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A Qualitative Study on Concerns, Needs, and Expectations of Hospital Patients Related to Climate Change: Arguments for a Patient-Centered Adaptation.

ABSTRACT: This study explores the concerns, needs, and expectations of inpatients with the goal to develop a patient-centered climate change adaptation agenda for hospitals. Statements of patients from geriatrics, internal medicine, psychiatry, and surgery (N = 25) of a German tertiary care hospital were analyzed using semi-structured interviews and the framework method. Areas of future adaptation were elaborated in joint discussions with transdisciplinary experts. Concerns included the foresight of severe health problems. The requested adaptations comprised the change to a patient-centered care, infrastructural improvements including air conditioning, and adjustments of the workflows. Guidelines for the behavior of patients and medical services appropriate for the climatic conditions were demanded. The patient-centered agenda for adaptation includes the steps of partnering with patients, reinforcing heat mitigation, better education for patients and medical staff, and adjusting work processes. This is the first study demonstrating that hospital patients are gravely concerned and expect adjustments according to climate change. Since heat is seen as a major risk by interviewees, the fast implementation of published recommendations is crucial. By synthesizing inpatients' expectations with scientific recommendations, we encourage patient-centered climate change adaptation. This can be the start for further collaboration with patients to create climate change resilient hospitals.

SUBMITTER: Lenzer B

PROVIDER: S-EPMC8201225 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundClimate change has been shown to have long-term effects on mental health, yet, to date, there have been few studies on how children and adolescents experience and respond to ecological changes and how and why they engage in climate action. We explored empirically young people's views about climate change and how distinct cultural contexts influence individual climate action.MethodsWe invited children and adolescents (ages 7 to 18) and their caregivers from the general population in the United States and France to participate in semi-structured focus groups. We recruited 74 participants, 39 in the U.S. (33 children and adolescents, 6 parents) and 35 in France (32 children and adolescents, 3 parents). Focus groups with participants centered on their emotions, beliefs, and actions around climate change. We analyzed the focus group data and developed themes via grounded theory and symbolic interactionist approaches.ResultsMany participants described experiencing anger, hopelessness, guilt, and sadness in response to climate change, and a smaller number endorsed significant anxiety symptoms; many described frustration about needing to fix the mistakes of earlier generations. Younger participants frequently misunderstood the purpose of their parents' eco-conscious behaviors unless they were provided with age-appropriate explanations. Participants described a spectrum of experiences when trying to discuss climate change with peers and family, ranging from genuine support to apathy to hostility. Between the two samples, U.S. participants experienced more conflict with adults about climate change than French participants, but French participants described a greater lack of political agency compared to U.S.ParticipantsParticipants in both samples expressed a relatively balanced view of climate action, recognizing the significance of individual actions while acknowledging the limits of their power in the face of systemic issues. Some found hope and empowerment through climate action and building communities around it.ConclusionDiscussing with children and adolescents what adults are doing to mitigate climate change can provide reassurance, model prosocial behaviors, and inspire their own investment in climate action. Adults seeking to support the psychological well-being of young people should both support their concerns and actions around climate change and create avenues for young people to meaningfully engage in climate action.

Project description:BackgroundPeople with chronic conditions have complex healthcare needs that lead to challenges for adequate healthcare provision. Current healthcare services do not always respond adequately to their needs. A modular perspective, in particular providing visualization of the modular service architecture, is promising for improving the responsiveness of healthcare services to the complex healthcare needs of people with chronic conditions. The modular service architecture provides a comprehensive representation of the components and modules of healthcare provision. In this study, we explore this further in a qualitative multiple case study on healthcare provision for children with Down syndrome in the Netherlands.MethodsData collection for four cases involved 53 semi-structured interviews with healthcare professionals and 21 semi-structured interviews with patients (the parents of children with Down syndrome as proxy). In addition, we gathered data by means of practice observations and analysis of relevant documents. The interviews were audio-recorded, transcribed verbatim and analyzed utilizing the Miles and Huberman approach.ResultsOur study shows that the perspectives on healthcare provision of professionals and patients differ substantially. The visualization of the modular service architecture that was based on the healthcare professionals' perspective provided a complete representation of (para)medical outcomes relevant to the professionals' own discipline. In contrast, the modular service architecture based on the patients' perspective, which we define as a person-centered modular service architecture, provided a representation of the healthcare service that was primarily based on functional outcomes and the overall wellbeing of the patients.ConclusionOur study shows that visualization of the modular service architecture can be a useful tool to better address the complex needs and requirements of people with a chronic condition. We suggest that a person-centered modular service architecture that focuses on functional outcomes and overall wellbeing, enables increased responsiveness of healthcare services to people with complex healthcare needs and provision of truly person-centered care.

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A Qualitative Study on Concerns, Needs, and Expectations of Hospital Patients Related to Climate Change: Arguments for a Patient-Centered Adaptation.

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