OBJECTIVES: National palliative care guidelines outline spiritual care as a domain of palliative care, yet patients' religiousness and/or spirituality (R/S) are underappreciated in the palliative oncology setting. Among patients with advanced cancer receiving palliative radiation therapy (RT), this study aims to characterize patient spirituality, religiousness, and religious coping; examine the ...

BACKGROUND: Respiratory therapist (RT) is a nascent career in China. Little information is about ICU respiratory care resources and practices, requirements for RTs and barriers to recruit RTs. METHODS: Using survey methodology, we designed and mailed a questionnaire to ICU supervisors and staffs at all 106 ICUs within 46 tertiary ...

INTRODUCTION: Sepsis is recognized as an often-lethal disease. Recommended guidelines are complex and time sensitive. Response teams (RTs) have demonstrated success in implementation of quality initiatives. The purpose of this study was to evaluate variations in noncompliance with recommended sepsis guidelines overall and between a sepsis-focused RT and standard care. ...

The burden and disparity of asthma in race/ethnic minorities present a significant challenge. In this review, we will evaluate data on asthma epidemiology in minorities, examine potential reasons for asthma disparities, and discuss strategies of intervention and culturally sensitive care.

To cite this article: Roy A, Downes MJ, Wisnivesky JP. Comprehensive environmental management of asthma and pediatric preventive care. Pediatr Allergy Immunol 2011; 22: 277-282. Indoor environmental triggers can increase asthma morbidity. National guidelines recommend comprehensive use of environmental control practices (ECPs) as a component of asthma management. The purpose ...

This article summarizes our experience using administrative, survey, and telephone information to define asthma severity, impairment, risk, and quality of care in our large Kaiser Permanente population. Our data suggest that the 2-year Healthcare Effectiveness Data and Information Set definition of persistent asthma is a good surrogate for survey-defined persistent ...

Airway management in the intensive care setting provides unique challenges that can be quite daunting, even for the most experienced practitioner. Airways are usually intubated for long periods, multiple comorbidities often interfere with "routine" airway management practices, and patients are often physiologically disadvantaged or hemodynamically unstable. Strapped with this calamity, ...

The Fourth National Audit Project of the Royal College of Anaesthetists and Difficult Airway Society (NAP4) was designed to identify and study serious airway complications occurring during anaesthesia, in intensive care unit (ICU) and the emergency department (ED). Reports of major complications of airway management (death, brain damage, emergency surgical ...

Introduction This research explored the experience of clinicians during the transition from working as an interdisciplinary team to providing a transdisciplinary model of care in a functional restoration program (FRP) for clients with chronic disabling musculoskeletal pain. Methods This qualitative study used a grounded theory approach to data collection and ...

CASE: Gerardo is an 8-year-old Latino boy who saw his primary care pediatrician with a second asthma exacerbation this year. His frustration with his illness was immediately apparent when he said, "I hate having to go to the nurse's office to take my albuterol!" His mother expressed concern that her ...

Puerto Ricans have higher lifetime and current asthma prevalence than other racial and ethnic groups in the United States. A great many Hispanics use ethnomedical therapies for asthma. This study elicited participant knowledge of ethnomedical therapies, developed a typology of the therapies, and considered whether some types are used or ...

The objective of the present study was to explore how mental health-care professionals initiate, improve, and maintain client autonomy while improving other aspects of quality of care. We studied the different ways in which they approach autonomy and the dilemmas associated with them. As a methodology, we used the insights ...

To describe development and testing of a counseling tool intended to inform family planning clients while helping the family planning provider facilitate the client's decision-making process; and to discuss challenges and requisites for shifting to shared decision-making from the extremes of decision-making dominated by the provider, on one hand, or ...

Health care policymakers have cited transportation barriers as key obstacles to providing health care to low-income suburbanites, particularly because suburbs have become home to a growing number of recent immigrants who are less likely to own cars than their neighbors. In a suburb of New York City, we conducted a ...

Bibliotherapy is a form of self-administered treatment in which structured materials provide a means to alleviate distress. Although the treatment has evidence of effectiveness, evaluations of bibliotherapy have typically focused on outcomes, and the perspectives of both the client and the service provider have been understudied. In the present study, ...

Global scale-up of antiretroviral therapy (ART) has focused on clinical outcomes with little attention on its impact on existing health systems. In June-August 2008, we conducted a formative evaluation on ART scale-up and clinic operations at three clinics in Uganda to generate lessons for informing policy and larger public health ...

