Background: In paternalistic models, healthcare providers’ responsibility is to decide what is best for patients. The main concern is that such models fail to respect patient autonomy and do not promote patient respo...Background: In paternalistic models, healthcare providers’ responsibility is to decide what is best for patients. The main concern is that such models fail to respect patient autonomy and do not promote patient responsibility. Aim: To evaluate mental healthcare team members’ perceptions of their own role in encouraging elderly persons to participate in shared decision-making after implementation of the CCM. The CCM is not an explanatory theory, but an evidence-based guideline and synthesis of best available evidence. Methods: Data were collected from two teams that took part in a focus group interview, and the transcript was analysed by means of qualitative thematic analysis. Results: One overall theme emerged—Preventing the violation of human dignity based on three themes, namely, Changing understanding and attitudes, Increasing depressed elderly persons’ autonomy and Clarifying the mental healthcare team coordinator’s role and responsibility. The results of this study reveal that until recently, paternalism has been the dominant decision-making model within healthcare, without any apparent consideration of the patient perspective. Community mental healthcare can be improved by shared decision-making in which team members initiate a dialogue focusing on patient participation to prevent the violation of human dignity. However, in order to determine how best to empower the patient, team members need expert knowledge and intuition.展开更多
Introduction: Chronic diseases have affected the health and quality of life of people in a vast number of countries. Critically, chronic diseases have been rapidly increasing worldwide and inflicting a heavy burden on...Introduction: Chronic diseases have affected the health and quality of life of people in a vast number of countries. Critically, chronic diseases have been rapidly increasing worldwide and inflicting a heavy burden on society. As such, health screening has been applied to reduce individuals’ risks of developing chronic diseases and to initiate health promotion or disease prevention. However, the participant rate is low, especially for people living in rural areas. The purpose of this study was to identify the factors that influence people’s decisions to undergo health screening. Method: Semi-structured interviews were undertaken for 16 people aged between 30 - 60 years, and all interviewees had never attended health screening at our hospital despite being invited. Interviewees were from four districts in Taiwan: Anle District of Keelung City;and Ruifang, Gongliao, and Wanli Districts of New Taipei City. These districts were sampled to represent urban and rural areas, respectively, and people in these rural areas were suspected to have high risk of metabolic diseases, kidney and lung diseases or cancers. Interviews were audio-recorded and transcribed verbatim, and NVivo 11 was used for data management. Result: Six motivating factors or barriers were identified: 1) Health attitudes and beliefs about the benefits of participating in health screening;2) expectation of health screening from the perspective of participants;3) cost consideration;4) impact of social influence on willingness to participate in health screening;5) the experiences of health screening;and 6) practical motivations or barriers of undergoing health screening. Conclusion: Health attitudes and beliefs about the benefits of having a health screening, personal health expectations, and free health services were identified as the top three important factors that influence a resident’s decision to undergo health screening for chronic diseases in Taiwan.展开更多
文摘Background: In paternalistic models, healthcare providers’ responsibility is to decide what is best for patients. The main concern is that such models fail to respect patient autonomy and do not promote patient responsibility. Aim: To evaluate mental healthcare team members’ perceptions of their own role in encouraging elderly persons to participate in shared decision-making after implementation of the CCM. The CCM is not an explanatory theory, but an evidence-based guideline and synthesis of best available evidence. Methods: Data were collected from two teams that took part in a focus group interview, and the transcript was analysed by means of qualitative thematic analysis. Results: One overall theme emerged—Preventing the violation of human dignity based on three themes, namely, Changing understanding and attitudes, Increasing depressed elderly persons’ autonomy and Clarifying the mental healthcare team coordinator’s role and responsibility. The results of this study reveal that until recently, paternalism has been the dominant decision-making model within healthcare, without any apparent consideration of the patient perspective. Community mental healthcare can be improved by shared decision-making in which team members initiate a dialogue focusing on patient participation to prevent the violation of human dignity. However, in order to determine how best to empower the patient, team members need expert knowledge and intuition.
文摘Introduction: Chronic diseases have affected the health and quality of life of people in a vast number of countries. Critically, chronic diseases have been rapidly increasing worldwide and inflicting a heavy burden on society. As such, health screening has been applied to reduce individuals’ risks of developing chronic diseases and to initiate health promotion or disease prevention. However, the participant rate is low, especially for people living in rural areas. The purpose of this study was to identify the factors that influence people’s decisions to undergo health screening. Method: Semi-structured interviews were undertaken for 16 people aged between 30 - 60 years, and all interviewees had never attended health screening at our hospital despite being invited. Interviewees were from four districts in Taiwan: Anle District of Keelung City;and Ruifang, Gongliao, and Wanli Districts of New Taipei City. These districts were sampled to represent urban and rural areas, respectively, and people in these rural areas were suspected to have high risk of metabolic diseases, kidney and lung diseases or cancers. Interviews were audio-recorded and transcribed verbatim, and NVivo 11 was used for data management. Result: Six motivating factors or barriers were identified: 1) Health attitudes and beliefs about the benefits of participating in health screening;2) expectation of health screening from the perspective of participants;3) cost consideration;4) impact of social influence on willingness to participate in health screening;5) the experiences of health screening;and 6) practical motivations or barriers of undergoing health screening. Conclusion: Health attitudes and beliefs about the benefits of having a health screening, personal health expectations, and free health services were identified as the top three important factors that influence a resident’s decision to undergo health screening for chronic diseases in Taiwan.