Aims: The aim of this study was to develop insights into how and why Dutch government policies on deployment and training of nurse practitioners and physician assistants have effect and under what circumstances.
Design: A realist analysis using qualitative interviews.
Methods: Data analysis of 50 semi-structured interviews conducted in 2019 with healthcare providers, sectoral and professional associations, and training coordinators. Stratified purposive and snowball sampling were used.
Results: Policies stimulated employment and training of nurse practitioners and physician assistants by: (1) contributing to the familiarity of participants in the decision-making process in healthcare providers with and medical doctors' trust in these professions; (2) contributing to participants' motivation in employment and training; and (3) eliminating barriers perceived by medical doctors, managers and directors. The extent to which policies affected employment and training was largely determined by sectoral and organizational circumstances, such as healthcare demand and complexity, and decision-makers in healthcare providers (medical doctors or managers/directors).
Conclusion: Effectuating familiarity and trust among participants in the decision-making process is a crucial first step. Next, policymakers can motivate participants and lower their perceived barriers by extending the scope of practice, creating reimbursement opportunities and contributing to training costs. Theoretical insights into nurse practitioner and physician assistant employment and training have been refined.
Impact: The findings highlight how governments, health insurers, sectoral and professional associations, departments, councils, healthcare providers and professionals can facilitate and support nurse practitioner and physician assistant employment and training by contributing to familiarity, trust and motivation, and by clearing perceived barriers.
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http://dx.doi.org/10.1111/jan.15607 | DOI Listing |
J Cardiopulm Rehabil Prev
January 2025
Author Affiliations: Department of Medicine, Cardiology Section, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts (Drs Washington-Plaskett and Gilman, Ms Zombeck, and Dr Balady), Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, Massachusetts (Ms Quinn).
Purpose: Uncovering the racial/ethnic health disparities that exist within cardiovascular medicine offers potential to mitigate treatment gaps that might affect outcomes. Socioeconomic status (SES) may be a more appropriate underlying factor to assess these disparities. We aimed to evaluate whether adherence, attendance, and outcomes in cardiac rehabilitation are associated with SES in a safety net hospital.
View Article and Find Full Text PDFMil Med
January 2025
Research Unit of Clinical Medicine, Psychiatry, University of Oulu, Oulu, 90014, Finland.
Introduction: Sense of coherence (SOC) refers to the psychosocial aspects and origins of health. Sense of coherence is related to physical and psychological health and quality of life. Military studies on SOC are commonly related to military deployment or operations, military training, and military fitness.
View Article and Find Full Text PDFPurpose: We aimed to evaluate the association between socioeconomic factors and patient-reported Western Ontario Osteoarthritis of the Shoulder (WOOS) index at 1 year after hemiarthroplasty, reverse, or anatomical total shoulder arthroplasty for osteoarthritis or cuff-tear arthropathy.
Methods: Eligible patients were identified using linked national data from the Danish Shoulder Arthroplasty Registry and Statistics Denmark between April 2012 and April 2019. Univariable and multivariable linear regression was used to identify the association between socioeconomic factors and the WOOS index at 1 year following primary shoulder arthroplasty adjusted for age, sex, underlying diagnosis, implant design, and comorbidities.
Alzheimers Dement
December 2024
Center for Health Disparities Research, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA.
Background: Accelerated aging is strongly linked to adverse social exposome and accelerated aging of the brain may be a dementia risk factor. Machine-learning can estimate the biological "brain age" from neuroimages, which provides complementary information to the chronological/calendar age. The difference between biological and chronological age is referred to as the "brain age gap.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
University of California, San Diego, La Jolla, CA, USA.
Background: People identifying as sexual and gender minorities (SGM) may have higher risk for subjective cognitive decline and Alzheimer's disease, although the risk for Parkinson's disease dementia (PDD) has not been investigated. Male sex is associated with a higher risk for PDD, it is unclear whether SGM status impacts the risk.
Methods: Data were obtained from Fox Insight on April 5, 2023.
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