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1.
Pan Afr Med J ; 40: 28, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34733396

RESUMEN

Introduction: the Coronavirus Disease 2019 pandemic has affected residency training globally. The aim of this study was to understand how the pandemic affected teaching and learning in residency programs in low resource settings where residents and faculty were working on the front line treating patients with the disease. Methods: this qualitative study enrolled residents and faculty from the Aga Khan University in Tanzania who were providing front line care during the pandemic. Purposeful sampling was used and data was collected using focus group discussions and in-depth interviews between August and September 2020. Analysis was done using qualitative content analysis. Results: twelve residents and six faculty members participated in this study. Two main themes emerged. The first was: "New and unfamiliar teaching and learning experiences." Residents and faculty had to adapt to changes in the learning environment and the academic program. Residents had increased responsibilities, including providing front line care and working with reduced supervision. The second theme was: "Learning opportunities amidst crisis." There were opportunities to improve critical care and procedural skills. They also had opportunities to improve non-technical skills like teamwork and communication. Conclusion: residents and faculty had to adapt to changes in teaching and learning. Residents also had to take up additional responsibilities. Support systems are required to help them adapt to the changes and settle in their new roles. There were opportunities to learn new skills, and training should be restructured to maximize the use of these opportunities.


Asunto(s)
COVID-19/prevención & control , Educación de Postgrado en Medicina/tendencias , Internado y Residencia , Adulto , COVID-19/epidemiología , COVID-19/psicología , Comunicación , Humanos , Entrevistas como Asunto , Aprendizaje , Pandemias , Investigación Cualitativa , SARS-CoV-2 , Tanzanía , Enseñanza
2.
Br J Community Nurs ; 26(11): 560-566, 2021 Nov 02.
Artículo en Inglés | MEDLINE | ID: mdl-34731038

RESUMEN

The sexual health needs of young people experiencing homelessness in the UK have not been researched adequately. This study aimed to examine knowledge and attitudes around sexual health and contraceptive use amongst this vulnerable group to develop suitable models of care in the community. A qualitative ethnographic case-study following Burawoy's extended case method was used. Semi-structured interviews with 29 young people experiencing homelessness and five key workers in London hostels were carried out together with ethnographic observations and analysis of documentary evidence. Thematic analysis was undertaken. Demographic data were collected. Three significant themes were identified: risks and extreme vulnerability, relationships and communication difficulties and emergence of a culture of homelessness. Young people experiencing homelessness require specialist delivery of sexual health care in safe surroundings. Initial care should focus on assessment of basic needs and current state of being. Establishing trusting relationships and considering ongoing vulnerability, can help promote meaningful and personalised sexual healthcare both at policy and practice level.


Asunto(s)
Comunicación , Atención a la Salud/organización & administración , Accesibilidad a los Servicios de Salud , Personas sin Hogar/psicología , Salud Sexual , Adolescente , Conducta Anticonceptiva , Femenino , Humanos , Entrevistas como Asunto , Masculino , Investigación Cualitativa , Salud Reproductiva , Reino Unido , Adulto Joven
3.
Br J Community Nurs ; 26(11): 526-531, 2021 Nov 02.
Artículo en Inglés | MEDLINE | ID: mdl-34731040

RESUMEN

Although dignity has been widely explored in the context of healthcare, it has rarely been the subject of empirical exploration when care is delivered by community district nursing teams. This paper demonstrates how a commonplace community nursing task (changing dressings) can constitute a clinical lens through which to explore the ways in which community nurses can influence patients' dignity. This ethnographic study involved two research methods: interviews with patients and nurses (n=22) and observations of clinical interactions (n=62). Dignity can manifest during routine interactions between community nurses and patients. Patient-participants identified malodour from their ill-bodies as a particular threat to dignity. Nurses can reinforce the dignity of their patients through relational aspects of care and the successful concealment of 'leaky' bodies.


