Summary Background Non‐alcoholic fatty liver disease (NAFLD) affects one‐fourth of the global population. Yet, the care of these patients is limited and awareness of NAFLD remains low in the general public. Investigations into the lives of these patients are often forgotten and traditional quantitative studies only paint part of the picture. Aim To assess the first‐hand accounts of these individuals and their perspective on living with NAFLD. Methods A systematic search was conducted on Medline, Embase, CINAHL, PsycINFO and Web of Science database for qualitative literature regarding patients' perspectives on NAFLD. An inductive thematic analysis was conducted to generate themes and supportive subthemes. Results We incuded eight articles in the review. There were three major themes including the impact on the quality of life, knowledge and information, and attitudes and perceptions on care. The impact of the quality of life details the emotional and physical distress of NAFLD. Knowledge and information include the lack of sufficient communication between healthcare providers and patients with a distinct knowledge gap. Attitudes and perceptions on care extrapolate the current active participation of patients and needs of the patients and the future care that they desire. Conclusion This review synthesises first‐hand accounts of individuals with NAFLD. With the growing burden of NAFLD, future public interventions must consider individual views for success to be found. The identified themes serve as a forefront for consideration for public policies. Ultimately, NAFLD is a multisystem disease, which must be managed by a multidisciplinary team.
Objectives Colonoscopy is integral in the early detection of colorectal cancer (CRC), be it for screening, diagnostic or therapeutic intentions. Despite the presence of multiple screening modalities, colonoscopy remains integral in providing a definitive CRC diagnosis. However, uptake rates remain low worldwide with minimal understanding towards stakeholders' perspectives. This systematic review is the first to outline the barriers and facilitators faced by providers and patients in receiving colonoscopy specifically. MethodsUsing PRISMA guidelines, our systematic review consolidates findings from Medline, Embase, CINAHL, PsycINFO and Web of Science Core collection. All perceptions of healthcare providers and screening participants aged 45 and above towards colonoscopy were included. ResultsForty-five articles were included in our review. Five major analytical themes were identified -procedural perceptions, personal experiences, thoughts and concerns, societal influences, doctor-patient relationship and healthcare system. The discrepancies in knowledge between patients and providers have evidently reduced in the present decade, potentially attributable to the rising influence of social media. The sharing of providers' personal experiences, involvement of patients' family in colonoscopy recommendations and propagation of patients' positive recounts were also more apparent in the past compared to the present decade, highlighting the need to reevaluate the balance between medical confidentiality and personal touch. Additionally, Asian patients were reportedly more apathetic towards CRC diagnosis due to their strong belief in destiny, a crucial association consistent with present studies. ConclusionThis study highlights pertinent gaps in our healthcare system, providing crucial groundwork for interventions to be enacted in engendering higher colonoscopy uptake rates.
BackgroundDisruptive behavior can harm high-quality care and is prevalent in many Western public health systems despite increasing spotlight on it. Comparatively less knowledge about it is available in Asia, a region commonly associated with high-power distance, which may limit its effectiveness in addressing disruptive behavior.PurposeThe aim of this study was to develop a comprehensive framework for tackling disruptive behavior among health care professionals in a public health system.MethodologyA nationwide cross-sectional study relying on the Nurse–Physician Relationship Survey was conducted in Singapore. Four hundred eighty-six public health care professionals responded.ResultsTwo hundred ninety-eight doctors (95.5%) and 163 nurses (93.7%) had witnessed a form of disruptive behavior. Doctors observed disruptive behavior committed by other doctors and nurses much more frequently than did nurses. Doctors made stronger associations between disruptive behavior and negative employee outcomes and between disruptive behavior and negative patient outcomes. Qualitative analyses of participants’ open-ended answers produced a multipronged three-dimensional approach for tackling disruptive behavior: (a) deterrent measures, (b) development of knowledge and skills, and (c) demonstration of organizational commitment through proper norms, empathizing with staff, and structural reforms.Practice ImplicationsDisruptive behavior is a multifaceted problem requiring a multipronged approach. Our three-dimensional framework is a comprehensive approach for giving health care professionals the capability, opportunity, and motivation to address disruptive behavior effectively.
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