Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 32
Filtrar
1.
JMIR Hum Factors ; 11: e51666, 2024 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-38837192

RESUMEN

BACKGROUND: Given the dearth of resources to support rural public health practice, the solutions in health analytics for rural equity across the northwest dashboard (SHAREdash) was created to support rural county public health departments in northwestern United States with accessible and relevant data to identify and address health disparities in their jurisdictions. To ensure the development of useful dashboards, assessment of usability should occur at multiple stages throughout the system development life cycle. SHAREdash was refined via user-centered design methods, and upon completion, it is critical to evaluate the usability of SHAREdash. OBJECTIVE: This study aims to evaluate the usability of SHAREdash based on the system development lifecycle stage 3 evaluation goals of efficiency, satisfaction, and validity. METHODS: Public health professionals from rural health departments from Washington, Idaho, Oregon, and Alaska were enrolled in the usability study from January to April 2022. The web-based evaluation consisted of 2 think-aloud tasks and a semistructured qualitative interview. Think-aloud tasks assessed efficiency and effectiveness, and the interview investigated satisfaction and overall usability. Verbatim transcripts from the tasks and interviews were analyzed using directed content analysis. RESULTS: Of the 9 participants, all were female and most worked at a local health department (7/9, 78%). A mean of 10.1 (SD 1.4) clicks for task 1 (could be completed in 7 clicks) and 11.4 (SD 2.0) clicks for task 2 (could be completed in 9 clicks) were recorded. For both tasks, most participants required no prompting-89% (n=8) participants for task 1 and 67% (n=6) participants for task 2, respectively. For effectiveness, all participants were able to complete each task accurately and comprehensively. Overall, the participants were highly satisfied with the dashboard with everyone remarking on the utility of using it to support their work, particularly to compare their jurisdiction to others. Finally, half of the participants stated that the ability to share the graphs from the dashboard would be "extremely useful" for their work. The only aspect of the dashboard cited as problematic is the amount of missing data that was present, which was a constraint of the data available about rural jurisdictions. CONCLUSIONS: Think-aloud tasks showed that the SHAREdash allows users to complete tasks efficiently. Overall, participants reported being very satisfied with the dashboard and provided multiple ways they planned to use it to support their work. The main usability issue identified was the lack of available data indicating the importance of addressing the ongoing issues of missing and fragmented public health data, particularly for rural communities.


Asunto(s)
Equidad en Salud , Humanos , Noroeste de Estados Unidos , Salud Pública/métodos , Servicios de Salud Rural , Femenino , Masculino , Población Rural , Adulto
2.
J Am Med Inform Assoc ; 31(2): 342-353, 2024 Jan 18.
Artículo en Inglés | MEDLINE | ID: mdl-37354553

RESUMEN

OBJECTIVE: To create and evaluate a public health informatics tool, Florence, for communicating information to the public. MATERIALS AND METHODS: This user-centered design study included 3 phases: (1) an interview and survey study with public health practitioners to assess needs for creating infographics; (2) the application of assessment findings and public health-motivated design guidelines to the design and development of a public health-specific infographic design tool; and (3) a feasibility and usability study to evaluate the feasibility and usability of the tool. RESULTS: In phase 1, participants noted the importance of tailoring infographics to an audience and wanted flexible tools along with design guidance to help make fewer design decisions. In phase 2, we developed a prototype tool with: (1) layout and functionality familiar to PH users, (2) quick and intuitive ways to add and modify data in visualizations, and (3) health-focused visual elements. In phase 3, participants found Florence to be usable, providing an intuitive and straightforward experience, and that the focus on public health was useful. DISCUSSION: Based on needs assessments and existing literature, we created Florence along with public health practitioners to address their domain specific needs, ultimately leading to a tool that participants in our study deemed useful. Future research can build on our work to develop user-centered tools to meet their needs. CONCLUSION: Infographics are important for public health communication. Creating user-centered solutions to address the unique needs of public health can support communication efforts.


