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The purpose of this study was to investigate diabetes self-care behaviors, stigmatization and A1C as predictors of a negative perception of insulin treatment in insulin-treated type 2 diabetic patients.

A descriptive cross-sectional and relational design was used. The study was carried out in the Diabetes Training Centre and Endocrine and Metabolism Clinic of a university hospital in the southeast of Turkey between May and October 2017. The research sample consisted of 100 type 2 diabetic patients determined by using a convenience sampling method. An introductory information form for type 2 diabetic patients, the Insulin Treatment Appraisal Scale (ITAS), Diabetes Self-Care Activities Survey (DSCAS) and Barriers to Insulin Treatment Scale (BIT) were used to collect the research data. The data were analyzed using descriptive statistics, correlations and step wise multi-linear regression.

The number of daily insulin injections, training received about insulin and stigmatization was significant predictors of a negative perception of insulin treatment.

Strategies to decrease diabetic individuals' fear of stigmatization should be utilized to minimize their negative insulin treatment perception (giving diabetic individuals training about diabetes, planning public training to inform society and using mass media tools). Diabetes educators should know that diabetic individuals' perception of the severity of the illness could influence the daily number of injections applied and decrease the negative perception regarding insulin.

Healthcare policies around the globe are aimed at achieving patient-centeredness. The patient is understood as a prosumer of healthcare, wherein healthcare service co-production and value co-creation take center stage. The article endeavors to unpack the state of the literature on the innovations promoting the transition toward patient-centeredness, informing policy and management interventions fostering the reconceptualization of the patient as a prosumer of healthcare services.

A hybrid review methodology consisting of a bibliometric-interpretive review following the Scientific Procedures and Rationales for Systematic Literature Reviews (SPAR-4-SLR) protocol is used. The bibliometric component enabled us to objectively map the extant scientific knowledge into research streams, whereas the interpretive component facilitated the critical analysis of research streams.

Patient-centeredness relies on a bundle of innovations that are enacted through a cycle of patients' activation, empowerment, involvement and engagement, wherein the omission of any steps arrests the transition toward service co-production and value co-creation. Institutional, organizational and cognitive barriers should be overcome to boost the transition of patients from consumers to prosumers in a patient-centered model of healthcare.

The article delivers the state of the art of the scientific literature in the field of innovations aimed at sustaining the transition toward patient-centeredness and provides some food for thoughts to scholars and practitioners who wish to push forward service co-production and value co-creation in healthcare.

Promoting health literacy, i.e. the ability to access, collect, understand and use health-related information, is high on the health policy agenda across the world. The digitization of health-care calls for a reframing of health literacy in the cyber-physical environment. The article systematizes current scientific knowledge about digital health literacy and investigates the role of health-care organizations in delivering health literate health-care services in a digital environment.

A literature review was accomplished. A targeted query to collect relevant scientific contributions was run on PubMed, Scopus and Web of Science. A narrative approach was undertaken to summarize the study findings and to envision avenues for further development in the field of digital health literacy.

Digital health literacy has peculiar attributes as compared with health literacy. Patients may suffer from a lack of human touch when they access health services in the digital environment. This may impair their ability to collect health information and to appropriately use it to co-create value and to co-produce health promotion and risk prevention services. Health-care organizations should strive for increasing the patients’ ability to navigate the digital health-care environment and boosting the latter’s value co-creation capability.

Tailored solutions should be designed to promote digital health literacy at the individual and organizational level. On the one hand, attention should be paid to the patients’ special digital information needs and to avoid flaws in their ability to contribute to health services’ co-production. On the other hand, health-care organizations should be involved in the design of user-friendly e-health solutions, which aim at engaging patients in value co-creation.

This contribution is a first attempt to systematize extant scientific knowledge in the field of digital health literacy specifically focused on the strategies and initiatives that health-care organizations may take to address the limited digital health literacy pandemic.

The paper aims to investigate the practices facilitating the transformation of healthcare services, understanding the resulting outcomes in terms of well-being and uplifting changes. a systematic literature review (SLR) focusing on analyzing the healthcare sector under the transformative service research (TSR) theoretical domain is conducted to achieve this goal.