In a previous intervention, we found that reminders from care managers failed to increase the number of their homebound older adult clients with advance directives. Thus, in the current study, we looked at the perceptions and attitudes of care managers about the need to discuss advance directives with their clients. ...

Allergic rhinitis is one of most prevalent chronic diseases and results in relatively high medical expenses and economic burden; however, in Korea, studies on economic costs are limited. Therefore, this study investigated the health care use and socioeconomic costs of allergic rhinitis in Korea. This study extracted the insurance claims ...

In this article, we draw on data collected from two samples of home care nurses to examine how relationships between nurses and family caregivers intersected with access to palliative home care nursing services. Participants referred to relationships as important for their practical benefits and for access to care: good relationships ...

The purpose of this exploratory, qualitative study was to investigate storytelling by home care clients to their home care workers (HCWs). Specific research questions were: (a) When does storytelling by a care recipient occur during usual care?; (b) How do HCWs engage older clients in storytelling?; (c) How do HCWs ...

This study explores reasons for late ART initiation among known HIV positive persons in care from a client/caretaker perspective in eastern Ugandan where ART awareness is presumably high yet AIDS related mortality is a common function of late initiation of ARVs. In Iganga, Uganda we conducted in-depth interviews with clients ...

The purpose of this study was to use a questionnaire based on the discrepancy model to assess the factors contributing to satisfaction and dissatisfaction with private outpatient physiotherapy services in Sydney; to test the applicability of the "consumer model" to physiotherapy practice, and to identify the criteria used to assess ...

The Institute of Medicine's report on racial and ethnic disparities in health care encourages enhancing patient-provider relationships by building trust. We explored factors important to 19- to 24-year-old African American women (N = 40) in choosing a health care provider. Eight focus groups were held in seven Ohio counties. Discussion ...

Case management is a standard practice in the United States for the effective care of people living with HIV and AIDS (PLHA); however, application of this approach in developing countries has not been demonstrated. Although great advances have been made in Africa to increase PLHA's access to HIV services, care ...

To gain an understanding of the factors that affect the risks and the adoption of risk control measures during the care of bariatric patients, focus groups were conducted in rural and metropolitan locations in Australia. It was found that the manual handling injury risk to carers is influenced by the ...

Each custom seating referral is a puzzle. By gathering the various pieces of client and caregiver input, client assessment, and trial equipment, the seating professional can create an overall plan that successfully meets client needs. Using a combination of commercial seating products, custom seating products, and creative hardware combinations has ...

The session report form (SRF) is a 25-item self-report measure scheduled to be completed by clinicians at the end of each session. This study addresses the utility of the SRF for describing session content by exploring patterns of self-reported behavior of 235 clinicians in 7,058 sessions with 600 clients. Results ...

The focus on recovery for persons with severe and persistent mental illness is leading state psychiatric hospitals to transform their method of care delivery. This article describes a quality improvement project involving a hospital's administration and multidisciplinary state-university affiliation that collaborated in the development and implementation of a nursing care ...

Mental health clinicians and program administrators must implement effective strategies for engaging and retaining clients in care. At a recent series of forums open to providers from clinics in New York City that was sponsored by the city and state public mental health authorities, high-performing providers described their client engagement ...

AIM: The aim of this study was to explore individual and organizational risk factors of exposure to violence in the Elder Care Sector. METHODS: A questionnaire study conducted among 8134 health-care workers in the elder care in 36 municipalities was carried out between October 2004 and May 2005. Participation in ...

AIM: To explore and compare older home care clients' (65+) and their professionals' perceptions of the clients' psychological well-being and care and to identify possible differences in these perceptions. BACKGROUND: Psychological well-being is considered an important dimension of quality of life. With advancing age, older people require home care support ...

BACKGROUND: The paper argues that a high quality personal relationship between professionals and clients is a necessary condition of professional knowledge. This epistemological claim is developed against the background of current methods of quality assessment that rely on objectively measurable 'indicators'. METHOD: A philosophical analysis regarding the nature of professional ...

Immigrant care workers play an increasingly important role in home and long-term care in Canada, yet the full extent of their relations with older persons in those settings is relatively unknown. This article examines the role of immigrant care workers in both home and long-term care sectors, with a focus ...

OBJECTIVE: During the deinstitutionalisation of psychiatric care in Germany, new psychiatric care approaches have been developed, which have been rarely scientifically evaluated. This study aims at evaluating the residential care and supported housing program of a public service in Westphalia, Northwestern Germany. METHODS: Data on 1486 clients about sociodemographics, individual ...

