BMC Health Services Research最新文献

{"title":"GP emigration from Ireland: an analysis of data from key destination countries.","authors":"Holly Rose Hanlon, Éidín Ní Shé, John-Paul Byrne, Susan M Smith, Andrew W Murphy, Aileen Barrett, Mike O'Callaghan, Niamh Humphries","doi":"10.1186/s12913-024-12117-2","DOIUrl":"https://doi.org/10.1186/s12913-024-12117-2","url":null,"abstract":"<p><strong>Background: </strong>Ireland is experiencing a general practitioner (GP) workforce crisis, facing an ageing workforce, a growing population with increased life expectancy, and increased complexity of patients. The GP crisis threatens access to primary care in Ireland, as well as Ireland's aim to transform into a primary-care centred system of universal healthcare via the proposed \"Sláintecare\" healthcare reforms. The challenges faced are common to many countries as health systems seek to expand their medical workforce post-pandemic. In addition Ireland has a legacy of austerity policies which impacted the health system, and triggered/generated largescale doctor emigration. However, little is known specifically about GP emigration and the role it potentially plays in the GP workforce crisis. This paper aims to address the gap in knowledge about the level of GP emigration from Ireland and consider the implications for the Irish health system and health systems internationally.</p><p><strong>Methods: </strong>As Ireland does not formally collect routine data on GP emigration, this paper presents routinely collected secondary data from four key destination countries; Australia, New Zealand, the United Kingdom, and Canada, in order to gain an initial picture of GP emigration from Ireland to these countries, from 2012-2021. The data were in the form of medical registration and immigration (visa) data and both stock (the total number of GPs registered in a country in a given year) and flow data (the number of GPs entering a country in a given year) were collated, where available.</p><p><strong>Results: </strong>The stock data shows a substantial cohort of Irish-trained doctors working in general practice in key destination countries. The flow data suggests a relatively small annual emigration flow of GPs from Ireland to individual countries. However when compared with the total numbers of GPs trained in Ireland each year, the numbers are notable.</p><p><strong>Conclusions: </strong>The available data suggests a mixed picture regarding GP emigration from Ireland. There is a significant stock of Irish-trained GPs abroad which perhaps represents a potential cohort of GPs who could be encouraged to return to practice in Ireland as part of Ireland's strategy for addressing the GP workforce crisis. The annual flow of GPs from Ireland to key destination countries, while small, should be monitored and factored into GP workforce planning. As global demand for GPs increases, countries will inevitably compete with each other to attract and retain GPs (see for example Australia's recent move to attract and recruit Irish trained GPs). The paper highlights the need for improved routine data on the GP workforce in Ireland, including the need for a national GP workforce dataset, in order to ensure that national workforce planning efforts are informed by the latest evidence on GP emigration.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"24 1","pages":"1628"},"PeriodicalIF":2.7,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary healthcare's carbon footprint and sustainable strategies to mitigate its contribution: a scoping review.","authors":"Stephen James Walsh, Aisling O'Leary, Colm Bergin, Sadhbh Lee, Áine Varley, Matthew Lynch","doi":"10.1186/s12913-024-12068-8","DOIUrl":"https://doi.org/10.1186/s12913-024-12068-8","url":null,"abstract":"<p><strong>Background: </strong>The escalating climate crisis poses a significant threat to global public health. The healthcare sector, designed to protect human health is a major contributor to greenhouse gas emissions, and thus, a key driver of climate degradation. This paradox endangers both planetary and human health, making the decarbonization of healthcare, including primary care, critical. However, research on primary care's contribution to emissions and strategies for mitigation remains limited.</p><p><strong>Aim: </strong>This scoping review aimed to map how primary care contributes to healthcare's environmental footprint and determine contributing factors. Additionally, it sought to identify existing and innovative strategies to reduce the carbon footprint of primary healthcare.</p><p><strong>Methods: </strong>A comprehensive strategy was developed to systematically search both published databases and grey literature. Key terms were identified and employed in the exploration of relevant databases and internet search engines.