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1.
Nurs Open ; 11(9): e70031, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39240184

RESUMO

AIM: To explore the experiences and needs of postgraduate nursing students within the Nigerian context. DESIGN: This qualitative study was conducted using a descriptive phenomenological approach. METHOD: Data were collected between February and April 2022 using a purposive sampling method and telephone semi-structured interviews. Colaizzi's method of Qualitative data Analysis was utilized. Twenty-two Nigerian postgraduate nursing students were interviewed. RESULTS: Three themes emerged: challenges of Nigerian postgraduate students before the pandemic, the impact of the pandemic on postgraduate education, and innovations to improve postgraduate education in Nigeria. The challenges include the burden of physical lectures, lack of infrastructure, and poor mentorship of postgraduate nursing students. The impact of the pandemic on postgraduate education includes abrupt disruption of the academic program, a prolonged academic calendar, and a communication gap between students and their research supervisors. Innovations to improve postgraduate nursing education in Nigeria also include adoption and sustainability of e-learning, upgrading post-basic to postgraduate nursing programmes, proper structuring of postgraduate nursing education, commencement of postgraduate nursing programmes in more universities and provision of financial aid for students. Our primary finding is that funding, mentorship and infrastructure were issues peculiar to all the respondents. CONCLUSION: This study concludes that efforts should be made to maintain a seamless educational program by ensuring an uninterrupted flow of learning through virtual means, thereby enhancing effective teaching and learning. IMPLICATIONS: Graduate nursing studies is one of the suggested solutions in the WHO strategic direction for nursing and midwifery globally to achieve Universal Health Coverage . The reason is that nurses can practice with more and better skills in any work setting, thus improving the quality of health care services. Our study provides insights into the experiences of postgraduate students and how these could discourage other nurses who might have thought about furthering their studies. Efforts should be made to provide all the support that these students need, using evidence from this study and similar studies to ensure they have a good learning experience and others can be motivated to learn at the graduate level as well. This will increase the proportion of nurses and midwives honed with better skills to provide more standard quality services that will improve patient care outcomes.


Assuntos
COVID-19 , Educação de Pós-Graduação em Enfermagem , Pesquisa Qualitativa , Estudantes de Enfermagem , Humanos , Nigéria , COVID-19/psicologia , Estudantes de Enfermagem/psicologia , Feminino , Masculino , Adulto , Pandemias , SARS-CoV-2 , Avaliação das Necessidades , Mentores/psicologia , Entrevistas como Assunto
2.
Lancet ; 404(10456): 988-990, 2024 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-39244275

RESUMO

The optimum number of units of blood and the associated number of blood donors required to meet a given population's needs remain undetermined globally. Typically, a whole blood donation rate of ten donations per 1000 population, at a minimum, is necessary to meet a country's blood needs. This rate is attributed to a WHO recommendation that 1% of a given country's population should donate blood to ensure a blood supply that is sufficient to meet clinical needs. This often cited metric was first referenced in a 1971 WHO report, yet neither supporting data or references were provided, suggesting that it was flawed at its founding. Regardless, this metric does not provide an accurate or contemporary determination of blood needs, which has ramifications for health service provision and planning, particularly in low-income and lower-middle-income countries. Modelling studies that account for geographical variability in disease burden, health-care infrastructure, and transfusion practices are needed to accurately estimate blood needs. A paucity of data to inform modelling remains a major obstacle in this regard. We discuss the history of the global blood donation index and highlight some factors that should be considered to better understand contemporary blood needs.


Assuntos
Doação de Sangue , Transfusão de Sangue , Saúde Global , Humanos , Doação de Sangue/provisão & distribuição , Transfusão de Sangue/estatística & dados numéricos , Países em Desenvolvimento , Necessidades e Demandas de Serviços de Saúde , Avaliação das Necessidades , Organização Mundial da Saúde
3.
Front Public Health ; 12: 1369456, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39224553

