Abstract:
BACKGROUND:Compared to patients with cancer, heart failure patients are seldom candidates for palliative care. Numerous studies have investigated reasons why heart failure patients do not receive palliative care; however, none of these studies have ever evaluated the situation in the German health care setting. This study aims to identify German healthcare providers' (HCP) perception of barriers and facilitators to palliative care of patients with chronic heart failure. METHODS:We conducted an online-survey with 315 nurses and physicians of different medical disciplines. RESULTS:Even though heart failure patients' need of palliative care and its advantages has been recognized, HCP see potential for development and improvement. A lack of knowledge about the content and measures of palliative care, poor communication and unclear responsibilities between medical disciplines, difficulties to determine the right time to initiate palliative care, and the feeling not to be prepared to discuss end-of-life issues with the patient has been identified as barriers. Further, HCP believe that patients and relatives do not possess adequate knowledge about the disease and its progression and are therefore unprepared in asking questions regarding palliative care. They rather tend to demand everything possible to be done in order prolong life, and are reluctant to accept that life is limited. Overall, HCP perceive that dying is a taboo subject within our society placing palliative care on the same level as assisted dying. In addition, results indicate that HCP have an inappropriate notion of ideal medicine fearing to lose patient and are worried about the appropriateness of PC remuneration. CONCLUSIONS:In order to overcome the described barriers, HCP, patients, and relatives need to be educated in palliative care. Information and education encompassing the aim, content and measures of palliative care needs to be provided for all parties in order to optimize patient care, to foster communication between healthcare professionals, patients, and relatives, and to overcome perceived barriers. TRIAL REGISTRATION:DRKS00007119.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Ziehm J,Farin E,Schäfer J,Woitha K,Becker G,Köberich Sdoi
10.1186/s12913-016-1609-xsubject
Has Abstractpub_date
2016-08-08 00:00:00pages
361issue
aissn
1472-6963pii
10.1186/s12913-016-1609-xjournal_volume
16pub_type
杂志文章abstract:BACKGROUND:India has experienced a steep rise in institutional childbirth. The relative contributions of public and private sector facilities to emergency obstetric care (EmOC) has not been studied in this setting. This paper aims to study in three districts of Gujarat state, India:(a) the availability of EmOC faciliti...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1473-8
更新日期:2016-07-07 00:00:00
abstract:BACKGROUND:Travel burden is a key element in conceptualizing geographic access to health care. Prior research has shown that both rural and minority populations bear disproportionate travel burdens. However, many studies are limited to specific types of patient or specific locales. The purpose of our study was to quant...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-7-40
更新日期:2007-03-09 00:00:00
abstract:BACKGROUND:Team-based approaches to research capacity building (RCB) may be an efficient means to promote allied health research participation and activity. In order to tailor such interventions, a clearer understanding of current patterns of research participation within allied health teams is needed. Different self-r...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-1996-7
更新日期:2017-02-06 00:00:00
abstract:BACKGROUND:The shortage of organs for kidney transplantation for patients with end-stage renal disease (ESRD) is magnified in Hispanics/Latin Americans in the United States. Living donor kidney transplantation (LDKT) is the treatment of choice for ESRD. However, compared to their representation on the transplant waitli...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-018-3151-5
更新日期:2018-05-16 00:00:00
abstract:BACKGROUND:Recognizing the importance of increased patient participation in healthcare decisions leads decision makers to consider effective ways to incorporate patient perspectives in Health Technology Assessment (HTA) processes. The implementation of local health HTA units in university hospitals in Quebec provides a...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-9-54
更新日期:2009-03-27 00:00:00
abstract:BACKGROUND:Shared Decision Making (SDM) is an approach where clinicians and patients share the best available evidence to make decision and where patients opinions are considered. This approach provides benefits for patients, clinicians and health care system. The aim of the present study is to investigate the patients...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4002-8
更新日期:2019-03-18 00:00:00
