Inquiry-The Journal of Health Care Organization Provision and Financing最新文献

{"title":"Employment Practices, Cost Minimization, and Their Implications for Food Provisions and Seafarers' Wellbeing on board Ships - A Qualitative Analysis.","authors":"Polina Baum-Talmor, Çağatay Edgücan Şahin","doi":"10.1177/00469580241229613","DOIUrl":"10.1177/00469580241229613","url":null,"abstract":"<p><p>The global shipping industry, responsible for delivering over 70% of the world's goods (in volume), has increasingly adopted cost minimization policies, contributing to precarious employment practices that adversely affect seafarers' wellbeing. This study focuses on the intricate relationship between employment precarity and food provision on cargo ships. By presenting seafarers' perspectives, we aim to understand how precarious employment practices and cost minimization in the industry influence power dynamics related to food and impact seafarers' wellbeing. Drawing on empirical data collected through shipboard observations and interviews with seafarers, this study examines the often-overlooked experiences and perspectives of seafarers. The research sheds light on the precarity of employment in shipping and its inherent impact on the provision of food on board and its implications for seafarers' physical and emotional health, including the availability of nutritious and sufficient food and its impact on their daily lives. Through in-depth interviews, seafarers' insights into their experiences of food including the quality, availability, and cultural appropriateness of food on board are explored, as well as the standard of training for cooks. Through this research, we found substandard conditions on some of the ships, cost-focused decision-making, and lack of standardized food preparation practices on board. These findings underline the need for improved regulations, better training opportunities, and increased consideration for seafarers' wellbeing. These changes are essential to ensure the provision of adequate and nutritious meals that promote the physical and mental health of seafarers on board ships. Specifically, the research underscores the need for policy and advocacy initiatives to improve seafarers' lives and promote fair working conditions in the global shipping industry. By amplifying the voices of seafarers and providing evidence-based insights, this study contributes to the larger discourse on workers' rights and the importance of decent working conditions. It calls for greater attention to the provision of adequate, nutritious, and culturally appropriate food on board cargo ships, recognizing its significance for seafarers' physical and mental wellbeing, as well as a call for standardized training for ship's cooks.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"61 ","pages":"469580241229613"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10832409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home Versus Hospital Rehabilitation of Older Adults Following Hip Fracture Yields Similar Patient-Reported Outcome Measures.","authors":"Hanna S Schroeder, Avi Israeli, Meir Iri Liebergall, Omer Or, Wiessam Abu Ahmed, Ora Paltiel, Dan Justo, Eyal Zimlichman","doi":"10.1177/00469580241230293","DOIUrl":"10.1177/00469580241230293","url":null,"abstract":"<p><p>The increase in hip fractures (HF) due to aging of the population and the rise in attractiveness of services provided at home following the COVID-19 pandemic, emphasize the need to compare outcomes of home versus hospital HF rehabilitation. To date, studies comparing the 2 services have focused primarily on clinical outcomes rather than patient-reported outcomes (PROs). This longitudinal observational study evaluated PROs of older adults with HF in the 2 settings. The SF36 questionnaire was used to measure PROs 3 times after surgery. The first PRO was retrospective and reflected pre-fracture health status. Descriptive statistics and mixed-effect logistic regression were used. Of 86 patients participating in the study, 41 had home rehabilitation and 45 had hospital rehabilitation. In both groups, the mental and physical scores plummeted 2 weeks after the HF, compared to pre-fracture status. The difference in improvement from pre-fracture status to recovery in both groups, were not significantly (<i>P</i> < .05) different, except for the pain domain. PROs of home versus hospital rehabilitation were similar, suggesting that rehabilitation at home can be as effective as hospital rehabilitation for suitable patients. This knowledge can improve quality of care in an aging global population.