RESUMO

Background: The aging population has led to a surge in demand for home care, which has developed rapidly in China in recent years. However, there has been less empirical research into the needs of healthcare workers about providing home care. The purpose of this study was to explore the latent classes of healthcare workers' needs in primary health care institutions and to identify associated factors. Methods: From August 2021 to June 2022, a convenience sampling method was adopted to conduct a questionnaire survey on the workers of 62 primary healthcare institutions in Sichuan Province. Latent class analysis was used to categorize home care needs by Mplus 8.3. Multinomial logistic regression analysis was adopted to explore the influencing factors using SPSS 25.0. Results: A total of 1,152 healthcare workers were included in the study. Their needs for home care were classified into four latent classes: overall high need group (18.0%); overall low need group (34.8%); high training and low support need group (29.9%), and the high security and low training need group (17.3%). The factors influencing the different need categories included working area, professional title, role of medical workers, had participated in training about home care, and feelings about home care, with Class 1 as the reference group. Conclusion: Our findings indicate that primary healthcare workers have multifaceted needs for providing home care. Paying attention to their diverse needs can help optimize home care and enhance service capacity. Exploring the factors affecting needs can provide targeted support to healthcare workers to ensure the quality and continuity of home care services.


Assuntos
Pessoal de Saúde , Serviços de Assistência Domiciliar , Análise de Classes Latentes , Humanos , China , Feminino , Serviços de Assistência Domiciliar/estatística & dados numéricos , Masculino , Pessoal de Saúde/estatística & dados numéricos , Adulto , Inquéritos e Questionários , Pessoa de Meia-Idade , Atenção Primária à Saúde/estatística & dados numéricos , Avaliação das Necessidades , Necessidades e Demandas de Serviços de Saúde
4.
Am J Mens Health ; 18(5): 15579883241272057, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39268989

RESUMO

The aim of this mixed-method study was to identify support needs, as well as barriers and facilitators to seeking support in a sample of Swedish fathers with a fear of childbirth (FOC). Participants completed an anonymous quantitative online survey (N = 131), with three free-text items for those self-identifying as having an FOC (N = 71) and five individual in-depth interviews. Data analysis included descriptive and chi-square analyses for quantitative data, and manifest content analysis for qualitative data. Those with a severe FOC were more likely to report having on-going mental health difficulties (p = .039) and one fifth (21%) of the participants with severe FOC wanted to receive professional treatment, but only 8.1% received treatment. Most participants either preferred individual support or to receive support together with their partner. Fathers with severe FOC were more likely to report one or more barriers than those without FOC (p = .005), where unwanted social stigma was the single largest barrier. Qualitative findings identified one main category: Expectant fathers missing and wishing for support for FOC composed four generic categories: (1) support in developing an understanding of their fear, (2) coping by being aware of feelings, (3) professional support through trust and respect, and (4) needing individualized support. To encourage healthy fathers, clinical professionals should find ways to support fathers, such as by providing them with their own perinatal appointments, asking them about their feelings, as well as screening, diagnosing, and treating fathers with severe FOC.


Assuntos
Pai , Medo , Parto , Humanos , Suécia , Masculino , Pai/psicologia , Adulto , Medo/psicologia , Parto/psicologia , Feminino , Apoio Social , Inquéritos e Questionários , Gravidez , Pessoa de Meia-Idade , Pesquisa Qualitativa , Avaliação das Necessidades , Adulto Jovem , Adaptação Psicológica
5.
J Prim Care Community Health ; 15: 21501319241278849, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39279318

RESUMO

BACKGROUND: The Nyakaza-Move-for-Health intervention program was developed in response to the alarming rise in non-communicable diseases (NCDs) globally, in sub-Saharan Africa and South Africa. The rise in NCDs is attributed to the low levels of participation in physical activity (PA) among adolescents. Therefore, this study aimed to design a culturally tailored PA intervention for adolescents, guided by the Intervention Mapping (IM) protocol. The intervention program aims to address the multifaceted determinants of physical activity behavior, promote healthy lifestyles and improve adolescent fitness levels. METHODS: The Intervention Mapping protocol was applied to design the intervention program. The IM has 6 steps: (1) Needs assessment, (2) developing a logic model of the problem (LMP), (3) Formulating program outcomes and objectives, (4) Program design and production, (5) Generating implementation plan, and (6) Generating intervention evaluation plan. Participants included (n = 48) adolescent learners recruited from 8 (n = 8) participating schools. Adolescent learners participated in focus group discussions (FGD) to identify personal, interpersonal and environmental determinants of physical inactivity. Twenty-six (n = 26) key informant stakeholders participated in a stakeholder engagement workshop (SEW) to determine the motivators and constraints in implementing physical activity interventions. RESULTS: The Nyakaza intervention program's process development involved extensive stakeholder engagement, capacity development training, and integration of community feedback into the design. The intervention included a social marketing campaign and structured after-school physical activity sessions based on the Health Belief Model (HBM) and Transtheoretical Model (TTM). Implementation and evaluation plans were created, emphasizing real-time monitoring and adaptations. Strategies to enhance parental and community support were developed to address participation barriers. Although not tested in this study, these plans laid a robust foundation for fostering sustainable behavior change and improving physical activity among adolescents in resource-constrained settings. CONCLUSION: The Nyakaza-Move-for-Health intervention demonstrates a promising framework for promoting adolescent physical activity and addressing Non-Communicable Diseases in a culturally relevant manner. The systematic approach, grounded in the intervention mapping protocol, ensured a robust and replicable intervention design. Future research should focus on long-term follow-up, integrating objective physical activity measures, and expanding the program to include nutrition education. Addressing identified barriers, such as parental involvement, is crucial for enhancing the intervention's effectiveness and sustainability.


