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West Indian med. j ; 65(Supp. 3): [20], 2016.
Artigo em Inglês | MedCarib | ID: med-18088


Objective: The study investigates the perception of publicvs private healthcare among doctors, nurses and the publicin Trinidad.Subjects and Methods: A cross-sectional study wasconducted on a sample of 1222 persons. Respondents wereasked via interviewer-administered questionnaire whichhealthcare system (public or private) they would chooseand why, if ability to pay was not a factor. They were alsoasked to state what in their view would improve thesystems. The data collected were subject to the Chisquaredtest and Fisher’s exact test to determine anysignificant associations.Results: One thousand two hundred and twenty-twopersons were interviewed (response rate 89%). Themajority of all groups would choose private healthcare (÷2= 238.06, df = 7, p-value = 0.000). The majority of nonmedicalgroups perceived private care to be faster andbetter (p = 0.000); doctors would like more accountabilityin private settings and more drugs and equipment in thepublic sector, while non-clinical groups wanted cheaperprivate care (p = 0.000).Conclusion: The publicly funded healthcare system seemsto be falling short on some quality standards, thus contravening a fundamental human right. The publicshould be informed when making a decision to opt forprivate care that the same doctors often work in bothsettings. For critical care, the public institutions have abetter staff complement, although this study highlightedthe need for more drugs and better equipment. Thegovernment needs to look closer at the reasons all groups,including doctors and nurses, would choose privatehealthcare.

Prática de Saúde Pública , Cobertura de Serviços Privados de Saúde , Corpo Clínico , Corpo Clínico Hospitalar , Recursos Humanos de Enfermagem , Recursos Humanos de Enfermagem no Hospital , Opinião Pública
In. Caribbean Public Health Agency. Caribbean Public Health Agency: 60th Annual Scientific Meeting. Kingston, The University of the West Indies. Faculty of Medical Sciences, 2015. p.[1-75]. (West Indian Medical Journal Supplement).
Monografia em Inglês | MedCarib | ID: med-17923


OBJECTIVE: To explore the perceptions and impact of violence experienced by Emergengy Department (ED) staff of the Princess Margaret Hospital in The Commonwealth of The Bahamas in order to inform administrative managers’ awareness and ED staff behavioural changes. DESIGN AND METHODS: A qualitative research design and interpretative epistemological view point was adopted. Purposive sampling method was utilized and 12 participants were recruited for the study. Data collected from semi-structured interviews were transcribed and thematically analysed to identify common themes. RESULTS: Five major themes were common to all interviews. Firstly, the overwhelming perception of violence was seen as an innate and inevitable ED occurrence. Secondly, facilitating elements were viewed multifactorially with verbal abuse perceived as the most common form experienced. Thirdly, personal and professional impact of ED violence was seen as having the potential to negatively affect patient care. Fourthly, support and coping measures viewed as post-incident essentials were considered lacking. Finally, suggested measures to decrease ED violence related to areas of patient, staff and ED improvements. However doubt was voiced as to the efficacy of such measures being adequately implemented. CONCLUSION: The study provided a useful insight into the perceptions and impacts of violence experienced by staff in the ED. The negative impact on staff personally was seen as having consequential negative effect on professional performance in the ED, with patient quality care ultimately being compromised. In sharing the results of this and the highlighted public health concern, awareness and behavioural changes were encouraged, along with the need for further research into this emotive issue.

Violência , Serviço Hospitalar de Emergência , Corpo Clínico Hospitalar , Bahamas
Emergency medicine journal ; 22: 391-392, 2005.
Artigo em Inglês | MedCarib | ID: med-17655


In summary, the problems of all Emergency Rooms are similar, but vary in detail. Achieving better waiting times in the Emergency Room may be at the expense of the quality of care in the entire system, if managed in isolation.

Humanos , Ocupação de Leitos , Serviço Hospitalar de Emergência/organização & administração , Corpo Clínico Hospitalar/organização & administração , Trinidad e Tobago
West Indian med. j ; 50(Suppl 5): 20, Nov. 2001.
Artigo em Inglês | MedCarib | ID: med-195


