Critical Information Technology Issues in Turkish Healthcare

While the importance of information technology in reducing soaring healthcare costs and enhancing service quality is increasingly being recognized, significant challenges remain in how it is implemented. Although there are a few studies investigating key IT issues in healthcare in advanced countries, there are virtually none in developing countries. We bridge this gap by investigating the critical information technology issues in healthcare facilities in Turkey. These issues are developed based on the opinions of senior hospital managers. The top ten issues include privacy, quality, security, and the implementation of electronic medical records. Further analyses provide additional insights into the results

Perspectives on care and communication involving incurably ill Turkish and Moroccan patients, relatives and professionals: a systematic literature review

<p>Abstract</p> <p>Background</p> <p>Our aim was to obtain a clearer picture of the relevant care experiences and care perceptions of incurably ill Turkish and Moroccan patients, their relatives and professional care providers, as well as of communication and decision-making patterns at the end of life. The ultimate objective is to improve palliative care for Turkish and Moroccan immigrants in the Netherlands, by taking account of socio-cultural factors in the guidelines for palliative care.</p> <p>Methods</p> <p>A systematic literature review was undertaken. The data sources were seventeen national and international literature databases, four Dutch journals dedicated to palliative care and 37 websites of relevant national and international organizations. All the references found were checked to see whether they met the structured inclusion criteria. Inclusion was limited to publications dealing with primary empirical research on the relationship between socio-cultural factors and the health or care situation of Turkish or Moroccan patients with an oncological or incurable disease. The selection was made by first reading the titles and abstracts and subsequently the full texts. The process of deciding which studies to include was carried out by two reviewers independently. A generic appraisal instrument was applied to assess the methodological quality.</p> <p>Results</p> <p>Fifty-seven studies were found that reported findings for the countries of origin (mainly Turkey) and the immigrant host countries (mainly the Netherlands). The central themes were experiences and perceptions of family care, professional care, end-of-life care and communication. Family care is considered a duty, even when such care becomes a severe burden for the main female family caregiver in particular. Professional hospital care is preferred by many of the patients and relatives because they are looking for a cure and security. End-of-life care is strongly influenced by the continuing hope for recovery. Relatives are often quite influential in end-of-life decisions, such as the decision to withdraw or withhold treatments. The diagnosis, prognosis and end-of-life decisions are seldom discussed with the patient, and communication about pain and mental problems is often limited. Language barriers and the dominance of the family may exacerbate communication problems.</p> <p>Conclusions</p> <p>This review confirms the view that family members of patients with a Turkish or Moroccan background have a central role in care, communication and decision making at the end of life. This, in combination with their continuing hope for the patient’s recovery may inhibit open communication between patients, relatives and professionals as partners in palliative care. This implies that organizations and professionals involved in palliative care should take patients’ socio-cultural characteristics into account and incorporate cultural sensitivity into care standards and care practices<it>.</it></p

Ethnically diverse patients’ perceptions and expectations on the importance of culturally competent care in primary health care settings : A Literature Review

The purpose of this final project was to discover the perceptions and expectations of ethnically diverse population regarding culturally competent care. We also wanted to find out what the patients considered to be the main barriers in providing culturally competent care. We aimed to find studies specifically in primary care settings. This final project is a part of Local and Global Development in Social Services and Health Care (LOG-Sote) project. This project aims to develop heath care services in Finland towards a more immigrant-friendly direction. The methodology of this final project was a systematic literature review consisting of fifteen research articles obtained through CINAHL, PUBMED and OVID (MEDLINE) databases. The findings indicated that the patients expected the care they received from the health care providers to be family-orientated, respectful and holistic. Patients also wanted their cultural, religious and traditional beliefs and practices to be taken into account throughout their care. The main barriers to culturally competent care, according to the patients from various different ethnic backgrounds, were mostly related to communication, lack of common language between the patients and the healthcare providers, inadequate information provided to the patients by the healthcare providers and unmet health care need. If the patients’ expectations and perceptions regarding culturally competent care are discovered, it would help the health care professionals to understand their patients’ needs and provide culturally appropriate care. This could help the health care professionals to further develop their cultural competence skills, thus, improving the cooperation with patients from different ethnical backgrounds.Opinnäytetyömme tarkoitus oli saada selville erilaisiin etnisiin ryhmiin kuuluvien potilaiden käsityksiä ja odotuksia kulttuurillisesti kompetenttiin hoitotyöhön liittyen. Halusimme myös saada selville, mitä potilaat pitivät pääasiallisina esteinä kulttuurillisesti kompetentin hoitotyön toteuttamiselle. Yritimme löytää tutkimusaineistoa erityisesti perusterveydenhuollon alueelta. Tämä opinnäytetyö on osa LOG-Sote-projektia (Lokaali ja Globaali kehitys sosiaali- ja terveysalalla). Hanke pyrkii kehittämään suomalaisia terveydenhuoltopalveluita maahanmuuttajaystävällisempään suuntaan. Aineiston kokoaminen ja analysointi suoritettiin soveltaen systemaattisen kirjallisuuskatsauksen menetelmää. Kirjallisuuskatsausta varten kerättiin 15 tieteellistä tutkimusartikkelia käyttäen CINAHL, PUBMED ja OVID (MEDLINE) tietokantoja. Tämän kirjallisuuskatsauksen löydökset osoittivat, että potilaat odottivat hoitotyön olevan perhekeskeistä, potilasta kunnioittavaa ja holistista. Potilaat halusivat myös, että heidän kulttuurilliset, uskonnolliset ja perinteiset uskomukset ja käytännöt otettaisiin huomioon hoitotyön eri vaiheissa. Potilaiden mukaan suurimmat esteet kulttuurillisesti kompetentin hoitotyön toteuttamiselle liittyivät pääasiallisesti kommunikointiin, yhteisen kielen puuttumiseen potilaan ja terveydenhuollon ammattilaisen välillä, riittämättömään tiedonsaantiin ja potilaiden terveydenhoidollisten tarpeiden toteutumattomuuteen. Selvittämällä, millaisia odotuksia ja käsityksiä erilaisista kulttuureista lähtöisin olevilla potilailla on hoitotyöstä, voivat terveydenhuollon ammattilaiset oppia ymmärtämään syvällisemmin potilaidensa lähtökohtia ja tarpeita hoitotyöhön liittyen. Tämä voisi auttaa terveydenhuollon ammattilaisia kehittämään omaa kulttuurillista kompetenssiaan ja näin ollen parantamaan yhteistyötä erilaisista kulttuureista lähtöisin olevien potilaiden kanssa

