Despite the Centers for Disease Control and Prevention recommendations to test patients ages 13 to 64 years for HIV at health care settings, routine HIV testing is lacking. As a result, many people are unaware of their HIV seropositive status. The purpose of this quantitative cross-sectional study was to examine relationships between HIV testing and provider type, knowledge, attitudes, and behaviors regarding HIV testing in the acute care setting. The study was informed by social cognitive theory. Using a convenient sampling method, a questionnaire derived from previous surveys (Society of General Internal Medicine and University of Washington) was sent to 600 eligible acute care providers from a suburban Chicago hospital who treated HIV-negative patients ages 13 to 64 years. Completed surveys were received from 88 participants. Chi-square and multiple logistic regression testing showed no significant relationships between HIV testing and provider type (p = .09), age (p = .91), gender (p = .84), experience (p = 1), and race/ethnicity. However, knowledge of HIV testing regulations and positive attitudes about HIV testing were significantly associated with the likelihood of offering an HIV test (p = .026, p = .004 respectively). Results have some clinical importance, but also indicated a lack of routine opt-out HIV testing. Results may be used to promote HIV testing among acute care providers which could reduce HIV-status unawareness in the population.

Some managers of primary care provider (PCP) facilities lack the strategies to implement electronic health records (EHRs), which could decrease healthcare costs and enhance the efficiency and quality of healthcare that patients receive. The purpose of this single-case study was to explore the strategies PCP managers used to implement EHRs to decrease healthcare costs. The population consisted of 5 primary care managers with responsibility for the administration, oversight, and direct working knowledge of EHRs in Central Florida. The conceptual framework was the technology acceptance model. Data were collected from semistructured face-to-face interviews and the review of company documents, including training logs, activity records, and cost information. Methodological triangulation was used to validate the creditability and interpretation of the data in transcribing themes. Three themes emerged from the analysis of study data: implementation of EHRs, costs of implementing EHRs, and perceived usefulness of EHRs. Participants indicated that the implementation of EHRs depended on motivation, financial cost, and the usefulness of EHRs relating to training that reflected user-friendliness. The implications of this study for social change include the potential to lower the cost and improve the efficiency of healthcare for patients. The use of EHR systems could enhance the quality of care delivered to patients through improved accessibility, elimination of duplicative tests, and retrieval of accurate patient information. The use of EHRs can lead to a comprehensive preventative healthcare system resulting in a healthier environment.

The purpose of the study was to examine reproductive life planning practices among Title X family planning health care providers and clinical staff. Reproductive life planning is a program priority for Title X clinics, those that receive federal money for providing family planning services to low-income women and men. The goal of reproductive life planning is to decrease unwanted and unintended pregnancies and improve preconception health care however; this practice has not been described. First, a conceptual analysis was conducted to create a definition of reproductive life planning that was consistent with the literature. Reproductive life planning is a process that is centered on reproductive and other life goals and is personalized, collaborative, fluid, and focused on health-promotion. Second, a mixed methods design was used to examine reproductive life planning practices and qualitative interviews were conducted to explore barriers and facilitators to implementing reproductive life planning practices. Data were obtained from health care providers and clinical staff employed at Title X clinics in Illinois, Iowa, Minnesota, Missouri, Nebraska, and North Dakota. A total of 148 clinicians completed a web-based survey which was analyzed to describe which types of patients, the topics covered, and the frequency with which reproductive life planning was discussed during an office visit. Surveys were then examined to identify 20 providers to conduct qualitative interviews with to further explore reproductive life planning practices. The qualitative interviews were also performed to explore the barriers and facilitators clinicians face to practicing reproductive life planning. The results of the web-based questionnaire were examined mainly with medians and frequencies to examine reproductive life planning practices. Qualitative interviews were coded using a content analysis approach to two aims; one to examine how reproductive life planning was using during clinic visits and two, to identify the barriers and facilitators clinicians face when discussing reproductive life planning with patients. Findings from the survey and the interviews suggest that most clinicians are discussing pregnancy intentions with their patients. However, from the interviews, three types of scope of reproductive life planning emerged; those clinicians who screened their patients’ pregnancy intentions, those who planted the seed in the patient’s mind, and those who explored the context of a patient’s life and their goals to contextualize how pregnancy and childbearing would fit into their lives in order to clarify pregnancy intention and move toward the corresponding health behaviors. It is argued that the third group of providers is using reproductive life planning as intended by experts. Finally, barriers to RLP discussions were examined as well as approached providers used to overcome the barriers. In conclusion, many clinicians are practicing reproductive life planning as intended, however many are not. Improved training and protocols are needed to ensure clinicians are providing their patients with the best reproductive life planning discussions. Additionally, systemic structures, like access to quality family planning services, need to be improved to aid clinicians in helping their patient plan their families.