</p><p><strong>Results: </strong>An initial search yielded 246 published articles and 25 grey literature sources. 14 additional articles were included following forward and backward searching of prominent authors and key articles. After screening and full-text review, 39 articles and 12 reports/toolkits were included. The majority of sources were opinion pieces, with limited quantitative, observational, or qualitative studies. Primary care's carbon footprint can be classified into clinical and non-clinical sources, with significant impacts from pharmaceuticals and inhaler propellant gases. Contributing factors include limited knowledge of emission sources, lack of awareness of sustainable practices, low prioritization of sustainability, barriers including ethical concerns and over-medicalization. Identified strategies to reduce emissions include decarbonization of patient care, increasing education and awareness, implementing non-clinical decarbonization efforts, and conducting more research to support sustainable initiatives. Developing metrics to track progress and securing policy supports to improve adoption and implementation were also highlighted as critical.</p><p><strong>Conclusion: </strong>The identification of sources of carbon hotspots in primary care is an essential precursor to enable the development of targeted decarbonization strategies. Decarbonizing primary care requires a multifaceted approach that addresses the underlying factors driving unsustainable practices. This would allow healthcare professionals to effectively balance the provision of high-quality patient care, while reducing their environmental impact, ultimately improving both human and planetary health.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"24 1","pages":"1630"},"PeriodicalIF":2.7,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends of socioeconomic and geographic inequalities in COVID-19 vaccine uptake in Ethiopia: using the WHO Health Equity Assessment Toolkit.","authors":"Abel Endawkie, Chala Daba, Lakew Asmare, Belay Desye, Temeselew Woldetsadik Mawugatie, Dagnachew Melak, Yawkal Tsega","doi":"10.1186/s12913-024-12082-w","DOIUrl":"https://doi.org/10.1186/s12913-024-12082-w","url":null,"abstract":"<p><strong>Background: </strong>Equity in COVID-19 vaccine uptake is the heart of managing the ongoing pandemic of COVID-19 disease. However, the evidence of inequality in COVID-19 vaccination in Ethiopia is limited. Therefore, this study investigated the trends of socioeconomic and geographic inequality of COVID-19 vaccine uptake in Ethiopia.</p><p><strong>Method: </strong>This study used the Global COVID-19 trends and impact survey as part of the WHO Health Equity Assessment Toolkit software 2021 version. The trends of socioeconomic and geographic inequalities in COVID-19 vaccine uptake between surveys were calculated with a 95% confidence interval (CI). A 95% CI was calculated along with measures of inequality in COVID-19 vaccine uptake and statistical significance was declared if the 95% CI of absolute and relative measures of inequalities does not include 0 and 1 respectively.</p><p><strong>Result: </strong>The COVID-19 vaccine uptake in the 45-65 age group significantly increased from 40.04%, 95% CI (32.49, 48.1) to 72.7%, 95%CI (63.7, 80.2) in 05/2021 to 03/2022 respectively. The absolute inequality of COVID-19 vaccine uptake among male vs female respondents was 3.6%, 95% CI (3.9, 11.2) in 08/2021 which was obtained by subtraction of the respecting proportion of vaccines uptakes 32.9% for males minus 29.28% for females and there was a significant more prevalence of vaccine uptake in males than in females. The absolute inequality in COVID-19 vaccine uptake among health workers vs non-health workers was 28.5%, 95% CI (17.8, 37.2), 03/2022 and there was a significantly higher prevalence of vaccine uptake in health workers than non-health workers in each survey. The relative measures of inequality in the ratios of COVID-19 vaccine uptake among urban vs rural was 0.85, 95%CI (0.7, 0.994) in 08/2021 which was obtained by dividing the respecting proportion of vaccine uptakes of urban by rural residents.</p><p><strong>Conclusion: </strong>The study showed that the proportion of COVID-19 vaccine uptake in Ethiopia significantly increased from 2021 to 2022 with distinct inequality. The study indicated there is significant absolute and relative inequality in COVID-19 vaccine uptake between health workers and non-health workers, male and female, and urban and rural residents in Ethiopia. Therefore, the effort should be geared towards reducing health workers vs non-health workers, urban vs rural, and gender inequalities in COVID-19 vaccine uptake through health literacy and recommend geographic and equity-oriented policies, to ensure effective pandemic management of COVID-19.