abstract:BACKGROUND:In 2011, South Africa improved its ability to test for rifampicin-resistant TB (RR-TB) by introducing GeneXpert MTB/RIF. At the same time, the South African National TB program adopted a policy decentralized, outpatient treatment for drug resistant (DR-) TB. We aim to analyze the impact of these changes on l...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-018-3762-x
更新日期:2018-12-17 00:00:00
abstract:BACKGROUND:The number of HIV-related hospitalizations has decreased worldwide in recent years owing to the availability of highly active antiretroviral therapy. However, the change in HIV-related hospitalizations in Portugal has not been studied. Using comprehensive hospital discharge data from mainland Portuguese hosp...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-0801-8
更新日期:2015-04-08 00:00:00
abstract:BACKGROUND:The national strategy for treatment of chronic diseases - including MS - and changes in the Swedish welfare system, call for analyses of the use of, and patient satisfaction with, care in a long-term perspective. The aim was therefore to explore the use of care and the predictive value of personal factors, d...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-1144-1
更新日期:2015-10-24 00:00:00
abstract:BACKGROUND:In response to persistently poor levels of maternal, newborn and child health (MNCH) in rural India, the National Rural Health Mission (NRHM) was launched to support the provision of accessible, affordable and quality health care in deprived and underserved communities. The Accredited Social Health Activists...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-15-S1-S5
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:While the benefits or otherwise of early hip fracture repair is a long-running controversy with studies showing contradictory results, this practice is being adopted as a quality indicator in several health care organizations. The aim of this study is to analyze the association between early hip fracture rep...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-15
更新日期:2012-01-18 00:00:00
abstract:BACKGROUND:Payers and policy makers across the international healthcare market are increasingly using publicly available summary measures to designate providers as "high-performing", but no consistently-applied approach exists to identifying high performers. This paper uses publicly available data to examine how differ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4293-9
更新日期:2019-07-18 00:00:00
abstract::The use of mixed methods (combining quantitative and qualitative data) is developing in a variety of forms, especially in the health field. Our own research has adopted this perspective from the outset. We have sought all along to innovate in various ways and especially to develop an equal partnership, in the sense of...
journal_title:BMC health services research
pub_type: 历史文章,杂志文章,评审
doi:10.1186/1472-6963-15-S3-S7
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Research on team effectiveness in healthcare has focussed on whether effective teams yield positive outcomes for patients and on the effectiveness of team interventions to improve performance. Limited understanding exists of what works for whom within an effective team, or how and why the context in which th...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/s12913-018-3331-3
更新日期:2018-07-11 00:00:00
abstract:BACKGROUND:The NHS spends billions of pounds annually on repeat prescriptions in primary care, but data on their extent and use is out of date. Understanding the scale of repeat prescribing and for whom it is prescribed is important for the NHS to plan services and develop policies to improve patient care. METHOD:Anon...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-76
更新日期:2014-02-19 00:00:00
abstract:BACKGROUND:African Vaccination Week (AVW) is an initiative of the Member States of the African Region aimed at promoting vaccination and ensuring equity and access to its benefits. The initiative has proven to be particularly effective in reaching populations with limited access to regular health services as well as pr...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-0989-7
更新日期:2015-09-02 00:00:00
abstract:BACKGROUND:Cost information is important for efficient allocation of healthcare expenditure, estimating future budget allocation, and setting user fees to start new financing systems. Myanmar is in political transition, and trying to achieve universal health coverage by 2030. This study assessed the unit cost of health...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2619-z
更新日期:2017-09-19 00:00:00
abstract:BACKGROUND:Blood borne infectious agents such as hepatitis B virus (HBV), hepatitis C virus (HCV) and human immune deficiency virus (HIV) constitute a major occupational hazard for healthcare workers (HCWs). To some degree it is inevitable that HCWs sustain injuries from sharp objects such as needles, scalpels and spli...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-13-276
更新日期:2013-07-17 00:00:00
