Browsing by Author "Bajgain, Bishnu"

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    Assessing the Experiences of Immigrants Receiving Primary Care during COVID-19: A mixed-methods study
    (2022-01) Bajgain, Bishnu; Santana, Maria J.; Aghajafari, Fariba; Jackson, Jeanette
    Background: The entire healthcare system, including primary healthcare (PHC) services, has been disrupted since the onset of the COVID-19 pandemic. As the crisis threatens all citizens significantly, further barriers to accessing care exist for those who are most vulnerable, experience marginalization, and have pre-existing challenges. We aimed to explore immigrants’ lived experiences in accessing and receiving PHC services during the pandemic. Methods: A multiphase mixed-methods study using a sequential explanatory design was employed. The first study includes a systematic review that synthesizes the evidence on the experiences that immigrant patients have receiving PHC. Study two provides insights from a recently employed “COVID-19 Experiences and Impacts Survey” data and compares the experiences of Albertans that were born in and outside Canada. Descriptive statistics and multivariable logistic regression were performed, using STATA. The third study is a qualitative inquiry that aims to gain a deeper understanding of the newcomers’ (living in Canada ≤5 years) and providers’ experiences in PHC during the pandemic. A thematic analysis was applied, using NVivo software. Results: The literature review revealed four major concerns affecting healthcare experiences of immigrant patients: 1) cultural and linguistic difference; 2) socioeconomic challenges; 3) health system factors; and 4) patient-provider relationship. The quantitative analysis of survey data (N=10,175) showed Canadian-born respondents were more likely to report worsening mental health during the pandemic, as well as higher levels of perceived stress, anxiety, or depression compared to non-Canadian-born survey respondents. In addition, Canadian-born respondents were more likely to prefer virtual healthcare compared to those respondents born outside Canada. Both cohorts reported that delayed care during the pandemic negatively impacted their health, and similar percentages in each cohort reported hesitancy getting the COVID-19 Vaccine. The qualitative inquiry included 23 interviews (15 newcomers, 8 providers) and revealed three aspects driving newcomers’ and healthcare providers’ experiences: overall experiences (doctor-patient relationship, care coordination, expectation on care), virtual care experience (accessibility, communication), challenges in accessing and receiving healthcare (language/cultural difference, care accessibility, health system literacy, competing priorities). Conclusion: This thesis presents a comprehensive exploration and description of immigrants’ lived experiences in accessing and receiving PHC during the pandemic. Immigrants reported many challenges in accessing and receiving PHC, and these challenges have been increased since the COVID-19 pandemic. The results of this thesis yielded six recommendations that can inform PHC quality improvement initiatives and PHC policy.
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    Educating patients about patient-reported outcomes—are we there yet?
    (2024-09-30) Unni, Elizabeth; van Muilekom, Maud M.; Absolom, Kate; Bajgain, Bishnu; Haverman, Lotte; Santana, Maria
    Abstract Background Using Patient Reported Outcome Measures (PROMs) in clinical settings can improve patient outcomes by enhancing communication between patient and provider. There has been significant improvements in the development of PROMs, their implementation in routine patient clinical care, training physicians and other healthcare providers to interpret the PROMs results to identify any issues reported by the patient, and to use the PROMs results to provide or modify the treatment. Main body Despite the increased use of PROMs, the lack of PROM completion by patients is a major concern in the optimal use of PROMs. Studies have shown several reasons why patients do not complete PROMs and one of the reasons is their lack of understanding of the significance of PROMs and their utility in their clinical care. While examining the various strategies that can be used to improve the uptake of PROM completion by patients, educating patients about the use of PROMs has been recommended. There is less evidence on how patients are trained or educated about PROMs. It may also be possible that the patient education strategies are not reported in the publications. This brings up the question of evaluation of the educational strategies used. Conclusion Our symposium at the 2023 ISOQOL conference brought together a range of experiences and learning around patient-centered PROMs educational activities used in the Netherlands, Canada, and the UK. This commentary is aimed to describe the lay of the land about educational activities around the use of PROMs in clinical care for patients, recognizing the gaps, and posing questions to be considered by the research and clinical community.
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    Patient-reported experiences and outcomes of virtual care during COVID-19: a systematic review
    (2023-12-01) Bajgain, Bishnu; Rabi, Sarah; Ahmed, Sadia; Kiryanova, Veronika; Fairie, Paul; Santana, Maria J.
    Abstract Introduction The onset of COVID-19 has caused an international upheaval of traditional in-person approaches to care delivery. Rapid system-level transitions to virtual care provision restrict the ability of healthcare professionals to evaluate care quality from the patient's perspective. This poses challenges to ensuring that patient-centered care is upheld within virtual environments. To address this, the study’s objective was to review how virtual care has impacted patient experiences and outcomes during COVID-19, through the use of patient-reported experience and outcome measures (PREMs and PROMs), respectively. Methods A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines to evaluate patient responsiveness to virtual care during COVID-19. Using an exhaustive search strategy, relevant peer-reviewed articles published between January 2020 and 2022 were pulled from MEDLINE, CINAHL, EMBASE, and PsychInfo databases. Study quality was independently assessed by two reviewers using the Mixed Methods Appraisal Tool. A patient partner was consulted throughout the study to provide feedback and co-conduct the review. Results After removing duplicates, 6048 articles underwent title and abstract review, from which 644 studies were included in the full-text review stage. Following this, 102 articles were included in the study. Studies were published in 20 different countries, were predominantly cross-sectional, and reported on the delivery of virtual care in specialized adult outpatient settings. This review identified 29 validated PREMs and 43 PROMs. Several advantages to virtual care were identified, with patients citing greater convenience, (such as saving travel time and cost, less waiting experienced to see care providers) and increased protection from viral spread. Some studies also reported challenges patients and caregivers faced with virtual care, including feeling rushed during the virtual care appointment, lack of physical contact or examination presenting barriers, difficulty with communicating symptoms, and technology issues. Conclusion This review provides supportive evidence of virtual care experiences during the COVID-19 pandemic from patient and caregiver perspectives. This research provides a comprehensive overview of what patient-reported measures can be used to record virtual care quality amid and following the pandemic. Further research into healthcare professionals’ perspectives would offer a supportive lens toward a strong person-centered healthcare system.