Asunto(s)
Comunicación , Enfermería en Salud Comunitaria/métodos , Relaciones Enfermero-Paciente , Enfermeros de Salud Comunitaria/psicología , Pacientes/psicología , Personeidad , Respeto , Antropología Cultural , Actitud del Personal de Salud , Vendajes , Humanos , Entrevistas como Asunto , Investigación Cualitativa , Población Urbana
4.
Rev Gaucha Enferm ; 42(spe): e20200336, 2021.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-34787233

RESUMEN

OBJECTIVE: To analyze the most frequent words in interviews given by nurses during the coronavirus pandemic. METHOD: This is a qualitative, exploratory, descriptive study, carried out with 45 interviews granted by nurses to newspapers of great circulation in Brazil and Portugal. The data were processed using the ATLAS.ti® software and analyzed using the word cloud tool. RESULTS: The seven most frequent words were: "home" (respect for isolation), "nurses" (valuing of the profession and structural problems), "patients/diseased" and "care" (referring to the severity of the disease), "family" (missing her own family/emotional stress) and "fear" (fear of contamination of oneself and others). FINAL CONSIDERATIONS: The word cloud revealed how straining nurses' experiences have been and reinforced the urgent need to rethink nursing work and the risks faced. Reflections like this contribute to the construction of more valued nursing and public policies for the protection of nurses.


Asunto(s)
COVID-19/psicología , Cuidados Críticos/psicología , Emociones , Enfermeras y Enfermeros/psicología , Pandemias , Brasil/epidemiología , COVID-19/epidemiología , COVID-19/enfermería , Femenino , Humanos , Entrevistas como Asunto , Portugal/epidemiología , Investigación Cualitativa , Estrés Fisiológico
5.
Pan Afr Med J ; 40: 34, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34795815

RESUMEN

Introduction: adolescent pregnancy in Ghana, like in most low and middle income countries, is an issue of immense public health importance. Pregnant adolescents are faced with the stronger dilemma of either terminating the unwanted pregnancy or keeping it. This discourse which is based on findings from empirical research in Accra Ghana aims at contributing to the usefulness of understanding the meaning and scope of autonomy when it comes to providing ethically grounded, and adolescent friendly, reproductive health care services to pregnant adolescents. The aim of this work was to document the meaning and determinants of autonomous decision making among pregnant adolescents in the James Town area of Accra, Ghana. Methods: thirty (30) semi-structured in depth interviews were conducted among adolescents who had been pregnant at least once, 23 in depth interviews among purposively selected stakeholders (parents, teachers, NGO staff working in reproductive health, community volunteers), and 8 focus group discussions among parents, teachers, adolescent students who had not been pregnant before, and adolescents who had at least one pregnancy in the past. Data were transcribed verbatim and analyzed thematically. Results: most adolescents reported that the final decision to continue a pregnancy to term or go in for an abortion was taken by them. The partner´s willingness to take responsibility of the pregnant adolescent and baby, as well as financial considerations, were main players in deciding upon the pregnancy outcomes. Cultural desirability for children and health care provider/father paternalism (power dynamics) in the decision-making process were central considerations in the decision-making process. Unaffordable and unfriendly safe abortion services pushed adolescents to either continue pregnancies to term against their will, or opt to visit unsafe abortion care providers. Conclusion: adolescents stand to make truly autonomous decisions if they are provided with the right information, at the right time, at the right place, by the right persons, and in the right way. Health system, economic, and cultural factors play significant roles in rendering pregnant adolescent autonomy meaningful when deciding upon their pregnancy outcomes. Continuing pregnancies to term against one´s will or being forced to go in for an abortion are ethically unjustified. Further research is required to examine the long-term consequences of forced pregnancy terminations or births.


Asunto(s)
Toma de Decisiones , Autonomía Personal , Embarazo en Adolescencia/psicología , Mujeres Embarazadas/psicología , Aborto Inducido/psicología , Adolescente , Femenino , Grupos Focales , Ghana , Humanos , Entrevistas como Asunto , Paternalismo , Embarazo , Embarazo no Deseado/psicología , Servicios de Salud Reproductiva/organización & administración
6.
CMAJ Open ; 9(4): E998-E1004, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34785529

