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Person-centredness is claimed to be one of the aims of healthcare, placing the person at the centre of healthcare (services). However, individual responsibility is expected and stressed in the implementation with limited structural support. This has led to the situation where despite the availability of HPV vaccination as the most beneficial preventive method, the coverage for girls aged 12â14 is below the recommended (>70%) rate. The objective of the research was to analyse structural constraints experienced by parents and service providers of the target group of girls regarding HPV vaccination under the circumstances of a global pandemic. Qualitative methods were used, namely in-depth interviews (n = 18) with nurses and midwives and three focus group interviews (n = 13) with parents of girls aged 12â14 years, as well as thematic textual analysis with the combination of inductive and deductive analysis methods. The research was granted ethical permission. The results outline that for parents the main challenge is the ability to find relevant supportive information for decision-making. For nurses, the challenge is to find appropriate ways to counsel and support parents and girls. The study revealed the lack of a country-wide strategy as one of the weak links in supporting the continuation of necessary preventive activities despite the external situation. Also, the skills of counselling and development of innovative communicative and educational digital tools that are target group specific yet also country- and culture-specific should be improved, as this may lead to more person-centred healthcare service for cervical cancer prevention.

In the contemporary approach to ante- and postnatal care, where men are anticipated to participate more, men themselves also wish to be more included. Even though national health policy presents person-centred care as a central goal, it is not clear if and how it manifests itself for some, as men continue to feel excluded from the ante- and postnatal care process. The aim of this research was to identify the information sources that men in Estonia currently rely upon regarding the ante- and postnatal period in order to both understand the possible areas of development and the potential application of health communication tools to support men in ante- and postnatal care. The research, which was part of a masterâs thesis, was a qualitative study conducted with 13 men who were fathers or were about to become fathers. The results indicate that despite the new standards in health policy, there is a lack of targeted support systems to address menâs information needs during the ante- and postnatal period in Estonia â a problem further intensified by the COVID-19 pandemic. The current results show that adequate information access requires advanced skills in source criticality, languages, health and digital literacy. The study found that the issue can be resolved through conscious use of health communication tools, which need to be in a person-centred format â easily found, user-friendly and logically structured. A systemic approach needs to be developed to further support men. Health communication strategies can mediate such an approach by being able to accommodate a wider range of skills and preferences.

Primary care is the basic level of care, where patients start their treatment journey. Proactive management at primary care level improves health access and quality of care through proactive approach for specific patient sub-groups, improves integration of care at different levels of the health care system, and improves patient outcomes. The aim of the study was to describe family nursesâ perceptions of high-risk patientsâ proactive management and identify further training needs; therefore, a descriptive and empirical two-stage study design was used. A convenience sample of 16 family nurses was recruited in the first stage. The study was conducted at five Estonian primary health centers. Data were collected by Modified Patient Assessment of Chronic Illness Care (MPACIC) online questionnaire between September and December 2020. Ethical approval was obtained. The nurses evaluated their proactive management of high-risk patients positively. Higher results were related to patient support, encouragement, involvement in everyday care, and individual goal setting questions. Lower results were related to referral to professionals, follow-up visits, and suggesting specific health related programs and events from which the patients could benefit. As a second stage of the study, a training program was developed based on the acquired results and training was conducted for 18 nurses at one primary health center, where care management has been used since 2017. The training program was found to be useful. Nurses need specific knowledge about the proactive management and care plan of high-risk patients, which can be ensured through systematic training. The subject of nursesâ perceptions could benefit from further study by qualitative methods.

Introduction Breast cancer is easily detectable by mammography and many countries run national screening programs for women as a target group. Yet, the majority of these countries have screening participation rates below the recommended level of 70%. Objective The aim of the present article was to examine a connection between existing health practices and a decision to participate during breast cancer screening. Methods Methodologically, this research was a web panel and quantitative telephone survey. The survey was conducted among 1200 Estonian women in the age group 50–69 years. Statistical data analysis was performed with SPSS using a descriptive and logistic regression model. Results The findings revealed that among different background variables, age and existing health practices significantly influenced the decision-making for participating in the screening. Results also highlighted that the possibility to participate in the screening increased with existing supportive health practices and with the increasing age. Other sociodemographic factors did not have a significant influence on the decision-making of participation. Conclusions There is a need to educate people from an early age about the developments in health practices that could support a healthy lifestyle in terms of individual responsibility. Thus, public health campaigns should not only call for action but also focus on health education in terms of the role of preventive medicine and health practices.

Although relatively easy to overcome for young and healthy individuals, seasonal influenza is a disease with considerable health, social, and economic consequences for society, especially for higher-risk groups. Even though vaccination against influenza is the most effective tool to prevent it, vaccination rates remain rather low. Together with the promotion of neoliberal individual responsibility over one’s health, vaccine hesitancy – a complex phenomenon indicating the lower uptake of vaccines compared to the accessibility of information and services – has risen among societies. In previous research, several barriers – for example, psychological, physical, contextual, and sociodemographic – have been identified as preventing influenza vaccine uptake among risk groups. We approach the topic by using the social constructionist theory regarding the meaning construction of illnesses on cultural, individual, and third-party level. The findings outline the importance of meaning construction on all these levels. It appears that culturally influenza has been seen as an inevitable infectious disease related to the northern climate. Due to that, influenza is not considered as a life-threatening disease that would need preventive actions, except some basic hygiene or usage of folk medicine tools (e.g., ginger and garlic). On an individual level, the meaning construction is based on individual experiences, both with the illness and the vaccine – in the case of negative experiences with vaccine, the perception of something useless or even harmful develops. In addition, it appears that people create their own strategies to rationalize rejection of vaccination for themselves. These involve considerations about belonging to the risk group or the possibility to manage daily activities in non-risky manner even when belonging to the risk group. On the third-party level, participants saw the potential of pharmacies to alleviate practical constraints (e.g., tight schedule, daily occupation, etc.). Different media channels are also important in mediating vaccination-related information, but the rationalization and selection of the channels vary widely. The context of the coronavirus changed the vaccination-related perception temporarily for a short term, indicating that fear-based special occasions do not entail a long-term shift in health behaviour as the development of health-related decisions and behaviour is also long-term.

Objectives: While healthcare systems struggle to manage the COVID-19 pandemic, community pharmacies have changed the way in which they serve society by ensuring the availability of primary-level medical care. This study aims to examine the rearrangement of service provision at community pharmacies through the prism of social practice theory. Study design: Qualitative in-depth semi-structured interviews. Methods: In total, 21 community pharmacists, 3 hospital pharmacists and 10 experts in Estonia were interviewed. For data analysis, two-dimensional thematic textual analysis was performed according to four types of practices proposed in social practice theory and based on temporal distinction. Results: The findings of this study reveal that, in order to maintain and improve community pharmacy service provision during the pandemic, there have been changes to all aspects of practice elements, including practical understandings, rules and teleological structures. The majority of challenges were experienced because of necessary changes to the habitual ways of providing pharmacy services, indicating resistance to these changes and reinforcing the need to continue existing ‘practice-bundles’. Limited access to healthcare services during the COVID-19 pandemic has resulted in community pharmacists becoming the primary (and only) accessible healthcare contact; thus, leading to a shift in awareness about the role of pharmacists. Conclusions: Although large-scale changes may result in the dissolvement of practice-bundles and require readiness to adjust current methods of service provision, dissolution is a gradual process. There is an urgent need to support pharmacists in managing the challenges of rearranging service provision, such as immediate organisational changes, lack of information and changing resources.