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style="font-size: 12pt / line-height: 115% / font-family: &quot / Times New Roman&quot / ,&quot / serif&quot / ">This study has reveled the levels of knowledge and compliance towards Universal Precautions and examined the factors that are influential in having a positive and negative effect on their adoption by healthcare practitioners in practice. Despite acceptable knowledge regarding the potential for infection and mechanisms to prevent these infections, this study has found out that health care workers are not as compliant with universal precautions as they need to be. The findings that compliance correlated directly with knowledge, with in-service training and with availability of protective equipment, provide important indications for future interventions. Therefore a regular on job refreshing training program on Universal Precautions, a written guideline and reminder poster on Universal Precautions and personal protective equipment need to be made available for all health care providers in every department of the hospital for better compliance. <span style="">&nbsp / </span><span style="">&nbsp / </span><span style="">&nbsp / </span><o:p></o:p></span></p> <p>&nbsp / </p>

BAKGRUND: HIV (humant immunbristvirus) är en smittsam blodsjukdom vilket finns över stora delar av världen. Stigmatiseringen i samhället kring HIV är utbrett och kan därmed komma att påverka patientens vård. Från vårdpersonalens sida finns det både negativa och positiva attityder kring människor vilka lever med HIV. Det är viktigt att belysa problemet för att alla patienter ska få en likvärdig vård. SYFTE: Studiens syfte är att beskriva hur människor vilka är HIV-positiva upplever bemötandet från vårdpersonal. METOD: En litteraturbaserad studie där analys har gjorts av nio kvalitativa vetenskapliga artiklar. RESULTAT: Tre teman har tagits fram: Att bli bemött som en människa, att bli bemött på ett nytt sätt och att bli diskriminerad. Ett positivt bemötande från vårdpersonalen upplevs då det finns en känsla av delaktighet. Ett negativt bemötande kan upplevas genom att vårdpersonal till exempel använder överdrivna försiktighetsåtgärder, är avståndstagande och vägrar att vårda. KONKLUSION: Ökad kunskap hos vårdpersonal skapar en ökad förståelse för sjukdomen och dess smittspridning vilket leder till att rädslor minskar och vårdpersonalens bemötande förbättras. / BACKGROUND: HIV (Human Immunodeficiency Virus) is an infectious blood disease found in large parts of the world. The stigma associated with HIV is widely spread in society and can therefore impact the efficacy of the patients’ treatment. Health care providers exhibit both positive and negative attitudes towards people living with HIV. It is important to highlight the problem in order for all patients to receive an equal treatment. AIM: The aim of this study is to describe how HIV-positive individuals experience the encounter with the health care providers. METHOD: A literature based study with analysis of nine qualitative scientific articles. RESULTS: Three themes have been researched: Being met as a human being, being met in a new way and being discriminated. A positive response from health care providers is perceived when there is a sense of participation. A negative response can be perceived for example when the health care provider uses excessive precautions, when they are distancing themselves or when the health care provider refuses to give treatment. CONCLUSIONS: Increased knowledge of health care providers creates a better understanding of HIV disease and its spread, leading to reduced fears and an improvement in the treatment offered by the health care providers.

