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2.
Enferm. clín. (Ed. impr.) ; 29(6): 357-364, nov.-dic. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184656

RESUMO

La instauración de las especialidades de Enfermería iniciada en 1953 ha contribuido de forma decisiva en la calidad de la atención sanitaria proporcionada en el Sistema Nacional de Salud. En la actualidad, un elevado número de enfermeras poseen un título oficial de especialista obtenido a través de las distintas modalidades de acceso que establece el Real Decreto sobre especialidades de Enfermería. Por otra parte, los programas formativos tienen que seguir desarrollándose para culminar el catálogo establecido en la mencionada normativa. Cabe destacar que muchos especialistas tienen dificultad para llevar a cabo un ejercicio profesional acorde a su formación y capacitación, debido a la escasa descripción de puestos de trabajo e identificación de competencias en los procesos de selección y acceso a los puestos de trabajo, necesarias para un buen desempeño profesional. Por ello, resulta imprescindible elaborar un catálogo de puestos de trabajo específico de cada una de las especialidades, para dar respuesta a las expectativas de las enfermeras y fortalecer el avance en la calidad de la atención de cuidados


The establishment of nursing specialties that started in 1953 has contributed decisively to the quality of the medical care provided by the National Health System. Nowadays, a large number of nurses have an official specialist qualification achieved through different means of access established by Royal Decree on nursing specialties. Furthermore, the training programmes must continue to develop in order to complete the catalogue established under the aforementioned regulation. It should be pointed out that many specialists face difficulties in carrying out professional practice according to their education and training, due to the lack of job descriptions and identification of competences during recruitment processes and access to job positions, needed for appropriate professional performance. Therefore, it is essential to create a catalogue for specific job positions for each of the specialties to meet the expectations of professional nursing and enhance progress in quality patient care


Assuntos
Humanos , Especialidades de Enfermagem/tendências , Prática Profissional/organização & administração , Prática Profissional/tendências , Competência Profissional , Especialidades de Enfermagem/legislação & jurisprudência
3.
Asclepio ; 71(2): 0-0, jul.-dic. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-191065

RESUMO

El artículo presenta un primer análisis sobre la asistencia sanitaria en la Corte española durante el siglo XIX. Se hará hincapié en cuestiones como la estructura y organización de dicha asistencia en Palacio, los médicos cortesanos desde una perspectiva de estudio sociológica y el papel y potencial influencia de destacados médicos de cámara. Hombres que, por su cercanía y contacto profesional directo con el Monarca de turno, podían manejarse con una cierta soltura en las redes de poder cortesanas y dentro de las relaciones de sociabilidad del ámbito más exclusivo del Madrid de mediados del siglo XIX: la Corte. En este sentido destacan los casos de Pedro Castelló Ginestá y Tomás del Corral y Oña. Todo ello desde un enfoque interdisciplinar bajo la imbricación de elementos metodológicos procedentes de la historia de la medicina y la nueva historia política


The article presents a first analysis about healthcare in the Spanish Court during the 19th century. Emphasis will be placed on issues such as the structure and organization of such assistance in the Palace, the court doctors from a sociological perspective and the role and potential influence of outstanding chamber doctors. Some men who, for their closeness and direct professional contact with the Monarch, could handle easily in the courtly networks of power and the social relationships in the most exclusive space of mid-19th century Madrid: the Court. In this regard, the illustratives cases of Pedro Castelló Ginestá and Tomás del Corral y Oña stand out. All this from an interdisciplinary approach under the imbrication of methodological elements from the history of medicine and the new political history


Assuntos
Humanos , Médicos/história , Educação Médica/história , Administração da Prática Médica/história , Assistência à Saúde/história , História do Século XIX , Espanha , Prática Profissional/história
4.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(7): 585-589, sept. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-185529

RESUMO

Introducción: Ixekizumab es un fármaco efectivo y seguro en el tratamiento de pacientes con psoriasis dentro de ensayos clínicos. Nuestro objetivo es valorar la eficacia y seguridad de ixekizumab en la práctica clínica habitual. Material: Estudio retrospectivo incluyendo todos los pacientes que han recibido ixekizumab en 2 servicios de dermatología de la ciudad de Valencia. Resultados: Se incluyeron un total de 75 pacientes, siendo el 53,3% varones y el 46,7% mujeres con una edad media de 48,61 años. El 77,3% (58 pacientes) presentaba una psoriasis en placas, mientras que el 22,7% (17 pacientes) presentaba psoriasis de predominio en un área especial. La comorbilidad más frecuente fue obesidad en el 48% de ellos y el 40% eran naive a biológicos. El PASI inicial medio fue de 9,99, mientras que el PASI medio a la semana 16 era de 1,5. Las respuestas de PASI75 y PASI90 fueron independientes de las comorbilidades analizadas, del sexo, de la edad y del PASI basal. Los pacientes naive a biológicos respondieron mejor que los pacientes que habían recibido tratamiento biológico previo, tanto en la semana 16 como en la semana 52 de forma estadísticamente significativa. Esta observación también se mantuveroni en los pacientes con psoriasis en un área especial. El 25,7% de los pacientes refería algún efecto adverso, siendo lo más frecuente reacción en el sitio de inyección. No se observaron reacciones adversas graves. Conclusiones: El estudio plasma nuestra experiencia en la práctica clínica real de ixekizumab, siendo un fármaco efectivo y seguro para el tratamiento de la psoriasis