Asunto(s)
Visualización de Datos , Salud Pública , Humanos , Comunicación
3.
Worldviews Evid Based Nurs ; 21(2): 148-157, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38159058

RESUMEN

BACKGROUND: Outcomes associated with rapid response teams (RRTs) are inconsistent. This may be due to underlying facilitators and barriers to RRT activation that are affected by team leaders and health systems. AIMS: The aim of this study was to synthesize the published research about facilitators and barriers to nurse-led RRT activation in the United States (U.S.). METHODS: A systematic review was conducted. Four databases were searched from January 2000 to June 2023 for peer-reviewed quantitative, qualitative, and mixed methods studies reporting facilitators and barriers to RRT activation. Studies conducted outside the U.S. or with physician-led teams were excluded. RESULTS: Twenty-five studies met criteria representing 240,140 participants that included clinicians and hospitalized adults. Three domains of facilitators and barriers to RRT activation were identified: (1) hospital infrastructure, (2) clinician culture, and (3) nurses' beliefs, attributes, and knowledge. Categories were identified within each domain. The categories of perceived benefits and positive beliefs about RRTs, knowing when to activate the RRT, and hospital-wide policies and practices most facilitated activation, whereas the categories of negative perceptions and concerns about RRTs and uncertainties surrounding RRT activation were the dominant barriers. LINKING EVIDENCE TO ACTION: Facilitators and barriers to RRT activation were interrelated. Some facilitators like hospital leader and physician support of RRTs became barriers when absent. Intradisciplinary communication and collaboration between nurses can positively and negatively impact RRT activation. The expertise of RRT nurses should be further studied.


Asunto(s)
Equipo Hospitalario de Respuesta Rápida , Médicos , Adulto , Humanos , Estados Unidos , Hospitales
4.
Diabetes Spectr ; 36(4): 345-353, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38024222

RESUMEN

Objective: Diabetes knowledge is associated with health, including lower A1C levels. The Diabetes Knowledge Questionnaire (DKQ-24), developed 30 years ago for Mexican Americans with type 2 diabetes and since used with diverse samples in many countries, contains outdated items that no longer accurately assess current knowledge needed for diabetes self-management. We revised the DKQ-24 and tested psychometric properties of the DKQ-Revised (DKQ-R) with a diverse sample. Methods: We conducted a five-phase instrumentation study as follows: 1) DKQ-24 items were revised to reflect current diabetes care standards; 2) the Delphi method was used to evaluate the DKQ-R's content validity (n = 5 experts); 3) cognitive interviews were conducted with people with type 2 diabetes (n = 5) to assess their interpretations of DKQ-R items; 4) cross-sectional administration of the DKQ-R to adults with type 2 diabetes was carried out to assess internal consistency reliability and convergent validity; and 5) an item analysis was conducted using discrimination index and point biserial analysis. Results: After receiving the experts' feedback and conducting the cognitive interviews, 39 items were administered to 258 participants with type 2 diabetes (42.2% women; 29.1% Latino, 42.6% Asian, mean age 55.7 years). To select the final items, we considered the item discrimination index, as well as item-to-total correlations, content area, and participant feedback. The final 22-item DKQ-R uses the same yes/no/I don't know response format as the DKQ-24. The DKQ-R is strongly correlated with the DKQ-24 (r = 0.71, P <0.01) and is weakly correlated with diabetes numeracy (r = 0.23, P <0.01), indicating adequate convergent validity; a Kuder-Richardson-20 coefficient of 0.77 indicated good reliability. Conclusion: The DKQ-R is a reliable and valid updated measure of diabetes knowledge for diverse populations with type 2 diabetes.

5.
J Adv Nurs ; 79(11): 4164-4195, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-37688364

RESUMEN

AIMS: To identify the barriers and facilitators to healthcare for people without documentation status. DESIGN: We conducted a systematic integrative literature review following the Whittemore and Knafl methodology. METHODS: Literature search was conducted to identify studies addressing barriers or facilitators to healthcare for people without documentation status in the United States between 2012 and 2022. Studies were critiqued for quality, with results analysed thematically using the social-ecological model. DATA SOURCES: Searches were conducted in PubMed, PAIS, Web of Science, CINAHL and Psych Info in October 2022. RESULTS: The review incorporated 30 studies (19 qualitative and 11 quantitative). People without documentation status encountered numerous healthcare barriers such as intrapersonal (lack of financial resources and health insurance, fear), interpersonal (language and cultural discrepancies, discrimination), community (bureaucratic requirements, anti-immigrant rhetoric) and policy-related barriers. Conversely, linguistically and culturally competent care, empathetic and representative staff, health navigators, safety-net clinics and supportive federal policies emerged as key facilitators. CONCLUSION: These findings illuminate the complex healthcare disparities experienced by people without documentation status and underscore facilitators enhancing care accessibility. Future research is needed to explore interventions to increase access to care for this population. IMPACT: This paper provides a comprehensive examination of the complex barriers and facilitators to healthcare for people without documentation status in the United States. The findings support the value of universal healthcare access, a priority of the World Health Organization, and can inform healthcare policies and practices worldwide. REPORTING METHOD: The review was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution was needed. TRIAL AND PROTOCOL REGISTRATION: The study protocol was registered with the PROSPERO database (registration number: CRD42022366289).

