ORCID Profile
0000-0001-9528-5595
Current Organisations
Haramaya University
,
Flinders University
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Publisher: CSIRO Publishing
Date: 2020
DOI: 10.1071/AH18250
Abstract: ObjectiveThe aim of this study was to explore Western Australian cancer patients’ experiences of out-of-pocket expenses (OOPE) during diagnosis and cancer treatment using a phenomenological approach. MethodsSemi-structured interviews were conducted with a purposive convenience s le of 40 Western Australian cancer patients diagnosed with breast, lung, prostate or colorectal cancer. Participants were asked about the impact of their diagnosis, the associated costs and their experience within the health system. Data were analysed using thematic content analysis. ResultsThree key themes influencing participant OOPE experiences were identified: (1) personal circumstances (2) communication with health providers and (3) coping strategies. Despite Australia’s public healthcare system, several participants found the costs affected their financial security and resorted to coping strategies including medication rationing and restrictive household budgeting. The key themes had a complex and interrelated effect on patient OOPE experiences and were used to adapt Carrera et al.’s model of economic consequences of cancer treatment on the patient and patient coping to describe these relationships in a mixed healthcare system. ConclusionOrganised efforts must be implemented to mitigate maladaptive coping strategies being used by cancer patients: (1) health providers should seek informed financial consent from patients before commencing treatment and (2) financial aid and support schemes for cancer patients should be reviewed to ensure they are delivered equitably. What is known on this topic?The financial cost of cancer can have significant adverse effects on cancer patients. Although financial transparency is desired by cancer patients, its implementation in practice is not clear. What does this paper add?This study adapts a conceptual model for the economic consequences of a cancer diagnosis and repurposes it for a mixed public–private health system, providing a framework for understanding downstream consequences of cancer costs and highlighting opportunities for intervention. What are the implications for health practitioners?Health practitioners need to initiate discussions concerning treatment costs earlier with cancer patients. There are several resources and guides available to assist and facilitate financial transparency. Without urgent attention to the financial consequences of cancer treatment and related expenses, we continue to leave patients at risk of resorting to maladaptive coping strategies, such as medication rationing and restrictive household budgeting.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-07-2022
Publisher: Wiley
Date: 11-08-2023
Publisher: CSIRO Publishing
Date: 16-02-2021
DOI: 10.1071/AH19265
Abstract: Objective To determine the extent of medical and non-medical out-of-pocket expenses (OOPE) among regional/rural and outer metropolitan Western Australian patients diagnosed with cancer, and the factors associated with higher costs. Methods Cross-sectional data were collected from adult patients living in four regional/rural areas and two outer metropolitan regions in Western Australia who had been diagnosed with breast, prostate, colorectal or lung cancer. Consenting participants were mailed demographic and financial questionnaires, and requested to report all OOPE related to their cancer treatment. Results The median total OOPE reported by 308 regional/rural participants and 119 outer metropolitan participants were A$1518 (interquartile range (IQR): A$581–A$3769) and A$2855 (IQR: A$958–A$7142) respectively. Participants most likely to experience higher total OOPE were younger than 65 years of age, male, resided in the outer metropolitan area, worked prior to diagnosis, had private health insurance, were in a relationship, and underwent surgery. Multivariate analysis of regional/rural participants revealed that receiving care at a rural cancer centre was associated with significantly lower non-medical OOPE (estimated mean A$805, 95% confidence interval (CI): A$735–A$875, P = 0.038 compared with other rural participants (A$1347, 95% CI: A$743–A$1951, P 0.001)). Conclusion The cancer patients who participated in this study experienced variation in OOPE, with outer metropolitan participants reporting higher OOPE compared with their regional/rural counterparts. There is a need for cost transparency and access to care close to home, so that patients can make informed choices about where to receive their care. What is known about the topic? In recent years, OOPE for health care in general and cancer in particular have been widely debated by consumers and not-for-profit organisations the topic has attracted much political attention because it affects both equity and access to care and has wider financial implications for the community. Research studies and reports from both consumer organisations and a Ministerial Advisory Committee found that cancer patients can face exorbitant out-of-pocket costs, and that in iduals with private health insurance and those with prostate and breast cancer reported higher costs. In Western Australia, a cancer centre providing comprehensive cancer care was established in the second most populous region to ameliorate the high costs for travel and accommodation that regional cancer patients are known to experience. What does this paper add? This study is unique because it collected detailed cost information from patients and reports on the OOPE of regional/rural and outer metropolitan Western Australian patients receiving care for one of the four most common cancers it therefore offers novel insight into the experiences of these groups. This study demonstrates that outer metropolitan cancer patients are experiencing much higher OOPE compared with regional/rural cancer patients. Additionally, regional/rural study participants who accessed a Regional Cancer Centre experienced significantly lower non-medical OOPE, compared with regional/rural study participants receiving care elsewhere. What are the implications for practitioners? First, there is a need for improved communication of OOPE to minimise costs to the patient, for ex le, by facilitating access to local cancer care. Health service providers and insurance companies can improve cost transparency for cancer patients by making this information more readily available, allowing patients to make informed financial choices about where to seek care. Second, the needs of working patients deserve specific attention. These patients face significant work uncertainty and additional distress following a cancer diagnosis.
