Viewing nurse practitioners' perceptions of patient care through the lens of enablement
- Frost, Jane, Currie, Marian, Cruickshank, Mary, Northam, Holly
- Authors: Frost, Jane , Currie, Marian , Cruickshank, Mary , Northam, Holly
- Date: 2017
- Type: Text , Journal article
- Relation: Journal for Nurse Practitioners Vol. 13, no. 8 (2017), p. 570-576
- Full Text: false
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- Description: Research conducted in primary health care (PHC) shows the value of patient enablement. Although nurse practitioners (NPs) are increasingly playing a role in PHC, limited research exploring their contribution to enabling patients exists. This article describes a qualitative descriptive study in which enablement was used to explore PHC NPs' perceptions of the care they provide to patients. Analysis of the focus group data identified 3 primary themes: patient centeredness and bespoke care; reciprocity, trust, and acceptance; and knowledge transference. Relating these themes to the constructs of the Patient Enablement Instrument demonstrated a clear link between NP care and patient enablement. © 2017 Elsevier Inc.
- Cant, Robyn, Pomeroy, Sylvia
- Authors: Cant, Robyn , Pomeroy, Sylvia
- Date: 2011
- Type: Text , Journal article , Review
- Relation: Nutrition and Dietetics Vol. 68, no. 2 (2011), p. 140-148
- Full Text: false
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- Description: Aim: Dietitian and general practitioner collaboration in the nutrition care of a patient is important to assist patients to achieve their nutrition goals. This paper aims to review the published literature on dietitians' correspondence practices with recipient general practitioners regarding nutrition interventions recommended to patients. Methods: A literature search was conducted of publications from 1995 to December 2009. Key words were used to search the electronic databases Medline, CINAHL Plus, ProQuest, PsycINFO and Google Scholar. Twenty papers that addressed this topic were selected by two authors for inclusion in the review. Results: There is evidence that dietitians often fail to provide general practitioners with formalised correspondence that describes dietitians' nutrition interventions with patients. Doctors report they lack patient information via dietitians' correspondence. Information about nutrition care of hospital patients often remains within hospital records. Doctors prefer standardised letter formats with content presented succinctly. The letter should include a nutrition diagnosis, agreed goals, a plan for ongoing dietetic visits and instructions for a general practitioner's supportive actions. Conclusion: Dietitians need skill in drafting reports or letters useful for general practitioners by selecting content of value to doctors and using a suitable style. Implementation of shared electronic records in Australia will facilitate information transfer to help realise collaborative patient care. Further investigations of dietitian-general practitioner correspondence are warranted to determine best practice. © 2011 The Authors. Nutrition & Dietetics © 2011 Dietitians Association of Australia.
Decade of Medicare : The contribution of private practice dietitians to chronic disease management and diabetes group services
- Authors: Cant, Robyn , Ball, Lauren
- Date: 2015
- Type: Text , Journal article
- Relation: Nutrition and Dietetics Vol. 72, no. 3 (2015), p. 284-290
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- Description: Aim: To review changes in utilisation of dietetics services through the Medicare Chronic Disease Management program over the last decade and describe patient uptake in 2013. Methods: Dietetics service data were extracted from published Medicare statistics for the periods (i) January 2004 to December 2013 and (ii) January to December 2013. Data comprised individual dietetics services by state and patient demography, and group services data for provider professions regarding type 2 diabetes: dietitians, diabetes educators and exercise physiologists. t-test was used to investigate the association of dietetics' individual service utilisation and workforce statistics. Results: Individual dietetics Chronic Disease Management consultations in private practice have increased annually since 2004. Dietetics has remained the third largest provider. In 2013, a total of 302910 individual consultations were conducted; 7% of allied health consultations. Likewise, individual services for Indigenous Australians increased since 2008. Utilisation of group services for type 2 diabetes comprised <2% of dietetics services. Dietitians provided more group services than diabetes educators but considerably fewer than exercise physiologists. Middle-aged and older patients were common, with highest uptake by those aged 55-74 years. Overall, total and per capita utilisation rates were considerably higher in NSW, Victoria and Queensland compared to less populous states, although this disparity has reduced since 2010. Conclusions: As 10 years has elapsed since the program's inception, further evaluation of the policy is needed to examine large variations in dietetics' Chronic Disease Management uptake by state and territory in both individual and group services. © 2015 Dietitians Association of Australia.
