice, and public health. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
Public perception of medical errors : experiences and risks shared in Australia
- Kim, Jeong-ah, Terry, Daniel, Jang, Sunny, Nguyen, Hoang, Gilbert, Julia, Cruickshank, Mary
- Authors: Kim, Jeong-ah , Terry, Daniel , Jang, Sunny , Nguyen, Hoang , Gilbert, Julia , Cruickshank, Mary
- Date: 2020
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 8, no. 1 (2020), p. 35-41
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- Description: Background: Research into patient safety has largely focused on healthcare organisations bureaucratic routines, with little research available regarding the impact of patient perceptions on clinical practice. Acknowledging and openly discussing patient perceptions of medical errors may result in improved quality of healthcare. The research study aimed to gain a better understanding of the public's perception of medical errors to drive a structured approach to improve healthcare outcomes. Methods: In this study, we examined the public experiences of medical errors using an anonymous on-line survey to collect empirical data from April to December 2018. A total of 407 responses were obtained with 303 participants meeting the criteria for inclusion in the study. Results: The majority (74.9%) of these participants identified that they had experienced a medical error during receiving healthcare in Australia and 73% of these confirmed that they were harmed as a result of these errors. Conclusion: Findings from this study indicate that many participants have experienced medical errors when accessing healthcare in Australia. These findings provide information and a deeper understanding of patient experiences and perceptions of healthcare service delivery which can be used by healthcare organisations to improve healthcare services and promote patient participation in their care. Copyright©2020 by authors, all rights reserved. Authors agree that this article remains permanently open access under the terms of the Creative Commons Attribution License 4.0 International License
- Authors: Kim, Jeong-ah , Terry, Daniel , Jang, Sunny , Nguyen, Hoang , Gilbert, Julia , Cruickshank, Mary
- Date: 2020
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 8, no. 1 (2020), p. 35-41
- Full Text:
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- Description: Background: Research into patient safety has largely focused on healthcare organisations bureaucratic routines, with little research available regarding the impact of patient perceptions on clinical practice. Acknowledging and openly discussing patient perceptions of medical errors may result in improved quality of healthcare. The research study aimed to gain a better understanding of the public's perception of medical errors to drive a structured approach to improve healthcare outcomes. Methods: In this study, we examined the public experiences of medical errors using an anonymous on-line survey to collect empirical data from April to December 2018. A total of 407 responses were obtained with 303 participants meeting the criteria for inclusion in the study. Results: The majority (74.9%) of these participants identified that they had experienced a medical error during receiving healthcare in Australia and 73% of these confirmed that they were harmed as a result of these errors. Conclusion: Findings from this study indicate that many participants have experienced medical errors when accessing healthcare in Australia. These findings provide information and a deeper understanding of patient experiences and perceptions of healthcare service delivery which can be used by healthcare organisations to improve healthcare services and promote patient participation in their care. Copyright©2020 by authors, all rights reserved. Authors agree that this article remains permanently open access under the terms of the Creative Commons Attribution License 4.0 International License
To remain, migrate abroad or resettle : a complex dynamic process affecting Pakistani physicians' career decisions
- Arif, Muhammad, Cruickshank, Mary, Fraser, John
- Authors: Arif, Muhammad , Cruickshank, Mary , Fraser, John
- Date: 2019
- Type: Text , Journal article
- Relation: Asia Pacific Journal of Health Management Vol. 14, no. 3 (2019), p.
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- Description: OBJECTIVE This study investigated Pakistani physicians' decision-making concerning their decisions to stay in Pakistan, migrate abroad, or resettle back into their country after working abroad. METHODS This qualitative study employed a phenomenological research design. Thirteen Pakistani physicians characterised as 'stayers', 'leavers' and 'resettlers' were interviewed via telephone to explore their lived experience in 2008-2009. RESULTS Results show a dynamic nature of the physicians' career decision-making depending on their constant weighing of complex personal, family, professional and societal factors. Stayers, leavers and resettlers are not mutually exclusive groups but rather individual physicians' can move between these groups at different stages of career and life. Physicians vary in their decision making. Stayers and resettlers place more emphasis on personal and family reasons and societal factors providing there is a permanent job for them. Leavers focus on health system problems and recent societal problems of personal and societal insecurity. CONCLUSIONS The findings of this study indicates that physician migration, retention and resettlement is a complex issue and there are multiple personal, social, political and economic factors that affect their decisions to stay, move abroad or resettle back into their countries. Therefore, it is recommended that future research focusing on health workers retention, migration and resettlement issues look at it from a holistic perspective rather than focusing only on the economic and professional imperatives. The findings of this study have international implications for health care managers dealing with a highly mobile international medical workforce. Strategies considering different stages of the physician career/ life cycle need to highlight the importance of identity, belonging and place as doctors weigh this with career goals. © 2019 Asia Pacific Journal of Health Management. All Rights Reserved.