RESUMEN

BACKGROUND: Asian Canadians and Asian Americans face COVID-19-related discrimination. The objective of this qualitative study was to explore the experiences of Asian health care workers dealing with discrimination, with a focus on racial micro-agressions, in Canada and the United States during the COVID-19 pandemic. METHODS: We adopted a qualitative descriptive approach. We used convenience and snowball sampling strategies to recruit participants. We conducted individual, in-depth semistructured interviews with Asian health care workers in Canada and the US via videoconferencing between May and September 2020. Eligible participants had to self-identify as Asian and be currently employed as a health care worker with at least 1 year of full-time employment. We used an inductive thematic approach to analyze the data. RESULTS: Thirty participants were recruited. Fifteen (50%) were Canadians and 15 (50%) were Americans; there were 18 women (60%), 11 men (37%) and 1 nonbinary person. Most of the participants were aged 25-29 years (n = 16, 53%). More than half were nurses (n = 16, 53%); the other participants were attending physicians (n = 5), physiotherapists (n = 3), resident physicians (n = 2), a midwife, a paramedic, a pharmacist and a physician assistant. Two themes emerged from the data: a surge of racial microaggressions related to COVID-19 and a lack of institutional and public acknowledgement. Participants noted that they have experienced an increase in racial microaggressions during the COVID-19 pandemic. They have also experienced threats of violence and actual violence. The largely silent organizational response to the challenges being faced by people of Asian descent and the use of disparaging terms such as "China virus" in the early stages of the pandemic were a substantial source of frustration. INTERPRETATION: Asian health care workers have experienced challenges in dealing with racial microaggressions related to COVID-19 in the US and Canada. More research should be done on the experiences of Asian Americans and Asian Canadians, both during and after the pandemic, and supportive measures should be put in place to protect Asian health care workers.


Asunto(s)
Americanos Asiáticos/psicología , COVID-19/psicología , Personal de Salud/psicología , Racismo/psicología , Adulto , Canadá , Femenino , Humanos , Entrevistas como Asunto , Masculino , Pandemias , Investigación Cualitativa , SARS-CoV-2 , Estados Unidos , Violencia Laboral/psicología , Xenofobia/psicología
7.
Pan Afr Med J ; 39: 277, 2021.
Artículo en Francés | MEDLINE | ID: mdl-34754354

RESUMEN

Introduction: malnutrition due to inadequate food supply is a major challenge in low- and middle-income countries. The purpose of this study is to identify the sociocultural drivers of malnutrition. Methods: we conducted a qualitative study in the Amoron´I Mania region, Madagascar. The study involved pregnant women, mothers and fathers, grandmothers and health actors such as "matrones", community workers and health workers. A total of 24 semi-structured individual interviews and 6 focus groups were used to collect data. Thematic analysis was used. Results: malnutrition refers to a lack of food and undernourishment. It revolves around the amount of rice consumption, socio-cultural factors and insufficient financial resources. Vulnerable groups were mainly composed of children and pregnant women. Severe malnutrition including signs was reported, but there was evidence for local adaptation. Thus, families were trying by different means to fight against malnutrition. Conclusion: the socio-cultural context modulates knowledge and perception of the causes, the manifestations and the vulnerability or non-vulnerability of an individual as well as the severity of malnutrition.


Asunto(s)
Abastecimiento de Alimentos , Conocimientos, Actitudes y Práctica en Salud , Desnutrición/epidemiología , Población Rural/estadística & datos numéricos , Adolescente , Adulto , Anciano , Femenino , Grupos Focales , Personal de Salud/estadística & datos numéricos , Humanos , Entrevistas como Asunto , Madagascar/epidemiología , Masculino , Desnutrición/fisiopatología , Persona de Mediana Edad , Percepción , Embarazo , Investigación Cualitativa , Índice de Severidad de la Enfermedad , Poblaciones Vulnerables/estadística & datos numéricos , Adulto Joven
8.
Pan Afr Med J ; 39: 282, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34754359

RESUMEN

Introduction: while pregnancy is a very beautiful and memorable experience for most women, some women may experience apathy towards childbirth and have feelings of fear and anxiety (tocophobia). Tocophobia can be far reaching with adverse physiologic and emotional consequences for mothers, infants and families. This study therefore explored tocophobia experiences among primigravid women and explored its influence on birth choices among antenatal women. Methods: the study employed a qualitative exploratory research design. Participants who were primigravida (women who had never experienced childbirth), were selected using purposive sampling technique on antenatal clinic days. Data was obtained using semi-structured interview questions. Data was analyzed using content analysis approach and thematic categorization. Results: results showed that few of the women experienced tocophobia and these fears were not strong enough to make them opt for caesarian section. Reasons attributed to tocophobia experience among the participants included "horror stories" told in the neighborhood, "past experiences" of close acquaintance and "entertainment videos" broadcast. Furthermore, all the participants preferred to have vaginal delivery. Conclusion: few of the primigravid women in Ekiti State, Nigeria, experience tocophobia and this experience does not influence their choice of delivery option, as all participant´s preferred vaginal delivery to caesarian section. It is important for midwives to be aware of their role in counselling and identifying women with tocophobia in order to promote good and safe transition from pregnancy to motherhood.


