Although I tried to ask a couple of probing questions in the interview, I think that I should have asked more probing questions where appropriate. After the first interview question was answered, I should not have moved to the next question quickly and should have asked a probing question to get more detailed answers (Braun & Clarke, 2013). This could have helped me understand the interviewee’s perception about health (Braun & Clarke, 2013). For example, I could have asked the interviewee to clarify how being financially unstable could have some effects on his health and what he meant by being financially unwell. Besides, it was not effective to ask this probing question in the interview “how frequently should a person exercise to be healthy?” This is because this question digs deeper for details that go beyond the aim of the research questions. Therefore, interviews in the future should focus on the purpose of the interview to ask more beneficial probing questions that would be appropriate to produce useful data (Braun & Clarke, 2013).
Although oriented questions were used in the interview, detailed use of the oriented questions in the interview could have been more beneficial. They could have generated a lot of data about the interviewee’s understanding of health and health changes over time. This could have been done by encouraging the interviewee to talk about his or her own experiences and social events (Braun & Clarke, 2013). For example, when the interviewee answered the question about the healthiest time in his life, I could have asked him to give some examples of why he thought that he was not healthy at any point in his life and why he thought that he was the healthiest when he was in college. Also, I could have asked him to draw on some memories and experiences to know his understanding of health. In the future, I will have to encourage interviewees to draw on some event, own experience, and some situational experience to generate detailed contextual data about the interviewee (Braun & Clarke, 2013).
Since my educational background is in health sciences, I wanted to know why the interviewee said that being socially unwell was considered as being unhealthy. I asked him “please tell me what you mean by being socially unwell?” After he answered the question, I asked him another question about the same thing to explore his further understanding of being socially unwell. The question was “if a person is socially unwell, then how can his or her well-being be affected?” Asking the two questions could have misled the interview conversation. Thus, instead of collecting data to know the interviewee’s perception about health and health changes over time, the conversation focused on social aspects of health. The more interviewing experience that can be gained through more practice is required to generate more useful data in the future. This is because it helps to reduce an interviewer’s stress and helps the interviewee to manipulate his/her background and beliefs positively.
Reference
Braun, V., & Clarke, V. (2013). Successful qualitative research: A practical guide for beginners. Thousand Oaks, CA: Sage.
In order to improve the performance of the unit, it was decided to conduct weekly surveys so as to collect more data regarding the impact of different factors on staff performance and patient outcomes. Also, pain management was seen as the key contributor to improved performance, so it was interesting to investigate this issue and reach a verdict regarding the effectiveness of interventions that were implemented by the management (Yoder-Wise, 2015). Nonetheless, there are several questions that yet have to be answered in order to provide the management with a full picture.
First of all, it can be claimed that the proposed strategies mentioned in the case were effective. This assumption is based on the idea that the team positively reacted to the implementation of a new strategy that revolved around pain management. At the same time, it can also be stated that patient satisfaction also contributed to the idea that the changes that occurred at the facility could be described as positive. Combining the information presented above, it can be hypothesized that sustainable change is achievable. My nursing unit was able to implement this strategy, and I believe that it was a smart decision that led to increased patient satisfaction and positive outcomes.
Nonetheless, it cannot be claimed that the unit will exceed the national benchmark in the next quarter (or next year). This hypothesis can be validated by the results of the data analysis that showed that only around 70% of patients were pleased with the outcomes. The overall national trend showed that the percentage should be slightly higher. This leads us to the conclusion that the nurse manager and CNO cannot be certain of the fact that the percentage of positive feedback will continue to grow relentlessly.
Regardless of the fact that the run chart showed slow and steady growth, it hardly has any predictive abilities. It may be safe to say that the existing level of performance will have the possibility to stay at the same level throughout the whole year, but the consistent growth is rather questionable (Stevens, 2013). This assumption can also be supported by the fact that sudden growth out of nowhere may be followed by unstable performance and reduction of the quality of care across the unit.
This conclusion also validates the idea that the nursing unit’s decision to celebrate is rational. The reason for this is the fact that the levels of positive patient outcomes and patient satisfaction are growing (Spath, 2013). At the same time, it is not realistic to assume that the growth will become unconditional, and the trend will continue. The unit should always be in search of more strategies that could contribute to the improvements in positive patient outcomes.
Based on the existing evidence, it can be concluded that the unit has successfully lowered the number of readmissions and critically addressed the question of collecting data. While it was found that improvements were relatively stable, it is still recommended to pay more attention to the quality of surveys and the level of bias displayed by the patients (especially knowing that the percentage of respondents is lower than it should be).
Therefore, any future improvements should focus on the creation of a patient-centered environment (Cherry & Jacob, 2016). The most important performance improvement tool that contributed to the outcome was a correctly selected leadership approach. The leadership style chosen by the manager of the unit positively affected the morale of the staff and motivated them to create a trust-based care environment.
References
Cherry, B., & Jacob, S. R. (2016). Contemporary nursing: Issues, trends, & management. Philadelphia, PA: Elsevier Health Sciences.
Spath, P. (2013). Introduction to healthcare quality management (2nd ed.). Chicago, IL: Health Administration Press.
Stevens, K. (2013). The impact of evidence-based practice in nursing and the next big ideas. The Online Journal of Issues in Nursing, 18(2), 1-13.
Yoder-Wise, P. S. (2015). Leading and managing in nursing (6th ed.). St. Louis, MO: Mosby.
Different units in healthcare facilities have a variety of individuals on whom the performance of the organization depends. These groups of people are called stakeholders as they both contribute to and rely on the organization and its success. For example, in nursing homes, nurses can be divided into a number of stakeholder groups. Furthermore, as each of these groups has its own unique personal duties, their members should adhere to the specific determinants of work quality – key performance indicators (KPIs). The following essay describes three main stakeholders of nursing homes and their KPIs.
Stakeholders
While nursing can be seen as an occupation with a set range of responsibilities, different types and levels of it may have various duties. Similarly, healthcare organizations also can have a list of unique tasks and activities. Thus, the first stakeholder in a nursing home is the organization itself – a nursing home, often represented by the board of directors. It is a duty of a nursing home to provide its clients with health care that is high-quality and patient-centered. The organization as a whole is responsible for care delivery and the performance of its members.
The second stakeholder group is the primary type of employee working in such homes – a nurse. Nurses contribute to the performance of the nursing home significantly as they are usually the most numerous group of workers in the facility. Their stake in the organization’s success is evident in their work and communication with clients. Finally, the third possible stakeholder is a nurse manager. While managers also perform the duties of regular nurses, they have a different set of responsibilities because they provide support not only to clients but also their subordinates.