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"61 ","pages":"469580241230293"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10943717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Implementation Approach to Translating Assessment Data into Treatment for Disorders of Addiction.","authors":"Jessica L Bourdon, Taylor Fields, Sidney Judson, Nehal P Vadhan, Jon Morgenstern","doi":"10.1177/00469580241237117","DOIUrl":"10.1177/00469580241237117","url":null,"abstract":"<p><p>Effective translation of data to inform real-time patient care is lacking in addiction inpatient settings. The current study presents the optimization of an assessment report that is used by clinicians to individualize treatment. A multi-aim, iterative approach was taken, utilizing an implementation science perspective to arrive at a final version of the assessment report. This occurred at a small inpatient addiction treatment facility. Participants were all available clinical staff (N = 7; female = 71%). A quantitative survey was used for aims 1 and 2 to, respectively, assess motives and context around the report as well as evaluate its design. Aim 3 focused on optimization via semi-structured interviews. Descriptive and modified content analyses were utilized appropriately across aims. This resulted in five versions of the assessment report being created between February 2021 and August 2022, the most recent of which was adapted into patients' electronic medical records. We discuss each version of the report in depth, including clinicians' iterative feedback and researchers' perceived barriers to this translational process. The response rate was 64.3%. The current study highlights a replicable approach for optimizing the translation of assessment data into treatment for patients with disorders of addiction as well as an assessment report that could be utilized by similar facilities with a naturally low sample size.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"61 ","pages":"469580241237117"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10938602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140112256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19: Experiences of Social Workers Supporting Older Adults With Dementia in Nigeria.","authors":"Oluwagbemiga Oyinlola, Kafayat Mahmoud, Abdullateef B Adeoti, Adewole A Abiodun","doi":"10.1177/00469580241239844","DOIUrl":"10.1177/00469580241239844","url":null,"abstract":"<p><p>Amidst the COVID-19 pandemic, numerous public health protocols were instituted by government agencies to safeguard individuals with dementia, their family caregivers, and formal care providers. While these preventive measures were implemented with good intentions, they inadvertently imposed significant challenges on medical social workers in Nigeria. This paper explored the experiences of medical social workers caring for people with dementia during the COVID-19 pandemic in Nigeria. Twenty-six medical social workers from 6 government hospitals in Southwestern Nigeria participated in an in-depth interview. The research reveals 3 pivotal aspects: Firstly, the escalating demands within the work environment, where medical social workers grapple with the intricate task of conveying sensitive information about dementia diagnosis and COVID-19 prevention protocol, managing expectations regarding dementia diagnoses, and navigating resource constraints for individuals with dementia during the pandemic. Secondly, discernible impacts on the work climate and interprofessional relationships shed light on the challenges these professionals face in collaborating with other healthcare providers. Lastly, the reverberations on social workers' personal lives underscore the pandemic's toll on their well-being. Thus, the findings underscore the need for proactive measures to equip medical social workers to face the distinctive challenges in dementia care during future pandemics. Recognizing the potential resurgence of global health crises, the research highlights the need for strategic preparedness to mitigate the impact of future pandemics on the well-being of individuals with dementia and the professionals dedicated to their care.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"61 ","pages":"469580241239844"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140159497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Assessment of Chronic Illness Care (PACIC) and Its Influence on Patient Compliance With Hypertension: A Cross-Sectional Study.","authors":"Chi Zhou, Fang Tan, Si Hong Lai, Jing Chun Chen, Chao Yi Chen, Gao Feng Zhang, Yin Dong","doi":"10.1177/00469580241277445","DOIUrl":"10.1177/00469580241277445","url":null,"abstract":"<p><p>The Chronic Care Model (CCM) is a framework that supports the proactive, planned, coordinated and patient-centered care of chronic diseases. The Patient Assessment of Chronic Illness Care (PACIC) scale is a valuable tool for evaluating patients' perspectives on chronic care delivery based on the CCM. Few studies have examined its application in China. This study assesses hypertension care in Chinese patients and explores how PACIC scores relate to patient compliance. A cross-sectional study was conducted in Hangzhou, China, from June to August 2021, including 253 hypertensive patients from 5 county hospitals and 13 primary healthcare centers. The study used the PACIC scale to assess hypertension care delivery and the