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1.
J Prim Care Community Health ; 11: 2150132720954687, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32865152

RESUMO

BACKGROUND: COVID-19 is a highly infectious disease which usually presents with respiratory symptoms. This virus is disseminated through respiratory droplets, and, therefore, individuals residing in close quarters are at a higher risk for the acquisition of infection. The prison population is at a significantly increased risk for infection. METHODS: Prisoners from the Montford Correctional facility in Lubbock, Texas, hospitalized in the medical intensive care unit at University Medical Center between March 1, 2020 and May 15, 2020 were compared to community-based patients hospitalized in the same medical intensive care unit. Clinical information, laboratory results, radiographic results, management requirements, and outcomes were compared. RESULTS: A total of 15 community-based patients with a mean age of 67.4 ± 15.5 years were compared to 5 prisoners with a mean age of 56.0 ± 9.0 years. All prisoners were men; 10 community-based patients were men. Prisoners presented with fever, dyspnea, and GI symptoms. The mean number of comorbidities in prisoners was 2.4 compared to 1.8 in community-based patients. Prisoners had significantly lower heart rates and respiratory rates at presentation than community-based patients. The mean length of stay in prisoners was 12.6 ± 8.9 days; the mean length of stay in community-based patients was 8.6 ± 6.5. The case fatality rate was 60% in both groups. CONCLUSIONS: Prisoners were younger than community-based patients but required longer lengths of stay and had the same mortality rate. This study provides a basis for comparisons with future studies which could involve new treatment options currently under study.


Assuntos
Infecções por Coronavirus/terapia , Cuidados Críticos/estatística & dados numéricos , Pandemias , Pacientes/estatística & dados numéricos , Pneumonia Viral/terapia , Prisioneiros/estatística & dados numéricos , Centros Médicos Acadêmicos , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/mortalidade , Feminino , Hospitalização , Humanos , Unidades de Terapia Intensiva , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Estudos Retrospectivos , Texas/epidemiologia , Resultado do Tratamento
3.
ESMO Open ; 5(5)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32878898

RESUMO

BACKGROUND: During the COVID-19 outbreak, healthcare professionals (HCP) are at the frontline of clinical management and at increased risk for infection. The SARS-CoV-2 seroprevalence of oncological HCP and their patients has significant implications for oncological care. METHODS: HCP and patients with cancer at the Division of Oncology, Medical University of Vienna were included between 21 March and 4 June and tested for total antibodies against SARS-CoV-2 employing the Roche Elecsys Anti-SARS-CoV-2 immunoassay. Reactive samples were confirmed or disproved by the Abbott SARS-CoV-2 IgG test. Additionally, a structured questionnaire regarding basic demographic parameters, travel history and COVID-19-associated symptoms had to be completed by HCP. RESULTS: 146 subjects (62 HCP and 84 patients with cancer) were enrolled. In the oncological HCP cohort, 20 (32.3%) subjects were medical oncologists, 28 (45.2%) nurses at our ward and 14 (22.6%) fulfil other functions such as study coordinators. In the patient cohort, most individuals are on active anticancer treatment (96.4%). 26% of the HCP and 6% of the patients had symptoms potentially associated with COVID-19 since the end of February 2020. However, only in 2 (3.2%) HCP and in 3 (3.6%) patients, anti-SARS-Cov-2 total antibodies were detected. The second assay for anti-SARS-Cov-2 IgG antibodies confirmed the positive result in all HCP and in 2 (2.4%) patients, suggesting an initial assay's unspecific reaction in one case. In individuals with a confirmed test result, an active COVID-19 infection was documented by a positive SARS-CoV-2 RNA PCR test. CONCLUSION: Specific anti-SARS-CoV-2 antibodies were found solely in persons after a documented SARS-CoV-2 viral infection, thus supporting the test methods' high sensitivity and specificity. The low prevalence of anti-SARS-CoV-2 antibodies in our cohorts indicates a lack of immunity against SARS-CoV-2. It highlights the need for continued strict safety measures to prevent uncontrolled viral spread among oncological HCPs and patients with cancer.