Background: Ixekizumab has proven efficacy and safety for the treatment of psoriasis in clinical trials. The aim of this study was to evaluate its effectiveness and safety in routine clinical practice. Methods: Retrospective study of all patients treated with ixekizumab in 2 dermatology departments in the city of Valencia, Spain. Results: Seventy-five patients (53.3% men and 46.7% women) with a mean age of 48.61 years were studied; 77.3% (n = 58) had plaque psoriasis and 22.7% (n = 17) had psoriasis predominantly affecting a specific area. The most common comorbidity was obesity (present in 48% of patients) and 40% of the overall group had not been previously treated with a biologic drug. Mean psoriasis area and severity index (PASI) fell from 9.99 at baseline to 1.5 at week 16. PASI-75 and PASI-90 (improvements of at least 75% and 90% in PASI) were independent of sex, age, baseline PASI, and the comorbidities analyzed. Responses at week 16 and 52 were significantly better in biologic-naïve patients for the overall group and the subgroup of patients with localized psoriasis. Adverse effects were reported for 25.7% of patients and the most common effect was injection-site reaction. There were no serious adverse effects. Conclusions: Our findings show that ixekizumab is both effective and safe in the treatment of psoriasis in routine clinical practice


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Anticorpos Monoclonais Humanizados/uso terapêutico , Fármacos Dermatológicos/uso terapêutico , Psoríase/tratamento farmacológico , Prática Profissional , Avaliação de Resultados em Cuidados de Saúde , Segurança do Paciente , Estudos Retrospectivos , Análise Estatística
5.
Pharm. pract. (Granada, Internet) ; 17(3): 0-0, jul.-sept. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-188124

RESUMO

Background: In Lebanon, mandatory continuing education (CE) for pharmacists was implemented in January 2014. Objective: The objectives of this study are to assess 1) the overall adherence to the mandatory CE program, 2) pharmacists' preferences related to CE, and 3) barriers to adherence to CE. Methods: By the end of October 2017, an evaluation of pharmacists' participation in the mandatory CE program was conducted using electronic reports available in the Learning Management System (LMS). Descriptive results were presented as frequencies and percentages. In addition, a cross-sectional survey was conducted among pharmacists to better understand their preferences and barriers to their participation to the CE program. Finally, a focus group was organized with pharmacists who did not start their CE. Results: Out of all registered pharmacists in Lebanon, 68.30% started their CE and 25.6% already achieved their required credits. Among pharmacists enrolled in the CE system, the majority (69%) used the online courses at least once. Moreover, CE enrolment was similar among old and young pharmacists except for those newly registered. The majority of pharmacists preferred clinical and pharmacological topics, followed by preventive medicine and transferable skills. Barriers to engaging in CE were mainly work and family obligations, lack of interest, lack of time, and difficulties in commuting and technology use. Conclusion: Although results of the present study are similar to those in developing countries, the resistance to change is higher. The Lebanese Pharmacists Association [Ordre des Pharmaciens du Liban] should develop strategies to motivate and enroll more pharmacists in the CE system, based on the barriers and preferences cited in the results, while continuing to offer high quality and cost-favorable CE programs to Lebanese pharmacists


No disponible


Assuntos
Humanos , Educação Continuada em Farmácia/organização & administração , Motivação , Intenção , Atitude do Pessoal de Saúde , Líbano , Educação de Pós-Graduação em Farmácia/organização & administração , Países em Desenvolvimento , Competência Profissional/estatística & dados numéricos , Prática Profissional/organização & administração , Inquéritos e Questionários/estatística & dados numéricos , Estudos Transversais
6.
Cult. cuid ; 23(54): 32-37, mayo-ago. 2019.
Artigo em Espanhol | IBECS | ID: ibc-190410

RESUMO

Con el presente manuscrito tan solo pretendo narrar de una forma breve y personal mis principales vivencias al comenzar a trabajar como enfermero en un hospital de Tenerife (España). Esto aconteció en el segundo semestre de 2009. Reflexiono sobre lo vivido y además intento argumentar mis vivencias apoyándome en los conocimientos que he adquirido elaborando una tesis doctoral fenomenológica en la que estudio este acontecimiento con enfermeras que comienzan a trabajar en diferentes instituciones sanitarias de Tenerife


In this document, I intend to narrate my main experiences in a brief and personal way when I started to work as a nurse in a hospital in Tenerife (Spain). These events happened in the second half of 2009. I reflect on the experience and I also try to argue my experiences based on the knowledge that I have acquired by developing a phenomenological doctoral thesis in which I study this event with nurses who begin to work in different health institutions in Tenerife


