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Nurse leaders are challenged by ethical issues in today’s complex health-care settings. The purpose of this study was to describe and analyze key elements of moral distress identified by nurse leaders from health-care systems in the USA, Germany, Austria and Switzerland. The aim was to develop an understanding of distressing ethical issues nurse leaders face in the USA and three German-speaking European countries.

This descriptive cross-sectional study surveyed a convenience sample of nurse leaders in the USA, Germany, Austria and Switzerland. The voluntary, anonymous survey also included qualitative questions and was distributed using the Qualtrics® platform. A thematic analysis of the qualitative data in each country was carried out and a comparative analysis identified similarities and differences between the groups of nurse leaders comparing the US data to that from three German-speaking European countries.

The survey was completed by 316 nurse leaders: Germany, Austria, and Switzerland (n = 225) and the USA (n = 91). Similar themes identified as causing all nurse leaders moral distress included a lack of individual and organizational integrity, hierarchical and interprofessional issues, lack of nursing professionalism, patient care/patient safety concerns, finances negatively impacting care and issues around social justice. Within these six themes, there were also differences between the USA and the three German-speaking European countries.

Understanding the experiences associated with distressing ethical situations can allow nurse leaders and organizations to focus on solutions and develop resilience to reduce moral distress in the USA and three German-speaking European countries.

The lack of a proper register to store, match and display information on the adapted property has led to a waste of resources and prolonged delays in matching the disabled and elderly people with appropriate properties. This paper presents the development of a Housing Adaptations Register with user-matching functionalities for different mobility categories. The developed system accurately captures and documents adapted home information to facilitate the automated matching of disabled/aged applicants needing an adapted home with suitable property using banding, mobility and suitability index.

A theoretical review was conducted to identify parameters and develop adaptations register construct. A survey questionnaire approach to rate the 111 parameters in the register as either moderate, desirable or essential before system development and application. The system development relied on DSS modelling to support data-driven decision-making based on the decision table method to represent property information for implementing the decision process. The system is validated through a workshop, four brainstorming sessions and three focus group exercises.

Development of a choice-based system that enables the housing officers or the Housing Adaptations Register coordinators to know the level of adaptation to properties and match properties quickly with the applicants based on their mobility status. The merits of the automated system include the development of a register to capture in real-time adapted home information to facilitate the automated matching of disabled/aged applicants. A “choice-based” system that can map and suggest a property that can easily be adapted and upgraded from one mobility band to the other.

The development of a housing adaptation register helps social housing landlords to have a real-time register to match, map and upgrade properties for the most vulnerable people in our society. It saves time and money for the housing associations and the local authorities through stable tenancy for adapted homes. Potentially, it will promote the independence of aged and disabled people and can reduce their dependence on social and healthcare services.

This system provides the local authorities with objective and practical tools that may be used to assess, score, prioritise and select qualified people for appropriate accommodation based on their needs and mobility status. It will provide a record of properties adapted with their features and ensure that matching and eligibility decisions are consistent and uniform.

Homelessness has many causes and also is stigmatized in the United States, leading to much misunderstanding of its causes and what policy solutions may ameliorate the problem. The problem is of course getting worse and impacting many communities far removed from the West Coast cities the authors examine in this study. This analysis examines the socioeconomic variables influencing homelessness on the West Coast in recent years. The authors utilize a panel fixed effects model that explicitly includes measures of healthcare access and availability to account for the additional health risks faced by individuals who lack shelter. The authors estimate a spatial error model (SEM) in order to better understand the impacts that systemic shocks, such as the COVID-19 pandemic, have on a variety of factors that directly influence productivity and other measures of welfare such as income inequality, housing supply, healthcare investment, and homelessness.

Globally, hepatitis C treatment uptake is lower among people who are homeless or unstably housed compared to those who are housed. Understanding and addressing this is essential to ensure no one is left behind in hepatitis C elimination efforts. This study aims to explore peoples’ experiences of unstable housing and health care, and how these experiences influenced engagement in hepatitis C treatment.

Purposive sampling was used to recruit people with lived experience of injection drug use, hepatitis C and unstable housing in Melbourne, Australia. In-depth semistructured interviews were conducted and a case study approach with interpretative phenomenological analysis was used to identify personal experiential themes and group experiential themes.

Four people were interviewed. The precarious nature of housing for women who inject drugs was a group experiential theme, however, this did not appear to be a direct barrier to hepatitis C treatment. Rather, competing priorities, including caregiving, were personal experiential themes and these created barriers to treatment. Another group experiential theme was “right place, right time, right people” with these three elements required to facilitate hepatitis C treatment.