Exploring the Knowledge Sharing Practices among Medical Doctors in Ibadan Metropolis, Nigeria

Medical doctors constitute a vital component of the health sector’s workforce. One major factor that aids their efficiency is knowledge of practice and what they do with it. Literature is replete with knowledge-sharing cases among other professionals but less visible concerning physicians, especially in Nigeria. This study investigates the knowledge-sharing practices among doctors in Ibadan, one of the country’s major cities. The descriptive survey research design was adopted, and data collected through interviews with sixteen doctors selected through convenience sampling. Findings show that the doctors shared knowledge regularly through social media, formal discussions, and informal deliberations. The findings also indicated that the doctors derive benefits from exchanging information, while the knowledgesharing process challenges stem from adverse social factors. This study is useful to medical practitioners, medical associations, and policymakers who need data for staff development and how that impacts the health sector

Oncologische zorg in multicultureel Vlaanderen : ervaringen van zorgverleners en beleving van familieleden

As in other West-European countries, Belgium is characterized by an increasing diversity in its population. Care in which provider and patient have a different cultural background is more and more common. For care to be well attuned to patients of foreign descent, gaining insight in the perspective of the provider and that of the care receiver is important. Considering the existential meaning of oncology care, these insights are certainly a matter of importance within the context of oncology. However, little is known about how health professionals experience and perceive their work with care users of diverse ethnic origins. With regard to family members of ethnic minority cancer patients also relatively little research has been undertaken. This dissertation aims to provide insight in both the experiences of oncology health workers in caring for ethnic minority care users and in the experiences of family members of older adult cancer patients of Turkish or Northwest African descent. As family members play an essential role in the cancer trajectory, insight in their perspective is valuable. The insights were gained by means of a systematic literature review and qualitative empirical research, based on constructivist grounded theory. First it is investigated what published research reveals about the views and experiences of oncology health workers when caring for ethnic minority patients. The limited literature reports mostly about challenges or barriers when caring for these patient groups. Views and experiences of participating oncology health workers are characterized by a willingness to provide proper care, but providing such care is hampered by a tangle of interrelated issues such as linguistic barriers, fear and uncertainty, and assumptions about cultural matters. Organizational aspects were shown to have a strong influence on healthcare workers caring for ethnic minority patients. Experiences and perceptions of oncology health providers in caring for patients of non-Western descent in Flanders are studied in a qualitative research, using focus group interviews. Barriers and difficulties appear to be paramount in the provision of care to patients of non-Western descent. Participants want to act according to their professional standards, which call for treating all patients equally and providing appropriate care. However ‘cure’ takes precedence over ‘care’ when participants are not willing or not fully able to overcome barriers. This results in feelings of inadequacy in those participants who equate professional standards to care of equal quality. Participants who interpret the professional standard as calling for equivalent care are irritated by ‘these’ patients who restrain them from providing appropriate care. The findings indicate that professional standards provide protection against possible discrimination that may result from personal beliefs. Extending professional standards from ‘treating all patients equally’ to ‘care attuned to each patient’ might be a way to prevent ‘cure’ taking precedence over ‘care’. Insight in the experiences of family members of older adult cancer patients of Turkish or northwest African descent is provided in a subsequent study. Analysis of the individual interviews yields insight in the strong moral meaning of care giving and in the way family members balance truth-telling when translating for their older relative. Cancer appears to be a family matter. Care giving has a strong moral meaning for all participants, particularly for children providing care to a parent. Care giving can be described as “guiding”: family members lead the patient through, or familiarize the patient with, the health care system. Despite shared values of the importance of family and family care giving, there are strong differences in the extent to which family members believe they should provide care, as well as the kind of professional care considered desirable. Hence shared cultural or religious normative values do not predict day-to-day care practices. Therefore, individualized approaches of care are essential. Following from the strong moral meaning care giving has, most relatives consider it their responsibility to contribute to a positive attitude of the patient. Based on several motives and embedded in their assessment of the patient’s emotional strength, understanding, and need to be informed, relatives decide to what extent they inform the patient. Some consider it best to omit medical information while others consider it best to inform the patient fully. What they decide influences the way they act as a translator or a contact person. The results emphasize the importance for healthcare providers to take into account the complexity and unpredictable character of the process of balancing truth-telling when family members translate for their ill older relative. Furthermore, it shows the importance of conversations between oncology healthcare providers and patients, together with close relatives, about views and attitudes to sharing information. Taken together, this dissertation indicates that an overarching professional standard of ‘care attuned to each patient’, indiscriminately, might prevent individuals receiving less qualitative care when being counted among a specific group. Attuned care requires gaining insight in what is really at stake for patients and their loved ones and to attune care to that information. Such a professional standard might improve oncology care for all care users

