RESUMO
BACKGROUND: The effectiveness of screening in colorectal cancer prevention depends on sustained participation rates. The objective of this study was to explore factors related to the longitudinal adherence of screening behavior in the context of a biennial population-based cancer screening program. METHODS: Eight focus groups were conducted with individuals who were invited two or three consecutive times to a population-based colorectal cancer screening program using a fecal occult blood test and who agreed to participate in the program at least once (n = 45). The criteria used to select the study members included adherence to fecal occult blood test maintenance, factors regarding their initial participation in the colorectal cancer screening, sex, and contextual educational level. RESULTS: The participants expressed a high level of satisfaction with the program; however, they showed a low level of understanding with respect to cancer screening. Consulting a general practitioner was cited by all participants as an important factor that mediated their final decision or influenced their behavior as a whole with regard to the program. Fear played a different role in the screening behavior for regular and irregular adherent participants. In the adherent participants, fear facilitated their continued participation in the screening program, whereas for the irregular participants, fear led them to avoid or refuse further screening. Having a close person diagnosed with colorectal cancer was a facilitator for the regular adherent participants. The irregular adherent participants showed some relaxation with respect to screening after a negative result and considered that further screening was no longer necessary. CONCLUSION: Considering the importance of primary healthcare professionals in the decision regarding sustained participation, it is important to better engage them with cancer screening programs, as well as improve the communication channels to provide accurate and balanced information for both health professionals and individuals.
Assuntos
Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/psicologia , Programas de Rastreamento/psicologia , Idoso , Tomada de Decisões , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sangue Oculto , Cooperação do Paciente , Atenção Primária à Saúde , Pesquisa QualitativaRESUMO
The aim of this qualitative study is to identify the dimensions people used to assess the risk of smoking and then compare them with those used by health professionals in primary healthcare. Five discussion groups were conducted. The field work was carried out in Barcelona (Spain), from February 2005 to January 2006. Data were analyzed following a semantic-thematic categorical content analysis (ACC-ts). Results showed that people tend to employ stereotypical discourses when evaluating the risk of smoking. Similarly, they reassess the risk in the context of their life experience and incorporate new nuances to the arguments sustaining their behavior. Once this reassessment takes place, the decision to continue smoking emerges, and smokers come up with additional arguments justifying their habit (i.e., age, benefits related to costs). Professionals are aware of this process and its multidimensional nature. Nevertheless, their discourse loses this multidimensional feature when discussing the strategies they use at smoking cessation interventions. This qualitative study increases the understanding of various meanings that people attribute to their life experience. These assumptions may be useful for developing health practices that are closer to people. As a practical utility of these results, it would be interesting to apply a preliminary assessment of the different meanings that people attribute to smoking from their life context in risk communication.
Assuntos
Percepção , Medição de Risco , Fumar/efeitos adversos , Adolescente , Adulto , Atitude Frente a Saúde , Escolaridade , Feminino , Direitos Humanos , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Fumar/psicologia , Abandono do Hábito de Fumar , Fatores Socioeconômicos , Espanha , Estereotipagem , Adulto JovemRESUMO
INTRODUCTION: The birth plan allows the woman to express her expectations and needs with regards to the childbearing continuum but its use has been debated in the clinical context and in published literature. The birth plan was first introduced in the Spanish Health Service in 2008 through the Strategy for the Care in Normal Childbirth. In Catalonia, the Normal Childbirth Care Programme has promoted the use of birth plans in hospitals participating in this Programme. OBJECTIVE: This works describes and analyses the birth plans produced by the participating hospitals in order to gather knowledge about the options available to women. METHOD: Qualitative study in which the content of birth plans is systematically and quantitatively described in order to evaluate options available to women. The final sample includes all the birth plans provided by 30 Catalonian public hospitals. Following an initial assessment, it was decided to devise a grading scale which allowed to code and assign a value to each of the items contained in the birth plans. RESULTS: Three different types of birth plan are identified: a) those which present a list of items with no (or very little) associated explanations, b) list of items with some explanations and c) plans without items which only explain normal working practices in the hospital and/or protocols.
Assuntos
Comunicação , Hospitais Públicos , Cuidado Pré-Natal/métodos , Relações Profissional-Paciente , Parto Obstétrico , Feminino , Humanos , Parto , Gravidez , Pesquisa Qualitativa , EspanhaRESUMO
La investigación cualitativa se difunde en el área de la salud en Iberoamérica en las últimas décadas. Numerosos programas de enseñanza y capacitación se han organizado en la región; pero son inexistentes los trabajos cuyo objetivo sea evaluar los avances y dificultades en su enseñanza. Este artículo presenta el diálogo de cinco académicos iberoamericanos sobre la enseñanza de la investigación cualitativa en salud. La reflexión gira en torno a cuatro temas: su acercamiento al campo y a su enseñanza; las fortalezas,logros de las iniciativas educativas en que han participado; las dificultades y obstáculos enfrentados, y los retos y prioridades de su enseñanza en el futuro. Los académicos participantes fueron elegidos por su experiencia en el tema y por su procedencia geográfica. El diálogo se estableció vía Internet, empleando una variante del método FODA y la técnica Delphi.Los participantes, separados geográficamente, con diferentes trayectorias profesionales y antecedentes académicos, exponen los motivos por los cuales esta forma de investigación ha tenido éxito: el entusiasmo de la gente joven y las mujeres, el interés creciente, el rigor académico, la interdisciplinariedad y la legitimación que ha ganado como forma válida de hacer ciencia. Entre los problemas y dificultades destacan la poca consolidación y madurez de las propuestas educativas, y un medio que poco le favorece. Los mismos plantean impulsar su enseñanza en diálogo con la orientación cuantitativa, formulan propuestas al interior de los programas educativos y haciendo uso de tecnologías. Sugieren tomar en cuenta las particularidades sociales para la enseñanza de este campo...