Compliance of Hypertensive Patients scale (CHPS) to measure patient compliance. Multiple linear regression analyses were used to explore the relationship between demographic characteristics and the total and domain scores of PACIC, as well as the association between CHPS and the domain scores of PACIC. The mean value of overall the PACIC score was 3.12 (out of 5). Problem solving/contextual domain had the highest average score for each item, while follow up/coordination domain had the lowest. Patient activation had negative effects on intention (β = -.18, <i>P</i> < .05), attitude (β = -.21, <i>P</i> < .05), responsibility (β = -.17, <i>P</i> < .05), and the total score of CHPS (β = -.24, <i>P</i> < .01). Delivery system design/decision support was negatively associated with lifestyle (β = -.21, <i>P</i> < .05) and the total score of CHPS (β = -.26, <i>P</i> < .01). Hypertensive patients perceived that they sometimes received hypertension care consistent with the CCM in Chinese primary healthcare settings. A higher level of PACIC score was beneficial for improving hypertensive patient compliance.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"61 ","pages":"469580241277445"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11382249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Unequal Economic and Livelihood Impacts of COVID-19 Lockdowns: Qualitative Evidence from Uganda.","authors":"David Musoke, Kevin Deane, Sarah Nalinya, Grace Biyinzika Lubega, Elizabeth Ekirapa-Kiracho, David McCoy","doi":"10.1177/00469580241284281","DOIUrl":"10.1177/00469580241284281","url":null,"abstract":"<p><p>Lockdowns were a key policy response to the COVID-19 pandemic. While they were viewed as a necessary intervention, concerns were raised about their potential for harmful economic and livelihood impacts. However, few studies have addressed the unequal economic and livelihood impacts of lockdowns. Our article reports findings from a qualitative study conducted in Uganda on economic and livelihood impacts of COVID-19 lockdowns in urban and rural settings. This study used 14 focus group discussions, 40 household, and 31 key informant interviews in both urban (Kampala district) and rural (Wakiso district) areas in central Uganda. Data analysis was conducted thematically with NVivo 2020 (QSR International). The findings emphasize the unequal impacts of the COVID-19 lockdowns across a range of dimensions: informal sector activities, formal employment, fluctuating prices alongside scarcity and surpluses, food insecurity, and government interventions. Wealthier households in urban areas were least affected, with urban households reliant on informal sector activities experiencing the most significant impacts. Our findings also suggest that longer-term development strategies, such as increased food self-sufficiency and informal sector interventions can support future pandemic preparedness and response. To address these impacts, policymakers should provide targeted support, alongside protecting key productive sectors, and supply chains.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"61 ","pages":"469580241284281"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Positive Social Mentalities and Quality of Spiritual Living in Old Age: Roles of Social Participation and Life Meaning.","authors":"Yifu Wang, Qian Xu, Hemei Tian, Peihao Yin","doi":"10.1177/00469580241282061","DOIUrl":"10.1177/00469580241282061","url":null,"abstract":"<p><p>Quality of spiritual living (QSL) in old age is closely related to the health and well-being of older adults. It is necessary to explore the psychosocial factors and mechanisms that affect the QSL of older adults. The researchers investigated 512 older Chinese people using the positive social mentalities scale, social participation scale, sense of life meaning scale, and spiritual living self-assessment questionnaire. (1) Positive social mentalities (PSMs), social participation (SP), and life meaning (LM) had significant positive correlations with QSL of older adults; (2) SP and LM had serial mediating effects between PSMs and QSL. PSMs influenced QSL through the serial mediating effects of SP and LM. It revealed the critical psychosocial factors and the mechanism affecting QSL in old age, which can provide scientific reference for implementing an active aging strategy.