- Authors: Cant, Robyn , Ball, Lauren
- Date: 2015
- Type: Text , Journal article
- Relation: Nutrition and Dietetics Vol. 72, no. 3 (2015), p. 284-290
- Full Text:
- Reviewed:
- Description: Aim: To review changes in utilisation of dietetics services through the Medicare Chronic Disease Management program over the last decade and describe patient uptake in 2013. Methods: Dietetics service data were extracted from published Medicare statistics for the periods (i) January 2004 to December 2013 and (ii) January to December 2013. Data comprised individual dietetics services by state and patient demography, and group services data for provider professions regarding type 2 diabetes: dietitians, diabetes educators and exercise physiologists. t-test was used to investigate the association of dietetics' individual service utilisation and workforce statistics. Results: Individual dietetics Chronic Disease Management consultations in private practice have increased annually since 2004. Dietetics has remained the third largest provider. In 2013, a total of 302910 individual consultations were conducted; 7% of allied health consultations. Likewise, individual services for Indigenous Australians increased since 2008. Utilisation of group services for type 2 diabetes comprised <2% of dietetics services. Dietitians provided more group services than diabetes educators but considerably fewer than exercise physiologists. Middle-aged and older patients were common, with highest uptake by those aged 55-74 years. Overall, total and per capita utilisation rates were considerably higher in NSW, Victoria and Queensland compared to less populous states, although this disparity has reduced since 2010. Conclusions: As 10 years has elapsed since the program's inception, further evaluation of the policy is needed to examine large variations in dietetics' Chronic Disease Management uptake by state and territory in both individual and group services. © 2015 Dietitians Association of Australia.
Defining timeliness in care for patients with lung cancer : a scoping review
- Ansar, Adnan, Lewis, Virginia, McDonald, Christine, Liu, Chaojie, Rahman, Muhammad Aziz
- Authors: Ansar, Adnan , Lewis, Virginia , McDonald, Christine , Liu, Chaojie , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article , Review
- Relation: BMJ Open Vol. 12, no. 4 (2022), p.
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- Description: Objectives Early diagnosis and reducing the time taken to achieve each step of lung cancer care is essential. This scoping review aimed to examine time points and intervals used to measure timeliness and to critically assess how they are defined by existing studies of the care seeking pathway for lung cancer. Methods This scoping review was guided by the methodological framework for scoping reviews by Arksey and O'Malley. MEDLINE, EMBASE, CINAHL and PsycINFO electronic databases were searched for articles published between 1999 and 2019. After duplicate removal, all publications went through title and abstract screening followed by full text review and inclusion of articles in the review against the selection criteria. A narrative synthesis describes the time points, intervals and measurement guidelines used by the included articles. Results A total of 2113 articles were identified from the initial search. Finally, 68 articles were included for data charting process. Eight time points and 14 intervals were identified as the most common events researched by the articles. Eighteen different lung cancer care guidelines were used to benchmark intervals in the included articles; all were developed in Western countries. The British Thoracic Society guideline was the most frequently used guideline (20%). Western guidelines were used by the studies in Asian countries despite differences in the health system structure. Conclusion This review identified substantial variations in definitions of some of the intervals used to describe timeliness of care for lung cancer. The differences in healthcare delivery systems of Asian and Western countries, and between high-income countries and low-income-middle-income countries may suggest different sets of time points and intervals need to be developed. ©
- Authors: Ansar, Adnan , Lewis, Virginia , McDonald, Christine , Liu, Chaojie , Rahman, Muhammad Aziz
- Date: 2022
- Type: Text , Journal article , Review
- Relation: BMJ Open Vol. 12, no. 4 (2022), p.