Assuntos
Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Corpo Clínico Hospitalar , Serviço Hospitalar de Oncologia , Pacientes , Pneumonia Viral/diagnóstico , Testes Sorológicos , Centros de Atenção Terciária , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Áustria/epidemiologia , Betacoronavirus/patogenicidade , Biomarcadores/sangue , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Feminino , Interações Hospedeiro-Patógeno , Humanos , Masculino , Pessoa de Meia-Idade , Recursos Humanos de Enfermagem no Hospital , Oncologistas , Enfermagem Oncológica , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Valor Preditivo dos Testes , Estudos Prospectivos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Estudos Soroepidemiológicos , Adulto Jovem
4.
Eur Rev Med Pharmacol Sci ; 24(16): 8580-8582, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32894564

RESUMO

OBJECTIVE: After massive weight loss, patients that meet specific criteria can be inserted in an ad-hoc post-bariatric surgery list in order to be subjected to body contouring procedures. During COVID-19 pandemic, the Italian National Health System has been overwhelmed by the continue load of life-threatening patients that needed medical assistance. Plastic surgery practice enormously scaled back during this period and this fact greatly affected elective procedures waiting lists. The aim of our study is to analyze how the lockdown and its related sanitary policies affected post-bariatric patients' behaviors towards the delay of their procedure. PATIENTS AND METHODS: A 7-item questionnaire was administered to all patients. Change in the desire to be subjected to body contouring procedures was recorded. Smoking status, level of training during quarantine and psychological co-morbidities were also evaluated. RESULTS: 124 patients completed the questionnaire. Data analysis showed that none of them encountered a decrease of the desire to be subjected to post-bariatric plastic surgery procedures. CONCLUSIONS: The present study showed that all the patients in the waiting list did not modify their interest in being subjected to post-bariatric surgery procedures, even though the waiting time increased.


Assuntos
Infecções por Coronavirus/patologia , Pacientes/psicologia , Pneumonia Viral/patologia , Adulto , Cirurgia Bariátrica , Betacoronavirus/isolamento & purificação , Índice de Massa Corporal , Infecções por Coronavirus/virologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia , Fumar , Inquéritos e Questionários , Listas de Espera , Adulto Jovem
5.
Artigo em Inglês | MEDLINE | ID: mdl-32937749

RESUMO

Outbreaks of severe acute respiratory syndrome (SARS) and coronavirus disease 2019 (COVID-19) have affected populations worldwide. Our literature review summarises the studies reporting psychological issues among healthcare staff and infected patients in mainland China, Hong Kong, and Taiwan during these two outbreaks and the potential strategies for addressing these issues. Our review shows that patients and healthcare staff presented similar psychological symptoms, including anxiety, fear, distress, and depression, which may lead to stress-related complications such as insomnia. In patients, these psychological impairments can be contributed to by being quarantined, perceptions of threats to life, and uncertainty about health status. Quarantine is also a factor for distress among healthcare staff, together with their heavy workload, the fear that they and their families would become infected, witnessing their patients' poor and deteriorating conditions, and the requirement to wear protective gear. Strategies that are needed to address these factors include providing counselling services, implementing mindfulness-based therapies and optimism interventions, and providing telecommunication facilities for patients to communicate with their families. Healthcare staff should also be provided with these services, together with appropriate and flexible work shift arrangements and morale boosting. These strategies would improve not only the mental well-being of patients and healthcare staff, but also the self-efficacy and competence of the staff to provide quality healthcare services.


Assuntos
Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Pacientes/psicologia , Pneumonia Viral/psicologia , Betacoronavirus , China , Hong Kong , Humanos , Saúde Mental , Pandemias , Taiwan
6.
Am J Disaster Med ; 15(2): 99-111, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32804390

RESUMO

OBJECTIVE: Identify operational lessons to support hospital and health system preparedness and response for sea-sonal and pandemic influenza based on firsthand experiences from the 2017-2018 influenza season. DESIGN: We conducted semistructured, retrospective interviews with New York City Health+Hospitals (NYCH+H) personnel to gather firsthand experiences from the 2017-2018 influenza season and evaluated stress data across four operational domains reported by NYCH+H hospitals during the 2017-2018 influenza season. SETTING: Frontline hospitals in the NYCH+H health system during and after the 2017-2018 influenza season. PARTICIPANTS: Interviews conducted with personnel from 5 NYCH+H frontline hospitals. Operational stress data re-ported by 11 NYCH+H hospitals during the 2017-2018 influenza season. MAIN OUTCOME MEASURES: Operational challenges and lessons from frontline hospitals responding to severe sea-sonal influenza. RESULTS: Operational stresses during the 2017-2018 influenza season varied over the influenza season, between facilities, and across operational domains. Patient surge and staff absenteeism pushed some facilities to their limits, and supply shortages highlighted shortcomings in existing procurement systems. Resources tied to pandemic influ-enza were unavailable without a pandemic declaration. CONCLUSION: Seasonal influenza poses dynamic operational stresses across health systems and cities, potentially causing major impacts outside of declared pandemics. Lessons from NYCH+H can help other hospitals and health systems anticipate operational challenges, but novel solutions are needed to mitigate effects of patient surge and per-sonnel and supply shortages during severe influenza seasons and pandemics. Improved data collection can help health systems better understand operational stresses and challenges across their facilities.