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"61 ","pages":"469580241282061"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11418441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Multi-Level Model of Institutional Innovation and Knowledge Creation Capabilities: Insights From the Development of Taiwan's Nation Health Insurance.","authors":"Shih-Chieh Fang, Chen-Wei Yang","doi":"10.1177/00469580241258902","DOIUrl":"10.1177/00469580241258902","url":null,"abstract":"<p><p>This study proposes a multi-level model of institutional innovation in the healthcare sector-in other words, field-level institutional change pressures that start as network-level institutional innovation by hospitals and government for their organizational performance, with an emphasis on the effect of organizational-level construct-knowledge creation capabilities. A case study using in-depth interviews and a historical inquiry approach has been used to qualitatively analyze our cases during the development of Taiwan's National Health Insurance (NHI). Our results propose a multi-level explanation of institutional innovation by showing how field-level institutional change pressures can stimulate the government's institutional innovation at the network level. Moreover, knowledge creation capabilities may positively influence the government hospitals' ongoing institutional change pressures induced institutional innovation activity for their performance at the organizational level in an institutional setting. This study contributes to health organization management researchers and administrators by developing explanations of institutional innovation and creating a much-needed multi-level insight into hospital behavior in the highly institutionalized healthcare sector.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"61 ","pages":"469580241258902"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11165960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Foreword to: Indiana University's Response to the Addictions Crisis: A Grand Challenge Initiative.","authors":"Robin Newhouse","doi":"10.1177/00469580241254993","DOIUrl":"10.1177/00469580241254993","url":null,"abstract":"<p><p>Use of heroin, prescription painkillers, methamphetamines, and fentanyl led to a national health crisis in 2017, resulting in 1852 overdose deaths in Indiana. Governor Eric J. Holcomb made tackling substance use in the state one of his highest priorities, calling on all Hoosiers to collaborate. In October 2017, Indiana University (IU) President Michael A. McRobbie responded, announcing that the University would be initiating the Responding to the Addictions Crisis Grand Challenge (AGC). Partners included Governor Holcomb, IU Health, and Eskenazi Health. Leveraging the university's research strengths and partnering with more than 160 community organizations across the state, the AGC sought to address substance use facing Indiana and beyond. Fifty interdisciplinary research projects were created through the AGC, focusing on IU's greatest strength in five areas: (1) education, training, and certification; (2) data science and analysis; (3) policy analysis, economics, and law; (4) basic, applied, and translational research; (5) community engagement and workforce development. Diversity, equity, and inclusion implications were often considered. This supplement describes the IU approach to address the health of the people of the State, investigator initiated projects and research conducted to inform practice, strategy and policy.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"61 ","pages":"469580241254993"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11181879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wellbeing and Happiness and Their Association With Working Conditions at Sea: A Cross-sectional Study Among the Global Workforce of Seafarers.","authors":"Rebecca Hayes-Mejia, Martin Stafström","doi":"10.1177/00469580241256349","DOIUrl":"10.1177/00469580241256349","url":null,"abstract":"<p><p>The aim of this study was to investigate whether seafarers' self-reported work experiences were associated with wellbeing and happiness while onboard. The study also examined which indicators of the work experiences had an effect in what direction. We analyzed the survey responses from 13 008 seafarers onboard, from 154 different nationalities, serving in 44 different international shipping companies. The outcome measures were wellbeing and happiness, and the exposure variables were work environment factors: satisfaction, expectations, ideal, skills and training, challenges, and workload. General psychosocial work environment onboard and socioeconomic independent variables were also included. We conducted different logistic regression analyses, and presented the results as odds ratios (OR) and 95% confidence intervals (CIs). The study found that most seafarers reported high levels of wellbeing and happiness and that these were significantly associated to the work environment factors, except for workload. A stratified analysis, showed that workload modified the effect of the other work environment factors. The study found that there were independently significant associations between work related factors and wellbeing and happiness among seafarers at sea. The findings suggest that a greater emphasis on these outcomes could have a positive impact both on crew retention and safety at sea.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"61 ","pages":"469580241256349"},"PeriodicalIF":1.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11143869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141177036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}