Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 10.975
Filtrar
Mais filtros








Intervalo de ano de publicação
1.
Addict Behav ; 124: 107093, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34500234

RESUMO

OBJECTIVE: Harmful drinkers represent an important Alcohol Use Disorder (AUD) group in public health terms, accounting for significant health and social costs. However, harmful drinkers are characterized by low problem recognition; they tend to construct their drinking identity as positive and problem-free, actively setting themselves apart from the stigmatised 'alcoholic other'. As such, harmful drinkers rarely engage in treatment and represent an important opportunity for lower threshold interventions and self-change. The present study sought to explore AUD problem framing and stigma effects on problem recognition. METHODS: Harmful drinkers without perceived addiction experience recruited online (n = 244, 54% male, 46% female, 96% British) were randomised to one of six conditions comprising beliefs about alcohol problems (control, continuum, binary disease model) and stigma (stigma, non-stigma), and completed measures relating to problem recognition. RESULTS: As predicted, results found that harmful drinkers exposed to binary disease model beliefs and stigmatising language had significantly lower problem recognition than those in other conditions. However, no support was found for the prediction that continuum beliefs would be associated with higher problem recognition. Results suggest that the interaction of binary disease model beliefs and stigma prompted alcoholic label avoidance. CONCLUSION: These findings suggest that problem framing has important consequences for harmful drinkers. Implications for behaviour change amongst harmful drinkers through mechanisms of problem framing and identity are discussed.


Assuntos
Transtornos Relacionados ao Uso de Álcool , Alcoolismo , Comportamento Aditivo , Consumo de Bebidas Alcoólicas , Feminino , Humanos , Masculino , Estigma Social
2.
Esc. Anna Nery Rev. Enferm ; 26: e20210109, 2022.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1346058

RESUMO

Resumo Objetivo Analisar as percepções de enfermeiros sobre gestão do cuidado e seus fatores intervenientes para o controle da tuberculose na Atenção Primária em Saúde. Método Estudo descritivo, qualitativo, realizado com 29 enfermeiros que atuavam no controle da tuberculose em 23 Unidades Básicas de Saúde de Belém, Pará. Os dados foram produzidos por entrevistas individuais, utilizando roteiro semiestruturado, e submetidos à análise de conteúdo temática, proposta por Bardin. Resultados Originaram-se duas categorias temáticas: "A gestão do cuidado de enfermeiros para o controle da tuberculose nas Unidades Básicas de Saúde" e "Fatores intervenientes na efetivação da gestão do cuidado no controle da tuberculose nas Unidades Básicas de Saúde". Conclusão e implicações para a prática O conhecimento dos enfermeiros sobre a política e a gestão do cuidado no controle da tuberculose precisa ser fortalecido, e embora eles tenham clareza sobre suas competências, não conseguem realizá-las em sua plenitude por questões referentes à pouca organização dos serviços, centralização das atividades nos enfermeiros, baixa cooperação multiprofissional, falta de insumos e de pessoal e questões socioeconômicas ligadas ao usuário com tuberculose.


Resumen Objetivo Analizar la percepción de enfermeros sobre la gestión de la atención y los factores intervinientes para el control de la tuberculosis en la Atención Primaria de la Salud. Método Estudio descriptivo cualitativo realizado con 29 enfermeros que pre en el control de la tuberculosis en 23 Unidades Básicas de Salud de Belém, Pará. Los datos fueron producidos por entrevistas individuales, utilizando un guion semiestructurado, y sometido al análisis de contenido temático propuesto por Bardin. Resultados Se originaron dos categorías temáticas: "La gestión de la atención de enfermeros para el control de la tuberculosis en las Unidades Básicas de Salud" y "Factores intervinientes en la efectividad de la gestión de la atención en el control de la tuberculosis en las Unidades Básicas de Salud". Conclusión e implicaciones para la práctica Es necesario fortalecer el conocimiento de las enfermeras sobre la política y la gestión de la atención en el control de la tuberculosis, y aunque tienen claras sus competencias, no pueden implementarlas en su totalidad debido a problemas relacionados con la mala organización de los servicios, la centralización de actividades en los enfermeros, baja cooperación multiprofesional, falta de insumos y personal y aspectos socioeconómicos relacionados con el usuario con tuberculosis.


