Refine
Document Type
- Article (4) (remove)
Language
- English (4) (remove)
Keywords
- End-of-Life-Care (1)
- Global health (1)
- Globalisation (1)
- Governance (1)
- International health (1)
- Nurse Education (1)
- Simulation (1)
- Simulation-based Learning (1)
- Social determinants (1)
- health care organizations (1)
- inclusion (1)
- organizational health literacy (1)
- palliative care (1)
- people with disabilities (1)
Institute
- Gesundheitswissenschaften (4) (remove)
Background
Global Health has increasingly gained international visibility and prominence. First and foremost, the spread of cross-border infectious disease arouses a great deal of media and public interest, just as it drives research priorities of faculty and academic programmes. At the same time, Global Health has become a major area of philanthropic action. Despite the importance it has acquired over the last two decades, the complex collective term “Global Health” still lacks a uniform use today.
Objectives
The objective of this paper is to present the existing definitions of Global Health, and analyse their meaning and implications. The paper emphasises that the term “Global Health” goes beyond the territorial meaning of “global”, connects local and global, and refers to an explicitly political concept. Global Health regards health as a rights-based, universal good; it takes into account social inequalities, power asymmetries, the uneven distribution of resources and governance challenges. Thus, it represents the necessary continuance of Public Health in the face of diverse and ubiquitous global challenges. A growing number of international players, however, focus on public-private partnerships and privatisation and tend to promote biomedical reductionism through predominantly technological solutions. Moreover, the predominant Global Health concept reflects the inherited hegemony of the Global North. It takes insufficient account of the global burden of disease, which is mainly characterised by non-communicable conditions, and the underlying social determinants of health.
Conclusions
Beyond resilience and epidemiological preparedness for preventing cross-border disease threats, Global Health must focus on the social, economic and political determinants of health. Biomedical and technocratic reductionism might be justified in times of acute health crises but entails the risk of selective access to health care. Consistent health-in-all policies are required for ensuring Health for All and sustainably reducing health inequalities within and among countries. Global Health must first and foremost pursue the enforcement of the universal right to health and contribute to overcoming global hegemony.
To date, studies on individual and organizational health literacy (OHL) in facilities for people with disabilities are scarce. Thus, the aims of this study are (1) to adapt an existing instrument for measuring organizational health literacy (OHL), namely, the “Health literate health care organization scale” (HLHO-10), to the context of facilities for people with disabilities, (2) to quantitatively examine characteristics of OHL, and (3) to qualitatively assess the definition and role of OHL by interviewing managers and skilled staff. An online study in Germany with N = 130 managers and skilled staff in facilities for people with disabilities was conducted, using the adapted HLHO-10 questionnaire. Univariate analyses were applied. Qualitative content analysis was used to investigate interview data from N = 8 managers and skilled staff from N = 8 facilities for people with disabilities in Hesse, Germany. Quantitative results revealed that respondents reported a below-average level in HLHO-10, with the lowest level found in the attribute of participative development of health information. The qualitative findings showed a clear need for improved navigation to and in facilities. The quantitative and qualitative findings are mainly consistent. Future research and measures should focus on facilities for people with disabilities in order to strengthen the development of and access to target-group-specific health information, as well as to establish a health-literate working and living environment.
- To strengthen its expanding role in global health, the German government is currently preparing a new global health strategy, to be published in 2019.
- As social, political and economic determinants are highly relevant for population health, the German government will need to increase coherence in order to promote its emphasis on creating equal opportunities and reducing inequalities in and between countries.
- For further strengthening its commitment to universal health coverage, for promoting decent work and healthy labour conditions, and for enforcing the right to health, the German government will have to stress the mandatory role of the public sector for global health
Background: In 2021, a significant proportion of adult deaths in Germany, comprising of 447,473 individuals, occurred within hospital settings, representing nearly half of the total deaths in the country, which numbered 1,023,687 (statistika 2021). Consequently, nurses play a pivotal role as primary caregivers for this patient group, necessitating comprehensive education to address their specific needs. Existing literature suggests that nursing students often lack the adequate preparation to provide care for this group, with factors such as insufficient theoretical knowledge and suboptimal mentoring during clinical placements (Bloomfield et al. 2015; Gillan et al. 2014; Leighton 2009, Leighton/Dubas 2009). The use of simulation has proven effective in bridging the theory-practice gap, particularly in the context of End-of-Life Care. The objective of this study was to assess nursing students' perceptions of the use of simulation in learning about End-of-Life Care (Gillan et al. 2014; Moreland et al. 2012).
Methods: Over a three-year period, three cohorts of third-year nursing students at Fulda University of Applied Sciences engaged in simulated experiences involving a dying patient and one or more family members. The authors created three different scenarios in which the students had to perform oral care, break bad news to family members and administer palliative pain medication. During the simulations, the family member(s) confronted the students with questions concerning spiritual care and improving the quality of life at this stage. This project utilized a qualitative design. After the simulation and debriefing sessions, semi-structured interviews and group discussion were conducted. After transcribing, the interviews were analyzed using open and axial coding, after the Glaser and Strauss approach to Grounded Theory.
Results: The process of theoretical coding yielded five results: Simulation revealed to be a good tool to learn about End-of-Life Care (1), simulation focused on communication (2), the importance of spiritual care (3), the aspect of realism (4) and a lack of theoretical knowledge (5).
Conclusion: Simulation-based learning seems to be a valuable tool in the teaching of End-of-Life-Care especially with a focus on communication.