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Healthcare Work and the Role of Clients in Change
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Healthcare Work and the Role of Clients in Change

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Economics".

Deadline for manuscript submissions: closed (30 June 2020) | Viewed by 29740

Special Issue Editor

Prof. Dr. Tarja Heponiemi

E-Mail Website
Guest Editor
National Institute for Health and Welfare, Helsinki, Finland
Interests: digitalization of healthcare; eHealth; mHealth; digital exclusion; migration; migrant healthcare workers; integration; competent workforce; service concepts; care processes

Special Issue Information

Dear Colleagues,

Healthcare worldwide is facing several challenges which impact the working life and operational environment in the sector and also affects the role of clients. Aging population and workforce in many countries, multiculturalism, and digitalization, accompanied with disparities between needs for services and available resources, will challenge established knowledge and practices and request renewed expertise and approaches.

The number of digital health services is increasing rapidly in many countries. This rapid change demands a cultural change from organizations, professionals, and clients. Clients are expected to step into a more skilled and active role, whereas professionals and health providers need to change their work processes and professional identity. There is also a risk that new digital services will increase social exclusion if the needs of potentially vulnerable groups such as older people, migrants, and mental health service users are not accounted for. This requires fundamental changes in professionals’ work and organizational processes, and the lack of these changes may hinder the adoption of digital services and lead to digital exclusion.

Increased migration results in healthcare becoming increasingly multicultural. In many countries, migrant healthcare employees fill in the shortage of, for example, physicians and nurses. While cultural diversity may enrich work environment and promote cultural competence, it also poses challenges to management of multicultural work teams in terms of language competence, communication, conflicts of values and cultural habits, equitable work division, and full use of the potential of both native and migrant workers. At the same time, migrants are increasingly clients in healthcare, which challenges employees’ skills and knowledge in responding to the needs of a culturally diverse clientele. Particular migrant groups, such as applicants for asylum, may have faced serious trauma events with physical and mental health effects, which impact service needs and require specific competencies from the professionals. 

Moreover, to tackle all the challenges of contemporary healthcare, healthcare providers have conducted many reforms and innovations related to, for example, division of labor and skill mix, integration, service concepts, new models for purchasing and providing care, public–private partnerships, and care processes.

This Special Issue in the International Journal of Environmental Research and Public Health is devoted to new research related to these topics which on the one hand challenge the healthcare sector worldwide but on the other hand offer solutions to arrange healthcare in new and perhaps more efficient ways.

A wide range of topics will be included in this issue related to challenges and opportunities of contemporary healthcare in a world that is getting increasingly digital, multicultural, and global, as well as influenced by the use of social media.

Prof. Dr. Tarja Heponiemi
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • digitalization of healthcare
  • eHealth
  • mHealth
  • digital exclusion
  • migration
  • migrant healthcare workers
  • integration
  • competent workforce
  • service concepts
  • care processes

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Published Papers (5 papers)

