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Tal O, Barnea R, Tur-Sinai A. Patient-centeredness-a cultural targeted survey among junior medical managers. Int J Equity Health 2023; 22:170. [PMID: 37649063 PMCID: PMC10469801 DOI: 10.1186/s12939-023-01979-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 08/02/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Patient-centeredness is a core element in healthcare. However, there is a gap between the understanding of this term by healthcare professionals, and patients' capability, self-efficacy, and willingness to take part in medical decisions. We aim to expose standpoints toward "patient centeredness" among junior medical managers (JMM), as they bridge between policy strategies and patients. We try to reveal cultural differences by comparing the views of the majority and the minority subpopulations of Israel (Arabic and Hebrew speakers). METHODS A cross-sectional survey among JMM studying for an advanced degree in health-system management at three academic training colleges in Israel was conducted in February-March 2022. The respondents completed a structured questionnaire comprising four sections: a) perceptions of trust, accountability, insurance coverage, and economic status; b) perceptions regarding decision-making mechanisms; c) preferences toward achieving equity, and d) demographic details. RESULTS A total of 192 respondents were included in the study-50% Hebrew speakers and 50% Arabic speakers. No differences were found between Arabic and Hebrew speakers regarding perception of trust, accountability, insurance coverage, and economic status. JMM from both subpopulations believed that patients' gender and age do not influence physicians' attitudes but Arabic-speaking respondents perceived that healthcare professionals prefer educated patients or those with supportive families. All respondents believed that patients would like to be more involved in medical decisions; yet Arabic-speakers perceived patients as tending to rely on physicians' recommendations while Hebrew speakers believed that patients wish to lead the medical decision by themselves. CONCLUSIONS Patient-centeredness strategy needs to be implemented bottom-up as well as top-down, in a transparent nationwide manner. JMM are key actors in carrying out this strategy because they realize policy guidelines in the context of social disparities, enabling them to achieve a friendly personalized dialogue with their patients. We believe that empowering these JMM may create a ripple effect, yielding a bottom-up perception of equity and initiating change.
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Affiliation(s)
- Orna Tal
- Shamir Medical Center, Be'er Yaakov, Israel.
- Bar-Ilan University, Ramat Gan, Israel.
- ICET, Israeli Center for Emerging Technologies, Beer Yaakov, Israel.
| | - Royi Barnea
- Assuta Health Services Research Institue, Assuta Medical Centers, Tel Aviv, Israel
- School of Health Systems Management, Netanya Academic College, Netanya, Israel
| | - Aviad Tur-Sinai
- Department of Health Systems Management, The Max Stern Yezreel Valley College, Yezreel Valley, Israel
- School of Nursing, University of Rochester Medical Center, Rochester, NY, USA
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Elsinga J, Kuodi P, Shibli H, Gorelik Y, Zayyad H, Wertheim O, Abu Jabal K, Dror A, Nazzal S, Glikman D, Edelstein M. Changes in Quality of Life Following SARS-CoV-2 Infection Among Jewish and Arab Populations in Israel: A Cross-Sectional Study. Int J Public Health 2023; 68:1605970. [PMID: 37378302 PMCID: PMC10291044 DOI: 10.3389/ijph.2023.1605970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Objectives: The long-term impact of COVID-19 on health inequalities is under-researched. We investigated changes in health-related inequalities following SARS-CoV-2 infection between the Jewish majority and the Arab/Druze minority in Israel. Methods: Patients with a positive SARS-CoV-2 RT-PCR test processed from one of the Northern-Israeli government hospitals between 03/2021 and 05/2022 were invited to participate. We collected socio-demographic, COVID-19-related, and health-related quality of life (HRQoL) information using a validated questionnaire. We compared pre- and post COVID-19 HRQoL changes between Jews and Arabs/Druze, up to 12+ months post-infection using an adjusted linear regression model. Results: Among the 881 included participants the average post-COVID HRQoL score was lower among Arabs/Druze than Jews (0.83 vs. 0.88; p = 0.005). Until 12 months post-infection, HRQoL changes were similar for Arabs/Druze and Jews. After 12 months, HRQoL dropped significantly more among Arabs/Druze than among Jews (0.11 points difference between the groups; p = 0.014), despite adjusting for socioeconomic variables. Conclusion: 12 months post-infection, COVID-19 affected the HRQoL of Arabs/Druze more than Jews, with the gap not fully explained by socio-economic differences. The COVID-19 pandemic may widen pre-existing long-term health inequalities.