Publisher: Elsevier BV
Date: 09-2017
Publisher: Elsevier BV
Date: 10-2017
Publisher: Informa UK Limited
Date: 02-2017
DOI: 10.2147/PPA.S126382
Publisher: Springer Science and Business Media LLC
Date: 2001
Publisher: Canadian Institute of Mining, Metallurgy, and Petroleum
Date: 10-2001
DOI: 10.2113/0100273
Publisher: Oxford University Press (OUP)
Date: 12-09-2023
Publisher: Wiley
Date: 12-06-2021
DOI: 10.1002/NOP2.961
Abstract: The aim of this study was to explore awareness of heart disease and associated health behaviours. A qualitative study was conducted using in‐depth interviews. The study participants were patients with hypertension. Data analysis was guided by Braun and Clarke's steps of thematic analysis and using NVivo12 software. A total of 18 patients with hypertension were interviewed. The patients had poor understanding of heart disease and were not concerned about developing heart disease in the future. Barriers to fruit and vegetable consumption were poor access, cost and sociocultural factors, whereas being busy, poor physical health and lack of access to an exercise facility were barriers to physical activity.
Publisher: Springer Science and Business Media LLC
Date: 2000
Publisher: Public Library of Science (PLoS)
Date: 04-06-2020
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-07-2022
Publisher: AIP Publishing
Date: 25-09-1995
DOI: 10.1063/1.115417
Abstract: Thin wurtzite GaN films have been grown by plasma-enhanced molecular beam epitaxy on the basal plane of 6H SiC, with and without AlN buffer layers. Threading defects, identified from high-resolution electron micrographs as double-positioning boundaries (DPBs), originate at the substrate–buffer and/or buffer–film interfaces. The density of these faults seems to be related to the smoothness of the substrate, so that their occurrence emphasizes the importance of adequate substrate preparation. Stacking faults within the GaN are often visible parallel to the SiC substrate basal plane, sometimes terminating at the DPBs. These faults are related to the particular growth conditions, with greatly decreased density obtained for lower plasma power during GaN deposition. Growth of high quality GaN without stacking faults was achieved without using AlN buffer layers by deposition directly onto a vicinal SiC surface having a miscut angle of 4°. Such stepped substrates represent a potentially useful means for controlled growth of the DPBs, which could then serve as suitable stress-relieving defects in lieu of misfit dislocations.
Publisher: Springer Science and Business Media LLC
Date: 2002
Publisher: Pan African Medical Journal
Date: 2019
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 24-11-2021
Abstract: This scoping review will assess the literature that documents or utilizes patient journey mapping methodologies in health care settings. It will also examine the reporting processes of studies that use this methodology. Health care systems are complex and can be challenging for patients to navigate. Using patient journey mapping as a research method promotes a deeper understanding of patient experiences when navigating these systems. Patient journey mapping provides valuable insights into where systems are working well, where gaps in care exist, and how the system could respond to these gaps. This review will consider peer-reviewed articles and publicly available academic literature documenting patient journey mapping methodologies. The review will also consider studies providing guidance and recommendations on how to report patient journey mapping studies in health care services and systems. The proposed review will follow JBI guidance for scoping reviews. The following databases will be searched: MEDLINE, Embase, Emcare, PsycINFO, Scopus, Web of Science Core Collection, the Directory of Open Access Journals, Informit, and ProQuest Dissertations and Theses Global. The search will not be limited to year of publication but will be limited to studies reported in English. The PRISMA-ScR extension will be used to document the literature search. Two reviewers will screen titles, abstracts, and full-text articles. An extraction table will be used to extract relevant data from all included articles and to facilitate data analysis.
