Bmc Health Serv Res
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Bmc Health Serv Res · Dec 2018
Randomized Controlled TrialTwelve-month effect of chronic pain self-management intervention delivered in an easily accessible primary healthcare service - a randomised controlled trial.
To investigate the effects after twelve months related to patient activation and a range of secondary outcomes on persons with chronic pain of a chronic pain self-management course compared to a low-impact outdoor physical activity, delivered in an easily accessible healthcare service in public primary care. ⋯ No long-term effect of the chronic pain self-management course was found in comparison with a low-impact physical activity intervention for the primary outcome patient activation or for any secondary outcome.
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Bmc Health Serv Res · Dec 2018
Quality and safety of in-hospital care for acute medical patients at weekends: a qualitative study.
The increased mortality risk associated with weekend admission to hospital (the 'weekend effect') has been reported across many health systems. More recently research has focused on causal mechanisms. Variations in the organisation and delivery of in-hospital care between weekends and weekdays have been identified, but this is not always to the detriment of weekend admissions, and the impact on mortality is uncertain. The insights of frontline staff and patients have been neglected. This article reports a qualitative study of patients and clinicians, to explore their views on quality and safety of care at weekends. ⋯ At weekends patients and staff are well aware of suboptimal staffing numbers, skill mix and access to resources at weekends, and identify that emergency admissions are prioritised over those already hospitalised. The consequences in terms of quality and safety and patient experience of care are undesirable. Our findings suggest the value of focusing on care processes and systems resilience over the weekends, and how these can be better supported, even in the limited resource environment that exists in many hospitals at weekends.
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Bmc Health Serv Res · Dec 2018
Demonstrating a new approach to planning and monitoring rural medical training distribution to meet population need in North West Queensland.
Improving the health of rural populations requires developing a medical workforce with the right skills and a willingness to work in rural areas. A novel strategy for achieving this aim is to align medical training distribution with community need. This research describes an approach for planning and monitoring the distribution of general practice (GP) training posts to meet health needs across a dispersed geographic catchment. ⋯ Current regional distribution was good, but individual town-level data further enabled the training provider to discuss the nuance of where and why more registrars (or supervisors) may be needed. The approach described enables distributed workforce planning and monitoring applicable in a range of contexts, with increased sensitivity for registrar distribution planning where most needed, supporting useful discussions about the potential causes and solutions. This evidence-based approach also enables training organisations to engage with local communities, health services and government to address the sustainable development of the long-term GP workforce in these towns.
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Bmc Health Serv Res · Dec 2018
Does diverse staff and skill mix of teams impact quality of care in long-term elderly health care? An exploratory case study.
Many European countries face challenges in long-term care for older people, such as the growing number of older people requiring care, the increasing complexity of their health care problems, and a decreasing workforce that is inadequately prepared. Optimizing the staff and skill mix of health care teams may offer part of the solution for these challenges. The aim of this study was to obtain insight into the development of teams in terms of staff and skill mix, and the influence of staff and skill mix on quality of care, quality of life, and job satisfaction. ⋯ A more diverse staff and skill mix, in combination with positive contextual conditions, can result in improved quality of care, quality of life, and job satisfaction. However, a "one size fits all" blueprint for the optimal staff and skill mix, that suits each team and organization, does not exist. This depends on the context, and should be based on the needs of the clients and possible future changes in these needs.
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Bmc Health Serv Res · Dec 2018
Multicenter StudyPrevalence of HIV infection and uptake of HIV/AIDS services among fisherfolk in landing Islands of Lake Victoria, north western Tanzania.
New HIV infections in Tanzania have been decreasing, however some populations remain at higher risk. Despite of that, evidence on the magnitude of HIV infection and the associated factors and HIV/AIDS services uptake among fisherfolk in Tanzania are inadequately explored. This study therefore aimed at determining prevalence of HIV infection and utilization of HIV/AIDS services among fishfolk in selected Islands of Lake Victoria for evidence-based interventions. ⋯ The magnitude of HIV infection among fisherfolk was up to 3 times higher than that of the general populations in Muleba and Buchosa districts. Higher age, using alcohol and lack of formal education predicted increased likelihood of HIV infection. The uptake of key HIV/AIDS curative and preventive services was generally low.