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[Relations between caregivers and patients must improve. Interview by Jan Thomasson].

https://arctichealth.org/en/permalink/ahliterature237369
Source
Vardfacket. 1986 Feb 20;10(4):4-6
Publication Type
Article
Date
Feb-20-1986

Frequency and pattern of emergency department visits by long-term care residents--a population-based study.

https://arctichealth.org/en/permalink/ahliterature144174
Source
J Am Geriatr Soc. 2010 Mar;58(3):510-7
Publication Type
Article
Date
Mar-2010
Author
Andrea Gruneir
Chaim M Bell
Susan E Bronskill
Michael Schull
Geoffrey M Anderson
Paula A Rochon
Author Affiliation
Women's College Research Institute, Women's College Hospital, Toronto, Canada. andrea.gruneir@wchospital.ca
Source
J Am Geriatr Soc. 2010 Mar;58(3):510-7
Date
Mar-2010
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Emergency Service, Hospital - utilization
Female
Health Services Accessibility
Health services needs and demand
Humans
Long-Term Care
Male
Nursing Homes
Ontario
Preventive Health Services
Primary Health Care
Retrospective Studies
Abstract
To obtain population-based estimates of emergency department (ED) visits by long-term care (LTC) residents.
Retrospective cohort study using administrative data.
All LTC facilities in Ontario, Canada.
All LTC residents who visited an ED at least once during a 6-month period.
All ED visits were described using the National Ambulatory Care Reporting System. Two distinct visit types were defined. Potentially preventable visits were defined as those for any ambulatory care sensitive condition; these are conditions for which exacerbations that result in hospital use suggest lack of access to adequate primary care. Low-acuity visits were defined as those triaged as non-urgent at ED registration and ended with return to the LTC facility without hospital admission.
Nearly one-quarter of LTC residents visited the ED at least once in 6 months. Of all visits, 24.6% were for a potentially preventable reason, most commonly pneumonia, urinary tract infection, and congestive heart failure. These visits had a high frequency of ambulance transport (90.4%), emergent triage (35.3%), hospital admission (62.4%), and death within 30 days (23.6%). Of all visits, 11.0% were low acuity. Fall-related injury was the most common cause. Low-acuity visits were the shortest (mean length 4.5 +/- 4.0 hours) and had the lowest frequency of death within 30 days (4.3%).
LTC residents made frequent visits to the ED. The visit types showed distinct patterns that suggest a need for better access to medical care for common conditions and a greater emphasis on fall prevention in LTC.
PubMed ID
20398120 View in PubMed
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The coordination of primary and oncology specialty care at the end of life.

https://arctichealth.org/en/permalink/ahliterature144265
Source
J Natl Cancer Inst Monogr. 2010;2010(40):31-7
Publication Type
Article
Date
2010
Author
Paul K J Han
Daniel Rayson
Author Affiliation
MA, Center for Outcomes Research and Evaluation, Maine Medical Center, 39 Forest Ave., Portland, ME 04101, USA. hanp@mmc.org
Source
J Natl Cancer Inst Monogr. 2010;2010(40):31-7
Date
2010
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Canada
Delivery of Health Care
Forecasting
Health services needs and demand
Humans
Interdisciplinary Communication
Medical Oncology
Neoplasms - psychology - therapy
Outcome and Process Assessment (Health Care)
Palliative Care
Patient Care Management - organization & administration
Patient care team
Primary Health Care
Quality of Health Care
Terminal Care - organization & administration
United States
Abstract
The end of life is a time in which both the intensity of cancer patients' needs and the complexity of care increase, heightening the need for effective care coordination between oncology and primary care physicians. However, little is known about the extent to which such coordination occurs or the ways in which it is achieved. We review existing evidence on current practice patterns, patient and physician preferences regarding involvement of oncology and primary care physicians in end-of-life care, and the potential impact of care coordination on the quality of care and health outcomes. Data are lacking on the extent to which end-of-life care is coordinated between oncology and primary care physicians. Patients appear to prefer the continued involvement of both types of physicians, and preliminary evidence suggests that coordinated care improves health outcomes. However, more work needs to be done to corroborate these findings, and many unanswered questions remain.
Notes
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PubMed ID
20386052 View in PubMed
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Physician retention in rural Alberta: key community factors.