Employing a structured SLR developed based on the PRISMA protocol (Pickering and Byrne, 2014; Pickering et al., 2015) and using Scopus and WoS databases, the study identifies and analyzes 49 papers published between 2021 and 2022. Content analysis is used to classify and analyze the papers.

The SLR reveals four transformative practices (how) within the healthcare sector under the TSR domain, each linked to specific well-being outcomes (what). The analysis shows that both practices and outcomes are mainly patient-related. An integrative framework for transformative healthcare service is presented and critically examined to identify research gaps and define the trajectory for the future development of TSR in healthcare. In addition, managerial implications are provided to guide practitioners.

This research is among the first to analyze TSR literature in the context of healthcare. The study critically examines the TSR’s impact on the sector’s transformation, providing insights for future research and offering a roadmap for healthcare practitioners to facilitate uplifting changes.

This study aims to deal with the paucity of studies in the stages of the development of loyalty behaviour of customers in the healthcare context by incorporating three crucial service quality dimensions (physical environment, personnel quality and technical quality) and also investigating trust and commitment as mediating factors.

Survey data were obtained from 420 respondents admitted to government hospitals in Kerala employing a convenience sampling method. The formulated hypotheses were tested using partial least square structural equation modelling.

Results indicate that patient satisfaction, trust and commitment can create favourable behavioural intentions amongst patients. When patients reveal higher trust, they are more inclined to value healthcare services and willing to commit to a long-term relationship, resulting in increased patient loyalty.

Organisational efforts should improve trust and commitment and build a good relationship between service providers and patients. Efforts should be taken to raise the standard of technical and personnel aspects, and a focus on physical infrastructure should also be considered to build a favourable behavioural intention to revisit and positive referrals.

This is the first empirical study to analyse technical quality, personnel quality and physical environment along with the mediating effect of trust, and commitment in a four-stage loyalty development model in the healthcare context of Kerala, India.

The article applies the citizen science phenomenon – i.e. lay people involvement in research endeavours aimed at pushing forward scientific knowledge – to healthcare. Attention is paid to initiatives intended to tackle the COVID-19 pandemic as an illustrative case to exemplify the contribution of citizen science to system-wide innovation in healthcare.

A mixed methodology consisting of three sequential steps was developed. Firstly, a realist literature review was carried out to contextualize citizen science to healthcare. Then, an account of successfully completed large-scale, online citizen science projects dealing with healthcare and medicine has been conducted in order to obtain preliminary information about distinguishing features of citizen science in healthcare. Thirdly, a broad search of citizen science initiatives targeted to tackling the COVID-19 pandemic has been performed. A comparative case study approach has been undertaken to examine the attributes of such projects and to unravel their peculiarities.

Citizen science enacts the development of a lively healthcare ecosystem, which takes its nourishment from the voluntary contribution of lay people. Citizen scientists play different roles in accomplishing citizen science initiatives, ranging from data collectors to data analysts. Alongside enabling big data management, citizen science contributes to lay people's education and empowerment, soliciting their active involvement in service co-production and value co-creation.

Citizen science is still underexplored in healthcare. Even though further evidence is needed to emphasize the value of lay people's involvement in scientific research applied to healthcare, citizen science is expected to revolutionize the way innovation is pursued and achieved in the healthcare ecosystem. Engaging lay people in a co-creating partnership with expert scientist can help us to address unprecedented health-related challenges and to shape the future of healthcare. Tailored health policy and management interventions are required to empower lay people and to stimulate their active engagement in value co-creation.

Citizen science relies on the wisdom of the crowd to address major issues faced by healthcare organizations. The article comes up with a state of the art investigation of citizen science in healthcare, shedding light on its attributes and envisioning avenues for further development.

The purpose of this paper is to understand how women with a diagnosis of schizophrenia or bipolar disorder approach medication decision making in pregnancy.

The study was co-produced by university academics and charity-based researchers. Semi-structured interviews were conducted by three peer researchers who have used anti-psychotic medication and were of child bearing age. Participants were women with children under five, who had taken anti-psychotic medication in the 12 months before pregnancy. In total, 12 women were recruited through social media and snowball techniques. Data were analyzed following a three-stage process.