There is limited research providing in-depth insight into how personal experiences with unstable housing and health care shape engagement with hepatitis C treatment. The analyses indicate there is a need to move beyond a “one size fits-all” approach to hepatitis C care. Instead, care should be tailored to the needs of individuals and their personal circumstances and regularly facilitated. This includes giving greater attention to gender in intervention design and evaluation, and research more broadly.

This paper aims to examine the global pattern of growth and development of eHealth research based on publication headcount, and analysis of the characteristics, of the keywords used by authors and indexers to represent their research content during 1945–2019.

This study adopted a bibliometric research design and a quantitative approach. The source of the data was Elsevier’s Scopus database. The search query involved multiple search terms because researchers’ choice of keywords varies very significantly. The search for eHealth research publications was limited to conference papers and research articles published before 2020.

eHealth originated in the late 1990s, but it has become an envelope term for describing much older terms such as telemedicine, and its variants that originated much earlier. The keywords were spread through the 27 Scopus Subject Areas, with medicine (44.04%), engineering (12.84%) and computer science (11.47%) leading, while by Scopus All Science Journal Classification Health Sciences accounted for 55.83% of the keywords. Physical sciences followed with 30.62%. The classifications social sciences and life sciences made only single-digit contributions. eHealth is about meeting health needs, but the work of engineers and computer scientists is very outstanding in achieving this goal.

This study demonstrates that eHealth is an unexplored aspect of health literature and highlights the nature of the accumulated literature in the area. It further demonstrates that eHealth is a multidisciplinary area that is attractive to researchers from all disciplines because of its sensitive focus on health, and therefore requires pooling and integration of human resources and expertise, methods and approaches.

This study aims to examine the volume of ehealth literacy documents during 2006–2022, and the nature of citation of ehealth documents by country, organizations, sources and authors.

The study adopted a bibliometric approach. Bibliographic data was collected on citation of ehealth documents by country, organizations, sources and authors from Scopus and mapped and visualized the citations using VosViewer.

A total of 1,176 documents were produced during 2006–2022, indicating a high rate of document production in this sub-discipline. Among the 102 countries that contributed documents on the subject, 58 qualified for the analysis. The USA had the highest number of cited documents on eHealth literacy, followed by Canada and Australia. The average publication year for the USA was 2018, with 348 publications and an average of 24.12 citations. Canada had a high average citation count of 44.69. Furthermore, the document examined citations by organizations.

The research implications of the study suggest that eHealth literacy is an actively growing field of research, with a substantial impact on the academic community, and researchers should focus on collaboration with high-impact institutions and journals to increase the visibility and recognition of their work, while also paying attention to the need for more research representation from African countries.

The study’s findings indicate a high rate of document production and growing interest in eHealth literacy research, with the USA leading in the number of cited documents followed by Canada, while Canadian eHealth literacy research receives relatively higher citation rates on average than the USA.

The study’s originality lies in its examination of citation patterns and global contributions to eHealth literacy literature, offering valuable insights for researchers. It identifies key authors, high-impact journals and institutions, providing valuable guidance for collaboration. The research highlights a growing interest in eHealth literacy, underscoring its potential impact on public health and digital health interventions.

This study aims to investigate the consumer behavior toward telemedicine services in India during the COVID-19 pandemic onset. With lockdown restrictions and safety concerns in visiting brick-and-mortar clinics or hospitals during the pandemic, Telemedicine had emerged as a potent alternative for seeking redressal to health issues. Based on theory and focus interviews with the telemedicine users, the researchers proposed a model to understand the intent and actual usage of telemedicine in India.

The cross-sectional study undertaken used a questionnaire designed on a seven-point Likert scale and administered to respondents with the objective of identifying the determinants of intent and actual usage of telemedicine services. Simple random sampling was used to collect primary data. The data was cleaned and finally a sample of 405 responses complete in all respects was considered for analysis. The questionnaire comprised of 34 items and following the recommendation of Hair et al. (2016), which says the minimum sample size in structural equation modeling should be ten times the number of indicator variables, a sample size of 405 was deemed adequate.

The research paper finds that performance expectancy, attitude, credibility and self-efficacy positively impact the intention of consumers to use telemedicine services. As the effort expectancy or risk perception toward telemedicine increases the intent and actual usage of telemedicine decreases. The intention to use telemedicine emerged as a strong predictor of the actual usage of telemedicine. Intent to use telemedicine was explained 81.4% by its predictors of performance expectancy, effort expectancy, attitude, risk, credibility and self-efficacy, and actual usage was explained 79.9% by its predictors. This study also reports that telemedicine was found to be popular among chronic as well as episodic patients though the preference was skewed in favor of the episodic patients. One of the advantages of telemedicine is its availability round the clock, and the study found that 8 a. m. to 12 noon time slot as the most preferred slot for seeking telemedicine services.