Abstract Objective To analyze nurses' perceptions on care management and its intervening factors for tuberculosis control in Primary Health Care. Method A descriptive and qualitative study conducted with 29 nurses who worked on tuberculosis control in 23 Basic Health Units in Belém, Pará. The data were produced by individual interviews, using a semi-structured script, and submitted to thematic content analysis, as proposed by Bardin. Results Two thematic categories emerged, namely: "Care management by nurses for tuberculosis control in Basic Health Units" and "Intervening factors in the application of care management for tuberculosis control in Basic Health Units". Conclusion and implications for the practice The nurses' knowledge about the care policy and management for tuberculosis control needs to be strengthened and, although nurses are aware of their competences, they are unable to fully implement them due to issues related to poor organization services, centralization of activities on them, low multiprofessional cooperation, scarcity of supplies and personnel, and socioeconomic issues related to tuberculosis patients.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Atenção Primária à Saúde , Tuberculose/prevenção & controle , Gestão em Saúde , Enfermeiras e Enfermeiros/psicologia , Prática Profissional , Apoio Social , Fatores Socioeconômicos , Tuberculose/enfermagem , Tuberculose/terapia , Educação em Saúde , Pesquisa Qualitativa , Vulnerabilidade em Saúde , Capacitação Profissional , Estigma Social , Cooperação e Adesão ao Tratamento , Cuidados de Enfermagem
3.
BMJ Open ; 11(11): e048241, 2021 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-34728443

RESUMO

OBJECTIVE: Amid the COVID-19 pandemic, social stigma towards COVID-19 infection has become a major component of public discourse and social phenomena. As such, we aimed to develop and validate the COVID-19 Public Stigma Scale (COVID-PSS). DESIGN AND SETTING: National-based survey cross-sectional study during the lockdown in Thailand. PARTICIPANTS: We invited the 4004 adult public to complete a set of measurement tools, including the COVID-PSS, global fear of COVID-19, perceived risk of COVID-19 infection, Bogardus Social Distance Scale, Pain Intensity Scale and Insomnia Severity Index. METHODS: Factor structure dimensionality was constructed and reaffirmed with model fit by exploratory and confirmatory factor analyses and non-parametric item response theory (IRT) analysis. Psychometric properties for validity and reliability were tested. An anchor-based approach was performed for classifying the proper cut-off scores. RESULTS: After factor analysis, IRT analysis and test for model fit, we created the final 10-item COVID-PSS with a three-factor structure: stereotype, prejudice and fear. Face and content validity were established through the public and experts' perspectives. The COVID-PSS was significantly correlated (Spearman rank, 95% CI) with the global fear of COVID-19 (0.68, 95% CI 0.66 to 0.70), perceived risk of COVID-19 infection (0.79, 95% CI 0.77 to 0.80) and the Bogardus Social Distance Scale (0.50, 95% CI 0.48 to 0.53), indicating good convergent validity. The correlation statistics between the COVID-PSS and the Pain Intensity Scale and Insomnia Severity Index were <0.2, supporting the discriminant validity. The reliability of the COVID-PSS was satisfactory, with good internal consistency (Cronbach's α of 0.85, 95% CI 0.84 to 0.86) and test-retest reproducibility (intraclass correlation of 0.94, 95% CI 0.86 to 0.96). The proposed cut-off scores were as follows: no/minimal (≤18), moderate (19-25) and high (≥26) public stigma towards COVID-19 infection. CONCLUSIONS: The COVID-PSS is practical and suitable for measuring stigma towards COVID-19 in a public health survey. However, cross-cultural adaptation may be needed.


Assuntos
COVID-19 , Estigma Social , Adulto , Controle de Doenças Transmissíveis , Estudos Transversais , Análise Fatorial , Humanos , Pandemias , Psicometria , Reprodutibilidade dos Testes , SARS-CoV-2 , Inquéritos e Questionários
4.
AIDS Patient Care STDS ; 35(11): 441-448, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34739336