6.
Qual Health Res ; 33(11): 1017-1029, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-37550990

RESUMEN

People with intellectual and developmental disabilities (IDD) experience elevated risk for poor health and social outcomes in adulthood and are at risk for experiencing homelessness and housing instability. Although the exact prevalence of IDD among homeless populations is unknown, a small body of literature related to the intersection of IDD and homelessness suggests differential health needs and service use patterns, with a need for targeted health and social services. In this study, we explore the perceptions and experiences of 18 homeless or disability service providers about (a) their clients at the intersection of IDD and homelessness and (b) their role and the services provided at the intersection of IDD and homelessness. Participants struggled to provide appropriate, accessible services for this population, owing to lack of training and awareness of specific needs, fragmented systems, and inadequately funded healthcare and housing support. Our findings also reveal that clients at this intersection have high contact with public systems, which places them at risk for losing their right to self-determination. Recommendations center on systems transformation to facilitate the ability of providers to collaborate and to make data-driven decisions to deliver person-centered care.


Asunto(s)
Discapacidades del Desarrollo , Personas con Mala Vivienda , Niño , Humanos , Discapacidades del Desarrollo/epidemiología , Servicio Social , Atención a la Salud , Vivienda
7.
J Health Care Poor Underserved ; 34(2): 758-797, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37464530

RESUMEN

A scoping review was conducted to present the state of the science regarding the health and health-related quality of life (HRQOL) effects of having a family member in contact with the criminal legal system (CLS). The review examined how the following have been studied: 1) types of family relationships, 2) the point of CLS contact, 3) mental health outcomes, 4) physical health outcomes, and 5) HRQOL outcomes. The final sample of 40 studies was largely secondary analyses of datasets (93%; n=37) that investigated a parent-child relationship (78%; n=31). Incarceration was the most frequently measured point of CLS contact (85%; n=34). Mental health outcomes were measured in 68% of the studies (n=27). Physical health outcomes were measured in 28% of the studies (n=11). Health-related quality of life outcomes were included in half of the studies (50%; n=20). Study findings indicate exposure to the CLS through a family member is associated with poorer health and HRQOL outcomes.


Asunto(s)
Criminales , Calidad de Vida , Humanos , Relaciones Padres-Hijo
8.
J Biomed Inform ; 144: 104419, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37301528

RESUMEN

OBJECTIVES: To examine the feasibility of promoting engagement with data-driven self-management of health among individuals from minoritized medically underserved communities by tailoring the design of self-management interventions to individuals' type of motivation and regulation in accordance with the Self-Determination Theory. METHODS: Fifty-three individuals with type 2 diabetes from an impoverished minority community were randomly assigned to four different versions of an mHealth app for data-driven self-management with the focus on nutrition, Platano; each version was tailored to a specific type of motivation and regulation within the SDT self-determination continuum. These versions included financial rewards (external regulation), feedback from expert registered dietitians (RDF, introjected regulation), self-assessment of attainment of one's nutritional goals (SA, identified regulation), and personalized meal-time nutrition decision support with post-meal blood glucose forecasts (FORC, integrated regulation). We used qualitative interviews to examine interaction between participants' experiences with the app and their motivation type (internal-external). RESULTS: As hypothesized, we found a clear interaction between the type of motivation and Platano features that users responded to and benefited from. For example, those with more internal motivation reported more positive experience with SA and FORC than those with more external motivation. However, we also found that Platano features that aimed to specifically address the needs of individuals with external regulation did not create the desired experience. We attribute this to a mismatch in emphasis on informational versus emotional support, particularly evident in RDF. In addition, we found that for participants recruited from an economically disadvantaged community, internal factors, such as motivation and regulation, interacted with external factors, most notably with limited health literacy and limited access to resources. CONCLUSIONS: The study suggests feasibility of using SDT to tailor design of mHealth interventions for promoting data-driven self-management to individuals' motivation and regulation. However, further research is needed to better align design solutions with different levels of self-determination continuum, to incorporate stronger emphasis on emotional support for individuals with external regulation, and to address unique needs and challenges of underserved communities, with particular attention to limited health literacy and access to resources.