Key Performance Indicators (KPIs)
Each stakeholder type has its own range of KPIs that it should follow to achieve the best results. For the first stakeholder, the nursing home, one of the main performance indicators is the rate of patients with certain conditions and the percentage of successful and unsuccessful treatment outcomes. Another KPI is the level of satisfaction of patients with the facility’s care. Job satisfaction of employees is another important KPI, along with the general hygiene of the place, quality of equipment, and speed of operations. For nurses, KPIs can be connected to their individual and group activities. For instance, their interaction with clients and the rate of successfully and timely performed procedures are among the main indicators. Other KPIs may include consistency in high-quality care, number of injuries inflicted on patients, rates of medical errors, and others.
Nursing managers also have similar KPIs. Nevertheless, they also perform as leaders and mentors. Thus, their KPIs may include successful training outcomes for subordinates, the level of the unit’s collaboration, and interaction with nurses. The work of the department as a whole can depend on nurse managers as well. The ability to introduce new ideas, the rates of nurse turnover and retention, the quality of the unit’s teamwork rely on nurse managers.
Conclusion
Nursing homes have many different stakeholders who each have their own duties and performance indicators. Organizations as a whole are dependent on their administration and workers of all levels and have such KPIs as client satisfaction and overall statistics of quality. Nurses and nurse managers have similar and differing responsibilities. Therefore, their KPIs also range from simple punctuality and lack of errors to teamwork effectiveness and rate of innovative solutions’ implementation.
Caffeine is a component of many common beverages such as coffee, tea, and energy drinks. It operates as a stimulant, and this effect often becomes the subject of studies concerning human physical and mental health and cognitive abilities. The connection between consuming caffeinated beverages and one’s response to exercise is also researched by many scholars. Caffeine may appear in the diets of athletes in many forms and serve as an aid in enhancing one’s performance during training and competing (Graham 2001).
However, caffeinated beverages such as coffee may be less effective in delivering these results in comparison to other substances such as topical gels and pure caffeine (Graham 2001). Nevertheless, all types of these products may have some effect on one’s health and performance.
The range of studies examining the effect caffeine can have on one’s exercising covers different aspects and outcomes of consuming this stimulant. For instance, one study found that daily consumption of caffeine-containing supplements did not have a significant impact on one’s body weight and composition when coupled with intensive aerobic training (Malek et al. 2006). Although prolonged consumption of caffeine was thought to affect the metabolic and hormonal processes of athletes, its influence on people’s bodies was not significant enough to assume such an impact could be viable (Malek et al. 2006). Caffeine also had no notable effect on people’s endurance and force during exercising, although it showed an ability to increase one’s speed of cognitive response (Van Duinen, Lorist, & Zijdewind 2005).
A notable divide between the resting metabolic rates of people consuming caffeine and having an active or a sedentary lifestyle was also not established (Poehlman et al. 1985). Also, insignificant differences in heart rate and blood pressure were found among people who consumed caffeine regularly and occasionally, regardless of their exercise training and experience (Poehlman et al. 1985). Another study confirmed a similar hypothesis investigated possible reasons behind researchers’ initial belief that caffeine can affect one’s exercise performance.
Here, the results showed that caffeine was raising people’s blood pressure regardless of whether they were exercising or resting and thus could not have affected people’s response to physical training (Daniels et al. 1998). Measuring one’s myocardial blood flow and its response to caffeine consumption before exercising and staying in an idle state yielded different results. This study showed that caffeine was able to affect people’s exercise-induced myocardial flow reserve and increase the flow above the average volume (Namdar et al. 2006).
The research regarding the connection between caffeine consumption and one’s response to exercising is replete with studies failing to find any significant effects of the stimulant on people’s vitals. Nevertheless, the process of studying such links remains important as it reveals the impact (or a lack thereof) of caffeine on people’s performance and health. This particular study continues to challenge the idea that caffeine significantly affects people’s well-being.
Aside from measuring people’s pulse rate before and after exercise, it also compares people’s response to caffeine before engaging in any physical activity, thus, revealing the effect of caffeine on the besting body. Two groups of subjects measured their pulse rates at three points in the time mentioned above and performed a simple step test as an exercise for the final part of the experiment (Cooney et al. 2013).
This study aims to establish whether caffeine has an effect on people’s pulse rate before and after exercising and compare it to the changes that happen in people who did not consume caffeine before physical activity. The central hypothesis states that there will be a visible difference between the pulse rates of two subject groups before and after exercising, proving that caffeine has a significant impact on one’s blood flow.
Methods
Refer to the School of Life and Environmental Sciences (2018).
Results
The study analyzed the results of two groups where one of them consumed a caffeinated beverage (group A), and the other consumed a decaffeinated beverage (group B). The former group of participants consisted of 57 individuals, while the latter had 49 individuals. The heart rate of both groups was measured at three points – before and after consuming the beverage and after exercising. All estimations of the pulse rates were documented in the form of beats per minute.
The mean (± SE) pulse rate of the first group was 76.1 ± 2 bpm pre-treatment, 78.4 ± 1.9 bpm after drinking the caffeinated beverage, and further rose to 124.8 ± 3.6 bpm after physical activity (Figure 1). The documented mean (± SE) pulse rates of the group that consumed a decaffeinated drink were 79 ± 1.9 bpm pre-treatment, 79.3 ± 1.9 bpm post-treatment, and 127.7 ± 4 bpm post-exercise (Figure 1).
Figure 1: Mean Pulse Rate for Two Subject Groups During Pre-Treatment, Post-Treatment, and Post-Exercise Times (Beats/Minute).
A two-way Analysis of Variance (ANOVA) was conducted after collecting and assessing raw data to establish or eliminate the possibility of notable divergences between the results of the two groups (Table 1; Table 2). There was no significant difference in the mean pulse rate between subjects who consumed caffeinated coffee and those who consumed decaffeinated coffee (ANOVA: F(1, 312) = 0.09, p > 0.05). Across all coffee treatment groups, the mean pulse rate at pre-treatment was significantly different to that at post-exercise (ANOVA: F(2, 312) = 211.50, p < 0.0001; Tukey’s multiple comparisons: p < 0.0001) and the mean pulse rate at post-treatment was significantly different to that at post-exercise (ANOVA: F(2, 312) = 211.50, p < 0.0001; Tukey’s multiple comparisons: p < 0.0001).
Table 1: Two-Way Analysis of Variance Testing the Effect of Caffeine on Mean Pulse Rate.