Publisher: Oxford University Press (OUP)
Date: 24-11-2282
DOI: 10.1093/EUROPACE/EUAD122.763
Abstract: Type of funding sources: None. Hypertension is a leading risk factor in the development and worsening of cardiac arrhythmias, in particular atrial fibrillation. Practice guidelines recommend an integrated management approach which includes multidisciplinary teams. to investigate the role of nurses in the management process, and to evaluate the effectiveness of nurse-led interventions on hypertension management, lifestyle behaviour and associated patient knowledge. A systematic review with meta-analysis was conducted following Joanna Briggs Institute (JBI) guidelines. MEDLINE (Ovid), Emcare (Ovid), CINAHL (EBSCO), Cochrane library and ProQuest (Ovid) were searched from inception to February 2022. Randomised controlled trials (RCTs) examining the effect of nurse-led interventions on hypertension management were identified. Title and abstract, and full text screening, assessment of methodological quality, and data extraction were conducted by two independent reviewers using JBI (Joanna Briggs Institute) tools. A statistical meta-analysis was conducted using RevMan version 5.4.1. A total of 37 RCTs and 9,731 participants were included. The overall pooled data demonstrated nurse-led interventions significantly improved systolic blood pressure (MD -5.39 95% CI -7.59, -3.34 I2 = 81.33 23 RCTs moderate certainty evidence) and diastolic blood pressure (MD –1.94 95% CI -3.27, -0.60 I2 = 79.66 22 RCTs moderate certainty evidence) compared to usual care. The duration of interventions contributed to the magnitude of blood pressure reduction. Nurse-led interventions effectively modified diet and physical activity, but the effect on smoking and alcohol consumption was inconsistent. This review revealed beneficial effects of nurse-led interventions in hypertension management compared to usual care. Integration of nurse-led interventions in routine hypertension treatment and prevention services could play an important role in alleviating the rising global burden of hypertension and conditions it may be associated with.
Publisher: Springer Science and Business Media LLC
Date: 22-02-2019
Publisher: Wiley
Date: 03-11-2022
DOI: 10.1111/JAN.15479
Abstract: To identify how patient journey mapping is being undertaken and reported. A scoping review of the literature was undertaken using JBI guidance. Databases were searched in July 2021 (16th-21st), including Ovid's Medline, Embase, Emcare and PsycINFO Scopus Web of Science Core Collection, the Directory of Open Access Journals Informit and ProQuest Dissertations and Theses Global. Eligible articles included peer-reviewed literature documenting journey mapping methodologies and studies conducted in healthcare services. Reviewers used Covidence to screen titles and abstracts of located sources, and to screen full-text articles. A table was used to extract data and synthesize results. Eighty-one articles were included. An acceleration of patient journey mapping research was observed, with 76.5% (n = 62) of articles published since 2015. Diverse mapping approaches were identified. Reporting of studies was inconsistent and largely non-adherent with relevant, established reporting guidelines. Patient journey mapping is a relatively novel approach for understanding patient experiences and is increasingly being adopted. There is variation in process details reported. Considerations for improving reporting standards are provided. Patient journey mapping is a rapidly growing approach for better understanding how people enter, experience and exit health services. This type of methodology has significant potential to inform new, patient centred models of care and facilitate clinicians, patients and health professionals to better understand gaps and strategies in health services. The synthesised results of this review alert researchers to options available for journey mapping research and provide preliminary guidance for elevating reporting quality.
Publisher: Oxford University Press (OUP)
Date: 03-07-2019
Abstract: Low and middle-income countries are facing a high burden of cardiovascular disease while there is limited availability of resources and evidence to educate and modify lifestyle behaviours in the population as well as to guide policy making. The goal of the present study was to quantify the prevalence of different cardiovascular risk behaviours among patients with known cardiovascular conditions in a developing country. A hospital-based cross-sectional survey was conducted in two referral hospitals in eastern Ethiopia. Outpatients who had a confirmed diagnosis of cardiovascular disease were recruited for the study. Data were collected through face-to-face interviews with patients using validated tools. A total of 287 cardiovascular disease patients was recruited, of which 56.4% were women and 90.2% were urban residents. Most patients had inadequate consumption of fruit and vegetables, 51.6% were physically inactive, 20% were current khat chewers, 19% were current alcohol drinkers and only 1% were current smokers. Approximately one-third (30%) of the patients had one of these risk behaviours, more than half (51.9%) had two, 15% had three and 3.1% had four risk behaviours. The majority (70%) of the patients had multiple (more than two) risk behaviours. The prevalence of multiple risk behaviours did not significantly vary with sex, residence and educational level differences ( P .05). Cardiovascular disease patients continue to follow unhealthy lifestyles although they attend follow-up care with a specific focus on risk management. The findings of this study provide evidence for policy makers that health services reform is required to promote healthy lifestyle behaviours for the patients.