Assuntos
Assistência à Saúde/organização & administração , Pessoal de Saúde/estatística & dados numéricos , Hospitais/estatística & dados numéricos , Influenza Humana , Pacientes/estatística & dados numéricos , Absenteísmo , Pessoal de Saúde/psicologia , Planejamento em Saúde/organização & administração , Administração Hospitalar , Humanos , Influenza Humana/diagnóstico , Influenza Humana/epidemiologia , Entrevistas como Assunto , Cidade de Nova Iorque/epidemiologia , Pandemias , Estudos Retrospectivos , Estações do Ano
8.
JAMA ; 324(3): 270-278, 2020 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-32692387

RESUMO

Importance: Philanthropy is an increasingly important source of support for health care institutions. There is little empirical evidence to inform ethical guidelines. Objective: To assess public attitudes regarding specific practices used by health care institutions to encourage philanthropic donations from grateful patients. Design, Setting, and Participants: Using the Ipsos KnowledgePanel, a probability-based sample representative of the US population, a survey solicited opinions from a primary cohort representing the general population and 3 supplemental cohorts (with high income, cancer, and with heart disease, respectively). Exposures: Web-based questionnaire. Main Outcomes and Measures: Descriptive analyses (with percentages weighted to make the sample demographically representative of the US population) evaluated respondents' attitudes regarding the acceptability of strategies hospitals may use to identify, solicit, and thank donors; perceptions of the effect of physicians discussing donations with their patients; and opinions regarding gift use and stewardship. Results: Of 831 individuals targeted for the general population sample, 513 (62%) completed surveys, of whom 246 (48.0%) were women and 345 (67.3%) non-Hispanic white. In the weighted sample, 47.0% (95% CI, 42.3%-51.7%) responded that physicians giving patient names to hospital fundraising staff after asking patients' permission was definitely or probably acceptable; 8.5% (95% CI, 5.7%-11.2%) endorsed referring without asking permission. Of the participants, 79.5% (95% CI, 75.6%-83.4%) reported it acceptable for physicians to talk to patients about donating if patients have brought it up; 14.2% (95% CI, 10.9%-17.6%) reported it acceptable when patients have not brought it up; 9.9% (95% CI, 7.1%-12.8%) accepted hospital development staff performing wealth screening using publicly available data to identify patients capable of large donations. Of the participants, 83.2% (95% CI, 79.5%-86.9%) agreed that physicians talking with their patients about donating may interfere with the patient-physician relationship. For a hypothetical patient who donated $1 million, 50.1% (95% CI, 45.4%-54.7%) indicated it would be acceptable for the hospital to show thanks by providing nicer hospital rooms, 26.0% (95% CI, 21.9%-30.1%) by providing expedited appointments, and 19.8% (95% CI, 16.1%-23.5%) by providing physicians' cell phone numbers. Conclusions and Relevance: In this survey study of participants drawn from the general US population, a substantial proportion did not endorse legally allowable approaches for identifying, engaging, and thanking patient-donors.


Assuntos
Atitude Frente a Saúde , Obtenção de Fundos/métodos , Doações , Hospitais , Pacientes/psicologia , Papel do Médico/psicologia , Adulto , Distribuição por Idade , Idoso , Estudos de Coortes , Economia Hospitalar , Feminino , Obtenção de Fundos/ética , Doações/ética , Cardiopatias , Hospitais/ética , Humanos , Renda , Masculino , Pessoa de Meia-Idade , Neoplasias , Pacientes/estatística & dados numéricos , Probabilidade , Distribuição por Sexo , Fatores Socioeconômicos , Inquéritos e Questionários/estatística & dados numéricos , Estados Unidos , Adulto Jovem
10.
PLoS One ; 15(7): e0236390, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32702007