Neste documento, pretendo narrar minhas principais experiências de forma breve e pessoal quando comecei a trabalhar como enfermeiro em um hospital em Tenerife (Espanha). Estes eventos aconteceram no segundo semestre de 2009. Refiro sobre a experiência e também tento discutir minhas experiências com base no conhecimento adquirido através do desenvolvimento de uma tese de doutorado fenomenológico no qual estudo este evento com enfermeiras que começam a trabalhar em diferentes instituições de saúde em Tenerife


Assuntos
Humanos , Masculino , Enfermeiros , Acontecimentos que Mudam a Vida , Ambiente de Trabalho , Prática Profissional
8.
Pharm. pract. (Granada, Internet) ; 17(2): 0-0, abr.-jun. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184682

RESUMO

Background: Indonesian community pharmacies hold a strategic position from which to promote the rational use of medicines by providing appropriate advice for patients requesting self-medication. To date, published studies related to the provision of advice in Indonesian community pharmacies are limited and have been conducted only in more developed western Indonesia. No studies have been undertaken in eastern Indonesia, which is less developed than and culturally different from the western region. Objectives: This paper aims to: (1) describe the types and amount of advice provided by pharmacy staff for three scenarios in a patient simulation study and for two scenarios in pharmacy staff interviews; and (2) ascertain the frequency of appropriate advice given in response to the scenarios. Methods: A patient simulation study was conducted at community pharmacies in an eastern Indonesian provincial capital. Four weeks after completing a patient simulation study, structured interviews with pharmacy staff were conducted. Two cough scenarios and one diarrhoea scenario were developed for the patient simulation study. Meanwhile, two scenarios (an ACE inhibitor-induced cough and a common cough and cold) were developed for pharmacy staff interviews. The types and amount of advice provided by pharmacy staff were recorded on paper and assessed for its appropriateness. The determination of appropriate advice was based on the literature and by consensus of two Indonesian experts. Results: In patient simulation, the most common type of advice provided in all scenarios was product recommendations. In interviews, medical referrals and recommending cough and cold medicine were the most common types of advice provided for ACE inhibitor-induced cough and common cough and cold scenarios respectively. Appropriate advice was provided in less than 0.5% in the patient simulation study, but two-third of participants in the interviews responded to the scenarios appropriately. Conclusions: Pharmacy staff did not provide appropriate advice in practice, although they may have adequate knowledge. A contributing factor was insufficient information gathered in patient encounters. Optimising information-gathering practice by pharmacy staff is needed


No disponible


Assuntos
Humanos , Masculino , Feminino , Adulto , Serviços Comunitários de Farmácia/classificação , Aconselhamento Diretivo/classificação , Prática Profissional/classificação , Indonésia/epidemiologia , Automedicação/estatística & dados numéricos , Simulação/métodos , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos , Papel Profissional
9.
Pharm. pract. (Granada, Internet) ; 17(2): 0-0, abr.-jun. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184685

RESUMO

Background: Hormonal contraceptive pills have evolved as a common form of contraception worldwide. Pharmacists play a vital role in providing safe and effective access to these medicines. In many developing countries such as the United Arab Emirates (UAE), these medicines are available to the general public without the presentation of a prescription which requires the pharmacist to shoulder responsibility by assessing and educating patients to assure their appropriate use. Objectives: To evaluate community pharmacists' current practice of dispensing and counseling on hormonal contraceptives. Methods: Simulated patient methodology was used in this study. A single simulated patient visited community pharmacies requesting an oral contraceptive as per a preplanned scenario. Information from the visits were recorded on a data collection form including: pharmacist assessing patient eligibility to take hormonal contraceptives, selecting the appropriate oral contraceptive, providing complete counseling on how to use the pill, adherence, missed dose handlings and side effects of the medication. The Pharmacist was prompted by the simulated patient to provide the information if they did not provide spontaneous counseling. The quality of pharmacists' counseling was rated and consequently coded as complete, incomplete or poor. Results: A total of 201 community pharmacies were visited. More than 92% of the pharmacists did not ask the simulated patient any question to assess their eligibility to use contraceptives. Twenty three pharmacists (11.4%) selected the proper product. One hundred seventeen (58.2%) of the pharmacists provided spontaneous counseling on how to use the pill, 17 of them had their counsel rated as complete, but none of the pharmacists provided spontaneous counseling regarding adherence or side effects of the medications. On prompting, 10 pharmacists (12%) provided complete counseling regarding how to use oral contraceptives, 14 pharmacists (7.0%) provided complete counseling on adherence and missing dose handling and five pharmacists (2.5%) provided complete counseling about expected side effects. Conclusions: Pharmacists' practice regarding hormonal contraceptive dispensing and counseling was suboptimal in this study. Areas needing intervention were related to pharmacist assessment of eligibility for oral contraceptive use, choice of optimal oral contraceptive for patient-specific co-morbidities and provision of adequate counseling regarding proper use, adherence and missed dose handlings