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Affiliation(s)
- Jelte Elsinga
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
- Department of Medical Microbiology and Infection Prevention, Amsterdam UMC, Amsterdam, Netherlands
| | - Paul Kuodi
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Haneen Shibli
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Yanay Gorelik
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Hiba Zayyad
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
- The Baruch Padeh Medical Center, Poriya, Poriah, Israel
| | - Ofir Wertheim
- The Baruch Padeh Medical Center, Poriya, Poriah, Israel
| | - Kamal Abu Jabal
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
- Ziv Medical Center, Safed, Israel
| | - Amiel Dror
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
- Galilee Medical Center, Nahariya, Israel
| | - Saleh Nazzal
- The Baruch Padeh Medical Center, Poriya, Poriah, Israel
| | - Daniel Glikman
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
- The Baruch Padeh Medical Center, Poriya, Poriah, Israel
| | - Michael Edelstein
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
- Ziv Medical Center, Safed, Israel
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Abstract
OBJECTIVES We examined differences across three groups in Israel to test the double jeopardy versus the intersection escape hypotheses-which evaluate whether being older and belonging to an underrepresented group serves as a double burden, exposing older minorities to higher levels of perceived ageism or on the contrary, older age serves as a protective factor, especially for underrepresented groups. DESIGN A cross-sectional, nationally representative sample, consisting of three groups: Veteran Israelis, Israeli Arabs and immigrants from the Former Soviet Union. The latter two groups represent underrepresented (minority) populations in Israel. SETTING Community-dwelling Israelis over the age of 50. PARTICIPANTS The sample was composed of 1570 participants. MEASUREMENT To examine the double jeopardy versus the intersectional escape hypothesis, self-perceptions of aging (SPA) and perceived age-based discrimination in the healthcare system were examined as outcome variables. RESULTS Among Israeli Arabs, being older was related to better SPA, whereas among the immigrants being older was related to worse SPA. As immigrants became older, they were more likely to report ageist experiences. Israeli Arabs reported higher levels of ageist experiences, regardless of their age. CONCLUSIONS The findings point to certain groups that require education about ageism and the aging processes and might require further protection from the experiences of ageism. The findings also point to the relevance of different theoretical paradigms that advocate for the consideration of culture and group membership in the understanding of the experiences of ageism.
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Vitman-Schorr A, Khalaila R. Utilization of ADCCs and quality of life among older adults: ethno-regional disparities in Israel. BMC Geriatr 2022; 22:18. [PMID: 34979954 PMCID: PMC8722010 DOI: 10.1186/s12877-021-02674-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 11/26/2021] [Indexed: 11/19/2022] Open
Abstract
Background Adult day care centers (ADCCs) are a common service provided for frail older adults in the community. We examined the influence of older adults’ utilization of ADCC’s on their quality of life (QoL), and whether ethno-regional disparities are factors in the gaps found concerning QoL in different regions and between different ethnic groups. Methods Cross sectional data were collected through structured interviews with 360 older adults attending ADCCs. Participants represented three ethnic groups and three regions in Israel. QoL was assessed by SF-36 questionnaire. Results The results revealed a positive correlation between weekly hours at the ADCC, satisfaction with attending ADCC, and QoL. Older adults living in the central region had higher QoL than those living in the southern and northern regions. Veteran Israeli Jews reported higher QoL than FSU immigrants Israeli Arabs in all regions. Connection to one’s residential area was also correlated with QoL. A significant moderating effect of the interaction (ethnicity*area of residence) on QoL was also revealed. Conclusions Attending ADCC is a vital community services to promote QoL in later life. Gaps in ADCC utilization between ethnic groups and residential region may cause disparities in QoL, specifically, in minority groups and those living in peripheral regions. Service providers should minimize the disparities by improving accessibility and availability for each person regardless of ethnicity and region of residence.