SS
DF
MS
F-value
p-value
Coffee x time interaction
70,11
2
35,05
0,09
0,91
Coffee treatment
388,3
1
388,3
1,01
0,32
Time
162219
2
81110
211,50
< 0.0001
Residual
119662
312
383,5
Adjusted Total
282339,4
317
Table 2: Tukey’s Multiple Comparisons Test for Significant Differences in the Mean Pulse Rate at Pre-Treatment, Post-Treatment, and Post-Exercise Times.
Mean Diff.
95% CI of diff.
Significant?
Adjusted p-value
Pre-treatment vs. post-treatment
-1,377
-7.712 to 4.958
No
0,8655
Pre-treatment vs. post-exercise
-48,69
-55.02 to -42.35
Yes
<0.0001
Post-treatment vs. post-exercise
-47,31
-53.65 to -40.98
Yes
<0.0001
Discussion
The insignificant increase in the pulse rate of people before and after consuming a caffeinated and a decaffeinated beverage indicates that caffeine does not have a notable effect on people’s blood flow. Both groups experienced a small change in their pulse rate, which may imply a presence of a placebo effect or a natural fluctuation of pulse rates due to anxiety related to the experiment or other unrelated reasons. This finding does not correspond with the results of other studies that noted a rather significant alteration of people’s blood flow in an idle state (Namdar et al. 2006). However, some studies’ outcomes correspond with the result of this research and confirm a lack of impact of caffeine on one’s pulse rate, blood pressure, and other processes (Graham 2001; Poehlman et al. 1985).
Another type of result is the change of the pulse rates before and after exercise. Here, the numbers in both groups increased significantly, which indicates the effect that physical activity has on people’s bodies (Duncker & Bache 2008). According to the final calculations, the insignificant difference in the mean rates shows that caffeine does not have a substantial impact on people’s pulse. This finding also supports previous studies which do not find a correlation between caffeine and altered body responses to exercising (Daniels et al. 1998; Malek et al. 2006; Van Duinen, Lorist, & Zijdewind 2005).
It should be noted that this experiment considers a single event of consuming caffeine. Moreover, it features a rather simple exercise (Cooney et al. 2013). The third limitation of the study is that it does not feature long-term outcomes of continuous caffeine use or athlete-level training. Thus, the methodology can be improved by broadening the range of participants, including prolonged studies of regular caffeine consumption, and using different exercises to confirm the results.
The results of the experiment do not confirm the original hypothesis and show that caffeine does not have a significant impact on people’s pulse rate before and after exercising. The results of the two participating groups do not have any significant differences that could indicate that caffeinated substances can disturb the body’s processes and change its response to physical activity. This study supports the existing scope of research is confirming the insignificant effect of caffeine on exercising.
Reference List
Cooney, JK, Moore, JP, Ahmad, YA, Jones, JG, Lemmey, AB, Casanova, F, Maddison, P, & Thom, JM 2013, ‘A simple step test to estimate cardio-respiratory fitness levels of rheumatoid arthritis patients in a clinical setting’, International Journal of Rheumatology, vol. 2013, no. 174541, pp. 1-8.
Daniels, JW, Molé, PA, Shaffrath, JD, & Stebbins, CL 1998, ‘Effects of caffeine on blood pressure, heart rate, and forearm blood flow during dynamic leg exercise’, Journal of Applied Physiology, vol. 85, no. 1, pp. 154-159.
Duncker, DJ & Bache, RJ 2008, ‘Regulation of coronary blood flow during exercise’, Physiological Reviews, vol. 88, no. 3, pp. 1009-1086.
Graham, TE 2001, ‘Caffeine and exercise: metabolism, endurance, and performance’, Sports Medicine, vol. 31, no. 11, pp. 785-807.
Malek, MH, Housh, TJ, Coburn, JW, Beck, TW, Schmidt, RJ, Housh, DJ, & Johnson, GO 2006, ‘Effects of eight weeks of caffeine supplementation and endurance training on aerobic fitness and body composition’, Journal of Strength and Conditioning Research, vol. 20, no. 4, pp. 751-755.
Namdar, M, Koepfli, P, Grathwohl, R, Siegrist, PT, Klainguti, M, Schepis, T, Delaloye, R, Wyss, CA, Fleischmann, SP, Gaemperli, O, & Kaufmann, PA 2006, ‘Caffeine decreases exercise-induced myocardial flow reserve’, Journal of the American College of Cardiology, vol. 47, no. 2, pp. 405-410.
Poehlman, ET, Despres, JP, Bessette, H, Fontaine, E, Tremblay, A, & Bouchard, C 1985, ‘Influence of caffeine on the resting metabolic rate of exercise-trained and inactive subjects’, Medicine and Science in Sports and Exercise, vol. 17, no. 6, pp. 689-694.
School of Life and Environmental Sciences 2018, Data collection for scientific report (BIOL1008 only), The University of Sydney, Sydney.
Van Duinen, H, Lorist, MM, & Zijdewind, I 2005, ‘The effect of caffeine on cognitive task performance and motor fatigue’, Psychopharmacology, vol. 180, no. 3, pp. 539-547.
Health care practices largely rely on effective management of patient care. There are various facets of this medical branch that are constantly modified with the upcoming needs and trends. In order to better establish relationship with patients and gain trustworthiness there is a great need of valuable services which ultimately depend on quality.
In the recent years, a novel promising tool in the health care industry known as Pay for Performance, also known as P4P has drawn the attention of many researchers.
P4P is a process of rewarding the health care providers, physicians, hospitals, and medical groups for rendering effective health care services to patients through pre-established targets. It was considered as the basic alteration of fee for service payment. This system of service is also driven by incentive programs with the objective of enhancing the quality.
However, ethical considerations also surround these services and need to be carefully evaluated before implementation.
Main body
Snyder and Neubauer (2007) described that although P4P program has the potential to develop an efficacy in care; it has to abide with the objectives of medical professionalism. This is because in certain instances there may be chances of deselecting patients such as elderly with multiple chronic conditions on the grounds that they are complicated.
This may indicate a total negligence by giving an impression that these services are just for ‘pay’ but not for the patient.
Therefore, P4P may face strong set back on these old age service ethics. These problems are not confined to a particular study. It was reported that P4P studies are still inadequate with average gains in performance and need to consider key issues such as the choice of clinical practice area, the size of financial incentives and
the details of persons receiving them, the selection of quality measures and performance thresholds that determine incentive eligibility and data collection methods (Scott, 2007).