Chang (2004) opined that telemedicine can fulfill the needs of all stakeholders: citizens, health-care consumers, medical doctors and health-care professionals, policymakers, and so on. Considering the promise telemedicine holds, this realm must be studied and leveraged to the full potential. The study found that patients were using telemedicine even for their day-to-day aliments. This indicates a growing popularity of telemedicine and as such an opportunity for telemedicine companies to leverage it. In India, pharmaceutical companies cannot give commercial advertisements for medicines, and the same can only be sold through a registered medical practitioner’s prescription. As such there is total dependency on the medical practitioner for the sale of medicines. Telemedicine companies offer services of home delivering medicines clubbed with medical consultation thus giving them forward integration in their business models. Using telemedicine the patients had control over the timings of the services offered, and as such the waiting time to get a consultation and subsequent treatment was reduced considerably. Best medical advice from across the globe is available to the patient at less cost. Medical practitioners also stand to benefit as they can treat a variety of cases, collaborate among the medical fraternity and give consultation safely in case of fatal contagious diseases.

This study points to a definite growing popularity of telemedicine services not only in episodic patients but also chronic patients. Telemedicine with its unique advantages holds the promise to grow exponentially in the future and is a compelling health-care segment to focus on for delivering health-care solution to the geographically distant consumers.

Infection and cross-contamination have been massive concerns in the medical field. This study aims to investigate consumers’ awareness and their choices of endoscopes, which may deter them from the cross-contamination problem.

A discrete choice experiment survey was administered to 166 respondents in Penang, Malaysia. Participants were asked to make hypothetical choices and estimate their preference for endoscopes. The multinomial logit model was used to estimate the assumptions based on the stated preference data collected.

Only two-fifths of respondents are aware of their rights regarding endoscope selection. The findings are consistent with utility theory, where choices are made to maximise personal satisfaction. If given the choice, consumers preferred the single-use endoscope over the reusable or the doctor’s preferred endoscope. Price, insurance coverage and personal income are significant determinants of the consumer’s choice of endoscopes.

This study only investigates subjects living in Penang. Other possible important attributes to endoscope choices, such as environmental and device availability may be considered in future study.

The findings may create awareness among consumers about their rights when choosing medical devices. It may also improve health-care institutions’ (users’) and device manufacturers’ (industry players’) understanding of consumer needs and demands from socioeconomic perspectives.

The research offers insights into consumer rights and awareness of health-care services. Ultimately leading to better policy to protect consumers’ rights and safety.

This study contributes to the rare literature on consumer rights toward medical devices, in particular, the consumer’s awareness of the choice of endoscopes.

Prior studies on the impact of incentives on physicians’ online participation mainly focused on different incentives while ignoring the difficulty of setting monetary incentives efficiently. Based on goal-setting theory, the current research examines the relationship between incentives with goals of varying difficulty and professional health knowledge sharing (PHKS) in online health knowledge-sharing platforms (OHKSPs).

Four field experiments with different monetary incentives were conducted by one of China’s largest OHKSPs, with whom the researchers cooperated in data collection. Monthly panel data on 10,584 physicians were collected from September 2018 to December 2019. There were 9,376 physicians in the treatment group and 1,208 in the control group. The authors used a difference-in-difference (DID) model to explore the research question based on the same control group and the Chow test with seemingly unrelated estimation (sureg) to compare regression coefficients between four groups. Several robustness checks were performed to validate the main results, including a relative time model, multiple falsification tests and a DID estimation using the propensity score matching method.

The results show that the monetary incentive significantly positively affected the volume of physicians’ PHKS directly with negative spillover to the duration of physicians’ PHKS. Moreover, the positive effect of incentives with higher difficulty on the volume of physicians’ PHKS was significantly smaller than that of incentives with low difficulty. Finally, professional title had a positive moderating effect on the volume of goal difficulty setting and did not significantly moderate the effect on the duration of physicians’ PHKS.

Some limitations of this study are: firstly, because the field experiments were enterprise benefit oriented, the treatment and control groups were not balanced. Secondly, the experiments for different incentive measures were relatively similar, making it challenging to validate a causal effect. Finally, more consideration should be given to the strategy for setting hierarchical incentives in future research.

The research indicates that monetary incentives have a bilateral effect on PHKS, i.e. a positive direct effect on the volume of physicians’ contributions and a negative spillover effect on the duration of physicians’ PHKS. The professional titles of physicians also moderate such bilateral switches of PHKS. Furthermore, when a physician’s energy is limited, the goal difficulty setting of the incentive mechanism tends to be low. The more difficult the incentives are, the more inefficient the effects on physicians’ PHKS will be.