Asunto(s)
Diabetes Mellitus Tipo 2 , Equidad en Salud , Automanejo , Humanos , Diabetes Mellitus Tipo 2/terapia , Motivación
9.
J Public Health Manag Pract ; 29(4): 496-502, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36867496

RESUMEN

CONTEXT: Rural public health personnel serve communities that have been particularly susceptible to COVID-19 and yet faced the pandemic with far less well-resourced capacity than their urban counterparts. A critical aspect of addressing local health inequities is access to high-quality population data and the capacity to effectively use data to support decision making. However, much of the data required to investigate inequities are not readily available to rural local health departments and the tools and training to analyze data are often lacking. PROGRAM: The purpose of our effort was to explore rural data challenges related to COVID-19 and provide recommendations for improving rural data access and capacity ahead of future crises. IMPLEMENTATION: We gathered qualitative data in 2 phases, more than 8 months apart, from rural public health practice personnel. Initial data were gathered in October-November 2020 regarding rural public health data needs during the COVID-19 pandemic and then to later identify whether the same findings held true in July 2021 or whether access to and capacity to use data to address the pandemic and related inequities improved as the pandemic progressed. EVALUATION: In our 4-state exploration focused on access and use of data among rural public health systems to promote health equity in the Northwest United States, we found tremendous and ongoing unmet data needs, challenges with communicating data, and a lack of capacity to meet this public health crisis. DISCUSSION: Recommendations for addressing these challenges include increasing dedicated resources specifically to rural public health systems, improving data access and infrastructure, and providing dedicated data-related workforce development.


Asunto(s)
COVID-19 , Equidad en Salud , Humanos , Población Rural , Salud Pública , Recolección de Datos , Gobierno Local , Estudios Transversales , Investigación Cualitativa , Exactitud de los Datos
10.
Sci Diabetes Self Manag Care ; 49(2): 101-111, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-36896911

RESUMEN

PURPOSE: The purpose of this study is to use text-mining methods to examine the dominant sources of online information and content about continuous glucose monitors (CGMs). Because the internet is the most popular source for health information, it is important to understand what is being said about CGMs in online sources of information. METHODS: A text miner, algorithmic-driven statistical program was used to identify the main sources of online information and topics on CGMs. Content was limited to English and was posted from August 1, 2020, to August 4, 2022. Using Brandwatch software, 17 940 messages were identified. After cleaning, there were 10 677 messages in final analyses conducted using SAS Text Miner V.12.1 software. RESULTS: The analysis identified 20 topics that formed 7 themes. Results show that most online information comes from news sources and focuses on the general benefits of CGM use. Beneficial aspects ranged from improvements in self-management behaviors, cost, and glucose levels. None of the themes mentioned changes to practice, research, or policies related to CGM. CONCLUSIONS: To improve diffusion of information and innovations going forward, novel ways of information sharing should be explored, such as diabetes specialist, provider, and researcher engagement in social media and digital storytelling.


Asunto(s)
Diabetes Mellitus , Medios de Comunicación Sociales , Humanos , Programas Informáticos , Minería de Datos/métodos , Glucosa
11.
J Public Health Manag Pract ; 29(3): E79-E89, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36731059