Educational interventions and strategies for spiritual care in nursing and healthcare students and staff: A scoping review

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.Aims and objectives: To map existing evidence about educational interventions or strategies in nursing and allied healthcare concerning students’ and staffs’ spiritual care provision. Background: Spiritual care is an important part of whole person care, but healthcare staff lack competence and awareness of spiritual issues in practice. To rectify this, it is important to identify what educational approaches are most helpful in supporting them to provide spiritual care. Design: A scoping review using the PRISMA-ScR checklist. Method: Searches in the databases CINAHL, MEDLINE, ATLA and ERIC were conducted for papers spanning January 2009–May 2020. Search terms were related to spirituality, spiritual care, education and clinical teaching. Appraisal tools were used. Results: From the 2128 potentially relevant papers, 36 were included. The studies were from 15 different countries and involved nurses, physicians and other healthrelated professions, and both quantitative, qualitative and mixed methods were used. The results are presented in three themes: Understanding of spirituality, Strategies in educational settings, and Strategies in practice settings. The review points to great diversity in the content, lengths and setting of the educational interventions or strategies. Conclusions: Courses in spiritual care should be implemented in curricula in both undergraduate and postgraduate education, and several studies suggest it should be mandatory. Courses should also be available for healthcare staff to raise awareness and to encourage the integration of spiritual care into their everyday practice. There is a need for greater consensus about how spirituality and spiritual care are described in healthcare settings. Relevance to clinical practice: Spiritual care must be included both in monodisciplinary and multidisciplinary educational settings. The main result of spiritual care courses is in building awareness of spiritual issues and self-awareness. To ensure the provision of spiritual care for patients in healthcare practices, continuing and multidisciplinary education is recommendedpublishedVersio

Educational interventions and strategies for spiritual care in nursing and healthcare students and staff: A scoping review

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.Aims and objectives: To map existing evidence about educational interventions or strategies in nursing and allied healthcare concerning students’ and staffs’ spiritual care provision. Background: Spiritual care is an important part of whole person care, but healthcare staff lack competence and awareness of spiritual issues in practice. To rectify this, it is important to identify what educational approaches are most helpful in supporting them to provide spiritual care. Design: A scoping review using the PRISMA-ScR checklist. Method: Searches in the databases CINAHL, MEDLINE, ATLA and ERIC were conducted for papers spanning January 2009–May 2020. Search terms were related to spirituality, spiritual care, education and clinical teaching. Appraisal tools were used. Results: From the 2128 potentially relevant papers, 36 were included. The studies were from 15 different countries and involved nurses, physicians and other healthrelated professions, and both quantitative, qualitative and mixed methods were used. The results are presented in three themes: Understanding of spirituality, Strategies in educational settings, and Strategies in practice settings. The review points to great diversity in the content, lengths and setting of the educational interventions or strategies. Conclusions: Courses in spiritual care should be implemented in curricula in both undergraduate and postgraduate education, and several studies suggest it should be mandatory. Courses should also be available for healthcare staff to raise awareness and to encourage the integration of spiritual care into their everyday practice. There is a need for greater consensus about how spirituality and spiritual care are described in healthcare settings. Relevance to clinical practice: Spiritual care must be included both in monodisciplinary and multidisciplinary educational settings. The main result of spiritual care courses is in building awareness of spiritual issues and self-awareness. To ensure the provision of spiritual care for patients in healthcare practices, continuing and multidisciplinary education is recommendedpublishedVersio