RESUMO

Stigma in health care settings can have negative consequences on women living with HIV, such as increasing the likelihood of missed visits and reducing trust in their clinical providers. Informed by prior stigma research and considering knowledge gaps related to the effect of patient-provider race concordance, we conducted this study to assess if patient-provider race concordance moderates the expected association between HIV-related stigma in health care settings and patients' trust in their providers. Moderation analyses were conducted using Women's Interagency HIV Study data (N = 931). We found significant main effects for patient-provider race concordance. Higher experienced stigma was associated with lower trust in providers in all patient-provider race combinations [White-White: B = -0.89, standard error (SE) = 0.14, p = 0.000, 95% confidence interval, CI (-1.161 to -0.624); Black patient-White provider: B = -0.19, SE = 0.06, p = 0.003, 95% CI (-0.309 to -0.062); and Black-Black: B = -0.30, SE = 0.14, p = 0.037, 95% CI (-0.575 to -0.017)]. Higher anticipated stigma was also associated with lower trust in providers [White-White: B = -0.42, SE = 0.07, p = 0.000, 95% CI (-0.552 to -0.289); Black patient-White provider: B = -0.17, SE = 0.03, p = 0.000, 95% CI (-0.232 to -0.106); and Black-Black: B = -0.18, SE = 0.06, p = 0.002, 95% CI (-0.293 to -0.066)]. Significant interaction effects indicated that the negative associations between experienced and anticipated HIV-related stigma and trust in providers were stronger for the White-White combination compared with the others. Thus, we found that significant relationships between HIV-related experienced and anticipated stigma in health care settings and trust in providers exist and that these associations vary across different patient-provider race combinations. Given that reduced trust in providers is associated with antiretroviral medication nonadherence and higher rates of missed clinical visits, interventions to address HIV-related stigma in health care settings may improve continuum of care outcomes.


Assuntos
Infecções por HIV , Confiança , Antirretrovirais/uso terapêutico , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Adesão à Medicação , Estigma Social
5.
Artigo em Inglês | MEDLINE | ID: mdl-34770234

RESUMO

This study aimed to examine the profile of COVID-19-related public stigma and its correlates in the general population of China. A cross-sectional online survey was conducted in China from 7 May to 25 May in 2020. A total of 1212 participants from the general population completed the survey measuring their stigmatizing attitudes towards COVID-19, as well as knowledge and causal attributions of COVID-19. Univariate and multivariate analyses were performed to examine the correlates of COVID-19-related public stigma. A total of 31.8% of participants endorsed stigmatization towards people with COVID-19. Those who were of older age (t = -3.97, p < 0.001), married (F = 3.04, p < 0.05), had a lower level of education (F = 8.11, p < 0.001), and a serious psychological response (F = 3.76, p < 0.05) reported significantly higher scores of public stigma. Dangerousness (B = 0.047, p < 0.001), fear (B = 0.059, p < 0.001), anger (B = 0.038, p < 0.01), and responsibility (B = 0.041, p < 0.001) were positively associated with public stigma. This study shows that public stigma related to COVID-19 is prevalent in the general population of China. Actions against public stigma need to contain the spread of misinformation about COVID-19, alter inappropriate attributions, alleviate unfavorable reactions, and provide psychosocial support for the public.


Assuntos
COVID-19 , Idoso , China , Estudos Transversais , Humanos , SARS-CoV-2 , Estigma Social , Inquéritos e Questionários
6.
Artigo em Inglês | MEDLINE | ID: mdl-34769841

RESUMO

(1) Background: Gestational surrogacy is the most common type of surrogacy today. Although technologically well-developed and legal in many countries, it challenges and even contradicts the basic traditional concepts of family, motherhood, and gender roles. In the present study, we examined the types of stigma coping strategies surrogate mothers discussed in an online support group in post-Soviet Russia. (2) Method: We conducted a qualitative thematic analysis of 15,602 posts on a Russian-language online support group for surrogate mothers. (3) Findings: group members discussed four types of coping strategies: stigma internalization, stigma avoidance, group identification, and stigma challenging. Nevertheless, these strategies varied across the surrogate motherhood stages. Group members advised each other on specific strategies to use to cope with the state of discreditable (invisible) stigma (i.e., during the first few months of their pregnancies), with different strategies for when the pregnancies became visible and they risked becoming discredited people. Furthermore, group members disclosed that they used these strategies even when they returned to their previous family and work routines. Theoretically, our findings challenge Goffman's classic theoretical dichotomy and coping research concerning discreditable (invisible) and discredited (visible) stigma. (4) Conclusion: Our findings indicate that surrogate mothers anticipate experiencing stigma and therefore plan for it by discussing potential coping strategies in the online group. Moreover, any intervention designed to cater to the needs of surrogate mothers must, therefore, take into consideration the social needs of their entire family.