P4P has prompted investments to be made on health information technology (health IT) such as electronic health records (EHRs) and electronic prescription (e-prescribing) systems. But it was found that several issues have been raised as they are costly, incentive usage is misaligned, and difficulty in implementation and possibility of work interruption (Cusack, 2008).The ethical issues arise when the patients’ health data is shared or linked without the knowledge of patient. Trustworthiness would be lost if the patient’s health data gets exposed through human errors or theft. This would finally diminish confidence in patients making them hide necessary information and getting therapeutically compromised.
Therefore, there is a need to better address these ethical implications of (EHR) by health personnel, leaders, and policy makers (Layman et al., 2008).
Next P4P has also served its utility in the emergency medicine at the group level or indirectly through hospital reward programs. (Sikka, 2007).But it was reported that emergency clinicians should recognize patients’ sovereignty and values, and incorporate relevant bioethical principles mostly those included in professional oaths and codes. (Iserson, 2006).
Therefore, it is reasonable to infer that while implementing P4P, clinicians should care human perceptions regarding treatment but not solely rely on value based measures.
P4P services need to depend largely on hospital staff especially nurses. Previous workers reported that comparatively less attention was given to nurses and nursing care. So, in order to understand the impact of the pay-for-performance measures on nursing labor and processes, attention should be given to nursing leadership (Bodrock & Mion, 2008).
However, there may be possibilities of ethical dilemmas that may affect P4P.Donnelly (2000)reported that cultural misunderstandings and language differences could result when the health care providers lack an awareness of the value systems of patients that differ from theirown. Since nurses are considered as valuable health care providers of P4P, they need to avoid all ethical problems likely associated with cross-cultural nursing.
P4P has developed in some countries where it was introduced for family practioners, in a contract form that increases existing income according to performance with respect to quality indicators covering clinical care for 10 chronic diseases, organization of care, and patient experience (Doran et al., 2006). But it was found out that Pay-for-performance incentives with such contracts are not dealing with disparities in the management and control of some diseases like diabetes between ethnic and socioeconomic groups (Millett et al., 2007)
Therefore there is a need of quality improvement initiatives that must incorporate greater emphasis on minority communities to avoid continued disparities in mortality from cardiovascular disease and the other major complications of diabetes (Millett et al., 2007).
It may indicate that P4P interventions might contribute to possible ethical problems if the existing disparities are not resolved. Mehrotra et al. (2007) described that P4P incentives mostly reward higher clinical quality and has better scope.
This was further strengthened by another report of developmental P4P programs that described the importance of both financial and non financial incentives in motivating significant changes in health care delivery, but the return on investment of these initiatives is not known yet (O’Kane, 2007). In contrast, it was believed previously that monetary incentives may possess features that are toxic to systemic improvement and high performance (Binderman, Kilo, & Oldham, 2000).
The main concerns were that it might erode opportunities for true improvement, breed an atmosphere of expectation, decrease innovation, injure intrinsic motivation, and damage teamwork. It was also suggested that monetary incentives should be given to a whole group or team of individuals to inspire teamwork, learning, and for obtaining greater productivity (Binderman, Kilo, & Oldham, 2000).
Here, it may indicate that P4P incentives appear promising in providing efficient health care despite serious drawbacks from the other side.It was of concern that P4P might introduce an unevenness of power that could affect the balance between patients and clinicians. This would predispose clinicians, who work for obtaining positive outcomes, to addictive behavior and might further increase the chances of ethical abuse (Taub,2007).
Keeping in view of real world P4P, several practical issues have been identified with the objective of improving and conducting pay for quality (P4Q) programs in different market environments. These are specific strategies for choosing quality metrics, units of accountability, size of incentive, data and measurement systems, payout formulas, and collaboration among payers (Young and Conard, 2007).
However, P4P may also face tough competition with disease management (DM) which is considered as a system with coordinated health care interventions and communication for populations with conditions in which patient self-care efforts are significant.
Smith (2007) described that in the current practice both DM and P4P were successful in providing efficient health care services to patients in terms of reducing costs and delivering quality. Therefore, health care providers who strongly rely on P4P may also need to adopt DM policies to ensure better managed care. This may be because growing dilemmas on P4P may enable patients choose alternative approaches like DM.
In such circumstances, physicians or other health care providers need to value patients beliefs and perceptions regarding a particular health care service by maintaining better patient relationship and without creating a possible ethical link.
Cutler et al. (2007) described from an evaluation study that a large group of 165 diabetic patients managed in a chronic disease care management (CDCM) program in a medical group operating under a small P4P financial incentive have shown higher rates of low-density lipoprotein cholesterol (LDL-C) lab testing and goal achievement than from patients managed by routine care.
This report may indicate that P4P is successful in offering its valuable services to a large size of subjects compared to conventional practices. It may have better implications if the similar strategy is extended and employed during other disease investigations.
This was further strengthened by another report that highlighted the importance of P4P while reviewing the various treatment interventions available in diabetes care. It has described that is essential for employing P4P initiatives as components like patient self-management education, provider contact, and the use of the American Diabetes Association (ADA) standards of care measures for screening and lab levels, in order to succeed in a diabetes management program (Cornell, 2007).
Therefore the major subcomponents of P4P identified here might ensure quality in rendering effective health care services to patients. This may be because education would
help in avoiding the likely misconclusions regarding a particular health care service and might enable positive dealings with health care providers, without landing in ethical dilemmas. The use of ADA standards would strengthen the confidence and fidelity in patients and enable them to stay accustomed to the current health care practices in use.
For example, it was found that diabetic patients involved with self-management education programs demonstrated reductions in glycosylated hemoglobin levels indicating that such programs would help patients manage symptoms and contain utilization of health care resources for several chronic conditions (Warsi, 2004).This was further supported by another research that described that patient (consumer) education and self-management programs and practices might help people with chronic disease live better by improving health outcomes and psycho-emotional and psychosocial measures (Koehn & Esdaile , 2008).Since provider contact has also been regarded as a component of P4P, it is reasonable to introduce communication.
It was described that there is need of researching patient-doctor communication and identifying the essential teaching strategies for measuring the clinical skill.Hence, developmemts in the provider-patient communication can have beneficial effects on health outcomes (Teutsch, 2003).
Communication would narrow the gap between the health care policy providers and patients thereby bringing the effective quality services to the patient door step.In order to deliver quality health care through P4P, there is a need to educate the patient such that it would influence the collection of vital information enabling him to act as an informed participant in his or her care. The patient should understand all sorts of educational interventions and sensitive issues like culture and on the whole he should receive information that would facilitate his successful participation in treatment (Musto, 2003).
Therefore, these reports may obviously indicate that P4P interventions are in constant need of components which should be improved by all means. This is only possible by carefully reviewing the available data and bringing modifications if required. Hence, health care providers must realize the importance of these components and strive for their validation through implementation.