Syfte: Att utifrån litteratur beskriva hur sjuksköterskan kan identifiera tecken på depression hos tonåringar med typ 1 diabetes och hur hon kan stödja dessa tonåringar. Metod: En deskriptiv litteraturstudie som baseras på 15 artiklar sökta i databaserna CINAHL och PubMed samt genom manuella sökningar. Huvudresultat: Tecken på depression hos tonåringar med typ 1 diabetes är högt HbA1c-värde, låg frekvens av blodsockerkontroller och lägre livskvalité. Sjuksköterskan kan använda sig av standardiserade mätinstrument för att identifiera tecken på depression hos tonåringar med typ 1 diabetes, till exempel CDI, CES-D, YSR, WHO-5 och VAS. Tonåringar med typ 1 diabetes önskar stödåtgärder i form av skräddarsydda strukturerade undervisningsprogram, roliga aktiviteter och uppföljning via SMS. Sjuksköterskan kan använda sig av gruppintervention, internetbaserade egenvårdsprogram samt be tonåringarna skriva själva om sin diabetes, vilket har visat sig ha positiva effekter på tonåringens välbefinnande. Vårdgivare uppger flera hinder i hanteringen av depression hos diabetespatienter, bland annat otillräcklig utbildning och tidsbrist. Slutsats: Det är viktigt med utbildning för sjuksköterskor inom området tonåringar, typ 1 diabetes och depression. Mer forskning är nödvändigt för att möta kombinationen typ 1 diabetes och depression hos tonåringar. / Aim: To describe according to the literature how the nurse can identify signs of depression in adolescents with type 1 diabetes and how the nurse can support them. Method: A literature study with descriptive design based on 15 scientific articles searched in the databases CINAHL, PubMed and by ancestry approach. Main results: Signs of depression in adolescents with type 1 diabetes are high HbA1c, low frequency of blood glucose monitoring and lower quality of life. The nurse can use standardized questionnaires to identify signs of depression in adolescents with type 1 diabetes, for example CDI, CES-D, YSR, WHO-5 and VAS. Adolescents with type 1 diabetes wish supportive measures such as tailored, structured education programs, fun activities and follow-up by text messaging. The nurse can use group interventions, internet-based self-care programs and ask adolescents to write about their diabetes, because this has positive effects on the adolescent’s well-being. Health care providers report several obstacles in the management of depression in patients with diabetes, among other things inadequate training and lack of time. Conclusion: It is important with training for nurses in the field of adolescents, type 1 diabetes and depression. More research is needed to meet the combination of type 1 diabetes and depression in adolescents.

Patients are the key stakeholders in health care providers and it is extremely important to increase their satisfaction level. Patient satisfaction is a subject of great interest to the health care providers and researchers alike. As there are a lot of factors related to health care providers that causes patient selection and rejection. Since competition has increased in recent years, this exerts more pressure on health care providers to render more improved service quality in addition to build trust and gain high reputation. Improved quality of service has now become an important aspect of patient satisfaction, building trust is now a crucial milestone and gaining high reputation is considered the key for any health care provider. In practice and theory it has been proven that service quality dimensions, trust and reputation is related to patient satisfaction. For this, we took 5Q model of the service quality combine with trust and reputation, and how it affects patient satisfaction is the main theme of the study. Purpose: The purpose of this study is to investigate that how 5Q model of the service quality, trust and reputation can effect patient satisfaction in health care sectors, for this study we researched Umeå hospital. This research is focused towards exploring the perceptions of patients who consume or undertook Umeå hospital services. It also provides an effective model for health care organization in practice and the study also contribute to literature from educational point of view.  Method: In this study hypothesis developed to investigate how 5Q model of the service quality, trust and reputation can effect patient satisfaction. For service quality 5Q model was used while several attributes were taken for trust and reputation to investigate the patient perception. Quantitative research strategy was adopted and convenience sampling technique was used to collect quantitative data from patients of Umeå hospital to get their satisfaction levels. Hypotheses were tested by using multiple regression analysis to the obtained data in SPSS. Findings: The study revealed interesting results for patient satisfaction regarding the 5Q model of the service quality, trust and reputation. Meanwhile 5Q model was used for service quality, which composes quality of object, quality of process, quality of infrastructure, quality of interaction and quality of atmosphere. Out of five dimensions, two gave positive effect and three gave no effect result by the patient for their satisfaction from the Umeå hospital. Trust gave no effect result, whereas reputation gave positive effect result by the patient for their satisfaction from the Umeå hospital. Implication/Contribution: The findings imply that 5Q model of the service quality is not the only factor that could lead to patient satisfaction in health care sectors but trust and reputation are also factors of great importance. Organizations need to improve every dimension of service quality, creating trust and achieve high reputation to gain high level of patient satisfaction. This study contributes to existing theories by confirming or adding value that have positive effect on patient satisfaction. 5Q model is a comprehensive model and it needs to be implemented in health care sector but with additional factors i.e. trust and reputation.  Key words: Patient satisfaction, Service quality, 5Q model, Trust, Reputation, Health care providers.