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"24 1","pages":"1629"},"PeriodicalIF":2.7,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family medicine research: seizing the moment to advance the field.","authors":"Brad Wright, Aoife O'Connor, Erin P Fraher, Miguel Marino, Bianca K Frogner","doi":"10.1186/s12913-024-12121-6","DOIUrl":"10.1186/s12913-024-12121-6","url":null,"abstract":"<p><p>Despite a growing awareness that primary care is essential to an accessible, equitable, high-quality, cost-effective health care system, family medicine research remains woefully underdeveloped. The increased focus of both state and federal policy makers on primary care payment and care delivery models presents an opportunity for family medicine to redefine itself as an academically rigorous discipline at the forefront of generating evidence that improves patient care and population health while reducing costs. In a critical review of the literature, we identified five themes-leadership, funding, resources, team science, and departmental culture-that are integral to family medicine departments seeking to grow and expand their research capacity.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"24 1","pages":"1627"},"PeriodicalIF":2.7,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing public health through technological rehabilitation: insights from a national clinician survey.","authors":"Marianna Capecci, Marialuisa Gandolfi, Sofia Straudi, Rocco Salvatore Calabrò, Nicolò Baldini, Lucia Pepa, Elisa Andrenelli, Nicola Smania, Maria Gabriella Ceravolo, Giovanni Morone, Donatella Bonaiuti","doi":"10.1186/s12913-024-11991-0","DOIUrl":"https://doi.org/10.1186/s12913-024-11991-0","url":null,"abstract":"<p><strong>Introduction: </strong>In the evolving healthcare landscape, technology has emerged as a key component in enhancing system efficiency and offering new avenues for patient rehabilitation. Despite its growing importance, detailed information on technology's specific use, types, and applications in clinical rehabilitation settings, particularly within the Italian framework, remains unclear. This study aimed to explore the use of technology and its needs by Physical Medicine and Rehabilitation medical doctors in Italy.</p><p><strong>Methods: </strong>We conducted a cross-sectional online survey aimed at 186 Italian clinicians affiliated with the Italian Society of Physical and Rehabilitation Medicine (SIMFER). The online questionnaire consists of 71 structured questions designed to collect demographic and geographical data of the respondents, as well as detailed insights into the prevalence and range of technologies they use, together with their specific applications in clinical settings.\"</p><p><strong>Results: </strong>A broad range of technologies, predominantly commercial medical devices, has been documented. These technologies are employed for various conditions, including common neurological diseases, musculoskeletal disorders, dementia, and rheumatologic issues. The application of these technologies indicates a broadening scope beyond enhancing sensorimotor functions, addressing both physical and social aspects of patient care.</p><p><strong>Discussion: </strong>In recent years, there's been a notable surge in using technology for rehabilitation across various disorders. The upcoming challenge is to update health policies to integrate these technologies better, aiming to extend their benefits to a wider range of disabling conditions, marking a progressive shift in public health and rehabilitation practices.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"24 1","pages":"1626"},"PeriodicalIF":2.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meanings and senses of Hansen's disease for health workers from a Vygotskian perspective: a qualitative study.","authors":"Karen da Silva Santos, Marlene Fagundes Carvalho Gonçalves, Felipe Lima Dos Santos, Priscila Norié Araujo-Betetti, Poliana Silva de Oliveira, Marcela Gonçalves, Patricia Bessaoud-Alonso, Cinira Magali Fortuna","doi":"10.1186/s12913-024-12083-9","DOIUrl":"https://doi.org/10.1186/s12913-024-12083-9","url":null,"abstract":"<p><strong>Background: </strong>Hansen's disease is an infectious disease with a slow and chronic evolution that can manifest itself through skin lesions, with changes in thermal, painful and tactile sensitivity, and also affect peripheral nerves, causing significant physical disabilities. This study aimed to analyze the meanings and senses for health workers from outpatient services who provide care to people diagnosed with Hansen's disease.