Further, as P4P interventions still require large studies for their quality delivery, there may a need to shed some light on subject selection. Patients may be generally selected by conducting surveys and retrieving the information from the National databases.
In an earlier study, to evaluate the relationship between maternal Selective serotonin-reuptake inhibitors (SSRI) use in early pregnancy and the occurrence of selected birth defects, researchers have used data from the National Birth Defects Prevention Study (NBDPS). Telephonic interviews were conducted to select the patients based on risk eligibility criteria set by clinical professionals (Sura Alwan et al., 2007).
In a random study on Pay-for-performance programs, researchers have extracted data from computing systems for 8105 family practices, data from the U.K. Census, and data on characteristics of individual family practices. They have employed clinical quality indicators to make them eligible for the study (Doran, 2007).It is reasonable to assume that the policies of P4P hold good for all kinds of clinical based settings and investigations due to its close attachment with patient care. Therefore, it can be inferred that the data collection process mentioned previously is in agreement with the guidelines set by American Medical Association (AMA) regarding pay – for- performance programs.
According to AMA guidelines, the intervention programs should use accurate administrative data and data abstracted from medical records. It is essential that the information obtained from the data would be reviewed and analysed physicians before using any rating system to determine physician payment or for public rating, which is also as per the AMA guidelines.
Therefore it may indicate that selection of subjects for intervention programs like P4P must get aligned with the stringent data collection process and analysis set by an authorized body.
Finally, it is essential to compare the P4P programs with non health industries which in the present case in Marketing.
In the recent years, internet advertising has contributed lot to the online marketing. It was reported that a wide range of online advertising companies are diverting their attention towards pay for performance marketing from their earlier method of disappointing cost-per-click module.
Here, the methodology involved was that advertisers would begin pay only for the clicks that led to consumer activity such as requesting more information, becoming a registered member of the site, and finalizing a purchase. In contrast, P4P programs in health care depend on quality that is possible only through the effective service deliveries to the patients and outcomes.
P4P in marketing initially requires some prior investment where as that in health care might generally require a later investment in the form of fees.P4P programs in health care in health care have to abide with the rules and regulations of professional organizations.
Where as those in marketing need not to depend so. The quality of Health care P4P’s mostly depends on physician –patient relationship where as that in marketing depends on investor – advertiser relationship. Ethical dilemmas that frequently interfere with the health care P4P’s and are inevitable and need to be carefully addressed. Whereas the chances of ethical interference in marketing although appear hidden may interfere possibly and could not be tackled easily as they escape the regulations across national boundaries.
This is because the efficacy or the pitfalls of health care P4P’s may be easily checked by an expert committee where as marketing PFP’s evade this process by seeking the aid of web technologies thus increasing the ethical complexity.
Trustworthiness would be generated from the patients in cases of effective health care P4P management. In contrast, despite increasing efforts efficient marketing P4P, trustworthiness would be lost because of increasing online advertising frauds and E-business email scams. Health care P4P ethics are more confined to patients where as marketing P4P ethics are unconfined and unbound.
In view of the above information, it is apparent that the P4P programs are not naïve and have been modified over the years with the changing opinions of people and providers.
It gives an impression that it is more attached to medical professionalism than other established fields. Various authors have contributed to bring the P4P to the forefront of common people and medical society.
Conclusion
Since the commencement of P4P a lot of ethical dilemmas and human errors have squeezed the essence of this emerging health care service tool. Financial and monetary incentives have been recognized as the promising channels to promote the growth of P4P. But concerns arise on ethical grounds fearing that it might fail to value human beliefs.
Information technology has shaped P4P through electronic health records (EHRs) and electronic prescription (e-prescribing) systems. But ethical concerns again interfere and indicate that the sensitive and valuable information of patient might get open access if due to technical snags or human errors. However, in depth studies have identified major components of P4P such as patient management education system and communication that may have better implications for revolutionizing the P4P practice. In addition, the guidelines set by AMA appear to protect the privacy of P4P making it an indispensable tool in health care administration. On the whole, both health and non health P4P policies need to be thoroughly regulated to safeguard and respect the ethical considerations.
References
Snyder, L and Neubauer, R.L. (2007). Pay-for-performance principles that promote patient-centered care: an ethics manifesto. Ann Intern Med 147,792-4.
Scott, I.A. (2007). Pay for performance in health care: strategic issues for Australian experiments. Med J Aust, 187, 31-5.
Layman, E.J. (2008). Ethical issues and the electronic health record. Health Care Manag (Frederick), 27, 165-76.
Sikka, R. (2006). Pay for performance in emergency medicine. Ann Emerg Med. 49,756-61.
Iserson, K.V.(2006). Ethical principles–emergency medicine. Emerg Med Clin North 4,513-45.
Pay for performance in hospitals: implications for nurses and nursing care. Bodrock, J.A and Mion, L.C. (2008). Pay for performance in hospitals: implications for nurses and nursing care. Qual Manag Health Care, 17,102-11.
Doran, T., Fullwood, C., Gravelle, H, Reeves, D., Kontopantelis, E., Hiroeh, U., Roland, M. (2006). Pay-for-performance programs in family practices in the United Kingdom. N Engl J Med, 355, 375-84.
Millett, C., Gray, J., Saxena, S., Netuveli, G., Khunti, K., Majeed, A. (2007). Ethnic disparities in diabetes management and pay-for-performance in the UK: the Wandsworth Prospective Diabetes Study. PLoS Med, 4, e216.
O’Kane, M.E.(2007). Performance-based measures: the early results are in. J Manag Care Pharm, 13(2 Suppl B), S3-6.
Taub, S.J. (2007). Pay for performance: is it ethical? Compr Ophthalmol Update. 8,277-83.
Young, G.J and Conrad, D.A (2007). Practical issues in the design and implementation of pay-for-quality programs. J Healthc Manag, 52, 10-8.
Smith, A.L (2007). Merging P4P and disease management: how do you know which one is working? J Manag Care Pharm, 13(2 Suppl B), S7-10.
Binderman, J., Kilo, C.M., Oldham, J. (2000). Rethinking incentives. J Med Pract Manage, 16, 70-4.
Cornell, S.A (2007). Clinical case study: achieving long-term control of insulin resistance. J Manag Care Pharm, 13(2 Suppl B), S11-5.
Warsi, A., Wang, P.S., LaValley, M.P., Avorn, J., Solomon, D.H. (2004). Self-management education programs in chronic disease: a systematic review and methodological critique of the literature. Arch Intern Med, 164, 1641-9.
Teutsch, C. (2003). Patient-doctor communication. Med Clin North Am, 87, 1115-45.