abstract:BACKGROUND:Although the value of telemonitoring in heart failure patients is increasingly studied, little is known about the value of the separate components of telehealth: ICT guided disease management and telemonitoring. The aim of this study is to investigate the value of telemonitoring added to ICT guided disease m...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1472-6963-11-167
更新日期:2011-07-13 00:00:00
abstract:BACKGROUND:There is a large "treatment gap" for depression worldwide. This study aimed to better understand the treatment gap in rural India by describing health care use and treatment-seeking for depression. METHODS:Data were analysed from a two round cross-sectional community survey conducted in rural Madhya Pradesh...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05162-0
更新日期:2020-04-06 00:00:00
abstract:BACKGROUND:We conducted a national level assessment of the quality of clinical care practice in the Ukrainian healthcare system for two important causes of death and chronic disease conditions. We tested two hypotheses: a) quality of care is predicted by physician and facility characteristics and b) health status is pr...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-446
更新日期:2014-09-30 00:00:00
abstract:BACKGROUND:Clinical documentation systems, such as templates, have been associated with process utilization. The T-System emergency department (ED) templates are widely used but lacking are analyses of the templates association with processes. This system is also unique because of the many different template options av...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-65
更新日期:2011-03-24 00:00:00
abstract:BACKGROUND:Cataract day surgery has rapidly gained worldwide acceptance, because the new surgical techniques and costs are generally lower than those involved in ordinary hospitalization. Cataract surgery serves as a proxy indicator of the trend towards day surgery hospitalization in Italy and, therefore, of regional v...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-7-16
更新日期:2007-02-01 00:00:00
abstract:BACKGROUND:Demand side financing (DSF) is a widely employed strategy to enhance utilization of healthcare. The impact of DSF on health care seeking in general and that of maternal care in particular is already known. Yet, its effect on financial access to care, out-of-pocket spending (OOPS) and provider motivations is ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-319
更新日期:2012-09-15 00:00:00
abstract:BACKGROUND:As one of the most populous metropolitan areas in the Pearl River Delta of South China, Shenzhen attracts millions of migrant workers annually. The objectives of this study were to compare health needs, self-reported health and healthcare utilisation of insured and uninsured migrant workers in Shenzhen, Chin...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-9-214
更新日期:2009-11-21 00:00:00
abstract:BACKGROUND:In many European countries, Occupational Health and Safety (OHS) providers report their activities and results annually. Ideally, this report should offer an overview of their activities and of the outcome regarding occupational health and safety. To establish a set of epidemiological and performance indicat...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-410
更新日期:2014-09-19 00:00:00
abstract:BACKGROUND:To our knowledge no study has at the same time assessed patients' satisfaction and their expectations concerning the organizational and contextual aspects of health care provided by their primary care physician (PCP). Assessing these aspects is important to inform future primary healthcare service planning. ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-0985-y
更新日期:2015-08-14 00:00:00
abstract:BACKGROUND:Implementation of person-centred care (PCC) is a challenging undertaking. Thus, a call has been issued for a robust and generic instrument to measure and enable evaluation of PCC across settings and patient groups. This study aimed to develop a generic questionnaire measuring patients' perceptions of PCC. Fu...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05770-w
更新日期:2020-10-20 00:00:00
abstract:BACKGROUND:Increasing unplanned hospital admissions disrupt planned health care, lead to additional morbidity and are expensive. A recent review found only weak evidence for case management preventing unplanned admissions, yet case management of older people is being implemented widely in the UK. We aimed to study the ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-8-115
更新日期:2008-05-29 00:00:00
abstract:BACKGROUND:The Birmingham Free Clinic (BFC) in Pittsburgh, Pennsylvania, USA is a free, walk-in clinic that serves medically uninsured populations through the use of volunteer health care providers and an on-site medication dispensary. The introduction of an electronic medical record (EMR) has improved several aspects ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1308-7
更新日期:2016-02-19 00:00:00