https://arctichealth.org/en/permalink/ahliterature144467
Source
Can J Public Health. 2010 Jan-Feb;101(1):79-82
Publication Type
Article
Author
Pamela J Cameron
David C Este
Catherine A Worthington
Author Affiliation
Faculty of Social Work, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4.
Source
Can J Public Health. 2010 Jan-Feb;101(1):79-82
Language
English
Publication Type
Article
Keywords
Alberta
Community Health Services
Delivery of Health Care - organization & administration
Health services needs and demand
Humans
Medically underserved area
Personnel Turnover - statistics & numerical data
Physicians - statistics & numerical data - supply & distribution
Qualitative Research
Rural Health Services - statistics & numerical data - supply & distribution
Abstract
As part of a larger case study exploring physician retention factors and strategies employed by rural communities, the objective of this analysis was to explore the community factors that promoted physician retention.
A qualitative, collective case study design was employed to study four rural communities (cases) in Alberta that retained family physicians for four years or longer. Participants included physicians, staff members, spouses and community members (all were patients from the communities studied). Communities were selected through a retention-specific matrix; each quadrant represented a particular community typology. Case data collected from interviews, documents and observations were analyzed, and similarities and differences among cases were assessed.
A range of community factors that could influence physicians' decisions to stay in a particular community were described by participants. Four themes, Appreciation, Connection, Active Support and Physical/Recreational Assets, were positively related to physician retention in the four communities studied. These community factors existed to different degrees but were present in all communities. Reciprocity was a fifth factor that emerged in three of the four communities studied.
Physicians, policy-makers, community members and health care professionals are encouraged to consider the community domain when planning and implementing strategies to retain rural physicians and other health care professionals. The four communities studied were able to promote retention of their primary care physicians by showing appreciation to them, building connections with them and their families, actively supporting their physicians and local health facilities, maintaining and improving local physical/recreational amenities, and nurturing reciprocal rapport with physicians.
PubMed ID
20364544 View in PubMed
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Regional and temporal trends in migration among people living with HIV/AIDS in British Columbia, 1993-2005.

https://arctichealth.org/en/permalink/ahliterature144473
Source
Can J Public Health. 2010 Jan-Feb;101(1):44-9
Publication Type
Article
Author
Viviane D Lima
Eric Druyts
Julio S G Montaner
Robert S Hogg
Author Affiliation
HIV/AIDS Drug Treatment Program, BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6. vlima@cfenet.ubc.ca
Source
Can J Public Health. 2010 Jan-Feb;101(1):44-9
Language
English
Publication Type
Article
Keywords
Acquired Immunodeficiency Syndrome - drug therapy - epidemiology
Anti-HIV Agents - therapeutic use
Antiretroviral Therapy, Highly Active
British Columbia - epidemiology
Emigration and Immigration - statistics & numerical data
Geography
HIV Infections - drug therapy - epidemiology
Health Knowledge, Attitudes, Practice
Health Services Accessibility
Health services needs and demand
Humans
Patient Acceptance of Health Care
Time Factors
Travel
Abstract
To examine regional and temporal trends in migration among patients receiving HIV treatment in British Columbia (BC).
Patients initiating antiretroviral therapy in BC between January 1993 and November 2004 were followed until November 2005. Migration was calculated as the cumulative number of times a patient's residential address changed during their course of treatment. Analyses were performed at the provincial and at the regional health authority (HA) and local health area levels. Demographic methods were used to estimate the in- and out-migration rates, indices of dissimilarity and concentration across regions over time.
A total of 3,588 participants were followed during the study period. Individuals who migrated most often migrated to the Vancouver Coastal HA (from the Interior: 30%, Fraser: 41%, Vancouver Island: 28%, and Northern: 19%), specifically the city of Vancouver, which has been treating the most patients with HIV since the early stages of the epidemic. We also showed that this movement intensified as more contemporary HAART regimens became available (p-value for trend
PubMed ID
20364538 View in PubMed
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Access and perceived need for physical and occupational therapy in chronic arthritis.