Asunto(s)
Parto Obstétrico/psicología , Parto/psicología , Trastornos Fóbicos/psicología , Mujeres Embarazadas/psicología , Adolescente , Adulto , Cesárea/estadística & datos numéricos , Parto Obstétrico/estadística & datos numéricos , Miedo , Femenino , Humanos , Entrevistas como Asunto , Partería/organización & administración , Nigeria , Embarazo , Atención Prenatal , Rol Profesional , Adulto Joven
9.
BMC Pregnancy Childbirth ; 21(1): 670, 2021 Oct 03.
Artículo en Inglés | MEDLINE | ID: mdl-34602060

RESUMEN

BACKGROUND: Coronavirus currently cause a lot of pressure on the health system. Accordingly, many changes occurred in the way of providing health care, including pregnancy and childbirth care. To our knowledge, no studies on experiences of maternity care Providers during the COVID-19 Pandemic have been published in Iran. We aimed to discover their experiences on pregnancy and childbirth care during the current COVID-19 pandemic. METHODS: This study was a qualitative research performed with a descriptive phenomenological approach. The used sampling method was purposive sampling by taking the maximum variation possible into account, which continued until data saturation. Accordingly, in-depth and semi-structured interviews were conducted by including 12 participants, as 4 gynecologists, 6 midwives working in the hospitals and private offices, and 2 midwives working in the health centers. Data were analyzed using Colaizzi's seven stage method with MAXQDA10 software. RESULTS: Data analysis led to the extraction of 3 themes, 9 categories, and 25 subcategories. The themes were as follows: "Fear of Disease", "Burnout", and "Lessons Learned from the COVID-19 Pandemic", respectively. CONCLUSIONS: Maternal health care providers experience emotional and psychological stress and work challenges during the current COVID-19 pandemic. Therefore, comprehensive support should be provided for the protection of their physical and mental health statuses. By working as a team, utilizing the capacity of telemedicine to care and follow up mothers, and providing maternity care at home, some emerged challenges to maternal care services can be overcome.


Asunto(s)
COVID-19/psicología , Personal de Salud/psicología , Servicios de Salud Materna/estadística & datos numéricos , Atención Perinatal/estadística & datos numéricos , Adulto , Agotamiento Psicológico/psicología , COVID-19/diagnóstico , COVID-19/epidemiología , COVID-19/virología , Emociones/fisiología , Femenino , Ginecología/estadística & datos numéricos , Personal de Salud/estadística & datos numéricos , Humanos , Recién Nacido , Entrevistas como Asunto , Irán/epidemiología , Servicios de Salud Materna/tendencias , Persona de Mediana Edad , Partería/estadística & datos numéricos , Atención Perinatal/organización & administración , Trastornos Fóbicos/psicología , Embarazo , Investigación Cualitativa , SARS-CoV-2/genética , Estrés Psicológico/psicología , Telemedicina/métodos
10.
PLoS One ; 16(10): e0258344, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34644328

RESUMEN

The COVID-19 pandemic has necessitated physical distancing which is expected to continue in some form for the foreseeable future. Physical distancing policies have increased reliance on digital forms of social connection and there are widespread concerns about social isolation and mental health in this context. This qualitative study sought to understand how loneliness was experienced during physical distancing in the initial national UK COVID-19 lockdown. Eight individuals who reported feeling lonely during the initial lockdown were interviewed in May 2020. Interviews were analysed using reflexive thematic analysis. Four main themes were identified: (1) Loss of in-person interaction causing loneliness, (2) Constrained freedom, (3) Challenging emotions, and (4) Coping with loneliness. The loss of in-person interaction contributed to feelings of loneliness and digital interaction was viewed as an insufficient alternative. Social freedom could be constrained by distancing policies and by social contacts, contributing to strained personal relationships and feelings of frustration as part of loneliness. Fluctuations in mood and difficult emotions were experienced alongside loneliness, and distraction and seeking reconnection were commonly reported methods of coping, although they were less accessible. These findings indicate that physical distancing measures can impact loneliness due to the limitations they impose on in-person social contact and the perceived insufficiency of digital contact as a substitute.