- Authors: Arif, Muhammad , Cruickshank, Mary , Fraser, John
- Date: 2019
- Type: Text , Journal article
- Relation: Asia Pacific Journal of Health Management Vol. 14, no. 3 (2019), p.
- Full Text:
- Reviewed:
- Description: OBJECTIVE This study investigated Pakistani physicians' decision-making concerning their decisions to stay in Pakistan, migrate abroad, or resettle back into their country after working abroad. METHODS This qualitative study employed a phenomenological research design. Thirteen Pakistani physicians characterised as 'stayers', 'leavers' and 'resettlers' were interviewed via telephone to explore their lived experience in 2008-2009. RESULTS Results show a dynamic nature of the physicians' career decision-making depending on their constant weighing of complex personal, family, professional and societal factors. Stayers, leavers and resettlers are not mutually exclusive groups but rather individual physicians' can move between these groups at different stages of career and life. Physicians vary in their decision making. Stayers and resettlers place more emphasis on personal and family reasons and societal factors providing there is a permanent job for them. Leavers focus on health system problems and recent societal problems of personal and societal insecurity. CONCLUSIONS The findings of this study indicates that physician migration, retention and resettlement is a complex issue and there are multiple personal, social, political and economic factors that affect their decisions to stay, move abroad or resettle back into their countries. Therefore, it is recommended that future research focusing on health workers retention, migration and resettlement issues look at it from a holistic perspective rather than focusing only on the economic and professional imperatives. The findings of this study have international implications for health care managers dealing with a highly mobile international medical workforce. Strategies considering different stages of the physician career/ life cycle need to highlight the importance of identity, belonging and place as doctors weigh this with career goals. © 2019 Asia Pacific Journal of Health Management. All Rights Reserved.
Venous access : The patient experience
- Robinson-Reilly, Melissa, Paliadelis, Penny, Cruickshank, Mary
- Authors: Robinson-Reilly, Melissa , Paliadelis, Penny , Cruickshank, Mary
- Date: 2016
- Type: Text , Journal article
- Relation: Supportive Care in Cancer Vol. 24, no. 3 (2016), p. 1181-1187
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- Description: The evolution of venous access via peripheral cannulation, particularly in relation to the risks and the benefits of this procedure, is reported widely in the literature. However, there is limited research specific to the patient experience of undergoing venous access. The intent of this qualitative study was to understand patients' experience of venous access, with the aim of bringing forth their voices about the experiences of repeated venous access/cannulation attempts. This qualitative study used a hermeneutic phenomenological approach to explore the experiences of 15 participants in two rural oncology units in Australia. The participants had experienced repeated peripheral cannulation in order to receive chemotherapy. Study participants were asked to describe what it was like for them to be repeatedly cannulated. Data were collected via audiotaped individual interviews, the participants' stories were transcribed and analysed thematically. Themes emerged from the participants' stories that provided insights into their perceptions of the experience of being cannulated and the decision-making processes regarding how and where the procedure occurred. The findings suggest that a holistic approach to care was often missing causing the participants to feel vulnerable. Gaining insight into their experiences led to a greater understanding of the impact of this procedure on patients and the need to improve care through encouraging more collaborative decision-making processes between clinicians and patients. The implications for policy and practice focus on improving patient outcomes via procedural governance and education, with the intent of translating the findings from this research into evidence-based practice.
- Authors: Robinson-Reilly, Melissa , Paliadelis, Penny , Cruickshank, Mary
- Date: 2016
- Type: Text , Journal article
- Relation: Supportive Care in Cancer Vol. 24, no. 3 (2016), p. 1181-1187
- Full Text:
- Reviewed:
- Description: The evolution of venous access via peripheral cannulation, particularly in relation to the risks and the benefits of this procedure, is reported widely in the literature. However, there is limited research specific to the patient experience of undergoing venous access. The intent of this qualitative study was to understand patients' experience of venous access, with the aim of bringing forth their voices about the experiences of repeated venous access/cannulation attempts. This qualitative study used a hermeneutic phenomenological approach to explore the experiences of 15 participants in two rural oncology units in Australia. The participants had experienced repeated peripheral cannulation in order to receive chemotherapy. Study participants were asked to describe what it was like for them to be repeatedly cannulated. Data were collected via audiotaped individual interviews, the participants' stories were transcribed and analysed thematically. Themes emerged from the participants' stories that provided insights into their perceptions of the experience of being cannulated and the decision-making processes regarding how and where the procedure occurred. The findings suggest that a holistic approach to care was often missing causing the participants to feel vulnerable. Gaining insight into their experiences led to a greater understanding of the impact of this procedure on patients and the need to improve care through encouraging more collaborative decision-making processes between clinicians and patients. The implications for policy and practice focus on improving patient outcomes via procedural governance and education, with the intent of translating the findings from this research into evidence-based practice.
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