Assuntos
Exercício Físico , Grupos Focais , Promoção da Saúde , Humanos , Adolescente , África do Sul , Promoção da Saúde/métodos , Feminino , Masculino , Avaliação das Necessidades , Estilo de Vida Saudável , Desenvolvimento de Programas , Doenças não Transmissíveis/prevenção & controle
6.
Psychooncology ; 33(9): e9311, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39285611

RESUMO

OBJECTIVE: Understanding survivorship issues among people with head and neck cancer (HNC) is important as survival rates increase. Most research has focused on urban patients, leaving a gap in understanding the challenges faced by those in rural areas. This study aims to summarise the literature on survivorship needs for people with HNC in rural areas. METHODS: PubMed, PsycINFO, Scopus, Medline, CINAHL, Web of Science, and Embase were searched from database inception to 10 July 2024, with no restriction on publication period, country, or language. Data on study aims, country, methodology, and major findings related to HNC survivors in rural areas were extracted. Study quality was assessed using the Joanna Briggs Institute critical appraisal checklists. RESULTS: Twenty-one studies met the inclusion criteria. Eight studies were qualitative, 11 were quantitative, and two adopted a mixed-methods approach. Results demonstrate the impact of complex treatments on physical (n = 13) and psychosocial (n = 14) functioning. This study also emphasises multifaceted challenges, including reduced access to specialised services, resulting in greater travel and financial burden, extending to caregivers. Hence, primary healthcare services are crucial in supporting these patients closer to home. CONCLUSIONS: Addressing the gaps in equitable post-treatment care requires an even distribution of healthcare funding and workforce in rural areas. Future research could target these issues to develop tailored interventions or models of care, such as shared care, to ease access and financial burden.


Assuntos
Sobreviventes de Câncer , Neoplasias de Cabeça e Pescoço , População Rural , Sobrevivência , Humanos , Neoplasias de Cabeça e Pescoço/psicologia , Neoplasias de Cabeça e Pescoço/terapia , Neoplasias de Cabeça e Pescoço/mortalidade , População Rural/estatística & dados numéricos , Sobreviventes de Câncer/psicologia , Sobreviventes de Câncer/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Avaliação das Necessidades
8.
BMC Med Educ ; 24(1): 958, 2024 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-39227949

RESUMO

INTRODUCTION: Mental health is considered a major public health issue. Non-psychiatric physicians often engage in the treatment of mental disorders. The aim of this study was to describe psychiatric drug prescription knowledge and practices among non-psychiatric specialists and evaluate their training needs. METHODS: A descriptive cross-sectional study was conducted from September 1st to October 15th, 2021, in 3 Moroccan healthcare facilities and among private practitioners in Kenitra. We asked non-psychiatric specialists about their knowledge and current practices regarding psychotropic drugs, and their needs in psychiatric training. RESULTS: The study included a total of 150 participants. The majority of participants demonstrated insufficient knowledge regarding the selection of psychotropic drugs and the duration of pharmacotherapy. Specifically, 61.3% were unaware of the average duration of treatment for depression. 22.7% of participants did not feel comfortable when prescribing psychotropic drugs. Anxiolytics were the most commonly prescribed class of psychotropic drugs, accounting for 30.7% of prescriptions. The most common indications for psychotropic drugs prescription were anxiety (35.3%), followed by insomnia (34.7%) and depression (31.3%). The majority of participants (72%) reported receiving clinical training in psychiatry, with 74.7% expressing varying levels of satisfaction with their undergraduate psychiatry training, while 7.3% expressed dissatisfaction. Regarding CME, only 11.3% of participants engaged in at least one psychiatry-related CME session in the past two years. 54.7% of participants expressed interest in expanding their knowledge of prescribing psychotropic drugs. Around 40% of participants preferred trainings in psychotropic drugs prescription related to their specialty, while 34% were not interested in receiving further training. CONCLUSIONS: Our study shows gaps in knowledge of non-psychiatric specialists, which raises concern regarding their ability to care for mental disorders. Educational efforts should be made to improve teaching of psychiatry from the undergraduate level. Continuing Medical Education should be tailored to the specific needs and preferred learning methods of non-psychiatric physicians.


