Browsing by Subject "Healthcare"

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    Open Access
    Exploring pain science education in the context of a healthcare dyad: what supports or hinders pain reconceptualisation?
    (2025) Le Roux, Stian; Rabie, Stephan; Madden, Victoria; Joska, John
    Background. Pain Science Education (PSE) has emerged as a useful treatment strategy for a wide range of painful conditions, including persistent musculoskeletal pain (PMP). The interaction between the two members of a healthcare dyad is subject to various contextual elements. It remains unclear which contextual elements within the PSE dyadic interaction help or hinder the recipient's reconceptualisation of pain. Purpose of the Study. The purpose of the study was to explore and understand participants' experiences of a PSE intervention and elicit perspectives of a PSE dyad relating to elements of their interaction that supported or hindered the reconceptualisation of pain. Methodology. This study employed a phenomenological research design. Semi-structured interviews were conducted with eight PSE dyads – healthcare providers and people under their care (n = 17). An interpretive phenomenological analysis framework was used to analyse and interpret the data. Summary of Qualitative Findings. Dyad members had mostly congruent perspectives on elements that supported reconceptualisation, especially a strong therapeutic alliance. Some intra-dyadic incongruencies included recipient pain beliefs, which some PSE recipients believed supported reconceptualisation, while their providers perceived them as a barrier. A common thread that influenced multiple contextual elements, was pain intensity. Pain relief was often identified as a helpful element as it increased trust in the provider and the PSE. Increased pain was an unhelpful element for some PSE recipients, but their PSE providers found that it helped reconceptualisation, considering it a learning opportunity. This was another area where intra-dyadic perspectives were incongruent. A novel insight included the value of experiential PSE, where providers facilitated reflection and discussion of painful sensations and experiences, with the explicit goal of deepening the learning by exploring pain as a sensory-affective experience. Observing other painful conditions was another learning avenue that dyads valued, where observation of other pain presentations could be compared with their own experience to gain a deeper understanding of pain. Conclusion. Exploring the perspectives of both members of a PSE dyad triangulated the meaning that each member made of the contextual elements that influenced reconceptualisation, drawing out the similarities and differences in their perspectives. PSE dyads valued a range of contextual elements, and dyadic perspectives mostly converged on the theme that PSE is built on a strong therapeutic alliance and a skilled PSE provider. A limitation of this study was that the selection bias was oriented toward participants with positive PSE experiences. This new perspective of elements that influence reconceptualisation may inform PSE implementation and increase its effectiveness.
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    Open Access
    Lack of adoption of electronic Medical Records Systems in developing countries. A case study of Zimbabwe
    (2019) Mhembere, Taurai Brian; Kabanda, Salah
    This study explored the phenomenon of electronic medical records systems in Zimbabwean primary healthcare institutions. The goal of the study was to investigate the lack of adoption of electronic medical records systems by primary healthcare institutions in developing countries using an interpretative case study approach focusing on the Zimbabwean context. Despite the positive benefits that are associated with EMRs, developing countries have been reluctant in implementing this technology within their primary healthcare institutions. A number of studies have been conducted on EMR systems but only a few have investigated the reasons for the limited use of EMR technology in developing countries particularly within the Zimbabwean context. This study primarily adopted a case study approach and was qualitative in nature. The study made use of in-depth interviews to obtain its data, and purposive sampling method was used to identify participants for the study. The study made use of a sample size of fourteen respondents who were identified based on their knowledge and could assist explore this particular topic relevant to the research. The targeted population for this research were key staff members privy to patients’ medical records management within the primary healthcare facilities. The data collected was analysed using thematic analysis soon after the transcription process. The results of the study show that EMRs technology in Zimbabwe has been implemented on a limited scale within its public hospitals. The technology is being used mostly in HIV/AIDS management or in particular departments. The study reveals that although healthcare institutions in Zimbabwe have adopted EMRs technology, most of the information is still being archived on the paper based system. The findings of the study show that Zimbabwe hasn’t adopted EMRs due to challenges such as lack of proper infrastructures, resistance in the use of EMRs, remoteness, shortages in skilled labour and concerns of confidentiality and privacy. Furthermore, the study shows that though the application of the EMR system is limited in Zimbabwean hospitals, the study found that its benefits have been noticeable. EMR technology has made it easy to access information, averted redundant expenditure and has made time improvements. However, the study revealed that EMR systems come with their own shortcomings such as lack of access to patient documents due to network faults and the need for familiarity with computer systems.
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    Open Access
    Schools of public health in low and middle-income countries: an imperative investment for improving the health of populations?
