Faustine Williams

The role of electronic medical record in care delivery in developing countries

Objectives Electronic medical record (EMR) is not only being welcomed by healthcare providers as a way to improve care delivery but also serves as a catalyst for development. The purpose of this study is to examine benefits of EMR and its ultimate contribution to development of healthcare delivery. Design This is a qualitative, explorative, and descriptive study using survey questionnaires and a sample size of 50 at the Korle-Bu Teaching Hospital in Accra, Ghana. Results Results from the research indicate the importance of an EMR system in developing countries to facilitate effective and efficient data collection, data entry, information retrieval and report generation, and research. However, developed nations are not doing enough to help developing countries implement modern technology necessary to facilitate care delivery. Conclusions To achieve the Millennium Development Goal (MDG) number 8 by 2015, developed nations must assist poor countries to develop their human capital, funds and work with the local community to design and implement system friendly with their environment to transform and improve care delivery development.

Computerized Prompting and Feedback of Diabetes Care: A Review of the Literature

Background: The objective of this study was to assess published literature on computerized prompting and feedback of diabetes care as well as to identify opportunities to strengthen diabetes care processes. Methods: Medline (1970–2008), Cumulative Index to Nursing and Allied Health Literature (1982–2008), and Cochrane Central Register of Controlled Trials (4th quarter 2008) were searched, and reference lists from included articles were reviewed to identify additional studies. Patient sample, clinician sample, setting, duration of the trial, intervention description, control description, and results were abstracted from each study. Results: Fifteen trials were included in this review. The following elements were observed in the interventions: general prompt for a particular patient to be seen for diabetes-related follow-up (5 studies), specific prompt reminding clinicians of particular tests or procedures related to diabetes (13 studies), feedback to clinicians in addition to prompting (5 studies), and patient reminders in addition to clinician prompts (5 studies). Twelve of the 15 studies (80%) measured a significant process or outcome from the intervention. Conclusions: The majority of trials identified at least one process or outcome that was significantly better in the intervention group than in the control group; however, the success of the information interventions varied greatly. Providing and receiving appropriate care is the first step toward better outcomes in chronic disease management.

Lived experiences of breast cancer survivors after diagnosis, treatment and beyond: qualitative study

The number of breast cancer survivors has increased since 1990 due to advances in biomedical technology that lead to an increase in early diagnosis and treatment. Research on survivorship has focused on the psychological and treatment aspects of the disease. The goal of this study was focused on exploring the lived experiences of breast cancer survivors from diagnosis, treatment and beyond.

Geographical Location and Stage of Breast Cancer Diagnosis: A Systematic Review of the Literature

Abstract:Objective: To examine systematically the literature on the effect of geographical location variation on breast cancer stage at diagnosis, race/ethnicity, and socioeconomic status. Methods. Eight electronic databases were searched using combination of key words. Of the 312 articles retrieved from the search, 36 studies from 12 countries were considered eligible for inclusion. Results. This review identified 17 (47%) of 36 studies in which breast cancer patients residing in geographically remote/rural areas had more late-stage diagnosis than urban women. Ten (28%) studies reported higher proportions of women diagnosed with breast cancer resided in urban than rural counties. Nine (25%) studies reported no statistically significant association between place of residence and stage at diagnosis for breast cancer patients residing in rural and urban areas. Conclusions. Cancer patients residing in rural and disadvantaged areas were more likely to be diagnosed with distant breast metastasis. Efforts to reduce these inequalities and subsequent mortality are needed.

Understanding Global Cancer Disparities: The Role of Social Determinants from System Dynamics Perspective

Background: In 2012, almost 57% of all cancer cases and 65% of cancer deaths occurred in low-and middle-income countries. If the current trend continues, the burden of cancer will increase to 22 million new cases annually by 2030, with 81% of new cases and almost 88% of mortality occurring in less developed countries. Methods: A qualitative review of the literature was conducted. This included a systematic search of eight electronic databases namely, PubMed, Academic Search Premier, CINAHL, Applied Social Sciences Index, EMBASE, SCOPUS, Cochrane and PsycINFO. The reference list of articles retrieved were also thoroughly searched. Inclusion criteria were studies that addressed global health, cancer disparities and global or economic development. Results: Thirty-one articles were identified that met the eligibility criteria. Results were synthesized in the form of a system dynamics causal loop diagram or map which led to identification of eight major stocks or system variables. These included, children and adult population, overall population health, pollution, quality of healthcare delivery, quality of neighborhood and built environment, social and community cohesiveness, healthy and social norms and attitudes, and literacy level. Based on this, a dynamic hypothesis of global health cancer disparities was developed. The causal loop diagram showed the role of multiple interacting feedback mechanisms as explanations for trends in global health cancer disparities and the underlying consequences. Conclusions: Addressing these determinants of health requires an effective dynamic approach to improving global cancer health. Application of a systems thinking methodological approach has the potential to provide new understanding to how global development trends in combination with global health efforts to improve population health could shift cancer disparities and burden associated with the disease.

Understanding Breast Cancer Patients' Journey from Diagnosis through Survivorship

Purpose – The purpose of this paper was to understand the lived experiences of women who have been diagnosed, treated and are cancer free as survivors. Design/methodology/approach – Using purposive sampling approach, participants were recruited from two Missouri cancer centers. A total of 15 breast cancer free women (ten white and five black) were interviewed. The participants ranged in age from 34 to 62 years, and all had at least a bachelor degree. Findings – Eight unique themes were identified from the interviews. The women noted that maintaining positive attitude, and support from family and friends were the greatest resources that helped them through their cancer journey. They were generally positive about their experiences but uncertain what “survivor” meant individually and personally. Research limitations/implications – All the women in this study had at least a college degree, stable family economic resources and health insurance. Originality/value – The women interviewed in this study did not wa...