Asunto(s)
Adaptación Psicológica , COVID-19/epidemiología , Soledad , Adulto , Anciano , COVID-19/virología , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Pandemias , Distanciamiento Físico , Investigación Cualitativa , Cuarentena , SARS-CoV-2/aislamiento & purificación , Reino Unido/epidemiología , Adulto Joven
11.
PLoS One ; 16(10): e0258484, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34644365

RESUMEN

Public perceptions of pandemic viral threats and government policies can influence adherence to containment, delay, and mitigation policies such as physical distancing, hygienic practices, use of physical barriers, uptake of testing, contact tracing, and vaccination programs. The UK COVID-19 Public Experiences (COPE) study aims to identify determinants of health behaviour using the Capability, Opportunity, Motivation (COM-B) model using a longitudinal mixed-methods approach. Here, we provide a detailed description of the demographic and self-reported health characteristics of the COPE cohort at baseline assessment, an overview of data collected, and plans for follow-up of the cohort. The COPE baseline survey was completed by 11,113 UK adult residents (18+ years of age). Baseline data collection started on the 13th of March 2020 (10-days before the introduction of the first national COVID-19 lockdown in the UK) and finished on the 13th of April 2020. Participants were recruited via the HealthWise Wales (HWW) research registry and through social media snowballing and advertising (Facebook®, Twitter®, Instagram®). Participants were predominantly female (69%), over 50 years of age (68%), identified as white (98%), and were living with their partner (68%). A large proportion (67%) had a college/university level education, and half reported a pre-existing health condition (50%). Initial follow-up plans for the cohort included in-depth surveys at 3-months and 12-months after the first UK national lockdown to assess short and medium-term effects of the pandemic on health behaviour and subjective health and well-being. Additional consent will be sought from participants at follow-up for data linkage and surveys at 18 and 24-months after the initial UK national lockdown. A large non-random sample was recruited to the COPE cohort during the early stages of the COVID-19 pandemic, which will enable longitudinal analysis of the determinants of health behaviour and changes in subjective health and well-being over the course of the pandemic.


Asunto(s)
COVID-19/epidemiología , Conductas Relacionadas con la Salud , Adulto , Anciano , COVID-19/virología , Femenino , Humanos , Entrevistas como Asunto , Estudios Longitudinales , Masculino , Salud Mental , Persona de Mediana Edad , Pandemias , Estudios Prospectivos , SARS-CoV-2/aislamiento & purificación , Encuestas y Cuestionarios , Reino Unido/epidemiología
12.
Pan Afr Med J ; 40: 4, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34650654

RESUMEN

Introduction: poor access to maternal health services is a one of the major contributing factors to maternal deaths in low-resource settings, and understanding access barriers to maternal services is an important step for targeting interventions aimed at promoting institutional delivery and improving maternal health. This study explored access barriers to maternal and antenatal services in Kaputa and Ngabwe; two of Zambia´s rural and hard-to-reach districts. Methods: a concurrent mixed methods approach was therefore, undertaken to exploring three access dimensions, namely availability, affordability and acceptability, in the two districts. Structured interviews were conducted among 190 eligible women in both districts, while key informant interviews, in-depth interviews and focus group discussions were conducted for the qualitative component. Results: the study found that respondents were happy with facilities´ opening and closing times in both districts. By comparison, however, women in Ngabwe spent significantly more time traveling to facilities than those in Kaputa, with bad roads and transport challenges cited as factors affecting service use. The requirement to have a traditional birth attendant (TBA) accompany a woman when going to deliver from the facility, and paying these TBAs, was a notable access barrier. Generally, services seemed to be more acceptable in Kaputa than in Ngabwe, though both districts complained about long queues, being delivered by male health workers and having delivery rooms next to male wards. Conclusion: based on the indicators of access used in this study, maternal health services seemed to be more accessible in Kaputa compared to Ngabwe.