Musto, P.K. (2003). General Principles of management: education. Nurs Clin North Am, 38, 621-33
Sura Alwan, Jennita Reefhuis, Sonja A. Rasmussen,Richard S. Olney, Jan M. Friedman. (2006).Use of Selective Serotonin-Reuptake Inhibitors in Pregnancy and the Risk of Birth Defects. N Engl J Med, 356, 2684-92.
Pay-for-Performance Marketing.(n.d). Web.
Internet marketing ethics issues. (n.d). Web.
Guidelines for Pay-for-Performance Programs. (n.d). Web.
Assessing the performance of medical institutions is critical to improving the quality of care provided to patients. Detailed assessment ensures that medical institutions understand their strengths and weaknesses and can take action required for enhancing the quality of service. The Joint Commission’s Annual Report is a document presenting the results of the regular quality assessment of American hospitals. This document is essential for gaining insight into how hospital performance is evaluated and compared. The present paper will outline some of the performance indicators used by the Joint Commission and describe the steps for gathering meaningful data on Aspirin on Arrival. Also, the essay will review the importance of comparing performance and explain the critical challenges of comparing data in the UAE.
Process Indicators
Process indicators are designed to determine the extent to which the facility adheres to evidence-based guidelines for promoting and maintaining patient health. According to the AHRQ (2015), “Process measures indicate what a provider does to maintain or improve health, either for healthy people or for those diagnosed with a health care condition” (para. 3). Process indicators can thus differ across diseases and units. For instance, PCI therapy within 90 minutes is among the main process indicators used for heart attack care measure (The Joint Commission 2014). This process indicator is based on clinical guidelines, as the use of PCI therapy for the treatment of heart attack is recommended to improve blood flow to the heart and prevent lasting damage.
Another process indicator is antibiotics to ICU patients. This process indicator is applied in pneumonia care evaluation and is based on guidelines for managing pneumonia, which recommend the use of antibiotics. In surgical care, the use of antibiotics is also important in measuring processes. For instance, antibiotics within one hour before the first surgical cut is a vital process indicator applied to all types of surgeries (The Joint Commission 2014). The use of antibiotics is critical to preventing surgical site infections and is thus included in performance measures. Process indicators can also involve the use of other medications recommended for specific conditions. For instance, the Joint Commission (2014) includes systemic corticosteroids for inpatient asthma as one of the critical process indicators in children’s asthma care assessment. Lastly, influenza immunization is an important process measure that affects the overall quality of care in medical facilities.
Outcome Indicators
Outcome indicators are used to measure the results of care provided by the facility. According to the AHRQ (2015), “Outcome measures reflect the impact of the health care service or intervention on the health status of patients” (para. 5). The Joint Commission (2014) uses fewer outcome indicators than process indicators, as the former are often difficult to measure and may not reflect the quality of care correctly due to the influence of other factors. The incidence of potentially preventable VTE and newborn bloodstream infections are among the outcome indicators applied in the report. Physical restraint and seclusion are also included as outcome measures for inpatient psychiatric services, as these indicators can be influenced by effective therapy. Lastly, exclusive breast milk feeding is an outcome indicator, as it reflects the influence of patient education and health care provided in the facility on mothers’ choice of feeding options.
Aspirin on Arrival
To collect meaningful data on Aspirin on Arrival, it is critical to follow the appropriate data collection procedure. The manual of the Joint Commission (2010) details the process of data collection for this process indicator. First of all, it would be critical to establish the scope of data required. According to the Joint Commission (2010), the data should include admission date, arrival date, birthdate, clinical trial, comfort measures, contraindications to Aspirin on Arrival, discharge date, discharge status, ICD diagnosis code, the point of origin for admission or visit, and transfer from another ED.
Secondly, it is essential to exclude patients who do not meet the criteria established in the manual. These include age (under 18), length of stay (over 120 days), enrollment in clinical trials, contraindications to aspirin, and more (The Joint Commission 2010). After the data is limited to patients who meet the criteria for inclusion, their medical records should be reviewed for Aspirin on Arrival. The results should be presented as the percentage of patients with acute myocardial infarction who received aspirin within the first 24 hours before or after arriving at the facility.
Performance Comparison in the UAE
Performance comparison is an essential practice that benefits businesses operating in a variety of sectors, including healthcare. First of all, performance comparison encourages facilities to collect data on performance measures, thus contributing to internal quality control processes. The information gathered as part of the performance comparison process can also outline areas that require improvement. For example, if the hospital’s rate of Aspirin on Arrival is significantly smaller than in other facilities, the management can take action to address the problem.
Another significant benefit of performance comparison is that it allows establishing benchmarks for specific quality indicators. As shown by Paddock (2014), benchmarking is a powerful tool in improving performance outcomes, as it sets a clear goal. Moreover, facilities achieving the highest results in specific performance indicators could share practices and recommendations for improving performance in the chosen area. Performance comparison is also beneficial for patients. Comparing data across hospitals allows patients to make informed choices about care providers, while also enhancing the competition in the healthcare sector, thus leading to improved quality of care.
Applying a performance comparison in the UAE could play an essential role in improving care quality. Moreover, it would assist the government in its efforts to improve healthcare in the state, thus contributing to the recent healthcare reforms (Koornneef, Robben & Blair 2017). However, there are two main challenges to implementation. First of all, the healthcare system in the UAE is somewhat fragmented, consisting of public and private hospitals, as well as internationally- and locally-owned facilities (Mahate & Hamidi 2016). This could cause difficulties, as the introduction of a performance comparison system would require universal legislation covering all types of facilities. Also, the share of patients treated in different types of facilities varies a lot: “public hospitals represent about a third of the total number of facilities but treat about 60% of the total number of patients” (Mahate & Hamidi 2016, p. 7). Thus, the performance of different types of hospitals could be associated with their workload, which could be a barrier to adequate data comparison.
Secondly, there is a lack of scientific research on hospital performance assessment and data comparison in the UAE (Koornneef, Robben & Blair 2017). This could pose obstacles to implementation, as the facilities will have little guidance on collecting and reporting data. Furthermore, care providers might resist the change due to the lack of evidence-based rationale for performance comparison in the UAE. Thus, extensive research on the subject is required before any efforts to initiate performance comparison are undertaken.
Conclusion
Overall, performance comparison of hospitals is a highly beneficial practice. It allows facilities to improve the quality of service provided and encourages healthy competition in the sector. The Joint Commission (2014) uses critical performance indicators to compare processes and outcomes in different facilities. The UAE would benefit from a similar system of performance comparison. However, it would be essential to overcome barriers to implementation, including the fragmentation of the healthcare sector and the lack of adequate research on the subject.