</p><p><strong>Methods: </strong>This is an exploratory qualitative study that used the Vygotskian theoretical-methodological framework based on the dimension of historical-dialectic materialism that bases its procedures on the use of meaning cores. The study was carried out in Ribeirão Preto, in the inland state of São Paulo, Brazil. In total, 13 health professionals participated in the study, including two nurses, three physicians, five nursing assistants, a physiotherapist and two social workers.</p><p><strong>Results: </strong>To understand the meanings and senses of Hansen's disease, we take three cores of meaning as a basis: (1) personal, professional and social aspects of health workers and Hansen's disease, the health workers report that their view of what Hansen's disease was based on the understanding that it was an infectious disease that caused deformities, known as \"leprosy\", and that those affected needed to be isolated; (2) Hansen's disease - neglected, invisible and unknown, the invisibility of Hansen's disease continues to haunt those affected by it, and diagnosis is still late, referring to the marks carried in the history of Hansen's disease that remain today; and (3) challenges and potential in the world of work in the Hansen's disease reference services, the dichotomies, challenges and potential of working with those affected by Hansen's disease are linked to the creation of bonds, love for the profession, religious beliefs and problems related to the lack of resources for the rehabilitation of those affected.</p><p><strong>Conclusions: </strong>The re-elaboration of meaning can occur when professionals are inserted in the world of work. The socially produced senses and meanings surrounding leprosy are related to its invisibility and late diagnosis. Changing the meanings and senses requires mediation and the use of critical active methodologies in health education, with investments from training bodies, social movements and health services.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"24 1","pages":"1623"},"PeriodicalIF":2.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142851766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cross-sectional study on socio-demographic correlates of self-reported self-care practices for hypertension and type 2 diabetes among adults living in rural Kenya.","authors":"MacKenna Schwarz, Bishal Gyawali, Dorothy Mwari Nkonge-Ngumba, Sylvia Khamati Anekha, Miriam Ngure, Tania Aase Dræbel","doi":"10.1186/s12913-024-12088-4","DOIUrl":"https://doi.org/10.1186/s12913-024-12088-4","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Hypertension and type 2 diabetes are among the most common non-communicable diseases that contribute to a large number of adult morbidity and mortality in Kenya. The impact of these conditions may pose great challenges in rural areas with limited access to healthcare services. The objective of the study was to assess socio-demographic factors associated with self-reported self-care practices for hypertension and type 2 diabetes among adults living in rural Kenya.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study used data from the 2019 Baseline Assessment of the Prevention and Control of Non-Communicable Disease Project in Imenti South, Meru County conducted by the Kenyan Red Cross Society. A community-based study using a cross-sectional design was conducted among four hundred and thirty-five participants in Imenti South sub-County, Meru County in Kenya in November 2019. Chi-square test and logistic regression analyses were conducted to explore sociodemographic factors associated with self-reported self-care practices for hypertension and type 2 diabetes. Crude and Adjusted Odds Ratios with a 95% Confidence Interval (CI) were reported.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 435 participants, 37.0% self-reported hypertension, while 15.4% reported having type 2 diabetes. Variances in self-care practices were evident between the conditions, notably in terms of adequate fruit and vegetable intake and blood pressure screening. Among individuals with type 2 diabetes, 94% lacked sufficient fruit and vegetable consumption, contrasting with 98.7% among hypertensive participants (p = 0.042). Similarly, a significant majority of individuals with hypertension (71.4%) had blood pressure screening (p = 0.031). Multivariable logistic regression analysis revealed that individuals over 40 years exhibited higher odds of good self-care practice for hypertension compared to their younger counterparts (AOR: 4.67, 95% CI: 1.53-14.27, p = 0.007), whereas those residing in Mitunguu were 71% less likely to engage in such practices than those in Abogeta (AOR: 0.29, 95% CI: 0.09-0.90, p = 