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- All Subjects: healthcare
- Creators: School of Molecular Sciences
This study examined the differences in mental and behavioral treatment outcomes between use of Telehealth and in-person appointments in effort to mitigate discrepancies that may lessen treatment efficacy.
Refugee women face many challenges to obtaining maternal, reproductive, and sexual health post-resettlement including the language barrier, navigating the healthcare system, finding childcare to attend appointments, and cultural mismatches between their beliefs and practices around the prenatal, childbirth, and postpartum periods and that of the healthcare system in which they resettle into. This cultural barrier poses a challenge to healthcare providers as well as it necessitates that they respect their patients’ cultural beliefs while still providing them with the highest standard of care. Cultural competency training has been used to assist providers in understanding and responding to cultural differences, but gaps still exist when it comes to navigating specific scenarios. The objective of this research was to conduct a literature review of studies pertaining to refugee maternal, reproductive, and sexual healthcare post-resettlement to investigate the following questions: how tensions between biomedically accepted best practices and cultural norms present themselves in these healthcare fields, how healthcare providers take into consideration their patients’ cultural beliefs and norms when providing maternal, reproductive, and sexual healthcare to refugee women, and what can be done to continue to improve the provision of culturally appropriate care to refugee women. Findings from twenty different studies that focused primarily on eight cultural groups identified that Cesarean sections, inductions, and certain family planning methods are significant points of contention regarding cultural norms for refugee women and that they prefer certain foods, birthing positions, and other cultural practices during the delivery. Healthcare providers consider their refugee patients’ cultural beliefs by creating relationships with them built on trust, utilizing community liaisons, and through attempts to accommodate cultural practices when possible. Some potential improvements offered to improve cultural competency were improved cultural competency training that focused on how healthcare providers ask questions and interact with their patients, increased partnership with refugee communities, and an emphasis on patient education surrounding interventions and procedures related to maternal and reproductive health that could cause hesitations. The results of this literature review accentuated the importance of relationships within the field of refugee women’s healthcare, between both refugee patients and their providers and refugee communities and the healthcare systems. Providing refugee women access to more culturally competent healthcare can increase their trust in the healthcare systems of the countries they resettle in and healthcare utilization that can contribute to improved health outcomes for refugee women and their children.
Despite differences in schooling and clinical experience prior to practice, advanced practice providers often have similar scopes of practice, which raises concerns about the quality of care being provided. In this paper, we explore if prescribing patterns are comparable between provider types by comparing differences in time spent on pharmacological interventions utilizing a simulated healthcare environment. Physicians (MDs and DOs), Nurse Practitioners (NPs), and Physician Assistants (PAs) actively practicing in Family Practice/Medicine or Internal Medicine in the U.S. state license/recognition were recruited at healthcare conferences and simulation centers. Participants were provided 20 minutes to complete the patient consultation on a Standardized Patient (SP) presenting with a chief complaint of a post-hospitalization follow-up for heart failure, fatigue, and some edema. All encounters were recorded and uploaded to be reviewed by undergraduate evaluators, who were responsible for quantifying the amount of time the participants spent on each of the task categories, including pharmacologic interventions. With a total of 46 participants in this study, the average amount of time spent discussing this activity per visit across each provider type was 14.8 seconds for MDs/DOs, 29.2 seconds for NPs, and 38.8 seconds for PAs. The results of this study suggest that PAs (p= 0.0028) spent significantly more time discussing pharmacological interventions and were significantly more likely to discuss pharmacological interventions (p=0.0243) when compared with physicians (MD/DOs). It is important to note that the sample size of PAs was very small (N=9), which could potentially skew the results and not be representative of the population. With limited literature that examines whether time spent discussing pharmacological interventions is comparable across provider types, it is important for more simulated healthcare research to be conducted on this topic.