RESUMO

BACKGROUND: Nurses have a primary role in providing palliative and end-of-life (EOL) care. Their knowledge of EOL care, attitudes toward care of the dying, and palliative care self-efficacy are important in care delivery. Little is known regarding palliative care preparedness among Mongolian nurses. This study examines palliative care knowledge, attitude towards death and dying, and self-efficacy among Mongolian nurses, and examines predictors of self-efficacy. METHODS: A cross-sectional descriptive study was conducted. Participants were 141 nurses employed at the National Cancer Center in Mongolia. Data was collected using a self-administered questionnaire. RESULTS: The median score for the knowledge of palliative care was 8.0/20. "Psychosocial and spiritual care" was the lowest score on the palliative care knowledge subscale. The mean score for attitude toward care of the dying was 69.1%, indicating positive attitudes. The mean score for the palliative care self-efficacy was 33.8/48. Nurses reported low self-efficacy toward communicating with dying patients and their families, and managing delirium. Palliative care knowledge and duration of experience as an oncology nurse significantly predicted self-efficacy toward palliative care, accounting for 14.0% of the variance. CONCLUSIONS: Palliative education for nurses should address the knowledge gaps in EOL care and focus in increasing palliative care self-efficacy. Considering palliative care knowledge and nursing experience as an oncology nurse were significant predictors of self-efficacy toward palliative care, more effort is needed to fill the knowledge gaps in EOL care among nurses, especially for less experienced nurses.


Assuntos
Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Enfermeiras e Enfermeiros/normas , Cuidados Paliativos/normas , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Oncologia/tendências , Pessoa de Meia-Idade , Mongólia/epidemiologia , Dor/epidemiologia , Dor/patologia , Pacientes , Autoeficácia , Inquéritos e Questionários , Assistência Terminal
11.
Reprod Biomed Online ; 41(3): 385-394, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32693991

RESUMO

RESEARCH QUESTION: The study set out to identify corrective measures aimed at reducing the risk of aerosol-mediated viral infection within an IVF laboratory. DESIGN: A failure modes and effect analysis (FMEA) was conducted by a multidisciplinary IVF team. A schematic representation of new protocols and procedures adopted during COVID-19 emergency has been defined, including directives about the behaviour to adopt when entering the clinic and the laboratory, in case of face-to-face contact with patients and between staff members. In addition, the risk of cross-contamination between samples belonging to different patients during cell handling and manipulation has been evaluated. Potential failure modes for each phase of the emergency have been analysed, focusing on possible sources of error. Risk priority numbers have been calculated as products of Occurrence × Severity × Detection scores. RESULTS: Except for cell-cell contamination, which was considered highly unlikely, failure modes during patient-staff, staff-staff and staff-cell interactions were estimated as carrrying a moderate to high risk of infection. The main corrective measures entailed precautionary logistic measures, the implementation of additional personal protective equipment and changes in the IVF laboratory procedures and scheduling of the daily routine. Some procedures were also revised, aiming to increase staff's awareness and caution. CONCLUSIONS: Standard laboratory protocols are insufficient to face a virus whose transmission is aerosol mediated. The measures outlined in this FMEA should thus be considered not only for facing this pandemic, but also for the future to promptly manage any aerosol-mediated virus infection, whose impact on the management of an IVF laboratory might be less severe than COVID-19 although not completely negligible.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Fertilização In Vitro/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/transmissão , Humanos , Programas de Rastreamento , Pessoal de Laboratório Médico , Pacientes , Equipamento de Proteção Individual , Pneumonia Viral/diagnóstico , Pneumonia Viral/transmissão , Medição de Risco , Fatores de Risco , Telemedicina
12.
PLoS One ; 15(7): e0235539, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32615581