- Full Text:
- Reviewed:
- Description: Objectives Early diagnosis and reducing the time taken to achieve each step of lung cancer care is essential. This scoping review aimed to examine time points and intervals used to measure timeliness and to critically assess how they are defined by existing studies of the care seeking pathway for lung cancer. Methods This scoping review was guided by the methodological framework for scoping reviews by Arksey and O'Malley. MEDLINE, EMBASE, CINAHL and PsycINFO electronic databases were searched for articles published between 1999 and 2019. After duplicate removal, all publications went through title and abstract screening followed by full text review and inclusion of articles in the review against the selection criteria. A narrative synthesis describes the time points, intervals and measurement guidelines used by the included articles. Results A total of 2113 articles were identified from the initial search. Finally, 68 articles were included for data charting process. Eight time points and 14 intervals were identified as the most common events researched by the articles. Eighteen different lung cancer care guidelines were used to benchmark intervals in the included articles; all were developed in Western countries. The British Thoracic Society guideline was the most frequently used guideline (20%). Western guidelines were used by the studies in Asian countries despite differences in the health system structure. Conclusion This review identified substantial variations in definitions of some of the intervals used to describe timeliness of care for lung cancer. The differences in healthcare delivery systems of Asian and Western countries, and between high-income countries and low-income-middle-income countries may suggest different sets of time points and intervals need to be developed. ©
- Ngo, Tuan, Nguyen, Huy, Pham, Thanh, Nguyen, Tien, Vu, Kien, Pham, Minh, Phung, Dung, Thi Tran, Anh, Nguyen, Phuong, Le, Phuong, Thi Dao, An, Ngo, Hiep, Hoang, Minh
- Authors: Ngo, Tuan , Nguyen, Huy , Pham, Thanh , Nguyen, Tien , Vu, Kien , Pham, Minh , Phung, Dung , Thi Tran, Anh , Nguyen, Phuong , Le, Phuong , Thi Dao, An , Ngo, Hiep , Hoang, Minh
- Date: 2022
- Type: Text , Journal article
- Relation: International Journal of Health Planning and Management Vol. 37, no. 5 (2022), p. 2684-2696
- Full Text: false
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- Description: Objective To determine the relationship between team dynamics with healthcare coordination and clinical job satisfaction of the community health workers (CHWs). Methods A cross‐sectional study was conducted among 133 health workers (including doctors, nurses, or midwives) at 21 Commune Health Cent in Quoc Oai District, Vietnam, from July 2015 to May 2017. A self‐administered questionnaire consisting of 5‐Likert items regarding team dynamics and healthcare coordination clinical work satisfaction was utilised. Descriptive statistics and correlation matrix were applied for seven factors of team dynamic, clinical work satisfaction, and patient care coordination queried by primary care providers. Bayesian model averaging (BMA) was used to identify the predictors of the level of team dynamics and healthcare coordination. Results The mean score of overall team dynamics among the study participants was 4.08. Clinical work satisfaction and patient care coordination scores among resident physicians were higher than those of attending clinicians however, the differences were not statistically significant. The results of BMA analysis indicated that team dynamics significantly associated with clinical work satisfaction, and it explains 9% of the total variance in clinical work satisfaction. Team dynamics level was also positively associated with patient care coordination. Patient care coordination was not a significant mediator between team dynamics and clinical work satisfaction. Conclusion Team dynamics is a potential contributor to improving patient care coordination and clinical job satisfaction of CHWs. As no significant correlation between patient care coordination and clinical job satisfaction was observed, to improve team performance, providing conditions that facilitate team building and teamwork should be conducted for CHWs in CHCs. Highlights Team dynamics, healthcare coordination and clinical work satistsfaction among health professionals are critical to quality of healthcare. In lower‐middle income countries like Vietnam, little has been known about these contributors at community‐based healthcare system. Identifying that team dynamics significantly associated with both patient care coordination and clinical work satisfaction among community health workers, but this association being not mediated by patient care coordination informs healthcare planning at community level. As team dynamics is a contributor to both patient care coordination and clinical job satisfaction, improving team dynamics should be considered as one of priorities for better community healthcare in low or middle resource setting.