Publisher: Elsevier BV
Date: 07-2023
Publisher: Oxford University Press (OUP)
Date: 07-2022
DOI: 10.1093/EURJCN/ZVAC060.080
Abstract: Type of funding sources: Other. Main funding source(s): SOLVE CHD Collaboration grant The burden of cardiovascular disease (CVD) is rapidly increasing, however, access to secondary prevention in rural areas is limited. Moreover, rural and remote CVD patients have limited access to primary care and other health services to receive ongoing support and post-discharge follow-up, and this may predispose them to insufficient secondary prevention in terms of a high risk of uncontrolled blood pressure and consequent life-threatening complications including coronary heart disease. Therefore, reform of secondary prevention in rural and remote areas is required to improve reach and access for patients living in such areas, and consequently improve clinical and other health outcomes. To evaluate the feasibility of an innovative, tailored telehealth education and counselling program to optimise secondary prevention of CVD in patients living in rural areas in South Australia. A quasi experimental study will be conducted by recruiting patients from existing database country access to cardiac health (CATCH) program. Patients with CVD, aged ≥ 18, enrolled into CATCH program and living in rural and remote South Australia. S le size is calculated using an online tool and is based on the primary endpoint to detect reduced readmission rate in patients with CVD and cardiac events. Patients with acute coronary syndrome/myocardial infarction, revascularisation procedure, stable and unstable angina, post coronary artery bypass grafting, post cardiac valve replacement surgery, and heart failure will be included. The s le size is calculated using online tool with appropriate statistical assumptions, which gives 113. The intervention of this study consists of two components: 1) delivery of a tailored telehealth counselling and education through telephone by a nurse and 2) use of an iPad application for patient education. Primary outcome is readmission for CVD and cardiac events. Secondary outcomes are knowledge of cardiovascular risk factors, lifestyle modification (e.g. smoking, alcohol, diet and physical exercise), medication adherence, health related quality of life and clinical outcomes such as lipid profile and blood pressure. TEACH-RA study will test the feasibility of a tailored telehealth education and counselling program in patients with cardiac conditions living in rural and remote areas.
Publisher: OMICS Publishing Group
Date: 2017
Publisher: Springer Science and Business Media LLC
Date: 30-04-2018
DOI: 10.1007/S12529-018-9722-3
Abstract: The aim of this study was to explore the influences on satisfaction with reconstructed breasts and intimacy following bilateral prophylactic mastectomy (BPM) in younger women (< 35) with a strong family history of breast cancer. Twenty-six women who had undergone BPM between 1 and6 years ago were recruited from New Zealand and Australia through a genetics clinic, registry, research cohort, and online (M Four themes were identified: satisfaction with breasts before surgery, outcome expectations, type of mastectomy, and open communication. Women who liked their breasts pre-BPM appeared less satisfied with their reconstructed breasts post-surgery, and women who disliked their breasts before BPM were more satisfied with their reconstructed breasts. Women with unrealistic expectations concerning the look and feel of reconstructed breasts were often unhappy with their reconstructed breasts and felt they did not meet their expectations. Unrealistic photos of breast reconstruction and satisfactory communication of realistic outcome expectations by surgeons or psychologists also appeared to influence satisfaction. Communication with partners prior to BPM appeared to improve satisfaction with intimacy post-BPM. The findings suggest that satisfaction with reconstructed breasts for younger women post-BPM appeared to be influenced by realistic outcome expectations and communication with others concerning reconstructed breast appearance and intimacy post-BPM. Implications for practice include discussion of realistic reconstructed breast appearance, referral to a psychologist to discuss sensitive issues, and accurate communication of surgical risks and consequences.