Assuntos
Cônjuges , Mães Substitutas , Adaptação Psicológica , Feminino , Humanos , Idioma , Mães , Gravidez , Federação Russa , Estigma Social
7.
J Abnorm Psychol ; 130(7): 713-726, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34780228

RESUMO

Sexual minority men are at greater risk of depression and suicidality than heterosexuals. Stigma, the most frequently hypothesized risk factor for this disparity, operates across socioecological levels-structural (e.g., laws), interpersonal (e.g., discrimination), and individual (e.g., self-stigma). Although the literature on stigma and mental health has focused on interpersonal and individual forms of stigma, emerging research has shown that structural stigma is also associated with adverse mental health outcomes. However, there is limited data on whether changes in structural stigma, such as when a stigmatized person moves to a lower stigma context, affect mental health, and on the mechanisms underlying this association. To address these questions, we use data from the 2017/18 European Men-who-have-sex-with-men Internet Survey (n = 123,428), which assessed mental health (i.e., Patient Health Questionnaire) and psychosocial mediators (i.e., sexual orientation concealment, internalized homonegativity, and social isolation). We linked these data to an objective indicator of structural stigma related to sexual orientation-including 15 laws and policies as well as aggregated social attitudes-in respondents' countries of origin (N = 178) and receiving countries (N = 48). Among respondents who still live in their country of birth (N = 106,883), structural stigma was related to depression and suicidality via internalized homonegativity and social isolation. Among respondents who moved from higher-to-lower structural stigma countries (n = 11,831), longer exposure to the lower structural stigma environments of their receiving countries was associated with a significantly: 1) lower risk of depression and suicidality; 2) lower odds of concealment, internalized homonegativity, and social isolation; and 3) smaller indirect effect of structural stigma on mental health through these mediators. This study provides additional evidence that stigma is a sociocultural determinant of mental health. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Depressão , Homossexualidade Masculina , Estigma Social , Suicídio , Depressão/epidemiologia , Saúde Global/estatística & dados numéricos , Homossexualidade Masculina/psicologia , Homossexualidade Masculina/estatística & dados numéricos , Humanos , Masculino , Análise Multinível , Suicídio/psicologia
8.
Cien Saude Colet ; 26(suppl 3): 5361-5370, 2021.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34787225

RESUMO

The article aims to raise reflections about the necropolitics directed to HIV/AIDS in Brazil from a set of rationalities that permeate the processes of configuration of the governmental agenda, treatment of the disease, and the policies and technologies involved. For this purpose, a non-systematic theoretical review was carried out from a threefold aspect: the stigma of AIDS, necropolitics, and life politics. We concluded that life politics, as opposed to necropolitics, contributes to the defense of human rights and health, above all, to the demystification of stigma and the politics of enmity historicized in AIDS.


Assuntos
Síndrome de Imunodeficiência Adquirida , Infecções por HIV , Brasil , Direitos Humanos , Humanos , Política , Estigma Social
9.
J Int Assoc Provid AIDS Care ; 20: 23259582211052399, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34751055

RESUMO

One in three people with HIV (PWH) has hypertension. However, most hypertensive PWH in sub-Saharan Africa are unaware of their hypertension diagnosis and are not on treatment. To better understand barriers to hypertension care faced by PWH, we interviewed 15 medical providers who care for patients with HIV and hypertension in northern Tanzania. The data revealed barriers at the patient, provider, and system level and included: stress, depression, and HIV-related stigma; lack of hypertension knowledge; insufficient hypertension training; inefficient prescribing practices; challenges with counselling; capacity limitations in hypertension care; high costs of care; and lack of routine hypertension screening and follow-up. Opportunities for improvement focused on prioritizing resources and funding towards hypertension care. System-related challenges were the underlying cause of barriers at individual levels. Strategies that focus on strengthening capacity and utilize existing HIV platforms to promote hypertension care delivery are urgently needed to improve cardiovascular outcomes among PWH.


