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Addressing the realities [correction of realties] of health care in northern aboriginal communities through participatory action research.

https://arctichealth.org/en/permalink/ahliterature175481
Source
J Interprof Care. 2004 Nov;18(4):360-8
Publication Type
Article
Date
Nov-2004
Author
Bruce Minore
Margaret Boone
Mae Katt
Peggy Kinch
Stephen Birch
Author Affiliation
Center for Rural and Northern Health Research, Lakehead University, Thunder Bay, Ontario, Canada. bruce.minore@lakeheadu.ca
Source
J Interprof Care. 2004 Nov;18(4):360-8
Date
Nov-2004
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Community Health Services - economics - supply & distribution
Consumer Participation
Continuity of Patient Care - economics - organization & administration
Diabetes Mellitus - ethnology - therapy
Female
Health Services Accessibility - organization & administration
Humans
Indians, North American
Male
Mental Health Services - supply & distribution
Neoplasms - ethnology - therapy
Rural Health Services - economics - supply & distribution
Abstract
To address concerns about disruptions in the continuity of health care delivered to residents in three remote aboriginal communities in northern Ontario, Canada, the local health authority initiated a study in collaboration with the department of Health Canada responsible for ensuring that aboriginal reserves receive mandatory health services, and an inter-disciplinary team of researchers from two universities. The study focussed on the delivery of oncology, diabetes and mental health care, specifically, as well as systems issues such as recruitment and retention of health human resources and financial costs. The paper discusses the procedures involved, the benefits derived and the challenges encountered in doing this as a community driven participatory action research project. It also summarizes the findings that led to community formulated policy and program recommendations.
PubMed ID
15801551 View in PubMed
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Continuity, assessment and feedback in orthopaedic nursing care practice is cost-effective.

https://arctichealth.org/en/permalink/ahliterature190025
Source
Scand J Caring Sci. 1999;13(3):177-85
Publication Type
Article
Date
1999
Author
L. Strömberg
G. Ohlén
U. Lindgren
O. Svensson
Author Affiliation
Department of Orthopaedics, K54, Huddinge University Hospital, Karolinska Institute, S-141 86 Huddinge, Sweden.
Source
Scand J Caring Sci. 1999;13(3):177-85
Date
1999
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Continuity of Patient Care - economics - organization & administration
Cost-Benefit Analysis
Hip Fractures - nursing - rehabilitation - surgery
Humans
Middle Aged
Orthopedic Nursing
Prospective Studies
Quality of Health Care
Sweden
Abstract
Hip fracture treatment and rehabilitation are often considered as separate issues and generally performed in different locations. The rapidly increasing proportion of patients that is old and very old now calls for a new approach. This is a prospective study of 909 consecutive hip fracture patients, over 64 years old, admitted to hospital from an independent living situation. In a specialized hip fracture unit, 256 patients were given an early and intense rehabilitation program. It focused on continuity, feedback, reorientation and continuous monitoring of cognitive function and activities of daily living (ADL). Eighty-five percent of the patients could return directly to their own home after the initial treatment period. The mean total utilization of health care resources during the first 4 months after the injury was lower (28 institutional days) than in 286 historical controls given conventional rehabilitation (39 days, p
PubMed ID
12033123 View in PubMed
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Perceived barriers and facilitators in providing palliative care for people with severe dementia: the healthcare professionals' experiences.

https://arctichealth.org/en/permalink/ahliterature296528
Source
BMC Health Serv Res. 2018 Sep 12; 18(1):709
Publication Type
Journal Article
Date
Sep-12-2018
Author
May Helen Midtbust
Rigmor Einang Alnes
Eva Gjengedal
Else Lykkeslet
Author Affiliation
Faculty of Medicine and Health Sciences, Department for Health Sciences in Aalesund, Norwegian University of Science and Technology, Box 1517, NO 6025, Aalesund, Norway. mmi@ntnu.no.
Source
BMC Health Serv Res. 2018 Sep 12; 18(1):709
Date
Sep-12-2018
Language
English
Publication Type
Journal Article
Keywords
Aged
Attitude of Health Personnel
Continuity of Patient Care - economics - organization & administration
Dementia - nursing
Focus Groups
Health Personnel - psychology
Health Resources
Health Services Accessibility - standards
Humans
Norway
Nursing Homes - economics - organization & administration
Palliative Care - economics - organization & administration
Qualitative Research
Abstract
Dementia has become a major public health issue worldwide due to its rapidly increasing prevalence and an increasing number of dementia-related deaths in long-term care facilities. The aim of this study was to examine health professionals' experiences of potential barriers and facilitators in providing palliative care for people with severe dementia in long-term care facilities.
This was a qualitative descriptive study. The data were collected from four focus groups and 20 individual in-depth interviews with healthcare professionals from four Norwegian nursing homes. The data were analysed by thematic text analysis, as described by Braun and Clarke.
The major findings indicate that healthcare professionals experience a lack of continuity as the main barrier to facilitating palliative care. Time pressure and increased efficiency requirements especially affect the weakest and bedridden residents with dementia. The healthcare professionals feel conflicted between wanting to spend more time caring for each individual resident and feeling pressure to help everyone. Although resources are scarce, dying residents are always given priority by healthcare professionals, either by the hiring of extra personnel or the reorganization of tasks in a way that facilitates someone staying with the terminal resident. Advanced care planning was highlighted as a facilitator in providing palliative care, but the extensive use of temporary staff among nurses and doctors and the relocation between the sheltered and long-term wards threaten the continuity in planning and providing palliative care.
The findings indicate that healthcare professionals experienced several structural barriers that prevented the provision of palliative care to people with severe dementia in long-term care facilities. Increasing demands for economic rationality lead to a lack of continuity of care. Organizational changes, such as measures to increase the competence and the proportion of permanent employees and the prevention of burdensome end-of-life transitions, should be implemented to improve continuity and quality of care.
PubMed ID
30208872 View in PubMed
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