Assuntos
Padrões de Prática Médica , Psicotrópicos , Humanos , Marrocos , Psicotrópicos/uso terapêutico , Estudos Transversais , Masculino , Feminino , Adulto , Padrões de Prática Médica/estatística & dados numéricos , Pessoa de Meia-Idade , Psiquiatria/educação , Transtornos Mentais/tratamento farmacológico , Conhecimentos, Atitudes e Prática em Saúde , Avaliação das Necessidades , Prescrições de Medicamentos/estatística & dados numéricos , Competência Clínica
9.
BMC Public Health ; 24(1): 2487, 2024 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-39267001

RESUMO

BACKGROUND: Refugee minors are considered particularly vulnerable to negative health consequences from war, flight and resettlement. Offering health assessments after arrival in a host country could uncover unmet health needs and provide access to treatment. In Norway, a national guide describes these assessments, but little is known about its implementation especially for refugee minors. Thus, the aim of this study was first to explore how health assessments of refugee minors are carried out, second how health professionals perceive the needs of refugee minors and third, the competencies they perceive as necessary to meet the needs of refugee minors. METHOD: A modified Delphi study in three rounds was conducted using online surveys and one focus group to collect data on the needs and resources of refugee minors, essential factors for a good and health assessment practice. Participants were 54 health professionals responsible for early health assessments of refugee minors, throughout the Norwegian municipalities, working in primary care settings. Quantitative data was analysed descriptively, and qualitative data with content analysis. RESULTS: Health assessments of refugee minors were predominantly conducted by public health nurses, but the organisational structures surrounding assessments varied greatly according to the size of the municipalities and to how much resources were allocated. The feeling of safety was found to be paramount to ensure a good start in a new country for refugee minors. The top four competences professionals should have, were 'general communication skills', a 'health professional background', 'expertise in children's health' and 'knowledge about the national guide'. To ensure good health services for refugee minors, improved, more comprehensive, and mandatory directives for children and young individuals was highlighted. CONCLUSION: Although most refugee minors were invited and attend health assessments, one third of participating municipalities did not offer health assessments to all newcomers and the organisation and content of the assessments were diverse. Several topics, especially mental health, were postponed or not routinely addressed, contrasting with current knowledge of unmet health needs for this group. Missing documentation, practical barriers and providing general health information took time away from doing the actual assessments. The perceived needs of refugee minors were safety and stability, combined with meaningful activities, thus a coordinated effort from several services is necessary. Suggestions for improvements were more time given to assessments, better organisation and co-operation, improved competence and guidelines adjusted for age.


Assuntos
Técnica Delphi , Grupos Focais , Menores de Idade , Atenção Primária à Saúde , Refugiados , Humanos , Refugiados/psicologia , Noruega , Atenção Primária à Saúde/normas , Menores de Idade/psicologia , Feminino , Masculino , Adolescente , Criança , Pessoal de Saúde/psicologia , Inquéritos e Questionários , Avaliação das Necessidades
10.
J Headache Pain ; 25(1): 146, 2024 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-39251942