AIM: This paper is a report of a study conducted to explore the competencies - especially deep-rooted personal qualities - of care providers who succeed in making contact and gaining trust with clients who are inclined to avoid the care they need. BACKGROUND: Demands, thresholds and fragmentation of services hinder ...

AIM: To evaluate the experience of care coordinators encountering clients with co-morbid diagnoses or features of pervasive development disorder (PDD) in an Early Intervention in Psychosis (EIP) service. METHODS: A cross-sectional survey was conducted using a semi-structured face-to-face interview schedule. RESULTS: Thirty-three care coordinators were interviewed. One-third of the care ...

BACKGROUND: Policy instruments based on the working of markets have been introduced to empower consumers of healthcare. However, it is still not easy to become a critical consumer of healthcare. OBJECTIVES: The aim of this study is to analyse the possibilities of the state to strengthen the position of patients ...

The purpose of this study was to describe the lived experience of midwifery clients throughout the life span. A qualitative study using a phenomenological approach was employed. In-depth interviews were conducted with a purposive sample of 12 midwifery clients. The research question was: What has been your experience with midwifery ...

This article explores the meaning of empathy and how it influences clinicians in their personal and professional lives. Empathy may benefit client and clinician by improving patient satisfaction and pain management, reducing medical errors, and helping to keep clinicians grounded in the priorities of patient care. The cultural and developmental ...

This study aims to describe the development, testing and optimization of a new standard instrument, the Consumer Quality Index (CQ-index) Long-term Care, for measuring client experiences with long-term care in the Netherlands. Three versions of the CQ-index questionnaires and protocols for study sampling and data collection were developed, designed for ...

Objective: Aggression by patients is a known risk factor for hospital workers. Within New Zealand, the bulk of ongoing care for physical and mental disabilities and health issues is not hospital based, but contracted to various non-governmental agencies. The rate of client aggression towards care workers from these organizations, to ...

This study examined the relationship between social workers' experiences when interfacing with managed care organizations and burnout. A total of 591 social workers completed questionnaires that included several measures: Self-perceived competence in the context of managed care, professional involvement with clients with severe mental illness, and burnout. Results showed that ...

Communication for informed choice is particularly challenging in clinical settings such as direct-entry midwifery, where the care model embraces diverse therapies and forms of knowledge. We identified three discursive moves (explanation, invocation, and evaluation) that Ontario midwives and clients used in making claims about proposed interventions. The analysis was informed ...

Empowerment-oriented and strengths-based practices focusing on community integration have gained recognition for various client groups in recent decades. This paper discusses whether care farms in the Netherlands are relevant examples of such practices. We identify characteristics associated with care farms that are relevant for three different client groups: clients with ...

Challenges in care management threaten health outcomes in persons living with HIV (PLWH), who also have other medical and psychiatric diagnoses, substance use problems, or adjustment issues (comorbid PLWH). Integrated primary care programs have been developed to address multiple care needs in comorbid PLWH. The effectiveness of these models has ...

AIM: To determine whether the Japanese preventive-care version of the Minimum Data Set-Home Care improves the health-related behaviors of older adults and the skills of preventive-care managers. METHODS: Municipal preventive-care managers were instructed on the use of the Japanese preventive-care version of the Minimum Data Set--Home Care and asked to ...

Four regional viral hepatitis clinics in British Columbia provide accessible integrated care and services but have not been evaluated. The purpose of this cross-sectional study was to assess clients' perceptions of the quality of care and services received, what aspects of care were important, and what the effect of care ...

People with serious mental illness have higher rates of morbidity and mortality from cardiovascular disease. This study describes health practitioners' views on their role and confidence assessing and managing cardiovascular risk. The key findings were of a widespread acknowledgement of the need to undertake systematic risk assessment and offer structured ...

AIMS AND OBJECTIVE: The negative impact of chronic leg ulcers on quality of life is well documented. The aim of this study was to determine the effectiveness of a new community nursing model of care on quality of life, morale, depression, self-esteem, social support, healing, pain and functional ability of ...

AIM: This paper is a report of a study conducted to explore the application of designing front- and back-office work resulting in efficient client-centred care in healthcare organizations that supply home care, welfare and domestic services. BACKGROUND: Front/back-office configurations reflect a neglected domain of design decisions in the development of ...