Assuntos
Infecções por HIV , Hipertensão , Aconselhamento , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Hipertensão/epidemiologia , Hipertensão/terapia , Estigma Social , Tanzânia/epidemiologia
10.
Artigo em Inglês | MEDLINE | ID: mdl-34769617

RESUMO

Workplace interventions that leverage social tactics to improve health and well-being are becoming more common. As an example, peer mental health support interventions aim to reduce stigma and promote treatment seeking in first responder populations. Given the social nature of these interventions, it is important to consider how the preexisting social context influences intervention outcomes. A peer mental health support intervention was delivered among first responders, and self-efficacy and intention to have supportive peer conversations were measured pre-and post-intervention. Trust in peers was measured prior to the intervention. Results suggest a floor effect may exist for self-efficacy, in which a foundational level of trust and pre-intervention self-efficacy may be needed to maximize intervention effectiveness. As the future of work brings complex safety and health challenges, collaborative solutions that engage multiple stakeholders (employees, their peers, and their organization) will be needed. This study suggests that more frequent attention to pre-existing intervention context, particularly social context in peer-focused intervention, will enhance intervention outcomes.


Assuntos
Socorristas , Saúde Mental , Humanos , Grupo Associado , Estigma Social , Local de Trabalho
11.
J Aging Stud ; 59: 100967, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34794712

RESUMO

It has been argued that older people living with dementia often experience stigma. Several media interventions have been designed to raise public awareness about dementia, as well as to de-stigmatise the condition and people living with it; however, few studies have investigated how media interventions may serve to reduce stigma. The present study focused on a Chinese reality show, Forget Me Not Café, which brought together five older people (aged 65 and older) living with dementia to run a pop-up restaurant and intended to reduce the stigma of dementia. The study aimed to explore how the reality show cast talk (or write) about dementia in older people. This study performed a thematic analysis on the written and spoken content about how the show presented dementia in older people. Four discursive themes were identified, including: age as a risk factor for dementia; early signs and symptoms of dementia in older people; the pressure on the family of people with dementia; and expectations of people living with dementia. The findings of this study show that the views of the reality show cast highlight the capability of older people with dementia to communicate effectively and live with the condition, their personal goals of sustaining a happy, meaningful, and sociable life, and the actions they took to positively influence personal circumstances. The findings also indicate that this reality show might help reduce the stigma of dementia and empower older people living with dementia, while it also tends to stress the responsibility for care on family carers and shift the responsibility of managing the dementia-related challenges to older people living with dementia. These suggest a neoliberal tenet of personal responsibility for health in China. Given the media's role in reflecting and shaping perceptions and attitudes towards dementia and people living with it, this study contributes to a greater understanding of the ways in which reality shows can be used to promote awareness and challenge the stigma of dementia and arguably other conditions.


Assuntos
Demência , Restaurantes , Idoso , Atitude , Cuidadores , Humanos , Estigma Social
12.
Psychiatr Danub ; 33(3): 378-385, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34795187

RESUMO

Stigma is a convoluted interaction between history, sociology, psychology, medicine, anthropology, and politics. Often, stigma is inter-twined at cognitive-emotional-behavioral level with a socio-cultural-economic-political milieu and hence distinct from prejudice, discrimination or, stereotypy. Stigma against diseases as a concept has evolved and has differed among various illnesses. At this time of humanitarian crisis, it is prudent to understand the concept, elements and models of stigma to tackle stigma against COVID-19 instrumentally. Stigma against COVID-19 can be partially extrapolated from various models described in psychiatry for mental illness. We propose an integrated socio-cognitive-emotional-behavioral model of stigma to conceptualize and understand the stigma against COVID-19, a matter of immense public health significance.


Assuntos
COVID-19 , Dípteros , Transtornos Mentais , Animais , Cognição , Humanos , SARS-CoV-2 , Estigma Social
13.
Nurs Clin North Am ; 56(4): 479-493, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34749889

RESUMO

Weight bias and stigma exist in a variety of realms in our society (media, education, employment, and health care), and unfortunately many view it as a socially acceptable form of discrimination. Patients with obesity often avoid scheduling appointments for health promotion visits and routine care due to perceived weight bias and stigma from their health care provider. Within the health care setting, it is important that health care providers strategically focus on reducing obesity bias and provide high-quality obesity management. People-first language should be used and waiting rooms and examination rooms should be accommodating to people of all sizes.