OBJECTIVE: To document the changing attitudes of staff and patients to the implementation of an open door policy (ODP) in the custodial psychiatry unit at the University Hospital of the West Indies. METHOD: The implementation of the changing therapeutic activities between October 2000 and January 2001 was followed using qualitative methods. Patients, their relatives and staff were interviewed around the time of implementation of each changing activity, and their attitudes documented. Patients attitudes to the transformed ward were sampled from May 2001 using the Verona Satisfaction Scale. The ODP had five separate components. The first was the opening of the main gate of the ward, which took place in October 2000. This was followed by a rationalization in stages of patients clinical status and their assignment to specific therapeutic activities. The implementation of daily therapeutic community group meetings was followed shortly afterwards by the implementation of an art therapy programme and other occupational activities. The opening of the Occupational Centre was the final phase of the programme in June 2001. RESULTS: The initial response of staff members to the opening of the main gate was angry and hostile with acts of passive resistance. Patient response was cautious but favourable, and they soon took advantage of leaving the ward unacompanied. Demarcation of the patients into groups of clinical severity soon allowed the staff to rationalize therapuetic activities for the patients. Both staff and patients were cooperative to this change. Implementation of the therapuetic community group meetings had a profound resocializing effect on patients and staff. Finally, the implementation of the art and activity therapy was warmly received by the patients, and proudly acclaimed by the staff. Analysis of the Verona Satisfaction Scores indicated a general acceptance and appreciation by the patients. CONCLUSIONS: The general consensus has been that the ward atmosphere was positively transformed by the ODP with patients being more satisfied with their care and being less hostile in their interactions with staff. Staff have cooperated with the changes, and have expressed appreciation of the benefits derived from the process. (AU)

Humanos , Pacientes , Corpo Clínico Hospitalar , Unidade Hospitalar de Psiquiatria , Atitude , Implementação de Plano de Saúde , Inovação Organizacional , Jamaica , Relações Profissional-Paciente , Aceitação pelo Paciente de Cuidados de Saúde , Satisfação do Paciente , Escalas de Graduação Psiquiátrica
In. Hatcher Roberts, Janet; Kitts, Jennifer; Jones Arsenault, Lori. Gender, health, and sustainable development: perspectives from Asia and the Caribbean; proceedings of workshops held in Singapore, 23-26 January 1995 and in Bridgetown, Barbados, 6-9 December 1994. Ottawa, International Development Research Centre, Aug. 1995. p.305-7.
Monografia em Inglês | MedCarib | ID: med-3491
In. Fraser, Henry S; Hoyos, Michael D. Therapeutics and family medicine update 1985 : proceedings of the continuing medical education symposia in Barbados and Antigua in 1984. Bridgetown, University of the West Indies (Cave Hill). Faculty of Medical Sciences, 1985. p.30-1.
Monografia em Inglês | MedCarib | ID: med-9836
Kingston; ; Mar. 1982. 91 p. tab.
Tese em Inglês | MedCarib | ID: med-13724


Research indicates that a large percentage of hospitalised patients in the United States and England suffer from protein energy malnutrition (P.E.M.) but this condition is usually undiagnosed. The study aimed to investigate the situation at a rural Jamaican hospital by firstly determining the nutritional status of the patients and secondly, assessing the awareness of the doctors of nutrition, in the management of their patients. The sample comprised 297 patients (108 medical, 90 surgical and 99 paediatric) consecutively admitted to the hospital during the three month study period. The investigator assessed the nutritional status using four standard anthropometric measurements viz:- weight, height, mid upper arm circumference (M.U.A.C.) and triceps skinfold thickness (T.S.F.) within twenty-four hours of admission. In addition, the patients' hospital notes were examined and records made of the nutritional management requested for each patient. Signs and symptons suggestive of malnutrition and biochemical analyses carried out or requested, were also recorded. These were used as an indication of the awareness of nutrition on the part of the attending physician. Of the 207 patients on whom anthropometric measurements were taken, 51 (38percent) adult patients from the medical and surgical wards, and 32 (43 percent) of the paediatric cases, were wasted to some degree. In addition, 25 (42 percent) of the paediatric patients measured were underweight and 8 of the adult patients were overweight. Of the 19 cases of obesity found among the adults, 15 were females. Triceps skinfold thickness were especially low among the adult population, 100 (72 percent ) having values below 60 percent of the reference used. Arm muscle circumference were high for those patients. Five of the moderate to severely malnourished adults (those under 80 percent weight for height) suffered from neoplastic diseases. Apart from this, malnutrition was not related to any specific diagnostic category. Signs and symptoms suggestive of malnutrition were infrequently mentioned in the patients' physical examination notes. A quarter of the adult patients were examined for oedema (mostly from the medical wards) while paediatric patients were checked for diarrhoea (28 percent ), vomiting (38 percent ) and dehydration (32 percent ). While pallor was examined for on all three wards to the same extent (42 percent ), anorexia was mentioned only in the dockets of nine patients. Thirty-eight (11 percent ) patients had no diet prescribed in their hospital notes. Generally, dietary prescription was based primarily on the patients' diagnosis but age and physical condition were also considered. Prescribed diets were usually appropriate for the patients in terms of the recorded diagnoses. However, with respect to nutritional status as derived from the study, the diets were incorrect in several cases. No diets were prescribed for the nutritional rehabilitation of malnourished patients. This study suggests that although P.E.M. is common in hospitalised patients, inadequate attention is paid to nutritional status in patient management (AU)

Humanos , Lactente , Criança , Adulto , Idoso , Masculino , Feminino , Estado Nutricional , Pacientes , Corpo Clínico Hospitalar , Desnutrição Proteico-Calórica/diagnóstico , Antropometria , Hospitais Rurais , Dietoterapia , Jamaica