No disponible


Assuntos
Humanos , Anticoncepcionais/administração & dosagem , Aconselhamento Diretivo/organização & administração , Serviços Comunitários de Farmácia/organização & administração , Anticoncepcionais Orais Hormonais/administração & dosagem , Anticoncepção/métodos , Prática Profissional/tendências , Papel Profissional , Qualidade da Assistência à Saúde/tendências , Emirados Árabes Unidos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle
10.
Gerokomos (Madr., Ed. impr.) ; 30(2): 98-106, jun. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-183949

RESUMO

En la prevención de las úlceras por presión (UPP) intervienen diferentes factores: estructurales, organizativos y relacionados con los profesionales; entre ellos, el grado de conocimientos que los profesionales sanitarios tengan es un aspecto fundamental. Objetivo: Identificar los instrumentos de medición de conocimientos de los profesionales de enfermería sobre las UPP. Como objetivos específicos: a) resumir las propiedades psicométricas (validez y fiabilidad) de cada instrumento y b) sintetizar el nivel de conocimientos sobre prevención según los estudios seleccionados. Metodología: Revisión narrativa de la literatura sobre los conocimientos en prevención de UPP. Búsqueda de estudios en 10 bases de datos bibliográficas desde el inicio de indexación hasta julio de 2018. Se incluyeron estudios cuantitativos que utilizasen instrumentos, test o cuestionarios, que cuantificasen los conocimientos en profesionales o estudiantes de enfermería. Se realizó una síntesis descriptiva. Resultados: Se seleccionaron 90 artículos, a partir de los cuales se identificaron 7 instrumentos (o alguna variación del cuestionario original) que han sido utilizados en al menos dos estudios publicados y 31 investigaciones, los cuales han desarrollado instrumentos ad hoc. Los dos más utilizados son el cuestionario Pieper Pressure Ulcer Knowledge (PPKUT) y el cuestionario Pressure Ulcer Knowledge Assessment Tool (PUKAT). No todos los instrumentos publicados presentan datos de fiabilidad y validez psicométrica. Entre los 31 estudios que describen un instrumento desarrollado ad hoc para esa investigación, solo en 5 de ellos se presentan datos de fiabilidad y validez. Aunque se han encontrado estudios que utilizan como fuente para la redacción de los ítems guías de práctica clínica (GPC), son muchos otros los que se basan en revisiones de la literatura, parten de instrumentos previos o no indican la fuente original. Los conocimientos descritos, de forma general en los diferentes estudios, están por debajo del punto de corte establecido por los autores. Conclusión: La medición del nivel de conocimientos sobre prevención de las UPP que tienen los profesionales de salud es importante como primer paso dentro de los programas de prevención de estas lesiones. Se han encontrado un elevado número de cuestionarios sin ninguna prueba de fiabilidad ni de validez, pero que han sido usados en estudios, lo cual contribuyen a generar datos poco relevantes y un grado de confusión. Es fundamental que los investigadores utilicen alguno de los cuestionarios que cuentan con evaluación psicométrica y que determinen dichas propiedades en la muestra utilizada en la investigación


Different factors (structural, organizational and related with professionals) intervene in the prevention of pressure ulcers (PU); the degree of knowledge of health professionals is one of the main aspects. Aim: To identify the instruments for measuring the knowledge of nursing professionals about pus. The specific objectives are: a) to summarize the psychometric properties (validity and reliability) of each instrument and b) to synthesize the knowledge on prevention according to the selected studies. Methodology: Narrative review on knowledge about PU prevention. Search in 10 bibliographic databases from the beginning of indexation until July 2018. The studies included were quantitative studies that used instruments, tests or questionnaires, which quantified the knowledge of professionals or nursing students. A descriptive synthesis was carried out. Results: 90 articles were selected, from which 7 instruments were identified (or some variation of the original questionnaire) that have been used in at least 2 published studies and 31 investigations, which have developed ad hoc instruments. The 2 most used tools are the Pieper Pressure Ulcer Knowledge (PPKUT) questionnaire and the Pressure Ulcer Knowledge Assessment Tool (PUKAT) questionnaire. Not all published instruments show data on psychometric reliability and validity. Among the 31 studies that describe an ad hoc instrument, only in 5 of them reliability and validity data are shown. Although some studies used Clinical Practice Guidelines as a source for item elaboration, there are many others that are based only in literature review; modified some previous instruments or did not indicate the original source. The knowledge described in the different studies, in general, are below the cut-off point established by the authors. Conclusions: Measuring the knowledge on PU prevention of health professionals is important as a first step in injury prevention programs. A large number of the questionnaires found have any proof of reliability or validity; nevertheless they have been used in studies, which contribute to the generation of irrelevant data and to create confusion. It is essential that researchers use questionnaires with good psychometric properties and these properties should be evaluated again in the sample used in the research