The Joint Commission 2014, America’s hospitals: improving quality and safety, Web.
Koornneef, E, Robben, P & Blair, I 2017, ‘Progress and outcomes of health systems reform in the United Arab Emirates: a systematic review’, BMC Health Services Research, vol. 17, no. 1, pp. 672-684.
Mahate, A & Hamidi, S 2015, ‘Frontier efficiency of hospitals in United Arab Emirates: an application of data envelopment analysis’, Journal of Hospital Administration, vol. 5, no. 1, pp. 7-17.
Paddock, SM 2014, ‘Statistical benchmarks for health care provider performance assessment: a comparison of standard approaches to a hierarchical Bayesian histogram‐based method’, Health Services Research, vol. 49, no. 3, pp. 1056-1073.
Discuss the implications of evidence-based practice for nursing leaders and managers
The unacceptable gap between what medical practitioners knew and what they did gave rise to the EBP movement in the 1960s. The campaign outlined two strategies for nursing leaders and managers. First, EBP should not be local or sporadic; instead, medical practitioners should mediate with health providers and policymakers to include EBP into their quality control guidelines (Stevens, 2013).
Moreover, nursing leaders and managers should organize their way of thinking which may be attained through adopting clinical inquiry. At that, one of the most effective methods is a narrative inquiry in which the application of new knowledge is discussed on a case-to-case basis or through stories (Wang & Geale 2015). All in all, it is not only essential for the nursing field to produce new knowledge but to also transform it into forms and procedures.
What is the Code of Ethics for Nurses and why is it important? Discuss your answer considering the Code of Ethics for Nurse’s tenets and principles?
Medical practitioners do not only manipulate the physical body, but they also interact with patients’ personalities which makes it crucial to respect patients’ integrity and dignity as human beings. Nurses are confronted with ethical challenges, and since it may be strenuous for an individual to provide moral judgment, the Code of Ethics was created to guide nurses in the decision-making process (Zahedi et al., 2013). The Code of Ethics includes nine provisions with interpretative elements (American Nurses Association, 2015).
It outlines a clear statement of nurses’ mission, duties, and obligations serve as a standard for ethical practices, and describes nurses’ contributions to society. The contents overlap with the basic medical principles among which are beneficence, non-maleficence, and patient autonomy. The Code also emphasizes the versatility of the nursing profession since it may also encompass education, research, and management.
Analyze the obstacles to improving the performance –appraisal process?
A good performance-appraisal process is a link between what the administration or managers want and the ways an employee can be motivated. When implemented adequately, medical practitioners are likely to adjust their practice to fit the imposed expectations and be overall satisfied with their performance (El-Fattah Mohamed Aly & El-Shanawany, 2016). However, there are numerous obstacles to enhancing the performance-appraisal process related to structure, process, and results (Nikpeyma, Saeedi, Azargashb, & Alavi-Majd, 2014).
As for the structure, nurses complained about the inefficient introduction of new laws and policies. It was reported that in the process, managers were not careful with evaluating and at times were unfair. Another critical issue was the lack of continuous evaluation throughout the year. Lastly, the study revealed that one of the common obstacles was inappropriate feedback that was not clear and did not give nurses any adequate advice on how they could improve.
Describe and discuss the key issues and processes related to policy and procedure development?
Ideally, new policies and procedures should facilitate adherence to internationally recognized medical practices, eliminate variation, and serve as a valuable resource for staff, especially new personnel.
Key issues
One of the problems that may arise is when two policy-making bodies introduce new laws that contradict each other to some extent. In this case, “two levels of care” emerge, and patients with similar or comparable needs may undergo different procedures (Irving, 2014). Another issue is medical facilities’ failure to implement policies and train their staff accordingly due to negligence or new policies’ inconsistency with their standard practice (Irving, 2014).
Recommendations
To avoid problems, policymakers and stakeholders should carefully govern the process of development and implementation. The steps include but are not limited to identifying the need, gathering data, and deciding who takes responsibility for enactment. After a draft is created and stakeholders contributed to the discussion, the policy may be finalized and implemented. It is necessary to monitor the efficiency of implementation and request reports when needed.
References
American Nurses Association. (2015). Code of ethics with interpretive statements. Web.
El-Fattah Mohamed Aly, N. A. , & El-Shanawany, S. M. (2016). The influence of performance appraisal satisfaction on nurses’ motivation and their work outcomes in critical care and toxicology units. European Scientific Journal, 12(20), 119-135.
Nikpeyma, N., Saeedi, Z. A., Azargashb, E., & Alavi-Majd, H. (2014). Problems of clinical nurse performance appraisal system: A qualitative study. Asian Nursing Research, 8(1), 15-22.
Stevens, K. (2013) The impact of evidence-based practice in nursing and the next big ideas. The Online Journal of Issues in Nursing, 18(2).
Wang, C. C., & Geale, S. K. (2015). The power of story: Narrative inquiry as a methodology in nursing research. International Journal of Nursing Sciences, 2(2), 195-198.
Zahedi, F., Sanjari, M., Aala, M., Peymani, M., Aramesh, K., Parsapour, A., Maddah, S. B., Cheraghi, M., Mirzabeigi, G., Larijani, B., … Dastgerdi, M. V. (2013). The code of ethics for nurses. Iranian Journal of Public Health, 42(Suppl.1), 1-8.
Sport is one of the fastest-growing industries in the world today. The industry entails activities aimed at maintaining physical fitness among individuals. In the United States of America, the industry has, over the years, grown rapidly. It has seen billions of dollars as investment from companies involved to provide services in the sector (Sawyer, 2009). Clubs and recreational facilities have been set up to meet the rising demand to keep fit, with more emphasis on physical education in learning institutions. Mark Twain University plans to construct a modern human performance and health center. The architectural design needs to put into consideration the space required in the facility. However, space is a constraining factor. Only the most important items are to be allocated space in the design.
The Need to Allocate Space for Both Equipment and Supplies
Human performance and health centers must be planned and constructed in line with the current trends in the industry. As such, plans for such facilities should be in line with laid down guidelines, principles, and practices governing sports. Individuals pursuing courses in physical education must be well trained to provide them with the skills required to promote fitness and health in the industry (Sawyer, 2009). A well-equipped laboratory is one of the most important facilities to be included in the construction of a health and human performance center. The relevant supplies must be present to ensure the smooth running of the recreational facilities.