Viral load monitoring for people living with HIV in the era of test and treat: progress made and challenges ahead – a systematic review
- Pham, Minh, Nguyen, Huy, Anderson, David, Crowe, Suzanne, Luchters, Stanley
- Authors: Pham, Minh , Nguyen, Huy , Anderson, David , Crowe, Suzanne , Luchters, Stanley
- Date: 2022
- Type: Text , Journal article
- Relation: BMC public health Vol. 22, no. 1 (2022), p. 1-1203
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- Description: Abstract Background In 2016, we conducted a systematic review to assess the feasibility of treatment monitoring for people living with HIV (PLHIV) receiving antiretroviral therapy (ART) in low and middle-income countries (LMICs), in line with the 90-90-90 treatment target. By 2020, global estimates suggest the 90-90-90 target, particularly the last 90, remains unattainable in many LMICs. This study aims to review the progress and identify needs for public health interventions to improve viral load monitoring and viral suppression for PLHIV in LMICs. Methods A literature search was conducted using an update of the initial search strategy developed for the 2016 review. Electronic databases (Medline and PubMed) were searched to identify relevant literature published in English between Dec 2015 and August 2021. The primary outcome was initial viral load (VL) monitoring (the proportion of PLHIV on ART and eligible for VL monitoring who received a VL test). Secondary outcomes included follow-up VL monitoring (the proportion of PLHIV who received a follow-up VL after an initial elevated VL test), confirmation of treatment failure (the proportion of PLHIV who had two consecutive elevated VL results) and switching treatment regimen rates (the proportion of PLHIV who switched treatment regimen after confirmation of treatment failure). Results The search strategy identified 1984 non-duplicate records, of which 34 studies were included in the review. Marked variations in initial VL monitoring coverage were reported across study settings/countries (range: 12–93% median: 74% IQR: 46–82%) and study populations (adults (range: 25–96%, median: 67% IQR: 50–84%), children, adolescents/young people (range: 2–94%, median: 72% IQR: 47–85%), and pregnant women (range: 32–82%, median: 57% IQR: 43–71%)). Community-based models reported higher VL monitoring (median: 85%, IQR: 82-88%) compared to decentralised care at primary health facility (median: 64%, IRQ: 48-82%). Suboptimal uptake of follow-up VL monitoring and low regimen switching rates were observed. Conclusions Substantial gaps in VL coverage across study settings and study populations were evident, with limited data availability outside of sub-Saharan Africa. Further research is needed to fill the data gaps. Development and implementation of innovative, community-based interventions are required to improve VL monitoring and address the “failure cascade” in PLHIV on ART who fail to achieve viral suppression.
- Authors: Pham, Minh , Nguyen, Huy , Anderson, David , Crowe, Suzanne , Luchters, Stanley
- Date: 2022
- Type: Text , Journal article
- Relation: BMC public health Vol. 22, no. 1 (2022), p. 1-1203
- Full Text:
- Reviewed:
- Description: Abstract Background In 2016, we conducted a systematic review to assess the feasibility of treatment monitoring for people living with HIV (PLHIV) receiving antiretroviral therapy (ART) in low and middle-income countries (LMICs), in line with the 90-90-90 treatment target. By 2020, global estimates suggest the 90-90-90 target, particularly the last 90, remains unattainable in many LMICs. This study aims to review the progress and identify needs for public health interventions to improve viral load monitoring and viral suppression for PLHIV in LMICs. Methods A literature search was conducted using an update of the initial search strategy developed for the 2016 review. Electronic databases (Medline and PubMed) were searched to identify relevant literature published in English between Dec 2015 and August 2021. The primary outcome was initial viral load (VL) monitoring (the proportion of PLHIV on ART and eligible for VL monitoring who received a VL test). Secondary outcomes included follow-up VL monitoring (the proportion of PLHIV who received a follow-up VL after an initial elevated VL test), confirmation of treatment failure (the proportion of PLHIV who had two consecutive elevated VL results) and switching treatment regimen rates (the proportion of PLHIV who switched treatment regimen after confirmation of treatment failure). Results The search strategy identified 1984 non-duplicate records, of which 34 studies were included in the review. Marked variations in initial VL monitoring coverage were reported across study settings/countries (range: 12–93% median: 74% IQR: 46–82%) and study populations (adults (range: 25–96%, median: 67% IQR: 50–84%), children, adolescents/young people (range: 2–94%, median: 72% IQR: 47–85%), and pregnant women (range: 32–82%, median: 57% IQR: 43–71%)). Community-based models reported higher VL monitoring (median: 85%, IQR: 82-88%) compared to decentralised care at primary health facility (median: 64%, IRQ: 48-82%). Suboptimal uptake of follow-up VL monitoring and low regimen switching rates were observed. Conclusions Substantial gaps in VL coverage across study settings and study populations were evident, with limited data availability outside of sub-Saharan Africa. Further research is needed to fill the data gaps. Development and implementation of innovative, community-based interventions are required to improve VL monitoring and address the “failure cascade” in PLHIV on ART who fail to achieve viral suppression.