https://arctichealth.org/en/permalink/ahliterature144640
Source
Disabil Rehabil. 2010;32(22):1827-32
Publication Type
Article
Date
2010
Author
Debbie Ehrmann Feldman
Sasha Bernatsky
Jean Frédéric Lévesque
My Tram Van
Michelle Houde
Karine Toupin April
Author Affiliation
Université de Montréal, Ecole de Réadaptation, C.P. 6128, Succ. Centre-Ville, Pavillon 7077 du Parc, Montreal, Quebec, Canada H3C3J7. debbie.feldman@umontreal.ca
Source
Disabil Rehabil. 2010;32(22):1827-32
Date
2010
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Arthritis, Rheumatoid - rehabilitation
Attitude of Health Personnel
Chronic Disease - rehabilitation
Health Care Surveys
Health Services Accessibility
Health services needs and demand
Humans
Interviews as Topic
Male
Middle Aged
Occupational therapy
Odds Ratio
Physical Therapy Modalities
Physicians, Family
Quebec
Referral and Consultation
Rheumatology
Abstract
Physical and occupational therapy are beneficial for persons with chronic arthritis; however, access is problematic. The goal was to examine issues related to access to these services for patients with chronic arthritis.
We used two data sources: 1) questionnaires sent to a random sample of 600 family physicians and to all 85 rheumatologists in the province of Quebec; and 2) interviews of 211 patients with physician-confirmed chronic arthritis recruited from 34 primary care settings in Quebec.
Only 11.5% of family physicians and 31.7% of rheumatologists referred patients with rheumatoid arthritis (RA) to rehabilitation, whereas 60.4% of family doctors referred patients with osteoarthritis. Only 26.1% of patients felt that they required rehabilitation and this was associated with lower self-efficacy (OR: 0.84, 95% CI: 0.72, 0.99) and higher educational level (OR: 2.10, 95% CI: 1.01, 4.36).
Family physicians are less likely to refer patients with RA to therapy. Only about a quarter of patients with chronic arthritis treated in primary care perceived the need for these services. Efforts to improve arthritis care should address education of physicians and patients regarding the benefits of rehabilitation and there should be efforts to increase therapy resources in order to enhance access.
PubMed ID
20345251 View in PubMed
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On the road again: patient perspectives on commuting for palliative care.

https://arctichealth.org/en/permalink/ahliterature144741
Source
Palliat Support Care. 2010 Jun;8(2):187-95
Publication Type
Article
Date
Jun-2010
Author
Barbara Pesut
Carole A Robinson
Joan L Bottorff
Gillian Fyles
Sandra Broughton
Author Affiliation
School of Nursing, University of British Columbia Okanagan, Kelowna British Columbia, Canada. barb.pesut@ubc.ca
Source
Palliat Support Care. 2010 Jun;8(2):187-95
Date
Jun-2010
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Aged
Attitude to Health
British Columbia
Cancer Care Facilities
Cost of Illness
Female
Health Care Surveys
Health services needs and demand
Hospitals, Urban
Humans
Income - statistics & numerical data
Life Style
Male
Medically underserved area
Middle Aged
Neoplasms - psychology - therapy
Palliative Care - organization & administration - psychology
Qualitative Research
Questionnaires
Rural Population - statistics & numerical data
Terminally Ill - psychology - statistics & numerical data
Transportation - economics - methods
Abstract
The aim of this research project was to gain an understanding of the experiences of rural cancer patients who commute to an urban cancer center for palliative care.
The study utilized a mixed method design. Fifteen individuals with a palliative designation participated in semi-structured interviews and filled out the Problems and Needs in Palliative Care Questionnaire.
Qualitative findings included three major themes: cultures of rural life and care, strategies for commuting, and the effects of commuting. Participants valued their rural lifestyles and gained significant support from their communities. Strategies included preparing for the trip with particular attention to pain management, making the most of time, and maintaining significant relationships. Establishing a routine helped to offset the anxiety of commuting. Commuting was costly but the quality of life and supportive relationships obtained through treatment were significant benefits. Questionnaire data suggested that participants were experiencing a number of problems but few indicated they desired more professional attention to those problems.
Rural lifestyles are often an important part of overall well-being and commuting for care is both costly and complex. Health care providers should assist individuals to weigh the relative contributions of staying in their rural locale versus commuting for care to their overall quality of life. Palliative-care individuals in this study indicated a number of ongoing problems but were not inclined to seek further assistance from health care providers in addressing those problems. Clinicians should actively inquire about problems and further research is needed to understand why patients are reluctant to seek help.
PubMed ID
20307369 View in PubMed
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The significance of fatigue in relatives of palliative patients.