0.033). However, none of the variables demonstrated a significant association with self-reported self-care practices for type 2 diabetes following adjustment for potential confounding variables in the multivariable logistic regression analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our study identified socio-demographic factors, including age (&gt; 40 years) and ward (Mitunguu), associated with self-reported self-care practices for hypertension among adults living in rural Kenya. However, we did not find significant associations between sociodemographic factors and self-care practices for type 2 diabetes. Furthermore, factors such as gender, education level, marital status, religion, employment status, and average monthly income did not show significant associations with self-care practices for hypertension or type 2 diabetes. These results provide insights regardin","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"24 1","pages":"1624"},"PeriodicalIF":2.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring experiences and perspectives of patients on hypertension management in Southern Ethiopia: a phenomenological study.","authors":"Eshetu Elfios Endrias, Temesgen Geta, Bemnet Desalegn, Bizuayehu Atinafu Ataro, Eskinder Israel, Christian Kebede, Melesse Belayneh, Beker Ahmed, Abdulkerim Hassen Moloro, Getachew Nigussie","doi":"10.1186/s12913-024-12111-8","DOIUrl":"https://doi.org/10.1186/s12913-024-12111-8","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is a significant public health challenge, particularly in low- and middle-income countries, where its management is often inadequate. Understanding patients' experiences and perspectives is crucial for improving hypertension care. Despite a growing body of literature on hypertension in Ethiopia, most studies focus on quantitative data, leaving a significant gap in qualitative insights into patient experiences and perspectives. This study uniquely contributes to the field by exploring the lived experiences of patients in Southern Ethiopia, providing context-specific evidence to inform patient-centered hypertension management strategies.</p><p><strong>Objective: </strong>This qualitative study aimed to explore the experiences and perspectives of patients with hypertension regarding their management and care at a comprehensive hospital in Southern Ethiopia.</p><p><strong>Methods: </strong>A phenomenological approach was employed to capture the experiences and perspectives of participants. In-depth interviews were conducted with 14 patients with hypertension, selected through purposive sampling. The interviews were audio-recorded, transcribed verbatim, and analyzed using OpenCode version 4.02 software to facilitate systematic coding and thematic analysis. Then, key themes and subthemes were identified from the data related to patient experiences and perspectives providing a relevant framework for understanding the complexities of hypertension management from the patients' perspectives.</p><p><strong>Results: </strong>The six key themes emerged, depicting participants' challenges, coping strategies, and interactions with the healthcare system. The themes identified are: adherence to treatment and self-care, awareness of perceived risk and health literacy, experience with the diagnosis, family support in hypertension management, stress awareness and management, and healthcare system and proximity to facilities. Participants noted obstacles to adherence, including long waiting times, forgetting medications, and stress related to their condition. CONCLUSION AND RECOMMENDATION: The findings highlight the need for specific patient-centered strategies that address the challenges faced by hypertensive patients in Southern Ethiopia, such as reducing wait times, enhancing family involvement in care, increasing adherence, and addressing stress. Strengthening healthcare services is essential for sustainable hypertension management.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"24 1","pages":"1625"},"PeriodicalIF":2.7,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obstacles to effective communication between physical/occupational therapists and patients in the Saudi Arabian context: a cross-sectional study.","authors":"Turki Aljuhani, Abrar M Al-Mutairi, Abdullah Alfraih, Mohammed Alharbi, Turki AlAmri, Ali Alahmari, Abdulaziz Alotaibi, Mohammed Senitan","doi":"10.1186/s12913-024-12077-7","DOIUrl":"https://doi.org/10.1186/s12913-024-12077-7","url":null,"abstract":"<p><strong>Background: </strong>Effective communication between healthcare providers and patients is essential for high-quality care and patient satisfaction. Barriers to communication can lead to misunderstandings and poorer health outcomes. This study aims to identify communication obstacles between physical/occupational therapists (PTs/OTs) and patients in the Saudi Arabian context.