The accounts highlighted decisional uncertainty, with medication decisions situated among multiple sources of influence from self and others. Women retained strong feelings of personal ownership for their decisions, whilst also seeking out clinical opinion and accepting they had constrained choices. Two styles of decision making emerged: shared and independent. Shared decision making involved open discussion, active permission seeking, negotiation and coercion. Independent women-led decision making was not always congruent with medical opinion, increasing pressure on women and impacting pregnancy experiences. A common sense self-regulation model explaining management of health threats resonated with women’s accounts.

Women should be helped to manage decisional conflict and the emotional impact of decision making including long term feelings of guilt. Women experienced interactions with clinicians as lacking opportunities for enhanced support except in specialist perinatal services. This is an area that should be considered in staff training, supervision, appraisal and organization review.

This paper uses data collected in a co-produced research study including peer researchers.

The purpose of this paper is twofold: First, it analyzes demand and supply-side factors that influence patient flows to and from Austria. Second, building on the empirical research and existing conceptualizations, the study offers a general extended framework to guide future comparative analysis.

The paper draws on multiple data sources including a literature review, secondary data, website analysis and semi-structured interviews with patients and health providers. Content analysis was carried out to identify common motives for seeking care abroad and providers' orientation towards medical travel.

Outbound medical travel is largely determined by factors of access, affordability and vicinity, while inbound medical travel is predominately driven by a lack of adequate medical infrastructure in source countries and quality, both in terms of medical and service quality. Providers distinguish themselves according to the extent they take part in medical travel.

The findings emerging from a single country case study approach cannot be generalized across settings and contexts, albeit contributing to a better understanding of current medical travel patterns in Europe.

Unlike most recent contributions, this study focuses both on inbound and outbound medical travel in Austria and investigates patient flows for distinctive treatments and drivers. While analysis of the supply-side of medical travel is often limited to tourism studies, this study provides a critical insight into developments in Europe from a health policy perspective, acknowledging that diverse medical travel patterns in Europe coexist.

This paper aims to describe the evolution of Sanokondu, highlighting the rationale, achievements and lessons learnt from this initiative. Sanokondu is a multinational community of practice dedicated to fostering health-care leadership education worldwide. This platform for health-care leadership education was conceived in 2014 at the first Toronto International Summit on Leadership Education for Physicians (TISLEP) and evolved into a formal network of collaborators in 2016.

This paper is a case study of a multinational collaboration of health-care leaders, educators, learners and other stakeholders. It describes Sanokondu’s development and contribution to global health-care leadership education. One of the major strategies has been establishing partnerships with other educational organizations involved in clinical leadership and health systems improvement.

A major flagship of Sanokondu has been its annual TISLEP meetings, which brings various health-care leaders, educators, learners and patients together. The meetings provide opportunities for dialog and knowledge exchange on leadership education. The work of Sanokondu has resulted in an open access knowledge bank for health-care leadership education, which in addition to the individual expertise of its members, is readily available for consultation. Sanokondu continues to contribute to scholarship in health-care leadership through ongoing research, education and dissemination in the scholarly literature.

Sanokondu embodies the achievements of a multinational collaboration of health-care stakeholders invested in leadership education. The interactions culminating from this platform have resulted in new insights, innovative ideas and best practices on health-care leadership education.

Providing high-quality and cost-efficient care of older people is an important development priority for many health and social care systems in the world. This paper suggests a shift from acute, episodic and reactive hospital-centered care toward longitudinal, person-centered and proactive home-centered care. The purpose of this paper is to contribute to the knowledge of a comprehensive development strategy for designing and providing home-centered care of older people.

The study design is based on qualitative research with an inductive approach. The authors study development initiatives at the national, regional and local levels of the Swedish health and social care system. The data collection methods included interviews (n = 54), meeting observations (n = 25) and document studies (n = 59).

The authors describe findings related to policy actions and system changes, attempts to achieve collaboration, integration and coordination, new forms of care offerings, characteristics of work settings at home and differences in patients' roles and participation at home and in the hospital.

The authors suggest home-centered care as a solution for providing person-centered and integrated care of older people and give examples of how this can be achieved.

The authors outline five propositions for research and development related to national policies, service modularity as a solution for customized and coordinated care, developing human resources and infrastructure for home settings, expanding services that enable older people living at home and patient co-creation.