https://arctichealth.org/en/permalink/ahliterature144742
Source
Palliat Support Care. 2010 Jun;8(2):137-42
Publication Type
Article
Date
Jun-2010
Author
Maria E Carlsson
Author Affiliation
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. maria.carlsson@pubcare.uu.se
Source
Palliat Support Care. 2010 Jun;8(2):137-42
Date
Jun-2010
Language
English
Publication Type
Article
Keywords
Adaptation, Psychological
Attitude to Health
Caregivers - psychology - statistics & numerical data
Causality
Cost of Illness
Cross-Sectional Studies
Family - psychology
Fatigue - epidemiology - etiology - prevention & control - psychology
Female
Health services needs and demand
Humans
Male
Motivation
Palliative Care - organization & administration - psychology
Pilot Projects
Qualitative Research
Self Care - methods - psychology
Self Efficacy
Social Support
Sweden - epidemiology
Workload - psychology - statistics & numerical data
Abstract
The aim of this study was to explore the significance of fatigue among relatives of palliative patients.
This pilot study has a descriptive and cross-sectional design and is the report of four open-ended questions focusing on the relatives' experiences of fatigue. The study population consisted of relatives of patients who were cared for in palliative care settings either at home or in an institution in Uppsala County during a specific day.
The relatives were very tired and identified worries, uncertainty, the patient's suffering, and many demands as the causes for the fatigue. The most obvious consequences of the tiredness were a lack of motivation, feelings of insufficiency and apathy, and putting their own interests aside. Many relatives expressed that having the company of close family members, taking exercise and spending time outdoors gave them strength to carry on. The health care system could make the situation easier for relatives of patients in palliative care by providing good care for the patient, and psychosocial support and respite care for the relatives.
The result of the pilot study is only preliminary, but it showed that relatives caring for patients in a late palliative phase suffer from great fatigue and require more attention, both scientifically and in the clinical settings.
PubMed ID
20307364 View in PubMed
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Environmental justice in the therapeutic inner city.

https://arctichealth.org/en/permalink/ahliterature144771
Source
Health Place. 2010 Jul;16(4):656-65
Publication Type
Article
Date
Jul-2010
Author
Jeffrey R Masuda
Alexis Crabtree
Author Affiliation
Department of Environment and Geography, University of Manitoba, 222 Isbister, 183 Dafoe Road, Winnipeg, Manitoba R3T2N2, Canada. jeff_masuda@umanitoba.ca
Source
Health Place. 2010 Jul;16(4):656-65
Date
Jul-2010
Language
English
Publication Type
Article
Keywords
Attitude to Health
British Columbia
Causality
Community-Based Participatory Research
Consumer Participation
Environmental health
Health services needs and demand
Humans
Photography
Poverty Areas
Public Facilities - statistics & numerical data
Residence Characteristics - statistics & numerical data
Resilience, Psychological
Social Environment
Social Justice
Social Support
Stereotyping
Urban Health - statistics & numerical data
Urban Renewal
Abstract
Vancouver's Downtown Eastside (DTES) has long been characterized as Canada's skid row within public narratives that raise concerns about communicable diseases, open drug use, survival sex work, and homelessness. This stigmatizing gaze has bolstered a deficit-oriented philosophy that emphasizes measures to mitigate these threats, ostensibly by erasing the moral and environmental depravity from the landscape. However, such measures threaten to further marginalize DTES residents by perpetuating public sentiments of fear and disgust toward the inner city. In this paper, we challenge this orientation by reporting the results of a research process in which DTES residents chronicled their impressions of the neighbourhood. Our findings reveal a paradoxical therapeutic response to environmental injustice in the inner city, one that enables society's most marginalized people to find support, solidarity, and acceptance in their everyday struggles to survive, even thrive, amidst the structural and physical violence of the urban margins.
PubMed ID
20303316 View in PubMed
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2351 records – page 1 of 236.