Asunto(s)
Accesibilidad a los Servicios de Salud , Servicios de Salud Materna/estadística & datos numéricos , Partería/estadística & datos numéricos , Atención Prenatal/métodos , Adolescente , Adulto , Femenino , Grupos Focales , Humanos , Entrevistas como Asunto , Salud Materna , Servicios de Salud Materna/economía , Servicios de Salud Materna/provisión & distribución , Persona de Mediana Edad , Partería/economía , Embarazo , Atención Prenatal/economía , Población Rural , Factores Socioeconómicos , Adulto Joven , Zambia
13.
J Manag Care Spec Pharm ; 27(10-a Suppl): S2-S13, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34652218

RESUMEN

BACKGROUND: Despite therapeutic advances for patients with schizophrenia, improving patient outcomes and reducing the cost of care continue to challenge formulary decision makers. OBJECTIVES: To (1) understand the perspectives of formulary decision makers on challenges to optimal schizophrenia population management and (2) identify best practices and recommendations for mitigating these challenges. METHODS: This mixed-methods study, conducted in a double-blind manner, comprised in-depth telephone interviews with formulary decision makers from February through May 2020, and a web-based follow-on survey that was sent to all participants in October 2020. US-based formulary decision makers were recruited if they were directly involved in schizophrenia drug formulary or coverage decision making for national or regional payers, health systems, or behavioral health centers. Formulary decision makers' perceptions of challenges, policies, and programs related to schizophrenia population health management were assessed generally and in the context of the COVID-19 pandemic. RESULTS: 19 formulary decision makers participated in the interviews and 18 (95%) completed the survey. Participants reported a spectrum of patient- and payer-driven challenges in schizophrenia population health management, including medication nonadherence, high pharmacy and medical costs, and frequent hospitalizations and emergency department visits. Participants noted that COVID-19 had worsened all identified challenges, although patient unemployment (mean score of 2.00 on a scale of 1 [made much worse] to 5 [made much better]) and reduced access to psychiatric care (mean score, 2.12) were most negatively affected. The most common strategies implemented in order to improve schizophrenia population health management included case management (89%), telemedicine (83%), care coordination programs (72%), strategies to mitigate barriers to accessing medication (61%), and providing nonmedical services to address social determinants of health (56%). Participants noted that, ideally, all treatments for schizophrenia would be available on their formularies without utilization management policies in place in order to increase accessibility to medication, but cost to the health plans made that difficult. Whereas 61% of respondents believed that long-acting injectable antipsychotics (LAIs) were currently underused in their organizations, only 28% represented organizations with open access policies for LAIs. Participants believed that among patients with schizophrenia, LAIs were most beneficial for those with a history of poor or uncertain adherence to oral medications (mean score of 4.50 on a scale of 1 [not at all beneficial] to 5 [extremely beneficial]) and those with recurring emergency department visits and inpatient stays (mean score, 3.94). Study participants reported slightly increased use of LAIs (mean score of 3.17 on a scale of 1 [negatively impacted] to 5 [positively impacted]) among their patients with schizophrenia in response to the COVID-19 pandemic; 29% of participants reported easing access restrictions for LAIs. CONCLUSIONS: Participants described persisting challenges and various approaches intended to improve schizophrenia population health management. They also recommended strategies to optimize future health management for this population, including expanding programs to address social determinants of health and mitigating barriers to accessing treatment. DISCLOSURES: This study was funded by Janssen Scientific Affairs, LLC. Roach, Graf, Pednekar, and Chou are employees of PRECISIONheor, which received financial support from Janssen Scientific Affairs, LLC, to conduct this study. Chou owns equity in Precision Medicine Group, the parent company of PRECISIONheor. Lin and Benson are employees of Janssen Scientific Affairs, LLC. Doshi has served as a consultant, advisory board member, or both, for Acadia, Allergan, Boehringer Ingelheim, Janssen, Merck, Otsuka, and Sage Therapeutics and has received research funding from AbbVie, Biogen, Humana, Janssen, Novartis, Merck, Pfizer, PhRMA, Regeneron, Sanofi, and Valeant.