Practitioner perceptions of the feasibility of common frailty screening instruments within general practice settings: a mixed methods study
- Ambagtsheer, Rachel, Casey, Mavourneen, Lawless, Michael, Archibald, Mandy, Yu, Solomon, Kitson, Alison, Beilby, Justin
- Authors: Ambagtsheer, Rachel , Casey, Mavourneen , Lawless, Michael , Archibald, Mandy , Yu, Solomon , Kitson, Alison , Beilby, Justin
- Date: 2022
- Type: Text , Journal article
- Relation: BMC Primary Care Vol. 23, no. 1 (2022), p.
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- Description: Background: Frailty is a highly prevalent clinical syndrome increasing older people’s vulnerability to risk of adverse outcomes. Better frailty identification through expanded screening implementation has been advocated within general practice settings, both internationally and within Australia. However, little is known about practitioner perceptions of the feasibility of specific instruments, and the underlying motivations behind those perceptions. Consequently, the purpose of this study was to explore the attitudes and perceptions of a convenience and volunteer sample of Australian general practitioners (GPs) and practice nurses (PNs) towards common frailty screening instruments. Methods: The feasibility of several frailty screening instruments (PRISMA-7 [P7], Edmonton Frail Scale [EFS], FRAIL Questionnaire [FQ], Gait Speed Test [GST], Groningen Frailty Indicator [GFI], Kihon Checklist [KC] and Timed Up and Go [TUG]) to 43 Australian GPs and PNs was assessed. The study adopted a concurrent embedded mixed-methods design incorporating quantitative (ranking exercise) and qualitative (content analysis) data collection integrated during the analysis phase. Results: Practitioners assessed multi-dimensional instruments (EFS, GFI, KC) as having relatively higher clinical utility, better integration into existing assessment processes and stronger links to intervention over uni-dimensional (GST, TUG) and simple (FQ, P7) instruments. Conclusions: While existing frailty screening instruments show promise as an initial step in supporting better care for older people, all the included instruments were associated with perceived advantages and disadvantages. Ultimately, clinicians will need to weigh several factors in their selection of the optimal screening instrument. Further translational research, with a focus on contextual fit, is needed to support clinical decision-making on the selection of instruments for frailty screening. © 2022, The Author(s).
- Authors: Ambagtsheer, Rachel , Casey, Mavourneen , Lawless, Michael , Archibald, Mandy , Yu, Solomon , Kitson, Alison , Beilby, Justin
- Date: 2022
- Type: Text , Journal article
- Relation: BMC Primary Care Vol. 23, no. 1 (2022), p.
- Full Text:
- Reviewed:
- Description: Background: Frailty is a highly prevalent clinical syndrome increasing older people’s vulnerability to risk of adverse outcomes. Better frailty identification through expanded screening implementation has been advocated within general practice settings, both internationally and within Australia. However, little is known about practitioner perceptions of the feasibility of specific instruments, and the underlying motivations behind those perceptions. Consequently, the purpose of this study was to explore the attitudes and perceptions of a convenience and volunteer sample of Australian general practitioners (GPs) and practice nurses (PNs) towards common frailty screening instruments. Methods: The feasibility of several frailty screening instruments (PRISMA-7 [P7], Edmonton Frail Scale [EFS], FRAIL Questionnaire [FQ], Gait Speed Test [GST], Groningen Frailty Indicator [GFI], Kihon Checklist [KC] and Timed Up and Go [TUG]) to 43 Australian GPs and PNs was assessed. The study adopted a concurrent embedded mixed-methods design incorporating quantitative (ranking exercise) and qualitative (content analysis) data collection integrated during the analysis phase. Results: Practitioners assessed multi-dimensional instruments (EFS, GFI, KC) as having relatively higher clinical utility, better integration into existing assessment processes and stronger links to intervention over uni-dimensional (GST, TUG) and simple (FQ, P7) instruments. Conclusions: While existing frailty screening instruments show promise as an initial step in supporting better care for older people, all the included instruments were associated with perceived advantages and disadvantages. Ultimately, clinicians will need to weigh several factors in their selection of the optimal screening instrument. Further translational research, with a focus on contextual fit, is needed to support clinical decision-making on the selection of instruments for frailty screening. © 2022, The Author(s).
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