    (BioMed Central, 2016-09-07) Rabbani, Fauziah; Shipton, Leah; White, Franklin; Nuwayhid, Iman; London, Leslie; Ghaffar, Abdul; Ha, Bui T T; Tomson, Göran; Rimal, Rajiv; Islam, Anwar; Takian, Amirhossein; Wong, Samuel; Zaidi, Shehla; Khan, Kausar; Karmaliani, Rozina; Abbasi, Imran N; Abbas, Farhat
    Background: Public health has multicultural origins. By the close of the nineteenth century, Schools of Public Health (SPHs) began to emerge in western countries in response to major contemporary public health challenges. The Flexner Report (1910) emphasized the centrality of preventive medicine, sanitation, and public health measures in health professional education. The Alma Ata Declaration on Primary Health Care (PHC) in 1978 was a critical milestone, especially for low and middle-income countries (LMICs), conceptualizing a close working relationship between PHC and public health measures. The Commission on Social Determinants of Health (2005–2008) strengthened the case for SPHs in LMICs as key stakeholders in efforts to reduce global health inequities. This scoping review groups text into public health challenges faced by LMICs and the role of SPHs in addressing these challenges. Main text: The challenges faced by LMICs include rapid urbanization, environmental degradation, unfair terms of global trade, limited capacity for equitable growth, mass displacements associated with conflicts and natural disasters, and universal health coverage. Poor governance and externally imposed donor policies and agendas, further strain the fragile health systems of LMICs faced with epidemiological transition. Moreover barriers to education and research imposed by limited resources, political and economic instability, and unbalanced partnerships additionally aggravate the crisis. To address these contextual challenges effectively, SPHs are offering broad based health professional education, conducting multidisciplinary population based research and fostering collaborative partnerships. SPHs are also looked upon as the key drivers to achieve sustainable development goals (SDGs). Conclusion: SPHs in LMICs can contribute to overcoming several public health challenges being faced by LMICs, including achieving SDGs. Most importantly they can develop cadres of competent and well-motivated public health professionals: educators, practitioners and researchers who ask questions that address fundamental health determinants, seek solutions as agents of change within their mandates, provide specific services and serve as advocates for multilevel partnerships. Funding support, human resources, and agency are unfortunately often limited or curtailed in LMICs, and this requires constructive collaboration between LMICs and counterpart institutions from high income countries.
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    Schools of public health in low and middle-income countries: an imperative investment for improving the health of populations?
    (2016) Rabbani, Fauziah; Shipton, Leah; White, Franklin; Nuwayhid, Iman; London, Leslie; Ghaffar, Abdul; Ha, Bui Thi Thu; Tomson, Göran; Rimal, Rajiv; Islam, Anwar; Takian, Amirhossein; Wong, Samuel; Zaidi, Shehla; Khan, Kausar; Karmaliani, Rozina; Abbasi, Imran Naeem; Abbas, Farhat
    Abstract Background Public health has multicultural origins. By the close of the nineteenth century, Schools of Public Health (SPHs) began to emerge in western countries in response to major contemporary public health challenges. The Flexner Report (1910) emphasized the centrality of preventive medicine, sanitation, and public health measures in health professional education. The Alma Ata Declaration on Primary Health Care (PHC) in 1978 was a critical milestone, especially for low and middle-income countries (LMICs), conceptualizing a close working relationship between PHC and public health measures. The Commission on Social Determinants of Health (2005–2008) strengthened the case for SPHs in LMICs as key stakeholders in efforts to reduce global health inequities. This scoping review groups text into public health challenges faced by LMICs and the role of SPHs in addressing these challenges. Main text The challenges faced by LMICs include rapid urbanization, environmental degradation, unfair terms of global trade, limited capacity for equitable growth, mass displacements associated with conflicts and natural disasters, and universal health coverage. Poor governance and externally imposed donor policies and agendas, further strain the fragile health systems of LMICs faced with epidemiological transition. Moreover barriers to education and research imposed by limited resources, political and economic instability, and unbalanced partnerships additionally aggravate the crisis. To address these contextual challenges effectively, SPHs are offering broad based health professional education, conducting multidisciplinary population based research and fostering collaborative partnerships. SPHs are also looked upon as the key drivers to achieve sustainable development goals (SDGs). Conclusion SPHs in LMICs can contribute to overcoming several public health challenges being faced by LMICs, including achieving SDGs. Most importantly they can develop cadres of competent and well-motivated public health professionals: educators, practitioners and researchers who ask questions that address fundamental health determinants, seek solutions as agents of change within their mandates, provide specific services and serve as advocates for multilevel partnerships. Funding support, human resources, and agency are unfortunately often limited or curtailed in LMICs, and this requires constructive collaboration between LMICs and counterpart institutions from high income countries.