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Affiliation(s)
- Adi Vitman-Schorr
- Shamir Research Institute, University of Haifa, Israel, 1290000, Kazrin, Israel.
| | - Rabia Khalaila
- Zefat Academic College, 11 Jerusalem St., P.O.B. 160, 13206, Zefat, Israel
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Hannawi S, Hannawi H, Naeem KB, Elemam NM, Hachim MY, Hachim IY, Darwish AS, Al Salmi I. Clinical and Laboratory Profile of Hospitalized Symptomatic COVID-19 Patients: Case Series Study From the First COVID-19 Center in the UAE. Front Cell Infect Microbiol 2021; 11:632965. [PMID: 33718282 PMCID: PMC7952884 DOI: 10.3389/fcimb.2021.632965] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 01/25/2021] [Indexed: 02/05/2023] Open
Abstract
INTRODUCTION COVID-19 is raising with a second wave threatening many countries. Therefore, it is important to understand COVID-19 characteristics across different countries. METHODS This is a cross-sectional descriptive study of 525 hospitalized symptomatic COVID-19 patients, from the central federal hospital in Dubai-UAE during period of March to August 2020. RESULTS UAE's COVID-19 patients were relatively young; mean (SD) of the age 49(15) years, 130 (25%) were older than 60 and 4 (<1%) were younger than 18 years old. Majority were male(47; 78%). The mean (SD) BMI was 29 (6) kg/m2. While the source of contracting COVID-19 was not known in 369 (70%) of patients, 29 (6%) reported travel to overseas-country and 127 (24%) reported contact with another COVID-19 case/s. At least one comorbidity was present in 284 (54%) of patients and 241 (46%) had none. The most common comorbidities were diabetes (177; 34%) and hypertension (166; 32%). The mean (SD) of symptoms duration was 6 (3) days. The most common symptoms at hospitalization were fever (340; 65%), cough (296; 56%), and shortness of breath (SOB) (243; 46%). Most of the laboratory values were within normal range, but (184; 35%) of patients had lymphopenia, 43 (8%) had neutrophilia, and 116 (22%) had prolong international normalized ratio (INR), and 317 (60%) had high D-dimer. Chest x ray findings of consolidation was present in 334 (64%) of patients and CT scan ground glass appearance was present in 354 (68%). Acute cardiac injury occurred in 124 (24%), acute kidney injury in 111 (21%), liver injury in 101 (19%), ARDS in 155 (30%), acidosis in 118 (22%), and septic shock in 93 (18%). Consequently, 150 (29%) required ICU admission with 103 (20%) needed mechanical ventilation. CONCLUSIONS The study demonstrated the special profile of COVID-19 in UAE. Patients were young with diabetes and/or hypertension and associated with severe infection as shown by various clinical and laboratory data necessitating ICU admission.
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Affiliation(s)
- Suad Hannawi
- Department of Medicine, Ministry of Health and Prevention, Dubai, United Arab Emirates
| | - Haifa Hannawi
- Department of Medicine, Ministry of Health and Prevention, Dubai, United Arab Emirates
- Department of Reserach, Ministry of Health and Prevention, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Kashif Bin Naeem
- Department of Medicine, Ministry of Health and Prevention, Dubai, United Arab Emirates
| | - Noha Mousaad Elemam
- Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Mahmood Y Hachim
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Ibrahim Y Hachim
- Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | | | - Issa Al Salmi
- Department of Medicine, Oman Medical Specialty Board, The Royal Hospital, Muscat, Oman
- The Research Section, Oman Medical Speciality Board, The Royal Hospital, Muscat, Oman
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