RESUMO

BACKGROUND: Having previously shown headache disorders to be prevalent in Mongolia, here we elaborate on headache as a public-health concern in this country, reporting symptom burden and headache-attributed impaired participation at individual and societal levels, and conducting a health-care needs assessment. METHODS: The study followed the standardized methodology developed by the Global Campaign against Headache, generating a representative general-population sample through multi-level randomized cluster sampling. Participants aged 18-65 years were interviewed at unannounced household visits by interviewers administering the HARDSHIP questionnaire. Symptom burden was established through questions on frequency, duration and intensity of headache, with proportion of time in ictal state calculated from frequency and duration. Individual impaired participation was established through the HALT questionnaire, enquiring into lost time from paid and household work and from leisure activities. Symptom burden and impaired participation yesterday were also assessed in those reporting headache yesterday. Population-level estimates were derived by factoring in prevalence. RESULTS: The total sample included 2,043 participants. Those reporting any headache in the last year (n = 1,351) spent, on average, 9.7% of all their time with headache, losing 1.3 workdays and 2.4 household days/3 months. These losses were considerably higher among those with probable medication-overuse headache (37.5%, 3.5 workdays, 6.7 household days) or other headache on ≥ 15 days/month (H15+) (21.9%, 2.4 workdays, 5.1 household days). At population-level (including those with and without headache), 6.2-7.4% of all time was spent with headache, 3.1% with H15+; 0.8 workdays and 1.4 household days/person/3 months were lost to headache, 0.3 workdays and 0.6 household days to migraine (the biggest contributor of all headache types). Our needs assessment estimated that one third (33.2%) of the adult population of Mongolia have headache (mostly migraine or H15+) likely to benefit from health care. CONCLUSION: This first population-based study on headache burden in Mongolia shows high levels of individual and societal burden, with H15 + the cause of greater burden at population level than migraine and TTH combined. Migraine, however, has the biggest impact on the nation's productivity. From a purely economic perspective, Mongolia, with limited health resources, would probably be best served by focusing on mitigating migraine-attributed burden.


Assuntos
Efeitos Psicossociais da Doença , Humanos , Adulto , Pessoa de Meia-Idade , Masculino , Feminino , Estudos Transversais , Mongólia/epidemiologia , Adolescente , Idoso , Adulto Jovem , Transtornos da Cefaleia/epidemiologia , Prevalência , Avaliação das Necessidades , Inquéritos e Questionários
11.
Health Promot Chronic Dis Prev Can ; 44(9): 367-375, 2024 Sep.
Artigo em Inglês, Francês | MEDLINE | ID: mdl-39264760

RESUMO

INTRODUCTION: Social prescribing (SP) is a holistic and collaborative approach to help individuals access community-based supports and services for their nonmedical social needs. The aim of this study was to assess the needs and priorities of Canadian older adults (aged 55 years and older), with a focus on optimizing SP programs for those who are systemically disadvantaged and socially marginalized. METHODS: Semistructured focus groups (N = 10 groups, 43 participants) were conducted online via Zoom with participants from across Canada. Data transcription and thematic analysis were completed in NVivo. Analyses were informed by self-determination theory. RESULTS: Our results suggest that older adults desire SP programs that respect their ability to maintain their autonomy and independence, aid and facilitate the development of connectedness and belonging, are built on a foundation of trust and relationship-building in interactions with providers and link workers, and prioritize the person and thus personalize SP to the unique needs of each individual. CONCLUSION: SP programs should be informed by the values of older adults. As work is currently underway to formalize and scale SP in Canada, personalizing these programs to the unique circumstances, needs and priorities of participants should be a top priority.


Assuntos
Grupos Focais , Pesquisa Qualitativa , Apoio Social , Humanos , Canadá/epidemiologia , Idoso , Feminino , Pessoa de Meia-Idade , Masculino , Avaliação das Necessidades , Idoso de 80 Anos ou mais , Necessidades e Demandas de Serviços de Saúde , Marginalização Social , Autonomia Pessoal
13.
J Hosp Palliat Nurs ; 26(5): 273-281, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39106153

RESUMO

Native Americans (Indigenous Americans) have high rates of serious illness in the United States. Informal caregivers are heavily relied on in caring for patients in low-resource settings. The needs of caregivers residing on reservations are sorely underreported. Therefore, our objective was to examine relationships between facilitators (communal mastery, cultural identity, and spirituality) and barriers (depression, anxiety, stress, and burden) with supportive care needs among adult informal caregivers in 1 reservation-based community. A cross-sectional survey was distributed in July and August 2022 as part of a larger multimethod, community-based participatory research study. We used descriptive statistics and linear regression models to examine relationships against the primary outcome, the Supportive Care Needs Assessment Tool for Indigenous People. Overall, 127 participants were included; most were female (n = 92, 72.4%), were between 30 and 49 years (n = 57, 44.9%), and had 6 months or less of caregiving experience (n = 41, 32.5%). Higher depression, anxiety, stress, and burden were significantly associated with higher Supportive Care Needs Assessment Tool for Indigenous People scores. Overall, mental health is a significant barrier that may indicate greater supportive care needs among informal caregivers, although further work is needed to differentiate symptoms and their impact on caregiving from a cultural perspective.