RESUMEN

OBJECTIVES: This study examined whether distinct factors exist among public health skills, measured through the Public Health Workforce Interests and Needs Survey (PH WINS). Understanding how workforce training needs group is important for developing targeted and appropriate public health workforce training sessions. DESIGN: Exploratory factor analysis was used to examine public health skills among tier 1 staff (nonmanagers) and a combined group of tier 2 and 3 staff (managers and executives). SETTING: Data for this study come from the 2017 PH WINS, which assessed public health workforce perceptions of training needs, workplace environment, job satisfaction, perceptions about national trends, and demographics. The analysis included 22 items. PARTICIPANTS: All public health staff in participating agencies were eligible to complete the survey. The national data set included participants from 47 state health agencies, 26 large local health departments (LHDs), and 71 mid-sized LHDs across all 10 Health and Human Services regions in the United States (including LHDs from all states). The analytic sample was n = 9630 in tier 1, n = 4829 in tier 2, and n = 714 in tier 3 staff. MAIN OUTCOME MEASURE: Three factors were identified within the skills portion of PH WINS, using exploratory factor analysis. To interpret retained factors, the following parameters were used: factor loadings greater than 0.4, factor cross-loadings less than 0.4 or higher than loadings on other factors, and communalities greater than 0.5. RESULTS: Factors included (1) data and systems thinking, (2) planning and management, and (3) community collaboration, with slight variation in item loadings between tier 1 and tier 2 and 3 staff analyses. CONCLUSION: This study was the first known factor analysis of the training needs and workforce skills portion of PH WINS in the published literature. This study advances our conceptualization of public health workforce skills and has the potential to shape future critical workforce training development.


Asunto(s)
Fuerza Laboral en Salud , Salud Pública , Humanos , Estados Unidos , Recursos Humanos , Encuestas y Cuestionarios , Análisis Factorial
12.
J Public Health Manag Pract ; 29(3): E69-E78, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36477581

RESUMEN

CONTEXT: The COVID-19 pandemic made the long-standing need for a national uniform financial reporting standard for governmental public health agencies clear, as little information was available to quantify state and local public health agencies' financial needs during the pandemic response. Such a uniform system would also inform resource allocation to underresourced communities and for specific services, while filling other gaps in practice, research, and policy making. This article describes lessons learned and recommendations for ensuring broad adoption of a national Uniform Chart of Accounts (UCOA) for public health departments. PROGRAM: Leveraging previous efforts, the UCOA for public health systems was developed through collaboration with public health leaders. The UCOA allows state and local public health agencies to report spending on activities and funding sources, along with practice-defined program areas and capabilities. IMPLEMENTATION: To date, 78 jurisdictions have utilized the UCOA to crosswalk financial information at the program level, enabling comparisons with peers. EVALUATION: Jurisdictions participating in the UCOA report perceptions of substantial up-front time investment to crosswalk their charts of accounts to the UCOA standard but derive a sense of valuable potential for benchmarking against peers, ability to engage in resource allocation, use of data for accountability, and general net positive value of engagement with the UCOA. IMPLICATIONS FOR POLICY AND PRACTICE: The UCOA is considered a need among practice partners. Implementing the UCOA at scale will require government involvement, a reporting requirement and/or incentives, technical assistance, financial support for agencies to participate, and a means of visualizing the data.


Asunto(s)
COVID-19 , Pandemias , Humanos , Pandemias/prevención & control , COVID-19/epidemiología , Práctica de Salud Pública , Salud Pública , Benchmarking
13.
Nurs Inq ; 30(1): e12518, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-35982547

RESUMEN

Recent frameworks, models, and reports highlight the critical need to address social determinants of health for achieving health equity in the United States and around the globe. In the United States, data play an important role in better understanding community-level and population-level disparities particularly for local health departments. However, data-driven decision-making-the use of data for public health activities such as program implementation, policy development, and resource allocation-is often presented theoretically or through case studies in the literature. We sought to develop a preliminary model that identifies the factors that contribute to data-driven decision-making in US local health departments and describe relationships between them. Guided by implementation science literature, we examined organizational-level capacity and individual-level factors contributing to using data for decision-making related to social determinants of health and the reduction of county-level disparities. This model has the potential to improve implementation of public health interventions and programs aimed at upstream structural factors, by elucidating the factors critical to incorporating data in decision-making.