RESUMO

The scope of practice of the osteopathic profession in Italy is underreported. The first part of the present study investigated the Italian osteopaths' profile, focusing on the socio-demographic information and geographical distribution together with the main characteristics of their education. The OPERA-IT study highlighted that the majority of respondents declared to work as sole practitioners (58.4%), while the remaining declared to work as part of a team. Since teamwork and networking are recognized as fundamental aspects of healthcare, the present study aims to compare the osteopathic practice, diagnostic and treatment modalities of osteopaths who work as a sole practitioner and osteopaths who work as part of a team to highlight possible differences. Moreover, patients' characteristics will be presented. The OPERA-IT study population was chosen to provide a representative sample. A web campaign was set up to inform the Italian osteopaths before the beginning of the study. The OPERA IT study used a previously tested questionnaire. The questionnaire was translated into Italian following the World Health Organization recommendation. The questionnaire was composed of 57 items grouped in five sections, namely: socio-demographics, osteopathic education and training, working profile, organization, and management of the clinical practice and patient profile. The survey was delivered online through a dedicated platform. The survey was completed by 4,816 individuals. Osteopaths who work as sole practitioners represented the majority of the sample (n = 2814; 58.4%). Osteopaths who work as part of a team declared to collaborate mostly with physiotherapists (n = 1121; 23.3%), physicians with speciality (n = 1040; 21.6%), and other osteopaths (n = 943; 19.6%). The two groups showed heterogeneous characteristics. Significative differences were observed in all the factors, namely: geographical distribution, age, gender, training, working contract and working place, daily consultations and time for each consultation, fees, and the average waiting period to book an appointment. The principal component analysis supported a ten-component model and explained 80.5% of the total variance. The analysis showed that osteopaths working as sole practitioners have an increased probability (OR = 0.91; CI 95%: 0.88-0.94; p<0.01) of using systemic diagnostic and treatment techniques and have distinct clinical features with higher probability (OR = 0.92; 0.88-0.96; p<0.01) of spending less time with patients, being paid less but treating a higher number of patients per week. The most represented patients' age groups were 41-64 years old (n = 4452; 92.4%) and 21-40 years old (n = 4291; 89.1%). Similarly, the most reported new patients' age groups were 41-64 years old (n = 4221; 87.7%) and 21-40 years old (n = 3364; 69.9%). The most common presenting complaints were back pain, neck pain, cervical radiculopathy, sciatica, shoulder pain, and headaches. Osteopathic practice in Italy seems to be characterised by interprofessional collaboration, mostly with physiotherapists. Our results highlighted two different profiles in terms of sociodemographic characteristics and work modalities between osteopaths who work as sole practitioners and those who work as part of a team. Although according to the respondents, people of all ages consult Italian osteopaths, the majority of patients are adults. Most of them have been referred to osteopathy by other patients or acquaintances. Patients seek osteopathic care mostly for musculoskeletal related complaints.


Assuntos
Médicos Osteopáticos/psicologia , Adulto , Bases de Dados Factuais , Feminino , Humanos , Itália , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Doenças Musculoesqueléticas/diagnóstico , Doenças Musculoesqueléticas/terapia , Pacientes/estatística & dados numéricos , Análise de Componente Principal , Encaminhamento e Consulta/economia , Inquéritos e Questionários , Adulto Jovem
13.
PLoS One ; 15(7): e0235683, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32628725

RESUMO

BACKGROUND: Guidelines recommend venous thromboembolism (VTE) prophylaxis in hospitalized medical patients with Padua prediction score (PPS) ≥4 points. This recommendation is based on the high risk of symptomatic VTE observed among these patients in the Italian PPS derivation study, and the fivefold risk reduction with VTE-prophylaxis. This study aims to assess the incidence of VTE in high risk medical patients in a medium sized hospital in Israel. METHOD: In this retrospective cohort study, data was collected of all medical patients hospitalized between January and June 2014. Patients were classified into low and high risk groups according to their PPS score, and according to whether they received anticoagulant thromboprophylaxis for VTE. Patients were further randomly selected to compare high risk patients that did or did not receive anticoagulant thromboprophylaxis. We further compared VTE incidence in high and low risk patients not treated with thromboprophylaxis. A search was conducted for diagnoses of venous thromboembolism and death during hospitalization and the following 90 days. RESULTS: 568 high risk patients (PPS ≥4 points) were included, 284 treated with prophylactic anticoagulation and 284 not. There were no VTE events in either group. There was no difference in mortality. A total of 642 non anticoagulated patients were randomly selected, 474 low risk and 168 high risk. There were no VTE events in either group. CONCLUSIONS: The risk of VTE appears to be very low in our study, suggesting that among medical patients with PPS ≥4, the risk of VTE may differ dramatically between populations.