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style="font-size: 12pt / line-height: 115% / font-family: &quot / Times New Roman&quot / ,&quot / serif&quot / ">This study has reveled the levels of knowledge and compliance towards Universal Precautions and examined the factors that are influential in having a positive and negative effect on their adoption by healthcare practitioners in practice. Despite acceptable knowledge regarding the potential for infection and mechanisms to prevent these infections, this study has found out that health care workers are not as compliant with universal precautions as they need to be. The findings that compliance correlated directly with knowledge, with in-service training and with availability of protective equipment, provide important indications for future interventions. Therefore a regular on job refreshing training program on Universal Precautions, a written guideline and reminder poster on Universal Precautions and personal protective equipment need to be made available for all health care providers in every department of the hospital for better compliance. <span style="">&nbsp / </span><span style="">&nbsp / </span><span style="">&nbsp / </span><o:p></o:p></span></p> <p>&nbsp / </p>

Background: Alzheimer???s disease and related dementias (ADRD) are often improperly or under-diagnosed in primary care; yet, it is expected that community-based care will be an increasingly important source of support for ADRD patients. In Ontario, primary care has continued to expand its services to include health team models, such as family health teams (FHTs) to provide multidisciplinary collaborative care for patients. Within such teams, memory clinic teams have also been implemented, which are clinic days set up typically once or twice a month to provide interprofessional collaborative care specifically for ADRD patients by trained health care providers (HCPs). Objective: Little is known about the experience of HCPs who work in primary care memory clinic team settings to provide care for ADRD patients. This study explored these experiences. Specifically, questions were asked around the rewards, challenges and motivations with working in the memory clinic structure and providing support to ADRD patients. Methods: A phenomenological approach was used. One-on-one semi-structured interviews were completed with 12 interprofessional team members in two primary care memory clinic teams. Interviews were transcribed and analyzed using Colaizzi???s (1978) method of analysis. Results: Overall, seven subthemes were found which describe the HCP experience. The first two subthemes describe experiencing the journey with the patient and caregiver. HCPs want to support patients while maintaining the patient???s dignity. They also balance emotional dilemmas with responsibilities. The next two subthemes describe experiencing the journey with the team. HCPs feel valued and connected to their team members. The memory clinic structure offers unique care provider experiences. Lastly, three subthemes were found which describe the personal and professional rewards of the experience. HCPs found thrilling complexities within the patient population in the memory clinic and that working in the clinic they are able to experience ongoing learning opportunities. HCPs also described that the memory clinic offers personal and professional fulfillment. Discussion: HCPs described an overall positive experience working in the memory clinic to support ADRD patients. HCPs take pride in being able to support patients and caregivers. Knowing that they are making a difference and doing good work are motivations to continue to work with complex populations, such as ADRD patients. HCPs enjoy working in close proximity to one another, respect their team members, and enjoy learning from each other. Team members motivate each other to stay and work with the ADRD population in primary care memory clinics. HCPs reap many rewards associated with working in a ???tight-knit??? memory clinic team setting for ADRD patients. As the number of HCPs working in team settings continues to grow in Canada, it is important to look at the experiences of these teams to understand the rewards, challenges and motivations of team members. Conclusions: These findings provide more context in understanding how to motivate future HCPs to work with more complex populations such as ADRD patients. Future research should address the outcomes of these clinics by exploring patient and family caregiver experiences with specialized teams, as it is important to gain their experiences to enhance the care practices for these individuals.

The purpose of this study is to, based on qualitative interviews with managers and group interviews with care providers, understand their interpretation of integrity and also their scope for action to satisfy disable people’s integrity at sheltered housing for adults. The questions of this study are: How do the managers and the care providers interpret the concept of integrity? Which scope for action do they have to satisfy the integrity of disabled people? Method: Individual – and group interviews have been used as methods to gather empirical data. Theory: The theories of scope for action and integrity as a theoretical conception have been used to analyze the empirical material. Results: The informants of this study found it difficult to give a specific definition of integrity. The main aspects we could distinguish were that integrity was interpreted as a personal sphere and self-determination. The result of this study shows that the scope for action to satisfy the integrity of disabled people is affected by many factors. First of all the scope for action is affected by the Swedish law LSS and the assignment within the organization. The scope for action is also affected by individual adaption for each person. This study shows the importance of the relationship between the managers, care providers and the persons. At last the informants emphasize some dilemmas in their scope for action to satisfy the integrity.