Assuntos
Cuidadores , Humanos , Estudos Transversais , Feminino , Masculino , Cuidadores/psicologia , Cuidadores/estatística & dados numéricos , Pessoa de Meia-Idade , Adulto , Inquéritos e Questionários , Idoso , Apoio Social , Avaliação das Necessidades , Pesquisa Participativa Baseada na Comunidade
14.
BMC Geriatr ; 24(1): 706, 2024 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-39182039

RESUMO

BACKGROUND: Ensuring the wellness of older individuals with disabilities requires prioritising the care needs of their carers. However, current practice lacks validated tools to measure the needs of carers in home environments. Thus, this study aimed to create and test a questionnaire on the care needs of family carers of older people with disabilities in China. METHODS: We used a standard development process to generate the questionnaire. The pilot testing included cognitive interviews to ensure interpretation as intended. Furthermore, we used a cross-sectional study method to conveniently select 640 Chinese family carers of older people with disabilities from August 1, 2022, to June 11, 2023, for face-to-face investigation. Exploratory factor analysis (EFA) aided in project reduction and factor estimation, with 30 participants undergoing retest evaluations every two weeks. Confirmatory factor analysis (CFA) assessed the model's structural validity, while internal consistency and retest reliability validated its accuracy. RESULTS: These tests established the model: content validity, item analysis and EFA. Six factors extracted from the initial analysis explained 62.891% of the observation variance. CFA showed good model fit, and the questionnaire had good reliability and validity. The final questionnaire included 21 items focusing on six dimensions: care assistance (three items), care environment (three items), care information (three items), formal support (four items), care ability (six items) and self-development (two items). CONCLUSION: The care needs questionnaire effectively evaluates the needs of family carers in their caring activities.


Assuntos
Cuidadores , Pessoas com Deficiência , Humanos , Cuidadores/psicologia , Masculino , Feminino , China , Inquéritos e Questionários , Idoso , Pessoa de Meia-Idade , Estudos Transversais , Pessoas com Deficiência/psicologia , Adulto , Reprodutibilidade dos Testes , Avaliação das Necessidades , Idoso de 80 Anos ou mais
15.
BMJ Open ; 14(8): e087231, 2024 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-39174071

RESUMO

OBJECTIVE: To identify the needs of caregivers of hospitalised adults with dementia in the hospital and during care transitions. DESIGN: Pragmatic qualitative inquiry with semi-structured interviews. SETTING: Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas, USA. PARTICIPANTS: 12 family caregivers (family member (n=11); friend (n=1)) and 15 health professionals (hospital medicine physicians (n=4), inpatient nurse case managers (n=2), social workers (n=4), outpatient geriatrics providers (n=2), a primary care provider (n=1), geriatric psychiatrists (n=2)) were interviewed. Caregivers were recruited while their care recipient was hospitalised and were interviewed at least 2 weeks after the care recipient was discharged from the hospital. Health professionals were eligible for the study if they provided care to patients with dementia in the inpatient or outpatient setting. RESULTS: Four recommendations emerged from the analysis: (1) engage caregivers as partners in the care team, (2) provide dementia-specific information and training, (3) connect caregivers to home and community-based services and (4) provide care navigation and support for the caregiver posthospitalisation. CONCLUSIONS: Hospital care transitions are challenging for caregivers of hospitalised adults living with dementia. Care transition interventions designed to support caregivers with tailored, dementia-specific information and services are needed.


Assuntos
Cuidadores , Demência , Hospitais de Veteranos , Pesquisa Qualitativa , Humanos , Cuidadores/psicologia , Demência/enfermagem , Demência/terapia , Masculino , Feminino , Idoso , Pessoa de Meia-Idade , Estados Unidos , Hospitalização , Entrevistas como Assunto , Adulto , Família/psicologia , Texas , Avaliação das Necessidades , Idoso de 80 Anos ou mais , United States Department of Veterans Affairs
16.
Health Care Manage Rev ; 49(4): 311-322, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39102343