Assuntos
Tromboembolia Venosa/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Anticoagulantes/uso terapêutico , Feminino , Heparina de Baixo Peso Molecular/uso terapêutico , Hospitais , Humanos , Incidência , Israel/epidemiologia , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Pacientes , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Tromboembolia Venosa/tratamento farmacológico , Tromboembolia Venosa/mortalidade
15.
PLoS One ; 15(7): e0235867, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32634170

RESUMO

OBJECTIVES: While the general practitioner (GP) in the Netherlands is the first point of entry to and gatekeeper of the healthcare system, no study exists to explore the experiences of women with female genital mutilation or cutting (FGM/C) in general practice. Therefore, the aim of this study is to look into the experiences of women with FGM/C in Dutch general practice. METHODS: Semistructured interviews were held with 16 women with FGM/C. Sampling was purposeful. The interview guide and thematic analysis were based on the Illness Perception Model and Kleinman's Explanatory model. Interviews were held in English or Dutch. All data were anonymized, and recordings were transcribed verbatim. Transcripts were coded and thematically analyzed. RESULTS: The women considered FGM/C to be connected to a range of health problems, for which not all of them sought medical care. They had difficulty discussing such a sensitive topic with their GP, did not know their problems could be relieved or perceived GPs to have insufficient knowledge of FGM/C. Lack of time during consultations and overall dissatisfaction with Dutch GP care hampered trust. They strongly preferred the GP to be proactive and ask about FGM/C. CONCLUSION: There is room for improvement as most women would like their GP to discuss their health problems related to FGM/C. GPs should take a proactive attitude and ask about FGM/C. In addition, to develop the trusted relationship needed to discuss sensitive topics and provide culturally sensitive person-centered care, sufficient time during consultations is needed.


Assuntos
Circuncisão Feminina/psicologia , Clínicos Gerais/normas , Pacientes/psicologia , Relações Médico-Paciente , Adulto , Feminino , Clínicos Gerais/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pessoa de Meia-Idade , Países Baixos , Satisfação do Paciente , Inquéritos e Questionários , Confiança
16.
PLoS One ; 15(7): e0235764, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32645071

RESUMO

INTRODUCTION: Chronic hepatitis C (HCV), considered by the World Health Organization as one of the greatest epidemiological health hazards, often with asymptomatic clinical course and one which, due to scanty knowledge, remains a crucial risk factor of serious chronic HCV infection complications. The purpose of this study is to validate the psychometric properties of the Polish version of the validated Brief Hepatitis C Knowledge Scale (BHCKS_PL), developed by Balfour in 2009. METHODS: The study, conducted from May to July 2018, included 246 persons (68,69% females), divided into four subgroups: patients (n = 86), nursing students (n = 74), medical students (n = 28), healthcare workers (nurses and doctors; n = 58). The 19-items questionnaire contained questions designed to assess general knowledge regarding hepatitis C and the transmission risk factors. RESULTS: An evaluation by means of multiple comparisons in pairs showed that there were significant differences in the knowledge level between the group of patients and the group of nursing students (Mdn: 14.0 vs 11.0, z = 7.713, P<0.001), and between students of medicine (Mdn: 16.0 vs 11.0, z = 0.339, P<0.001) and healthcare workers (17.0 vs 11.0, z = 11.447, P<0.001). Moreover, significant differences were observed between the groups of students of nursing and medicine (Mdn: 14.0 vs 16.0, z = 3.646, P = 0.002) and healthcare workers (Mdn: 14.0 vs 17.0, z = 4.117, P<0.001). No significant differences in the knowledge level between the students of medicine and healthcare workers were observed (z = 0.377, P = 1.000). CONCLUSIONS: The completed validation suggests good BHCKS_P psychometric characteristics with the internal consistency convergent and known-groups validity. The questionnaire can be used in educational practice. The obtained results of the measurement provide information about the studied person based on the total score.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Hepatite C , Inquéritos e Questionários , Adulto , Feminino , Pessoal de Saúde , Hepatite C/diagnóstico , Hepatite C/transmissão , Hepatite C Crônica/diagnóstico , Hepatite C Crônica/transmissão , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes , Polônia , Psicometria/métodos , Estudantes de Medicina , Estudantes de Enfermagem
17.
PLoS One ; 15(7): e0235708, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32645113