Asunto(s)
Equidad en Salud , Determinantes Sociales de la Salud , Humanos , Estados Unidos , Formulación de Políticas , Salud Pública , Asignación de Recursos
14.
Nurs Outlook ; 70(5): 710-724, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35933178

RESUMEN

BACKGROUND: Nurse scientists have significantly contributed to health equity and ensuring cultural tailoring of interventions to meet unique needs of individuals. Methodologies for cultural tailoring of self-mangament interventions among marginalized populations have limitedly accommodated intersectionality and group heterogeneity when addressing health needs. PURPOSE: Identify methodological limitations in cultural tailoring of interventions among priority populations and issue recommendations on cultural elements that researchers can target to ensure valid cultural tailoring approaches. METHODS: Synthesis of literature on health equity, self-management, and implementation and dissemination research. FINDINGS: Among priority populations, intersectionality and group heterogeneity has made group-based cultural tailoring approaches less effective in eliciting desirable health outcomes. Precision health methodology could be useful for cultural tailoring of interventions due to the methodology's focus on individual-level tailoring approaches. DISCUSSION: We offer ways to advance health equity research using precision health approaches in cultural tailoring through targeting unique elements of culture and relevant psychosocial phenotypes.


Asunto(s)
Equidad en Salud , Automanejo , Humanos , Medicina de Precisión , Recolección de Datos
15.
Am J Public Health ; 112(S3): S314-S320, 2022 06.
Artículo en Inglés | MEDLINE | ID: mdl-35679541

RESUMEN

We present an analysis of challenges facing public health nursing faculty members (PHNF) in the United States and their broader societal implications. The COVID-19 pandemic has exacerbated these challenges, making them untenable. Current academic structures-influenced by the broader sociopolitical climate-are problematic for PHNF: they disincentivize PHNF from researching social determinants of health and public health systems, teaching systems-level content that may be deemed "controversial" and that is not included on licensure exams, and engaging in service through advocacy and community partnerships. The fault lines within health care, public health systems, and higher education indicate that it is time to reevaluate how to incentivize socially just and equitable outcomes. Toward this goal, we propose that collective action and systemic change, including the perspectives of PHNF, is needed to better realize our shared goals. The analysis serves as a catalyst for conversations about academic structures, health care systems, the role of public health, and the kind of society we envision for ourselves and future generations. (Am J Public Health. 2022;112(S3):S314-S320. https://doi.org/10.2105/AJPH.2022.306819).


Asunto(s)
COVID-19 , Enfermería en Salud Pública , COVID-19/epidemiología , Docentes , Humanos , Pandemias , Salud Pública , Estados Unidos/epidemiología
16.
Res Gerontol Nurs ; 15(4): 203-212, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35708961

RESUMEN

The aim of the current study was to explore relationships among perceived cognitive function, glucose variability, and self-management in older adults with type 2 diabetes mellitus (T2DM). A mixed methods design was used with data from: (a) questionnaires on perceived cognitive function and diabetes self-management; (b) continuous glucose monitoring (CGM) reports; and (c) semi-structured interviews. Thirty adults with T2DM (47% female; mean age = 68.5 [SD = 5.2] years) participated. Those who exercised more days per week had more stable glucose. Those who reported fewer days of diet adherence had more hypoglycemia. Participants who reported higher levels of memory dissatisfaction exhibited higher levels of glucose variability. Findings point to the potential of glucose variability as a target to reduce the effect of diabetes on cognitive function. Instruction in recognition of glucose patterns found via CGM can be integrated into self-management education to improve self-management and subsequent glucose control and cognitive function. [Research in Gerontological Nursing, 15(4), 203-212.].


Asunto(s)
Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Automanejo , Anciano , Glucemia , Automonitorización de la Glucosa Sanguínea/métodos , Automonitorización de la Glucosa Sanguínea/psicología , Cognición , Diabetes Mellitus Tipo 1/psicología , Diabetes Mellitus Tipo 2/terapia , Femenino , Glucosa , Hemoglobina Glucada/análisis , Humanos , Masculino , Percepción
17.
Nurs Outlook ; 70(3): 374-376, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35469594

RESUMEN

Given the longstanding inequities clarified by the pandemic, the time has come for nursing informatics to adopt the goals of social justice and equity as its primary focus. Social justice informatics (SJI) is an emerging field that leverages the power of data, information, and technology in pursuit of advancing equity through collaboration with diverse communities. We propose that an SJI orientation should be adopted to change the paradigms of power by placing communities at the center of the work and ensuring future informatics work is free from unintended consequences. However, to support this, legacy practices and policies will need to be replaced, which is discussed using the exemplar of academic systems. While this process will not be easy, it is hoped that by committing to and refining the vision presented here we will create a society that more accurately reflects our shared values of equity and prosperity.