The architectural design of a facility must put into consideration the nature of activities going to be undertaken therein. As such, the necessary modifications must be made to accommodate the intended use. Ample space must be allocated to these uses. When planning, it is important to allocate space for both equipment and supplies. Equipment refers to tangible property purchased by an organization and is usually of high cost. Such property is also considerably durable and is used for more than one year. As a result, regular purchases of equipment are not required (Nagel & Southall, 2011). Regular and frequent maintenance practices are, however, required to ensure that the equipment is functioning effectively and efficiently. In most cases, equipment includes electrical appliances, which are bulky and occupy a lot of space.
Supplies refer to tangible items used together with equipment (Sawyer, 2009). Supplies are, however, of lower cost and shorter life span compared to equipment. Supplies do not require a lot of time and effort to install and may be put into use immediately after purchase. In addition, they are small in size compared to equipment.
Because of these differences, it is important to allocate different spaces for equipment and supplies. Equipment is usually installed at specific locations in buildings and facilities and does not require to be moved regularly. On the other hand, supplies are needed to operate equipment and are only used when necessary (Nagel & Southall, 2011). Separate space should be allocated to supplies to avoid congesting the space set aside for equipment. Allocating separate spaces is also important for safety purposes.
Different types of equipment and supplies are required in a human performance and health center (Sawyer, 2009). Equipment includes field markers, first aid kits, lawnmowers, chalk and whiteboards, clipboards, computers, and showerheads. Supplies include ink for field markers and pens, lubricants, fuel, paper, computer programs, and drugs. Such substances as oil and ink may cause accidents when carelessly left in the facilities.
Conclusion
The need to keep healthy and fit has prompted individuals, organizations, and governments to set up facilities with the aim of providing much-needed services. Learning institutions must adequately train individuals taking courses related to this field to ensure they provide safe and effective services to end-users (Nagel & Southall, 2011). Universities and other learning institutions must put in place the necessary structures to provide individuals pursuing related careers with the necessary skills.
References
Nagel, M., & Southall, R. (2011). Introduction to sport management: Theory and practice. Dubuque, USA: Kendall Hunt Publishing Company
Sawyer, T. (2009). Facilities planning for health, fitness, physical activity, recreation and sports. New York, USA: Sagamore Publishing.
The behavior and performance of an individual are affected to a large extent by the individual’s interaction with the environment. An individual’s performance can only be understood through a particular context in which he or she operates. The context here means the social, cultural, and physical features that function externally to an individual. This means that interaction between an individual and context determines the tasks that fall within his or her performance range. Disability in function is usually seen as an interaction between contextual factors and health conditions. Ecology of Human Performance provides a framework in which the relationship between important factors in the practice of occupational therapy, these are “context, person, tasks, and performance” (Dunn et.al., 1994 p. 1), and the therapeutic interventions are investigated.
Case Study
In this case study, Mrs. Fuller suffers from low bone mass and a loss in the tissues of the bones, a condition known as osteoporosis that causes weak bones. We are told that Mrs. Fuller operates between their apartment in the city and the country home that is 3 hours drive from the city. She is a retired librarian who now accompanies her husband on business trips. She manages both homes, and she is also a volunteer at a local hospital where she delivers meals. She is a board member of a local women’s shelter. She is a sportswoman who likes playing golf and skiing, and also plays the piano. All these define the context in which Mrs. Fuller operates. She interacts with the environment through all the above. It is known that individuals see their potential tasks through the context. Mrs. Fuller does not just see herself as a skier but as a downhill skier.
We can also use occupational therapy to define an individual’s role in life. In this case, Mrs. Fuller is a mother and a wife. These roles are accompanied by various demands. For instance, as a mother and wife, Mrs. Fuller has to attend to household chores, and of late she is complaining of back pain after these chores. She can no longer downhill ski, play golf, and can not play the piano for long hours as she used to. Osteoporosis has placed her in a context that does not support the performance of her abilities. This has made her see the activities that were once important in her life as insignificant.
Using EHP, occupational therapists can come up with a variety of interventions to help Mrs. Fuller live her normal life. Many interventions work depending on an individual’s context. The first intervention that Mrs. Fuller needs is, to restore her skills and abilities. It is known that Mrs. Fuller has osteoporosis; therefore, she needs to take a lot of calcium to restore the strength of her bones. Mrs. Fuller will also need to work on physical endurance or coping skills to be able to perform the tasks she previously performed comfortably.
The second intervention is to adapt to the current context. In this case, the therapist needs to find an environmental control unit. For instance, a suitable chair that supports Mrs. Fuller’s postural support needs can be made to be used when playing her piano. Another intervention that may be used on Mrs. Fuller is the prevent strategy. A therapist may advise Mrs. Fuller to avoid those activities that might cause injury to her back. In this case, she may be forced to find a helper in her daily chores. EHP and OT can, therefore, be used to assist therapists to find ways of helping persons in need like Mrs. Fuller live fulfilling lives.
This study is by Oyekunle Akinloye and Raji Yinusa, who are both from the University of Ibadan in Nigeria. It deals with the use of complementary and alternative medication as a solution for improving sexual performance in men as compared to the use of conventional medicine. The research is quantitative in nature. This is because the research findings have been represented in form of numbers and statistics with precise measurement and analysis of the data collected. This is unlike qualitative analysis, which generalizes and mostly presents its data in words with few statistics.
The tool used to collect data for this study was questionnaires both open and close- ended ones. The kind of questions asked aimed at getting answers related to the type of sexual dysfunctions experienced by the respondents, the medication chosen and the reasons for choosing them, sources of those remedies and their efficiency and side effects. Academic papers, books and other researches relating to the use of complementary and alternative remedies to cure different ailments was the source of supplementary information.
The research was conducted in Ogbomoso city in Nigeria. The city was chosen because of its strong cultural attachment to their environment and the strong belief of its inhabitants in traditional medication to cure their ailments. The sample of the study included 530 male respondents who were sexually active and vocally compliant. Their mean age was 32 years.
From the data collected, the researchers found out that 79.24 % of those interviewed used complementary and alternative medication, 7.18% used modern remedies while 13.58 % used neither traditional nor modern medicines to enhance their sexual performance. From the above figures, it is therefore evident that most men from Ogbomoso use CAM. This is attributable to its accessibility, and the fact that it is useable irrespective of one’s economic status, unlike orthodox medicines, which are quite expensive.
References
Amanda, J. W. (2010). Childhood Obesity: The New Epidemic. New York: Unpublished Research Paper.
Oyekunle, O.A., & Raji, Y. (2011).Assessment Of Complementary and Alternative Medicine (CAM) Usage to Enhance Male Sexual Performance in Ogbomos Metropolis. Journal of Public Health and Epidemiology, 3, 271-274.