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Research

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10 pages, 303 KiB  
Article
Professional Master’s Degree Students’ Perceptions on the Changes Digitalisation Imposes on Counselling in the Social and Health Care Sector
by Piia Silvennoinen
Int. J. Environ. Res. Public Health 2020, 17(17), 6243; https://doi.org/10.3390/ijerph17176243 - 27 Aug 2020
Cited by 3 | Viewed by 3339
Abstract
The study portrays the social and health care master’s students’ (N = 19) perceptions on the changes in work practices due to digitalisation, with a special focus on online counselling. Furthermore, the data include thoughts on the impact digitalised interaction, i.e., online [...] Read more.
The study portrays the social and health care master’s students’ (N = 19) perceptions on the changes in work practices due to digitalisation, with a special focus on online counselling. Furthermore, the data include thoughts on the impact digitalised interaction, i.e., online counselling, has on their work and professional identities. The students studied how the motivational interviewing method combined with a solution-focused counselling approach is applicable in online settings by using simulation pedagogy. The data consisted of students’ learning diaries. Furthermore, the data were analysed using inductive content analysis. The results show that the digitalisation of work practices demands blended professionalism, which allows the professional to work both face-to-face and online with clients. In addition, the education of social and health care professionals needs to address the lack of competences and skills in digitalised work practices and provide a conceptual and practical understanding of blended professionalism in the sector. Full article
(This article belongs to the Special Issue Healthcare Work and the Role of Clients in Change)
14 pages, 522 KiB  
Article
Construction, Factor Structure, and Internal Consistency Reliability of the Hospital Physical Therapy Perceived Satisfaction Questionnaire (H-PTPS)
by Manuel Albornoz-Cabello, José Manuel Pérez-Mármol, Mª de los Ángeles Cardero-Durán, Cristo Jesús Barrios-Quinta and Luis Espejo-Antúnez
Int. J. Environ. Res. Public Health 2020, 17(16), 5857; https://doi.org/10.3390/ijerph17165857 - 12 Aug 2020
Cited by 2 | Viewed by 2844
Abstract
Patient satisfaction is a crucial aspect in the evaluation of the quality of health care provided by health services and units, especially in patients that require physical rehabilitation. This study aims to design and analyze the factor structure and internal consistency reliability of [...] Read more.
Patient satisfaction is a crucial aspect in the evaluation of the quality of health care provided by health services and units, especially in patients that require physical rehabilitation. This study aims to design and analyze the factor structure and internal consistency reliability of the Hospital Physical Therapy Perceived Satisfaction Questionnaire (H-PTPS) measuring the level of physical therapy patient satisfaction in hospital rehabilitation services. This study has a multicenter cross-sectional survey design. This study used the structural validity and internal consistency domains from COSMIN (consensus-based standards for the selection of health status measurement instruments) guideline. The H-PTPS questionnaire consists of 20 closed questions. A sample of 384 adult patients from physical therapy units from three Spanish public hospitals completed this questionnaire. A factor structure and internal consistency reliability analysis were performed. The factor analysis including the 20 items of the H-PTPS showed an adequacy index of 0.922 according to the Kaiser–Meyer–Olkin measure and the Barlett test allowed us to reject the null hypothesis (p < 0.001). In the rotated component matrix, four specific factors were obtained, explaining 66.75% of the accumulated variance. All factors present satisfactory internal reliability, achieving Cronbach’s alpha indices and Omega coefficients higher than 0.74. The H-PTPS questionnaire has shown a four-factor solution with satisfactory reliability evaluating the satisfaction of Spanish patients treated in physical therapy units in the hospital rehabilitation services. Full article
(This article belongs to the Special Issue Healthcare Work and the Role of Clients in Change)
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19 pages, 377 KiB  
Article
Being Heard, Exerting Influence, or Knowing How to Play the Game? Expectations of Client Involvement among Social and Health Care Professionals and Clients
by Elina Weiste, Sari Käpykangas, Lise-Lotte Uusitalo and Melisa Stevanovic
Int. J. Environ. Res. Public Health 2020, 17(16), 5653; https://doi.org/10.3390/ijerph17165653 - 5 Aug 2020
Cited by 11 | Viewed by 5632
Abstract
Contemporary social and health care services exhibit a significant movement toward increasing client involvement in their own care and in the development of services. This major cultural change represents a marked shift in the client’s role from a passive patient to an active [...] Read more.
Contemporary social and health care services exhibit a significant movement toward increasing client involvement in their own care and in the development of services. This major cultural change represents a marked shift in the client’s role from a passive patient to an active empowered agent. We draw on interaction-oriented focus group research and conversation analysis to study workshop conversations in which social and health care clients and professionals discussed “client involvement”. Our analysis focuses on the participants’ mutually congruent or discrepant views on the topic. The professionals and clients both saw client involvement as an ideal that should be promoted. Although both participant groups considered the clients’ experience of being heard a prerequisite of client involvement, the clients deviated from the professionals in that they also highlighted the need for actual decision-making power. However, when the professionals invoked the clients’ responsibility for their own treatment, the clients were not eager to agree with their view. In addition, in analyzing problems of client involvement during the clients’ and professionals’ meta-talk about client involvement, the paper also shows how the “client involvement” rhetoric itself may, paradoxically, sometimes serve to hinder here-and-now client involvement. Full article
(This article belongs to the Special Issue Healthcare Work and the Role of Clients in Change)
10 pages, 291 KiB  
Article
Tailoring EHRs for Specific Working Environments Improves Work Well-Being of Physicians
by Suvi Vainiomäki, Tarja Heponiemi, Jukka Vänskä and Hannele Hyppönen
Int. J. Environ. Res. Public Health 2020, 17(13), 4715; https://doi.org/10.3390/ijerph17134715 - 30 Jun 2020
Cited by 7 | Viewed by 2659
Abstract
Electronic health records (EHRs) have an impact on physicians’ well-being and stress levels. We studied physicians’ experiences with EHRs and their experienced time pressure and self-rated stress by an electronic questionnaire sent to Finnish physicians aged under 65 in 2017. Our sample was [...] Read more.
Electronic health records (EHRs) have an impact on physicians’ well-being and stress levels. We studied physicians’ experiences with EHRs and their experienced time pressure and self-rated stress by an electronic questionnaire sent to Finnish physicians aged under 65 in 2017. Our sample was 2980 physicians working in the public sector, health care centers (35.5%) or hospitals (64.5%). Experienced technical problems were positively associated with experienced time pressure, whereas user-friendliness of the EHRs was negatively associated with experienced time pressure. Low perceived support for internal cooperation was associated with high levels of time pressure in hospitals. Those experiencing high levels of technical problems were 1.3 times more likely to experience stress compared to those experiencing low levels of technical problems. Better user-friendliness of the EHRs was associated with lower levels of self-rated stress. In both working environments but more strongly in primary health care, technical problems were associated with self-rated stress. Technical problems and user-friendliness of EHRs are the main factors associated with time pressure and self-rated stress. Health care environments differ in the nature of workflow having different demands on the EHRs. Developing EHR systems should consider the special needs of different environments and workflows, enabling better work well-being amongst physicians. Full article
(This article belongs to the Special Issue Healthcare Work and the Role of Clients in Change)