Assuntos
Humanos , Lesão por Pressão/epidemiologia , Lesão por Pressão/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Reprodutibilidade dos Testes , Competência Profissional , Psicometria/métodos , Prática Profissional/estatística & dados numéricos , Gerenciamento da Prática Profissional/organização & administração , Gerenciamento da Prática Profissional/estatística & dados numéricos , Papel do Profissional de Enfermagem
11.
Cir. Esp. (Ed. impr.) ; 97(5): 254-260, mayo 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-187271

RESUMO

Introducción: Las características técnicas, humanas, científicas y asistenciales de las Unidades que atienden una patología compleja son poco estudiadas y conocidas. Métodos: Estudio descriptivo multiinstitucional (encuesta) desarrollado conjuntamente por la sección Hepatobiliopancreática de la Asociación Española de Cirujanos y el capítulo español de la IHPBA (Asociación Internacional Hepatopancreatobiliar) sobre las características de las Unidades donde se realiza cirugía pancreática en España. Resultados: Se enviaron 82 encuestas. Respondieron 69 centros (84%) pertenecientes a 16 comunidades autónomas. La suma de habitantes de las áreas propias fue 23.183.262. El número medio de camas por hospital fue 673. La Unidad que realiza la cirugía pancreática es la Unidad de Cirugía Hepatobiliopancreática o Cirugía HPB y Trasplante Hepático en 56 hospitales (77%). El número medio de cirujanos es 4,5 por Unidad. Cincuenta y cinco Unidades (80%) carecen de anestesistas específicos. El número de pancreatectomías realizadas durante 2017 en los centros encuestados fue 1.315 duodenopancreatectomías cefálicas (DPC), 566 pancreatectomías distales (PD) y 178 duodenopancreatectomías totales (DPT). La media por centro fueron 19,1 DPC, 8,2 PD y 2,6 DPT. La DPC más habitual se realiza mediante abordaje clásico, con pancreatoyeyunostomía, montaje en un asa, con gastroyeyunostomía antecólica y 2 drenajes. Solo 7 Unidades efectúan la DPC por laparoscopia y solamente 13 Unidades no realizan PD laparoscópica. Conclusiones: Esta encuesta proporciona información actualizada del trabajo asistencial y científico de un gran porcentaje de las Unidades donde se realiza cirugía pancreática en España, y además puede servir de punto de partida a trabajos multicéntricos prospectivos


Introduction: The technical, human, scientific and treatment characteristics of the Units that manage complex pathologies have not been studied in depth. Methods: Multi-institutional descriptive study (survey) developed jointly by the Hepatobiliary-Pancreatic Division of the Spanish Association of Surgeons and the Spanish Chapter of the IHPBA (International Hepatopancreatobiliary Association) on the characteristics of the Units where pancreatic surgery is performed in Spain. Results: 82 surveys were sent. 69 medical centers responded (84%), belonging to 16 autonomous regions of Spain. The total population of these regions was 23,183,262 (50% of the Spanish population). The average number of beds per hospital was 673. The unit that performs pancreatic surgery is a Hepatobiliary-Pancreatic Surgery Unit or HPB and Liver Transplant Surgery Unit in 56 hospitals (77%). The average number of surgeons is 4.5 per Unit. Fifty-five Units (80%) lack specific anesthetists. The number of pancreatectomies performed during 2017 at the hospitals surveyed was 1,315 pancreaticoduodenectomies (PD), 566 distal pancreatectomies (DP) and 178 total pancreaticoduodenectomies (TPD). The mean per hospital was 19.1 PD, 8.2 DP and 2.6 TPD. PD was usually performed using a classic approach, with pancreatojejunostomy, single-loop technique, antecolic gastrojejunostomy and using two drain tubes. Only 7 Units performed PD laparoscopically and only 13 units did not perform laparoscopic DP. Conclusions: This survey provides updated information about the majority of the Units where pancreatic surgery is performed in Spain and could also serve as a starting point for prospective multicenter studies


Assuntos
Humanos , Procedimentos Cirúrgicos do Sistema Digestório/métodos , Pâncreas/cirurgia , Pancreatopatias/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/estatística & dados numéricos , Pesquisas sobre Serviços de Saúde , Unidades Hospitalares/organização & administração , Unidades Hospitalares/estatística & dados numéricos , Prática Profissional/estatística & dados numéricos , Espanha
12.
Rev. bioét. derecho ; (45): 11-24, mar. 2019. ilus, tab
Artigo em Catalão | IBECS | ID: ibc-177372

RESUMO

La iatrogènia és, actualment, un dels principals problemes de salut pública, que acostumem a atribuir exclusivament a errors i negligències, menyspreant l'exagerat intervencionisme sanitari a causa del consumisme i també negant la ignorància i amb poca tolerància de la incertesa. La consideració dels dubtes i de les equivocacions des d'una perspectiva ètica pot contribuir a la millor comprensió i prevenció dels danys associats a la pràctica mèdica i sanitària mitjançant la promoció de la prudència com a valor essencial de qui ha de prendre decisions sobre la salut i les malalties de les persones i les comunitats


