Currently, the organization of Canadian and American pediatric hospitals includes dedicated areas to match patient acuity and additional personnel to stabilize and facilitate transfer. The functioning of these systems of care results in calls for immediate medical assistance for ward patients approximately 5000 times annually.
The present study describes video recording practices in paediatric hospitals in North America and Great Britain. Video recording is primarily used for education and most areas have a consent process.
BackgroundThe prevalence of self-identified chronic pain in Canadian adults is approximately one in five people. Marginalization and addictions have been shown to complicate chronic pain in vulnerable populations. This study aimed to understand the experience of chronic pain among female Survival Sex Workers in Vancouver's downtown eastside (DTES).MethodsThis study used an exploratory qualitative analysis with in-depth, semi-structured interviews. Members of PACE Society who self-identified as a current or former Survival Sex Worker and who had a chronic pain experience known to PACE support workers were invited to participate. Interviews were conducted, audio recorded and transcribed. The investigators met to read the transcripts and discuss emerging themes. The process continued until no new themes were observed.ResultsParticipants ranged in age from 42 to 56 years old and all self- identified as females and Survival Sex Workers. Eleven of thirteen interviews were analyzed for themes. Drug use for pain management, both prescribed and illicit, was the most important theme. Poverty, the need to continue working and the lack of stable housing were barriers to adequately addressing the source of chronic pain. Participants felt judged for living in the downtown eastside, being a drug user and/or being Aboriginal and only two participants had been referred to a pain specialist. All participants were involved in support networks made up of other Sex Workers and all spoke of a sense of community and survival.ConclusionsOur study emphasizes the complex nature of chronic pain and addictions among a uniquely marginalized population. The study is unique in that it contributes the perspectives of a traditionally “hard-to-reach” population and demonstrates that Sex Workers should not only participate in but should lead development and implementation of research and programs for managing chronic pain in the setting of addiction.
We performed the first post-privacy legislation survey of digital recording in Canadian health care. There is widespread acceptance of digital recording in public spaces and health care; however, respondents preferred to provide consent before recording. Balancing these preferences with the demonstrated advantages of video recording in health care presents challenges for optimal health policy creation. This study provides contemporary data to inform discussions.
IntroductionThe first Choosing Wisely Canada (CWC) recommendation for Emergency Medicine states: “Don’t order CT head scans in adults and children who have suffered minor head injuries (unless positive for a validated head injury clinical decision rule)”. In order to provide patients with information on the risks and benefits of computed tomography (CT) scans in minor traumatic brain injuries (mTBI) and to encourage discussions between patients and their doctor, we designed a patient-focused mTBI infographic for the emergency department (ED).MethodsStakeholders worked with content experts to co-design the infographic, which was posted in two emergency department (ED) waiting rooms. A survey was administered to evaluate whether the infographic influenced patient beliefs about the risks and benefits of CT scans and to gauge patient willingness to have a discussion with their doctor about the necessity of a scan.ResultsOne hundred fifteen patients completed the survey. Prior to participating, 38% of patients thought a CT after an mTBI was always a good idea and 60% thought it was sometimes a good idea. After viewing the poster, 87% of respondents stated they better understood when a CT scan may be appropriate, 93% felt they better understood the risks of CT scans, and 76% understood that their doctor can often rule out serious illness without a CT scan. Only 19% of patients still felt that a CT was always necessary after an mTBI.ConclusionsThe mTBI infographic changed patient perceptions regarding the need for CT scans and increased awareness of the indications and risks of CT scans. This study demonstrates that targeted patient education materials can help support CWC recommendations.
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