Review

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15 pages, 739 KiB  
Review
Identifying the Roles of Healthcare Leaders in HIT Implementation: A Scoping Review of the Quantitative and Qualitative Evidence
by Elina Laukka, Moona Huhtakangas, Tarja Heponiemi and Outi Kanste
Int. J. Environ. Res. Public Health 2020, 17(8), 2865; https://doi.org/10.3390/ijerph17082865 - 21 Apr 2020
Cited by 40 | Viewed by 14746
Abstract
Despite major investment, health information technology (HIT) implementation often tends to fail. One of the reasons for HIT implementation failure is poor leadership in healthcare organisations, and thus, more research is needed on leaders’ roles in HIT implementation. The aim of the review [...] Read more.
Despite major investment, health information technology (HIT) implementation often tends to fail. One of the reasons for HIT implementation failure is poor leadership in healthcare organisations, and thus, more research is needed on leaders’ roles in HIT implementation. The aim of the review was to identify the role of healthcare leaders in HIT implementation. A scoping review with content analysis was conducted using a five-step framework defined by Arksey and O’Malley. Database searches were performed using CINAHL, Business Source Complete, ProQuest, Scopus and Web of Science. The included studies were written either in English or Finnish, published between 2000 and 2019, focused on HIT implementation and contained leadership insight given by various informants. In total, 16 studies were included. The roles of healthcare leaders were identified as supporter, change manager, advocate, project manager, manager, facilitator and champion. Identifying healthcare leaders’ roles in HIT implementation may allow us to take a step closer to successful HIT implementation. Yet, it seems that healthcare leaders cannot fully realise these identified roles and their understanding of HIT needs enforcement. Also, healthcare leaders seem to need more support when actively participating in HIT implementation. Full article
(This article belongs to the Special Issue Healthcare Work and the Role of Clients in Change)
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