La iatrogenia es actualmente uno de los principales problemas de salud pública, que acostumbramos a atribuir exclusivamente a errores y negligencias, menospreciando el exagerado intervencionismo sanitario promovido por el consumismo y también debido a la negación de la ignorancia y a la intolerancia de la incertidumbre. La consideración de las dudas y de las equivocaciones desde una perspectiva ética puede contribuir a la mejor comprensión y prevención de los daños asociados a la práctica médica y sanitaria mediante la promoción de la prudencia como valor esencial de quienes que han de tomar decisiones sobre la salud y las enfermedades de las personas y las comunidades


Iatrogenesis is now, one of the main public health problems, which we tend to attribute exclusively to errors and negligence, belittling the exaggerated health interventionism promoted by consumerism and also due to the denial of ignorance and the intolerance of uncertainty. The consideration of doubts and mistakes from an ethical perspective can contribute to the better understanding and prevention of the damages associated with medical and public health practice by promoting prudence as an essential value of those who have to make decisions on people's health


Assuntos
Humanos , Incerteza , Doença Iatrogênica , Saúde Pública/ética , Administração da Prática Médica/ética , Prática Profissional/ética , Prática de Saúde Pública/ética
13.
Int. j. clin. health psychol. (Internet) ; 19(1): 1-11, ene. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-184920

RESUMO

Background/Objective: The World Health Organization's diagnostic guidelines for ICD-11 mental and behavioural disorders must be tested in clinical settings around the world to ensure that they are clinically useful and genuinely global. The objective is evaluate the inter-rater reliability and clinical utility of ICD-11 guidelines for psychotic, mood, anxiety- and stress-related disorders in Mexican patients. Method: Adult volunteers exhibiting the selected symptoms were referred from the pre-consultation unit of a public psychiatric hospital to an interview by a pair of clinicians, who subsequently assigned independent diagnoses and evaluated the clinical utility of the diagnostic guidelines as applied to each particular case, on the basis of a scale developed for this purpose. Results: 23 clinicians evaluated 153 patients. Kappa scores were strong for psychotic disorders (.83), moderate for stress-related (.77) and mood disorders (.60) and week for anxiety and fear-related disorders (.43). A high proportion of clinicians considered all diagnostic guidelines to be quite to extremely useful as applied to their patients. Conclusions: ICD-11 guidelines for psychotic, stress-related and mood disorders allow adequate inter-rater consistency among Mexican clinicians, who also considered them as clinical useful tolos


Antecedentes/Objetivo: Las guías diagnósticas CIE-11 para trastornos mentales y del comportamiento de la Organización Mundial de la Salud deben ser evaluadas en pacientes reales alrededor del mundo a fin de asegurar que son clínicamente útiles y genuinamente globales. Se evalúa la consistencia inter-evaluadores y la utilidad clínica de las guías para los trastornos psicóticos, afectivos, de ansiedad y relacionados con el estrés en pacientes mexicanos. Método: Voluntarios con síntomas psicóticos, afectivos, de ansiedad o relacionados con el estrés derivados de una unidad de pre-consulta de un hospital psiquiátrico, para una entrevista con una pareja de clínicos, quienes posteriormente asignaron diagnósticos de manera independiente y evaluaron la utilidad clínica de las guías aplicadas a cada caso en particular, con base en una escala desarrollada para este propósito. Resultados: 23 clínicos evaluaron 153 pacientes. Los coeficientes Kappa fueron fuertes para trastornos psicóticos (0,83), moderados para los relacionados con el estrés (0,77) y afectivos (0,60), y débiles para los de ansiedad y relacionados con el miedo (0,43). Una alta proporción de clínicos consideró que las guías eran bastante o extremadamente útiles. Conclusiones: Las guías CIE-11 para dichos trastornos permiten una adecuada consistencia inter-evaluadores en clínicos mexicanos, quienes les consideran herramientas clínicamente útiles


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Transtornos Psicóticos/diagnóstico , Transtornos do Humor/diagnóstico , Transtornos de Ansiedade/diagnóstico , Estresse Psicológico/diagnóstico , Organização Mundial da Saúde , Reprodutibilidade dos Testes , Guias de Prática Clínica como Assunto , México , Variações Dependentes do Observador , Prática Profissional
14.
Med. paliat ; 25(4): 291-297, oct.-dic. 2018.
Artigo em Espanhol | IBECS | ID: ibc-180511

RESUMO

OBJETIVO: Ofrecer la sistemática del análisis bioético a partir de un caso clínico. MÉTODO: Tras la exposición del caso clínico se abordan 3 posibles conflictos éticos utilizando como modelo de deliberación la metodología principialista de Diego Gracia. CONCLUSIONES: La atención al final de la vida está jalonada de daciones complejas en las que entran en conflicto valores y perspectivas que deben ser analizadas para que la decisión final sea la mejor


AIM: To show the bioethics analysis procedure based on a case report. METHOD: After the case report we will analyze 3 possible ethical conflicts by using as a deliberation model the principalism methodology by Diego Gracia. CONCLUSIONS: End-of-life care is full of complex decision making processes where values and perspectives must be analysed to arrive at the best decision