Publisher: Wiley
Date: 12-08-2023
DOI: 10.1111/JOCN.15993
Abstract: To identify the atrial fibrillation (AF)‐specific information needs of patients with AF. Patients’ understanding of AF is pertinent to optimising treatment and outcomes, thus highlighting the need for effective patient education. The information required to deliver effective AF‐specific patient education is less examined. Guided by Arksey and O’Malley's framework, a scoping review was conducted for studies reporting the AF‐specific information needs of patients with AF. Systematic searches were conducted across six databases (Medline, PubMed, CINAHL, Scopus, PsycINFO and ProQuest). All analyses were narrated in prose and outlined in tables. The PRISMA‐ScR checklist was used to report this review. The systematic search yielded 3816 articles, of which 22 were included. Three major themes emerged from the thematic analysis. Each theme was supported by three subthemes. First, in ‘Understanding AF’, patients reported the need for ‘Easy‐to‐understand information’, information on the ‘Screening and diagnosis’ of AF and ‘Trajectory of disease and its associated risks’. Second, in ‘Treating AF’, patients required information on the ‘Role of anticoagulation’, ‘Existing or novel therapeutic options’ and ‘Monitoring effectiveness of treatment’. Lastly, in ‘Living with AF’, patients needed education in ‘Symptom management’, ‘Secondary prevention of risks’ and ‘Recognition of emergency situations’. This review has identified the key AF‐specific information needs of patients with AF. Being cognisant of the information needs of patients with AF, healthcare providers may become more effective in developing person‐centred patient education interventions. Delivering relevant patient education is an important cornerstone for atrial fibrillation care. Nurses by convention play a professional role in patient education. It may be facilitative for nurses to refer to the review findings when developing and implementing patient education interventions. Being in the midst of an ongoing pandemic, patient education strategies may require the use of telecommunication technologies.
Publisher: Informa UK Limited
Date: 25-09-2023
Publisher: Hindawi Limited
Date: 10-02-2021
DOI: 10.1111/ECC.13425
Publisher: Oxford University Press (OUP)
Date: 03-05-2023
Abstract: This review aimed to investigate the effectiveness of nurse-led interventions vs. usual care on hypertension management, lifestyle behaviour, and patients’ knowledge of hypertension and associated risk factors. A systematic review with meta-analysis was conducted following Joanna Briggs Institute (JBI) guidelines. MEDLINE (Ovid), EmCare (Ovid), CINAHL (EBSCO), Cochrane library, and ProQuest (Ovid) were searched from inception to 15 February 2022. Randomized controlled trials (RCTs) examining the effect of nurse-led interventions on hypertension management were identified. Title and abstract, full text screening, assessment of methodological quality, and data extraction were conducted by two independent reviewers using JBI tools. A statistical meta-analysis was conducted using STATA version 17.0. A total of 37 RCTs and 9731 participants were included. The overall pooled data demonstrated that nurse-led interventions may reduce systolic blood pressure (mean difference −4.66 95% CI −6.69, −2.64 I2 = 83.32 31 RCTs low certainty evidence) and diastolic blood pressure (mean difference −1.91 95% CI −3.06, −0.76 I2 = 79.35 29 RCTs low certainty evidence) compared with usual care. The duration of interventions contributed to the magnitude of blood pressure reduction. Nurse-led interventions had a positive impact on lifestyle behaviour and effectively modified diet and physical activity, but the effect on smoking and alcohol consumption was inconsistent. This review revealed the beneficial effects of nurse-led interventions in hypertension management compared with usual care. Integration of nurse-led interventions in routine hypertension treatment and prevention services could play an important role in alleviating the rising global burden of hypertension. PROSPERO: CRD42021274900
Publisher: Elsevier BV
Date: 12-1997
Publisher: Springer Science and Business Media LLC
Date: 1999
Publisher: Pan African Medical Journal
Date: 2018
Publisher: Canadian Institute of Mining, Metallurgy, and Petroleum
Date: 07-2001
DOI: 10.2113/0100165
Publisher: Elsevier BV
Date: 03-2020
Publisher: Hindawi Limited
Date: 03-06-2020
DOI: 10.1111/HSC.13027
Publisher: Springer Science and Business Media LLC
Date: 2002
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 21-07-2022
Publisher: Scitechnol Biosoft Pvt. Ltd.
Date: 2017
No related grants have been discovered for Lemma Negesa Bulto.