RESUMO

BACKGROUND: There is growing attention to individual-level patient social needs such as unstable housing and food insecurity. Such considerations, however, have historically been the purview of public health and have not been a priority of more traditional health care delivery organizations, such as acute care hospitals. PURPOSE: The purpose of this study was to examine whether the presence of patient and family advisory boards (PFABs) among acute care community hospitals was associated with screening for and programs to address patient social needs. METHODS: We used a secondary data set derived from the American Hospital Association's 2020 and 2021 annual surveys, along with multinomial and negative binomial regression models to assess the relationship between the presence/absence of a PFAB and the likelihood of offering and the number of areas addressed by social needs screening programs. RESULTS: More than half (55.9%) of all responding hospitals reported having a PFAB in 2020 (55.9%) and 2021 (52.7%). The presence of a PFAB among hospitals was significantly associated with patient social needs screening, more areas addressed by programs, and more types of partners to address these needs. CONCLUSIONS: Community hospitals with a PFAB have more robust programs and partnerships to address patient social needs. PRACTICE IMPLICATIONS: Hospital leaders should consider going beyond simply establishing programs to address social needs but also consider comprehensiveness of these programs to recognize the intersectionality of social needs. One way to do this is to formally establish a PFAB to help hospitals better identify and prioritize the needs in local communities and design social needs programs/solutions that are patient- and family-centric.


Assuntos
Hospitais Comunitários , Humanos , Estados Unidos , Comitês Consultivos , Família , Inquéritos e Questionários , Avaliação das Necessidades
17.
Patient Educ Couns ; 128: 108392, 2024 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-39142033

RESUMO

OBJECTIVES: To explore the educational needs of physicians and residents regarding shared decision making (SDM). METHODS: We conducted eight focus groups with 12 general practitioners (GPs), 14 hospital specialists, 12 hospital specialist residents and 13 GP residents in Belgium. We used thematic analysis to guide data analysis. RESULTS: We identified five educational needs: (1) the need for a clear understanding of the definition of SDM and its scope; (2) how to deal with a changing professional identity; (3) acquisition of skills to perform SDM; (4) the need for reflective practice in a supportive environment; and (5) sustainable and longitudinal integration in education. CONCLUSIONS: This is the first focus group study emphasizing dealing with a changing professional identity as an educational need, besides the need for SDM-related knowledge and skills. Physicians stated that implementing spiral learning is needed at all stages of medical training, aimed at all specialties to foster interprofessional collaboration. PRACTICE IMPLICATIONS: Our findings can support development of future educational SDM interventions, integrating both competence development and professional identity formation. We provide practical recommendations on didactic formats and strategies, hoping to finally reach better implementation of SDM in daily practice.


Assuntos
Tomada de Decisão Compartilhada , Grupos Focais , Internato e Residência , Pesquisa Qualitativa , Humanos , Feminino , Masculino , Bélgica , Adulto , Médicos/psicologia , Competência Clínica , Pessoa de Meia-Idade , Relações Médico-Paciente , Participação do Paciente , Avaliação das Necessidades , Atitude do Pessoal de Saúde , Tomada de Decisões
18.
J Headache Pain ; 25(1): 133, 2024 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-39152396

RESUMO

BACKGROUND: We have previously shown headache to be highly prevalent in Cameroon. Here we present the attributed burden. We also perform a headache-care needs assessment. METHODS: This was a cross-sectional survey among adults (18-65 years) in the general population. Multistage cluster-sampling in four regions (Centre, Littoral, West and Adamawa), home to almost half the country's population, generated a representative sample. We used the standardised methodology of the Global Campaign against Headache, including the HARDSHIP questionnaire, with diagnostic questions based on ICHD-3 and enquiries into symptom burden, impaired participation (lost productivity and disengagement from social activity), quality of life (QoL) using WHOQoL-8, and willingness to pay (WTP) for effective care. We defined headache care "need" in terms of likelihood of benefit, counting all those with probable medication-overuse headache (pMOH) or other headache on ≥ 15 days/month (H15 +), with migraine on ≥ 3 days/month, or with migraine or tension-type headache (TTH) and meeting either of two criteria: a) proportion of time in ictal state (pTIS) > 3.3% and intensity ≥ 2 (moderate-to-severe); or b) ≥ 3 lost days from paid and/or household work in the preceding 3 months. RESULTS: Among 3,100 participants, mean frequency of any headache was 6.7 days/month, mean duration 13.0 h and mean intensity 2.3 (moderate). Mean pTIS was 9.8%, which (with prevalence factored in) diluted to 6.1-7.4% of all time in the population. Most time was spent with H15 + (5.3% of all time), followed by TTH (1.0%) and migraine (0.8%). For all headache, mean lost days/3 months were 3.4 from paid work, 3.0 from household work and 0.6 from social/leisure activities, diluting to 2.5, 2.2 and 0.6 days/3 months in the population. QoL (no headache: 27.9/40) was adversely impacted by pMOH (25.0) and other H15 + (26.0) but not by migraine (28.0) or TTH (28.0). WTP (maximally XAF 4,462.40 [USD 7.65] per month) was not significantly different between headache types. An estimated 37.0% of adult Cameroonians need headache care. CONCLUSION: Headache disorders in Cameroon are not only prevalent but also associated with high attributed burden, with heavily impaired participation. Headache-care needs are very high, but so are the economic costs of not providing care.