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Qualidade da Assistência à Saúde/ética , Cuidados Paliativos na Terminalidade da Vida/ética , Bioética , Tomada de Decisões/ética , Prática Profissional/ética , Cuidados Paliativos/ética , Autonomia Profissional
15.
Pharm. pract. (Granada, Internet) ; 16(4): 0-0, oct.-dic. 2018. tab
Artigo em Inglês | IBECS | ID: ibc-180988

RESUMO

Background: The expansion of pharmacist scope of practice to include provision of immunizations has occurred or is being considered in various countries. There are limited data evaluating the experiences of Canadian pharmacists in their role as immunizers. Objective: To describe the experiences of pharmacists in the Canadian province of New Brunswick as immunizers, including vaccines administered and perceived barriers and facilitators to providing immunizations. Methods: An anonymous, self-administered, web-based questionnaire was offered via email by the New Brunswick Pharmacists' Association to all its members. The survey tool was adapted, with permission, from a tool previously used by the American Pharmacists Association and validated using content validity and test-retest reproducibility. Pharmacist reported immunization activities and perceived facilitators and barriers to providing immunization services were assessed. Results: Responses from 168 (response rate of 26%) were evaluable. Approximately 90% of respondents worked in community practice full time, 65% were female and 44% were practicing for 20 or more years. Greater than 75% reported administering: hepatitis A and B, influenza, and zoster vaccines. The majority of respondents felt fully accepted (agreed or strongly agreed) as immunization providers by patients, local physicians, and the provincial health department (97%, 70%, and 78%, respectively). Most commonly reported barriers were: lack of a universally funded influenza immunization program, insufficient staffing and space, and concerns around reimbursement for services. Conclusions: Pharmacists in New Brunswick, Canada are actively participating in the provision of a variety of immunizations and felt fully supported by patients and other healthcare providers. Barriers identified may provide insight to other jurisdictions considering expanding the role of pharmacists as immunizers


No disponible


Assuntos
Humanos , Assistência Farmacêutica/tendências , Vacinação/tendências , Imunização/tendências , Canadá/epidemiologia , Programas de Imunização/organização & administração , Prática Profissional/organização & administração , Inquéritos e Questionários/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde
16.
Rev. Rol enferm ; 41(11/12,supl): 173-180, nov.-dic. 2018. graf
Artigo em Inglês | IBECS | ID: ibc-179959

RESUMO

Introduction: In the current health care environment, the needs of the population provided the perfect opportunity for nurses to (re)define their practice and professional career. Within this framework, this study aimed thus at identifying the bases that are underlying the practice, as well as the factors that stimulate or jeopardise the quality of care and a practice that is consistent with the desired grounding. Method: Qualitative study with a phenomenological nature carried out in 19 public hospitals in mainland Portugal with the participation of 56 nurses. The tool used for collecting data was a semi-structured interview. Results: Regarding the factors that stimulate or jeopardise the quality of care a prac-tice that is consistent with the desired grounding, we could highlight features that were perfectly integrated in the triad structure, process and result. In relation to "structure", we could point out the following: organizational resources, human and material resources, service organization, nursing sustainment practices and organization of nursing care. Concerning "process", we could analyse: decision-making process, guiding principles for the professional practice, scientific methodology of health care service, health care documentation process, communication process, collaborative practice and management practice. In what concerns "result", the features were less evident in the participants' speech, and more stressed among clients and nurses. Conclusion: The explanatory approach to the grounding of the professional nursing practice, outlined in a three-dimensional perspective, makes clear the theoretical framework that grounds the practice, as well as the factors in hospital environment, that stimulate or jeopardise the quality of the nursing care


No disponible


Assuntos
Humanos , Avaliação em Enfermagem/tendências , Cuidados de Enfermagem/tendências , Processo de Enfermagem/organização & administração , Prática Profissional/organização & administração , Competência Profissional/estatística & dados numéricos , Qualidade da Assistência à Saúde/tendências , Gestão da Qualidade Total/tendências
18.
Pap. psicol ; 39(3): 200-207, sept.-dic. 2018.
Artigo em Espanhol | IBECS | ID: ibc-180295

RESUMO

El objetivo de este artículo es presentar una revisión del estado de la investigación y la práctica profesional acerca del papel desempeñado por las identidades múltiples individuales y sobre los procesos implicados en las múltiples identidades organizacionales, así como las consecuencias de ambos tipos de identidades para los individuos y las organizaciones. El artículo concluye con una serie de implicaciones prácticas y de líneas futuras de investigación y de intervención en relación con ambos fenómenos


The aim of this paper is to present a state-of-the-art review of research and professional practice regarding the role played by multiple individual identities and the processes involved in multiple organizational identities, as well as the consequences of both types of identities for individuals and organizations. The paper concludes by highlighting practical implications and proposals for future research and intervention related to both phenomena