Asunto(s)
COVID-19/prevención & control , Toma de Decisiones Clínicas/métodos , Personal de Salud , Gestión de la Salud Poblacional , Salud Poblacional , Esquizofrenia/terapia , Antipsicóticos/uso terapéutico , COVID-19/epidemiología , Método Doble Ciego , Femenino , Estudios de Seguimiento , Humanos , Entrevistas como Asunto/métodos , Masculino , Cumplimiento de la Medicación , Esquizofrenia/diagnóstico , Esquizofrenia/epidemiología
14.
Medicine (Baltimore) ; 100(37): e27256, 2021 Sep 17.
Artículo en Inglés | MEDLINE | ID: mdl-34664874

RESUMEN

ABSTRACT: International evidence-based guidelines recommend self-management support for stroke survivors to improve their health outcomes. We developed a 4-week nurse-led stroke self-management programme (SSMP) and conducted a randomised controlled trial to assess its effects. This paper reports the findings of a qualitative study nested within the randomised controlled trial to explore stroke survivors' experiences of SSMP participation. Semi-structured interviews were conducted with all adult participants who were clinically diagnosed with a first or recurrent ischaemic or haemorrhagic stroke, residing at home, communicable in Cantonese, had a Montreal Cognitive Assessment score below the second percentile, and participated in at least 1 SSMP session. All interviews were conducted in Cantonese, lasted approximately 45 minutes, and were audio-recorded. Interview data were transcribed verbatim and analysed thematically. Sixty-four stroke survivors (mean age 66.33 years, SD 12.34) were recruited, and 59 were interviewed via phone immediately after completion of SSMP. Three themes were derived. Overall, participants were satisfied with the SSMP. Their understanding of self-management was improved, and they recognised its importance in recovery. Their confidence in self-management was also enhanced through the use of multifaceted strategies. Suggestions were made to enhance their participation experiences, including increased home visits and group sessions, making group session attendance optional and arranging them more accessibly, meeting the survivors who shared their survival experiences in the videos, and access to the videos online. This study concurred that the SSMP enhanced stroke survivors' self-efficacy in self-management. Rearrangement of the programme format and enhancements in accessibility could be further examined to enable more effective stroke self-management.


Asunto(s)
Vida Independiente/psicología , Automanejo/psicología , Accidente Cerebrovascular/enfermería , Sobrevivientes/psicología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Vida Independiente/lesiones , Entrevistas como Asunto/métodos , Masculino , Persona de Mediana Edad , Teoría de Enfermería , Evaluación de Programas y Proyectos de Salud/métodos , Evaluación de Programas y Proyectos de Salud/estadística & datos numéricos , Investigación Cualitativa , Automanejo/métodos , Automanejo/estadística & datos numéricos , Accidente Cerebrovascular/psicología , Rehabilitación de Accidente Cerebrovascular/enfermería , Rehabilitación de Accidente Cerebrovascular/psicología , Rehabilitación de Accidente Cerebrovascular/normas , Sobrevivientes/estadística & datos numéricos
15.
J Nurs Adm ; 51(11): 546-553, 2021 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-34690303

RESUMEN

OBJECTIVE: The purpose of this study was to identify what guides nursing practice. BACKGROUND: Change occurred when the Magnet Recognition Program® no longer required a nursing theory. METHODS: This was a mixed-methods study to identify the process used to implement nursing theory-guided practice and the relationship to professional practice recognition. Deidentified quantitative data were collected from 36 chief nursing officers (CNOs). Seventeen CNOs participated in the qualitative interview. RESULTS: Thirteen CNOs were from a Magnet®-designated facility. Ten CNOs were on the Magnet journey, and 2 had no intent to seek Magnet recognition. Two CNOs were from a Pathway to Excellence®-designated facility. One CNO was on the Pathway to Excellence journey. The majority of respondents who were Magnet® recognized who participated in the survey used Watson's Theory of Human Caring. Themes were identified that share the benefits and strategies to integrate nursing-guided theory into nursing processes, structures, and outcomes. CONCLUSION: Findings will benefit CNOs as they make decisions related to pursuing Magnet status recognition.