</p><p><strong>Methods: </strong>This cross-sectional study, which was conducted from September 2022 to January 2023, involved 228 patients and 46 therapists from the rehabilitation services department. Data were collected via two self-administered questionnaires and analyzed via Pearson's chi-square test of independence and Fisher's exact test for categorical nominal data to assess associations between variables. A p value of less than 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Most patients (25.4%) were young adults aged 18-30 years, predominantly Saudi nationals (96.5%), with undergraduate degrees (63%). High satisfaction with therapists was reported by 69.3% of patients. The key barriers identified included limited consultation time (15.8%) and the use of medical records (4.8%). Therapists, primarily young professionals aged 25-30 years (54.3%) with 3-5 years of experience (43.5%), also reported time limitations (30.4%), physical setup issues (37.0%), and poor patient history-taking (56.5%) as significant barriers. Additional findings from our study indicated that monolingual Arabic-speaking therapists faced greater challenges in understanding language (p = 0.02), and younger therapists (aged 25-30) reported greater difficulties in managing multiple problems during sessions (p = 0.03), highlighting age and linguistic background as significant factors influencing communication efficacy.</p><p><strong>Conclusions: </strong>Addressing communication barriers through targeted interventions, such as enhanced training, improved clinical structures, and advanced electronic health records, can improve patient satisfaction and treatment outcomes. Future research should focus on longitudinal studies and specific communication training programs.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"24 1","pages":"1597"},"PeriodicalIF":2.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of an advanced practice role for oxygen prescription by physiotherapists in pulmonary rehabilitation: an explanatory sequential mixed-method quality evaluation.","authors":"Thomas F Riegler, Thimo Marcin, Patrick Brun","doi":"10.1186/s12913-024-12041-5","DOIUrl":"https://doi.org/10.1186/s12913-024-12041-5","url":null,"abstract":"<p><strong>Background: </strong>Physiotherapists play a key role in the administration of supplemental oxygen during physical activity in pulmonary rehabilitation. However, supplemental oxygen requires a medical prescription making processes cumbersome for physiotherapists. This study aimed to implement and evaluate an advanced practice role for physiotherapists (APO₂) allowing them to prescribe oxygen during physical activity.</p><p><strong>Methods: </strong>Training and certification process for respiratory physiotherapists employed in an inpatient rehabilitation clinic was implemented. A mixed-method approach for retrospective evaluation was used. Quantitative analysis included routine clinical data from oxygen prescriptions, titrations, and exercise capacity. Additionally, healthcare professionals' experiences and perceptions of the new APO₂ role was explored using a survey. Qualitative data included interprofessional interviews, survey comments, and data from the critical incidence reporting system.</p><p><strong>Results: </strong>In 15% of patients during the evaluation period, certified APO₂ were involved in oxygen prescription. These patients had more frequent titrations (median 8 [interquartile 6, 10] vs. 5 [4, 8]), prescription adjustments (3 [2, 4] vs. 1 [1, 2]), and narrower oxygen dosage ranges prescribed (2 [1, 3] vs. 4 [3, 4]). No significant difference in exercise capacity was observed and no adverse events reported. Survey data from 19 healthcare professionals and interviews indicated that the specialised expertise of APO₂ positively impacts interprofessional collaboration and workflow efficiency.</p><p><strong>Conclusions: </strong>Physiotherapy-led oxygen prescription during physical activity in pulmonary rehabilitation is feasible, safe, and perceived as beneficial for the workflow and interprofessional collaboration across healthcare professions.</p><p><strong>Trial registration: </strong>According to Swiss law (Human Research Act, Art. 2), ethics approval for the study and informed consent were not required and were waived off. All methods were in accordance with the regulations and guidelines of the Swiss Human Research Act and Swiss ethics law.</p>","PeriodicalId":9012,"journal":{"name":"BMC Health Services Research","volume":"24 1","pages":"1585"},"PeriodicalIF":2.7,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}