Assuntos
Atitude do Pessoal de Saúde , Viés , Obesidade/psicologia , Discriminação Social , Estigma Social , Humanos , Estereotipagem
14.
Nurs Clin North Am ; 56(4): 553-563, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34749894

RESUMO

Many psychiatric disorders are associated with obesity and include mood disorders, anxiety disorders, personality disorders, attention deficit hyperactivity disorder, binge eating disorders, trauma, bipolar disorder, and schizophrenia. According to National Obesity Observatory, there is evidence that both obesity and mental health disorders take up a significant portion of the global burden of disease. The bidirectional nature of obesity and mental illness indicates the importance of screening all persons being treated for either obesity or mental illnesses be screened for the other. Failure to do so may decrease the effectiveness of treatment for each one individually.


Assuntos
Transtornos de Ansiedade/complicações , Transtornos do Humor/complicações , Obesidade/complicações , Estigma Social , Fatores Etários , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Humanos , Psicotrópicos/efeitos adversos , Fatores Sexuais
15.
Nurs Clin North Am ; 56(4): 583-597, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34749897

RESUMO

Pediatric obesity is a heterogeneous, chronic, relapsing disease associated with metabolic and psychosocial complications. Weight-based victimization, including unrelenting microaggressions, negatively impacts child mental and physical health. Evidence-based guidelines offer individualized, stepwise approaches to obesity treatment. Pediatric nurses positively impact children with obesity by providing affirmation, clinical management, and psychosocial support. Pediatric nurses are respected and positioned to present evidence-based obesity education, correct common obesity myths, sensitively address obesity-related bias and discrimination, and model person-first language and actions. This article shares how nurses in multiple practice areas can make a meaningful impact on the lives of children and adolescents with obesity.


Assuntos
Bullying/psicologia , Papel do Profissional de Enfermagem , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/psicologia , Estigma Social , Adolescente , Criança , Vítimas de Crime/psicologia , Família/psicologia , Humanos , Obesidade Pediátrica/tratamento farmacológico , Estados Unidos/epidemiologia
16.
Nurs Clin North Am ; 56(4): 599-607, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34749898

RESUMO

The health outcomes of men are significantly worse, when compared with their female counterparts, for the top 15 leading causes of death nationwide. At this time, men are not actively engaged in the health care system, creating a challenge for those managing patients in the clinical setting. The premature morbidity and mortality of men financially burdens the health care system and places a financial strain in secondary and tertiary preventive care that is simply not sustainable. Obesity is a catalyst that fuels disease and is directly responsible for the pathogenesis for the disease claiming the lives of men nationwide.


Assuntos
Adiposidade , Masculinidade , Saúde do Homem , Obesidade , Atenção Primária à Saúde , Estigma Social , Atitude Frente a Saúde , Humanos , Masculino , Obesidade/epidemiologia , Obesidade/terapia , Atenção Primária à Saúde/organização & administração , Fatores Sexuais , Estados Unidos/epidemiologia
17.
Nurs Clin North Am ; 56(4): 609-617, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34749899

RESUMO

Women who are obese are at risk for conditions that are different from those experienced by men. Some of these conditions are gender based; others are socially determined. In societies where appearance and being thin are valued and promoted in the media, advertising, literature, and other areas, women who are obese are subject to biases and stereotyping that impact them socially, financially, and academically. Obesity should be assessed and managed in the same way as other chronic disorders with patient-centered care, respect, and support from the health care team. Clinicians must approach the subject of weight with sensitivity.


Assuntos
Parto Obstétrico , Obesidade/complicações , Assistência Centrada no Paciente , Síndrome do Ovário Policístico/fisiopatologia , Estigma Social , Índice de Massa Corporal , Parto Obstétrico/efeitos adversos , Feminino , Humanos
18.
AIDS Res Ther ; 18(1): 85, 2021 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-34784918