Asunto(s)
Informática , Justicia Social , Humanos
18.
ANS Adv Nurs Sci ; 45(3): 256-273, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34966026

RESUMEN

The purpose of this qualitative secondary analysis research was to describe the impact of the COVID-19 pandemic on self-management behaviors and practices for people living with the dual diagnoses of HIV/AIDS and type 2 diabetes mellitus and to identify early pandemic-specific disruptions or changes to their self-management practices. In-depth interviews conducted in May-June 2020 with 9 participants, and analyzed using content analysis, revealed 5 themes: adjusting to living with HIV/AIDS and diabetes impacts beliefs about COVID-19 risks; COVID-19 information seeking and accuracy; trade-offs in self-managing multiple chronic conditions; balance between safety, relationships, and the society at large; and discordant perceptions and actions. Some participants were resilient from previous experiences. Many received mixed messages about their risk for COVID-19, resulting in inaccurately or inconsistently applying guidelines for social isolation.


Asunto(s)
COVID-19 , Diabetes Mellitus Tipo 2 , Infecciones por VIH , Automanejo , Trastornos Relacionados con Sustancias , Prueba de COVID-19 , Diabetes Mellitus Tipo 2/terapia , Diagnóstico Dual (Psiquiatría) , Infecciones por VIH/terapia , Humanos , Pandemias , Investigación Cualitativa
19.
J Neurol Disord ; 10(11)2022.
Artículo en Inglés | MEDLINE | ID: mdl-38282969

RESUMEN

Background: As the population ages and more people are affected by multiple chronic conditions, the prevalence of Peripheral Neuropathy (PN) has also rapidly increased. This swift rise in PN leaves clinicians and patients challenged by a lack of consistent diagnosis and treatment guidelines. Purpose: To assist those affected by PN, it is imperative to understand the breadth of symptoms, experiences, and factors related to the quality of life. The primary aims of this study are to (1) characterize the symptoms of PN in a nationwide sample; (2) discern differences in symptom clusters, given perceived causes of PN; and (3) identify significant physiological symptoms related to the quality of life for people with PN. Methods: An online survey of people in online PN support groups. Participants were recruited primarily via an open request sent to recipients of web-based communications from nationally recognized online PN support groups. Inclusion criteria were as follows: Self-reported diagnosis of PN, ability to read English or Spanish, residence in the U.S., and age ≥ 18 years. Results: A total of 608 individuals with PN were included in the analysis. This sample represents 49 U.S. states and the District of Colombia; 221 were male and 387 female. Their disease severity and etiology were similar to previously reported information on this population, with 53.3% of respondents suffering from PN without a known cause. Among known causes, diabetes was the most common (19.6%), followed by chemotherapy (6.9%) and autoimmune diseases (3.6%). Factors affecting the quality of life among people with PN included lower extremity mobility, upper extremity mobility, sleep disturbance, depressive symptoms, and patient activation.

20.
Am J Transl Res ; 13(3): 1617-1635, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33841684

RESUMEN

BACKGROUND: As the U.S. population grows older and more diverse, self-management needs are increasingly complicated. In order to deliver effective personalized interventions to those suffer from chronic conditions social determinants of health must be considered. Therefore, psychosocial phenotyping holds strong promise as a tool for tailoring interventions based on precision health principles. PURPOSE: To define psychosocial phenotyping and develop a research agenda that promotes its integration into chronic disease management as a tool for precision self-management interventions. METHODS: Since psychosocial phenotyping is not yet used in interventions for self-management support, we conducted a literature review to identify potential phenotypes for chronic disease self-management. We also reviewed policy intervention case reports from the Centers for Medicare and Medicaid Services to examine factors related to social determinants of health in people with chronic illnesses. Finally, we reviewed methodological approaches for identifying patient profiles or phenotypes. RESULTS: The literature review revealed areas within which to collect data for psychosocial phenotyping that can inform personalized interventions. The findings of our exemplar cases revealed that several environmental or key SDOH such as factors realted with economic stability and neighborhood environment have been closely linked with the success of chronic disease management interventions. We elucidated theory, definitions, and pragmatic conceptual boundaries related to psychosocial phenotyping for precision health. CONCLUSIONS: Our literature review with case example analysis demonstrates the potential usefulness of psychosocial phenotyping as a tool to enhance personalized self-management interventions for people with chronic diseases, with implications for future research.

SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...