Assuntos
Humanos , Transtorno Dissociativo de Identidade/psicologia , Psicologia Industrial , Satisfação no Emprego , Prática Profissional
19.
Rev. bioét. derecho ; (44): 149-162, nov. 2018.
Artigo em Português | IBECS | ID: ibc-176795

RESUMO

O objetivo deste trabalho é verificar a percepção e a compreensão de profissionais de saúde sobre violência e proteção de crianças atendidas em um hospital geral universitário. Foram realizadas entrevistas semiestruturadas com dezoito profissionais de saúde. A abordagem relatada para as situações de violência varia desde o envolvimento até o descaso. Poucos entrevistados tiveram contato com o tema durante a sua formação profissional. A mãe foi identificada como a principal pessoa responsável pelas crianças, mas também como a principal agente de violência. Na perspectiva dos entrevistados, a criança só estará protegida se tiver uma família estruturada. A percepção e a compreensão dos profissionais em relação à violência e proteção de crianças são heterogêneas, modificando-se conforme a sua área de atuação.


El objetivo de este trabajo es verificar la percepción y comprensión de los profesionales sanitarios sobre la violencia y la protección de niños y niñas ingresados en un hospital universitario. Se realizaron entrevistas semiestructuradas a dieciocho profesionales sanitarios. Los niveles de involucramiento de los profesionales en las situaciones de violencia van desde el compromiso a la negligencia. Algunos profesionales tuvieron contacto con estos temas durante su formación profesional. La madre ha sido identificada como la principal responsable del cuidado de niños y niñas y como la persona activamente responsable por ellos. Desde la perspectiva de los entrevistados, los niños sólo estarán protegidos si tienen una familia estructurada. Las percepciones y concepciones de los profesionales de la salud son heterogéneas y se modifican de acuerdo al campo de especialización


The aim is to verify the health professionals' perceptions, and understandings about violence and protection of children admitted in a Teaching Hospital. It was performed semi structured interviews with eighteen health professionals. The account on situations cited by the professional went since engagement until negligence. A few health professional had contact with the content along their professional education. The mother has been identified as a main person who is responsible for the care of the children, and with the person who is actively responsible for it. In the perspective of interviewed, the child will be protected just if he/she has a structured family. The health professionals' perceptions, and understandings are heterogeneous, and modified accordingly with the field of specialization


L'objectiu d'aquest treball és verificar la percepció i comprensió dels professionals sanitaris sobre la violència i la protecció de nens i nenes ingressats en un hospital universitari. Es van realitzar entrevistes semiestructurades a divuit professionals sanitaris. El nivell d'implicació dels professionals en les situacions de violència van des del compromís a la negligència. Alguns professionals van tenir contacte amb aquests temes durant la seva formació professional. La mare ha estat identificada com la principal responsable de la cura de nens i nenes i com la persona activament responsable dels mateixos. Des de la perspectiva dels entrevistats, els nens només estaran protegits si tenen una família estructurada. Les percepcions i concepcions dels professionals de la salut són heterogènies i es modifiquen d'acord amb la seva especialitat


Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Masculino , Feminino , Pessoal de Saúde/ética , Ética Profissional , Prática Profissional/ética , Violência Doméstica/ética , Violência Doméstica/legislação & jurisprudência , Autonomia Profissional , Pessoal de Saúde/estatística & dados numéricos
20.
Rev. psicol. trab. organ. (1999) ; 34(2): 113-121, ago. 2018. tab, graf
Artigo em Inglês | IBECS | ID: ibc-176646

RESUMO

Virtual internships (or e-internships) represent unique transitional and temporary learning experiences that have not been studied widely. Using 18 interviews conducted with interns and internship providers, the authors explored the extent to which psychological contracts appear to emerge and operate within this computer-mediated context. The results were analyzed using thematic analysis. The findings indicate that while e-internships are temporary and hence transitional, they are not inevitably transactional. Relational and balanced contract characteristics are not necessarily uncommon in e-internships when these feature supervisory engagement and commitment to the e-internship as well as the customized use of technology to interact, monitor, and engage with interns


Las prácticas virtuales (o e-prácticas) representan experiencias únicas de aprendizaje temporal y transitorio que no han sido muy estudiadas. Usando 18 entrevistas realizadas con estudiantes en prácticas y con los proveedores de éstas, los autores exploraron hasta qué punto en este contexto mediado por ordenador parecen surgir y operar contratos psicológicos. Los resultados se analizaron usando análisis temático. Los hallazgos indican que aunque las e-prácticas son temporales y, por ello, transitorias, no son inevitablemente transaccionales. Contratos con características equilibradas y relacionales no son necesariamente infrecuentes en las e-prácticas cuando las mismas presentan el compromiso y la implicación de la supervisión con las e-prácticas, además del uso personalizado de la tecnología para interactuar, controlar, e implicarse con internos en prácticas


Assuntos
Humanos , Prática Profissional , Relações Interpessoais , Instrução por Computador , Comunicação , Interface Usuário-Computador , Tecnologia da Informação
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