RESUMO

INTRODUCTION: Programmes that merge management of Human Immunodeficiency Virus (HIV) and tuberculosis (TB) aim to improve HIV/TB co-infected patients' access to comprehensive treatment. However, several reports from sub-Saharan Africa (SSA) indicate suboptimal uptake of antiretroviral therapy (ART) even after integration of HIV and TB treatment. This study assessed ART uptake, its barriers and enablers in programmes integrating TB and HIV treatment in SSA. METHOD: A systematic review was performed. Seven databases were searched for eligible quantitative, qualitative and mixed-methods studies published from March 2004 through July 2019. Random-effects meta-analysis was used to obtain pooled estimates of ART uptake. A thematic approach was used to analyse and synthesise data on barriers and enablers. RESULTS: Of 5139 references identified, 27 were included in the review: 23/27 estimated ART uptake and 10/27 assessed barriers to and/or enablers of ART uptake. The pooled ART uptake was 53% (95% CI: 42, 63%) and between-study heterogeneity was high (I2 = 99.71%, p < 0.001). WHO guideline on collaborative TB/HIV activities and sample size were associated with heterogeneity. There were statistically significant subgroup effects with high heterogeneity after subgroup analyses by region, guideline on collaborative TB/HIV activities, study design, and sample size. The most frequently described socioeconomic and individual level barriers to ART uptake were stigma, low income, and younger age group. The most frequently reported health system-related barriers were limited staff capacity, shortages in medical supplies, lack of infrastructure, and poor adherence to or lack of treatment guidelines. Clinical barriers included intolerance to anti-TB drugs, fear of drug toxicity, and contraindications to antiretrovirals. Health system enablers included good management of the procurement, supply, and dispensation chain; convenience and accessibility of treatment services; and strong staff capacity. Availability of psychosocial support was the most frequently reported enabler of uptake at the community level. CONCLUSIONS: In SSA, programmes integrating treatment of TB and HIV do not, in general, achieve high ART uptake but we observe a net improvement in uptake after WHO issued the 2012 guidelines on collaborative TB/HIV activities. The recurrence of specific modifiable system-level and patient-level factors in the literature reveals key intervention points to improve ART uptake in these programmes. Systematic review registration: CRD42019131933.


Assuntos
Infecções por HIV , Tuberculose , Antirretrovirais/uso terapêutico , Antituberculosos/uso terapêutico , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Estigma Social , Tuberculose/tratamento farmacológico
19.
Rev Bras Enferm ; 75Suppl 1(Suppl 1): e20210038, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34816966

RESUMO

OBJECTIVE: to analyze the stigma characteristics perceived in the experience of men who had COVID-19. METHOD: this qualitative study involved men living in Brazil, diagnosed with COVID-19, who answered semi-structured questions in an online form. Data were subjected to thematic and lexical analysis, interpreted in the light of the stigma theory. RESULTS: 92 men, adults, cisgender, heterosexual, of mixed race/color, belonging to middle class, living in the urban area, with higher education participated. The stigma characteristics evidenced were the occurrence of leave, perception of impolite treatment, use of labels and discrimination by co-workers, family members, neighbors and even healthcare professionals, with consequences for the psycho-emotional dimension. FINAL CONSIDERATIONS: discrimination and exclusion derived from stigma surprised men marked by class and gender privileges, little used to being downgraded in interactions when compared to other groups.


Assuntos
COVID-19 , Infecções por HIV , Adulto , Humanos , Masculino , Pesquisa Qualitativa , SARS-CoV-2 , Estigma Social
20.
Afr J Prim Health Care Fam Med ; 13(1): e1-e3, 2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34797118

RESUMO

The Kenyan Ministry of Health envisages that family physicians should play an important role in the implementation of community orientated primary care (COPC) in collaboration with the community health team. The Kenyan Community Health Strategy forms a solid basis for the implementation of the COPC model. Residents and faculty of the Family Medicine department at the Aga Khan University Hospital Nairobi collaborated with the Kaloleni sub-county of Kilifi County government near Mombasa in a five-step COPC process to better understand and act against the high prevalence of HIV stigma in the coastal region. Firstly, a deeper understanding of human immunodeficiency virus (HIV) stigma was acquired through community visits and work in the comprehensive care clinic. Secondly, a collaborative implementation team was formed to design a targeted and feasible intervention. In a participatory approach, a two-step intervention was employed, firstly sensitising healthcare workers and community health volunteers (CHVs) on the high prevalence of HIV stigma in their community and educating them on HIV-related issues. Secondly, the information was disseminated to the community through home visits by CHVs, health talks and the set-up of an HIV support group at the facility. This short report illustrates the important contribution of family physicians to implementation of COPC and capacity building of the primary healthcare team.


Assuntos
Medicina de Família e Comunidade , Infecções por HIV , Infecções por HIV/terapia , Humanos , Quênia , Atenção Primária à Saúde , Estigma Social
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA