Abstract:There is a lack of interpretive research in the domestic violence literature and, in particular, within an ethnocultural context. Interviews were held with four Filipina women in Calgary, Alberta who had previously been in violent relationships, in combination with a referral group of key informants with leadership and knowledge of community issues related to domestic violence. By adopting a phenomenological approach to the research, it was hoped that new understandings of what is identified in clinical paradigms as the "risk" and "protective" factors associated with domestic violence would be unearthed. This research study is at once exploratory and informative and is intended to contribute to the development of a province-wide plan to address and prevent domestic violence through the Brenda Strafford Chair in the Prevention of Domestic Violence at the Faculty of Social Work, University of Calgary.Keywords: domestic violence prevention, ethnocultural communities, Filipino, phenomenological approach and domestic violence Acknowledgements: We gratefully acknowledge our research participants, women and men from the Filipino Community in Calgary, who bravely stepped forward to share their stories and insights with us. Without you, this research would not be possible. This project was made possible through funding from the Centre for Criminology and Justice Research (CCJR), which contributes independently produced, evidence-based research in the study of criminal and social justice issues and the promotion of safe communities.
Context: COVID-19 has disrupted routine care for many patients. During the height of the pandemic, when primary care clinics were shuttered or only seeing urgent cases, patients postponed seeking routine care and few options for community-based care existed. As a workaround, virtual consultations-remote access using any form of communication or technology-were adopted. This was not without limitations, especially for older adults.
Background: During the height of the pandemic, primary care clinics were shuttered or only seeing urgent cases. Virtual consultations were adopted to ensure patients had their health concerns met. This study sought to explore the primary care experiences of older adult patients during the COVID-19 pandemic, specifically the impact of COVID-19 on the ability of older patients’ ability to have their non-COVID-19 health needs addressed, and older patients’ specific experiences with virtual care. Methods: Qualitative interviews were conducted over Zoom or telephone and followed an investigator-designed semi-structured interview guide. Interviews were recorded and transcribed verbatim. Thematic analysis was used to make sense of and interpret the data. Results: Twenty-nine participants (average age 68 years) participated in the study. Participants indicated that they were able to have their health needs addressed despite COVID-19 impacted how primary care was delivered. Impacts included physicians being more rushed, not taking time with new medical concerns in some cases and creating a sense of fear and doom with the strict protocols in place to mitigate the spread of COVID-19. Virtual care was generally well-received by participants, with some exceptions. Advanced age and difficulties with hearing were two of the main reasons for poor experiences with virtual care. Conclusions: Overall, patients in this Study were able to have their health needs addressed. Tailoring virtual care to either phone or videoconferencing for those who have cognitive or sensory impairments, language barriers, or poor connections (and who many need to see non-verbal cues or read lips) is important.
Context: As with elsewhere in the world, the majority of COVID-19 patients in Canada's first waves of the pandemic did not require acute care. The Calgary health zone, in the Canadian province of Alberta, sought ways to effectively manage these patients in community-based primary care. The COVID-19 Integrated Pathway (CIP) is an intervention developed in the Calgary health zone to facilitate the flow of data about, and provision of primary care to, these patients. The CIP -which remained in use during the 2021 third wave -is comprised of two inter-related components: 1) a data pathway that disseminates patient COVID-19 lab test results from the province's public health system to local primary care organizations; and 2) a clinical pathway or algorithm that offers guidance for patient care. Objective: To facilitate improved implementation and potential scaling of the CIP, this study sought to understand the contextual factors that shaped the creation, and use, of the CIP's data and clinical pathways. Study Design: Inductive, open-focused interviews with key informants elicited the contextual factors shaping the creation, uptake, use, and effectiveness of the CIP. . Setting or Dataset: Key informants (n=57) from Calgary health zone public health, and primary care facilities, as well as patients who had transited the CIP (n=5).Population studied: Leaders, administrators, clinicians, and patients who were familiar with the CIP from: Alberta Health Services' (AHS) Public Health and Primary Care facilities, as well as non-AHS Primary Care Networks (PCN).. Outcome Measures: Contextual factors shaped the creation and implementation of the CIP Results: A range of contextual pre-conditions facilitated the rapid development of the CIP's components in the Calgary health zone, as well as their uptake and evolution. These included: a history of collaboration and coordination across the Calgary health zone; existing organizational structures between AHS and Calgary's 7 PCNs; champions within multiple systems of the health sector; and existing expertise and leadership in developing and using clinical algorithms for the provision of primary care. Conclusions: The CIP's data and clinical pathways helped deliver clear, consistent, and timely care to COVID-19 patients in the Calgary health zone. While there may be some challenges to scaling the intervention, sustaining the CIP will create a more robust pandemic response in the future.
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