RESUMO

BACKGROUND: Older emergency department (ED) patients often have complex problems and severe illnesses with a high risk of adverse outcomes. It is likely that these older patients are troubled with concerns, which might reflect their preferences and needs concerning medical care. However, data regarding this topic are lacking. METHODS: This study is a sub study of a prospective, multicenter, observational cohort study among older medical ED patients (≥65 years). Patients or their caregivers were asked about their illness-related concerns during the first stage of the ED visit using a questionnaire. All concerns were categorized into 10 categories, and differences between patients and caregivers, and between age groups were analyzed. Odds Ratios were calculated to determine the association of the concerns for different adverse outcomes. RESULTS: Most of the 594 included patients (or their caregivers) were concerned (88%) about some aspects of their illness or their need for medical care. The most often reported concerns were about the severity of disease (43.6%), functional decline (9.4%) and dying (5.6%). Caregivers were more frequently concerned than patients (p<0.001) especially regarding the severity of disease (50.5 vs 39.6%, p = 0.016) and cognitive decline (10.8 vs. 0.3%, p <0.001). We found no difference between age groups. The concern about dying was associated with 30-day mortality (OR 2.89; 95%CI: 1.24-6.70) and the composite endpoint (intensive- or medium care admission, length of hospital stay >7 days, loss of independent living and unplanned readmission within 30 days) (OR 2.32; 95%CI: 1.12-4.82). In addition, unspecified concerns were associated with mortality (OR 1.88; 95%CI: 1.09-3.22). CONCLUSION: The majority of older patients and especially their caregivers are concerned about their medical condition or need for medical care when they visit the ED. These concerns are associated with adverse outcomes and most likely reflect their needs regarding medical care. More attention should be paid to these concerns because they may offer opportunities to reduce anxiety and provide care that is adjusted to their needs. TRIAL REGISTRATION: This study was registered on clinicalTriagls.gov (NCT02946398).


Assuntos
Cuidadores , Serviço Hospitalar de Emergência/estatística & dados numéricos , Pacientes , Idoso , Idoso de 80 Anos ou mais , Envelhecimento Cognitivo , Estudos de Coortes , Assistência à Saúde/organização & administração , Feminino , Humanos , Vida Independente/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Alta do Paciente/estatística & dados numéricos , Readmissão do Paciente/estatística & dados numéricos , Estudos Prospectivos , Inquéritos e Questionários
18.
J Pregnancy ; 2020: 7306108, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32695515

RESUMO

Background: Obstetric fistula is abnormal passageway between the vagina and bladder or rectum, and it has the most devastating effects on physical, social, and economic levels and represents a major public health issue of thousands of women, which failed to provide accessible and appropriate intrapartum care for women within a developing country, particularly in Ethiopia. Therefore, we tried to assess the awareness and its associated factors of obstetrics fistula among pregnant mothers attending antenatal care clinics. Methods: A health institutional-based cross-sectional study was employed from March 4 to 29/2019 among 413 pregnant women. Data was collected by a systematic random sampling technique and entered into a computer using Epi data 3.5, edited and analyzed using Statistical Package of Social Sciences 23.0 version. Bivariate and multivariate logistic regression analyses were employed to estimate the crude and adjusted odds ratio with a confidence interval of 95% and p value of less than 0.05 considered statically significant. Result: This study identified that 39.5% with 95% confidence interval (34.6-44.6%) of pregnant women had good awareness about obstetrics fistula. Multivariate logistic regression analysis showed that living in urban [AOR = 1.98, 95% CI = 1.07 - 3.69], attending formal education [AOR = 2.11, 95% CI = 1.06 - 4.12], having history antenatal care [AOR = 3.87, 95% CI = 1.60 - 9.68], and childbirth at health institution [AOR = 7.10, 95% CI = 2.52 - 2.02] were significantly associated with awareness of obstetrics fistula. Conclusion and recommendation. This study showed that awareness of obstetrics fistula was low. Residency, education, and occupation of the women, having history of antenatal care and childbirth at health institution was significantly associated with awareness of obstetrics fistula. Still, there is a gap on awareness of obstetrics fistula; therefore, it is good to emphasize on providing information on maternal health care issues, particularly about obstetrics fistula.


Assuntos
Conscientização , Fístula , Pacientes/psicologia , Complicações na Gravidez , Cuidado Pré-Natal , Doenças Retais , Doenças da Bexiga Urinária , Estudos Transversais , Etiópia , Feminino , Acesso aos Serviços de Saúde , Humanos , Educação de Pacientes como Assunto , Gravidez
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