Asunto(s)
Enfermeras Administradoras/psicología , Teoría de Enfermería , Guías de Práctica Clínica como Asunto , Rol Profesional/psicología , Humanos , Entrevistas como Asunto , Investigación Cualitativa , Encuestas y Cuestionarios
19.
PLoS One ; 16(10): e0259275, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34710174

RESUMEN

BACKGROUND: In April 2020, the United Nations predicted that the COVID-19 pandemic will have a 'calamitous' impact on the lives of women. This was based on concerns about an upsurge in Intimate Partner Violence (IPV) arising from increased opportunities for relational conflict due to forced co-existence and therefore additional time spent with abusive partners. AIM: Research has shown an increase in IPV during times of crisis. The COVID-19 pandemic has generated unprecedented circumstances and stress, and opportunities to do research to understand whether the COVID-19 pandemic impacted on IPV experiences were limited. Thus, the present study aimed to understand women's experiences of being in and leaving an abusive relationship during the COVID-19 pandemic. METHODS: Individual, telephonic interviews were conducted with 16 women living in domestic violence shelters within three Provinces during South Africa's lockdown period. RESULTS: Findings reveal that the public health measures implemented by the South African Government to curb the spread of the virus, may have placed vulnerable groups at increased risk of violence. Specifically, lockdown likely magnified the risk for escalation of abuse in families already experiencing IPV prior to COVID-19. The study highlights an IPV and COVID-19 relationship, showing that the gender insensitive pandemic control measures, such as stay at home orders and travel restrictions, likely placed women at risk of increased abuse. Given the recurrency of COVID-19 epidemic waves, attention must be given to gender disparities or many South African women may experience worse outcomes. CONCLUSION: This study reminds us that being ordered to stay at home is not always the safest option for women and thus, in a country with one of the highest levels of GBV, it becomes imperative to ensure that IPV safeguards are integrated into COVID-19 measures. It also becomes evident that COVID-19 requires enhanced ways of responding by paying attention to gender disparities.


Asunto(s)
COVID-19/psicología , Violencia de Pareja/psicología , Violencia de Pareja/tendencias , Adulto , Mujeres Maltratadas/psicología , Violencia Doméstica/tendencias , Femenino , Humanos , Entrevistas como Asunto , Violencia de Pareja/estadística & datos numéricos , Pandemias , SARS-CoV-2/patogenicidad , Maltrato Conyugal/psicología , Maltrato Conyugal/estadística & datos numéricos , Maltrato Conyugal/tendencias , Adulto Joven
20.
PLoS One ; 16(10): e0258695, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34648600

RESUMEN

BACKGROUND: There is an increasing transition rate of experienced clinical nurses from practice to academia. When nurses transition from practice to academia for the right reasons, it culminates in job satisfaction and retention. Thus, understanding what attracts clinical nurses to academia is an important consideration for employing and retaining competent nurse educators. Yet, there are gaps in research about what motivates nurses to transition from practice to academia within the Ghanaian context. This study aimed to explore the reasons for novice nurse educators' transition from practice to academia in three Health Training Institutions in the Upper East Region of Ghana. METHODS: This qualitative descriptive phenomenology study used a purposive sampling method to select 12 novice nurse educators. Data were collected using a semi-structured interview guide through individual face-to-face in-depth interviews. Written informed consent was obtained and interviews were audio-taped and transcribed verbatim. Data analysis was done manually guided by Colaizzi's method of data analysis. RESULTS: Novice nurse educators transitioned from practice to academia because they were dissatisfied with their clinical nursing practice, they wanted more flexible work, they wanted to work autonomously, and they previously taught their clients in the clinical setting. Four themes emerged namely: (1) dissatisfied with clinical nursing, (2) quest for flexible work role, (3) quest for work autonomy, and (4) previous clinical teaching. CONCLUSION: The reasons for transitioning from practice to academia were mostly born out of novice nurse educators' previous negative experiences in the clinical setting which ought to be considered in the recruitment and retention of teaching staff to train the future nurses. There is the need to revise and implement a tutor recruitment policy that takes into account, what attracts clinical nurses to the academic setting.


Asunto(s)
Docentes de Enfermería/psicología , Enfermeras y Enfermeros/estadística & datos numéricos , Adulto , Selección de Profesión , Competencia Clínica , Femenino , Ghana , Humanos , Entrevistas como Asunto , Masculino , Motivación , Investigación Cualitativa , Teletrabajo
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