Assuntos
Efeitos Psicossociais da Doença , Humanos , Camarões/epidemiologia , Adulto , Pessoa de Meia-Idade , Masculino , Feminino , Estudos Transversais , Adolescente , Adulto Jovem , Idoso , Qualidade de Vida , Avaliação das Necessidades , Transtornos da Cefaleia/epidemiologia , Transtornos da Cefaleia/economia , Transtornos da Cefaleia/terapia , Prevalência , Inquéritos e Questionários
19.
Support Care Cancer ; 32(9): 576, 2024 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-39107432

RESUMO

PURPOSE: This study aimed to determine supportive care needs and related factors after surgery in patients with breast cancer. METHODS: This cross-sectional study was conducted with 98 breast cancer patients in a Training and Research Hospital in Istanbul between September 2022 and November 2023. The Personal Information Form and the Supportive Care Needs Survey Short Form Turkish version were used to collect data. One-way variance analysis, post hoc (Tukey, LSD), and t-test were used to analyze the data. RESULTS: The total scale mean score for women who underwent surgery for breast cancer in the study was 83.95 22.97. Statistically significantly higher total scale scores were observed in younger women and those who received chemotherapy and radiotherapy than in others. The mean physical and daily living subscale scores of those who received chemotherapy and radiotherapy were higher than those who did not (p < .05). The psychology subscale mean scores of those who were young and unemployed were higher than the others (p < .05). The mean sexuality scores of those who were young, those with high education levels, and those who received chemotherapy were higher than the other groups (p < .05). Age factor affects SCN scores in women with breast cancer. CONCLUSION: Supportive care needs are higher among women with breast cancer who are younger and receive chemotherapy and radiotherapy. The physical needs of those who receive chemotherapy and radiotherapy, the psychological needs of those who are younger and unemployed, and the need for support regarding sexuality were greater among those who are younger and with higher education. Nurses should be aware of the specific needs of these disadvantaged groups and provide individualized holistic care.


Assuntos
Neoplasias da Mama , Humanos , Feminino , Estudos Transversais , Neoplasias da Mama/cirurgia , Neoplasias da Mama/terapia , Neoplasias da Mama/psicologia , Pessoa de Meia-Idade , Adulto , Turquia , Inquéritos e Questionários , Idoso , Apoio Social , Fatores Etários , Avaliação das Necessidades
20.
BMC Geriatr ; 24(1): 724, 2024 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-39215257

RESUMO

BACKGROUND: Family caregivers of persons with dementia are faced with complex caregiving management needs. This study had two aims: (1) to identify caregiving management needs of family caregivers of persons with dementia and (2) identify any variables that might influence these needs. METHODS: This cross-sectional study recruited family caregivers of persons with dementia (N = 250) through referrals from clinicians at a dementia outpatient clinic in Northern Taiwan. Data were collected with a 32-item researcher-developed instrument, the Caregiving Management Needs Scale (CMNS), to identify management needs specific to family caregivers of persons with dementia. The CMNS was comprised of questions about the types of assistance or support family caregivers would like to receive to facilitate caregiving. RESULTS: CMNS scores indicated caregivers had moderate management needs. Caregivers of relatives with a moderate severity of dementia had significantly higher scores on the CMNS compared with caregivers of persons with very mild dementia (p < 0.01). Linear regression analysis indicated significant predictors of high caregiving management needs were caregivers who were female (p < 0.01), and persons with dementia with behavioral problems (p < 0.01), low scores for Activities of Daily Living (p < 0.01), regular medication adherence (p < 0.01), and use of long-term care services (p < 0.001) were significant (F[13, 236] = 7.12; p < 0.001; R2 = 28.2%). CONCLUSIONS: Understanding variables and predictors of caregiving management needs for family caregivers could reduce the complexity of caregiving. TRIAL REGISTRATION: ClinicalTrials.gov NCT05151185.


Assuntos
Cuidadores , Demência , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidadores/psicologia , Estudos Transversais , Demência/terapia , Demência/psicologia , Família/psicologia , Necessidades e Demandas de Serviços de Saúde , Avaliação das Necessidades , Valor Preditivo dos Testes , Taiwan/epidemiologia , Adulto Jovem
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