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1.
Rev. enferm. UERJ ; 28: e35224, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1096015

RESUMEN

Objetivo: investigar a atuação dos enfermeiros frente à amamentação cruzada e correlacionar com a atual questão da precarização do trabalho. Método: estudo qualitativo do tipo descritivo com base metodológica de análise do discurso, realizado com seis enfermeiras da Estratégia de Saúde da Família (ESF) por meio de um grupo focal. Resultados: o tema amamentação cruzada é apresentado como um indicador de conflitos ético-profissionais no processo de trabalho, expressando-se nos seguintes aspectos: conhecimento das prescrições de contraindicação, sensação de dificuldade em intervir e transferência à nutriz por qualquer dano à saúde da criança. Considerações finais: no cotejo entre esses resultados e uma organização de trabalho com normas e rotinas institucionalizadas, discutem-se como efeitos da não utilização de técnicas de aconselhamento, a fragilização da autonomia da nutriz, de forma imperceptível, reproduzidas por enfermeiros na assistência.


Objective: to investigate nurses' role related to cross-breastfeeding and to correlate with the current issue of precarious work.Method: descriptive andqualitative study based on methodological discourse analysis, carried out with six nurses from Estratégia de Saúde da Família (ESF) Program through a focus group. Results: cross-breastfeeding topic is presented as an indicator of ethical-professional conflicts in the work process, expressing itself in the following aspects: knowledge of prescriptions of contraindication, feeling of difficulty in intervening and transference to the nursing mother for any harm to the child's health. Final considerations: in the comparison between these results and a work organization with institutionalized norms and routines, we discuss the effects of not using counseling techniques, the fragility of nurses' autonomy, imperceptibly reproduced by nurses in care.


Objetivo: investigar el papel de las enfermeras relacionadas con la lactancia cruzada y su correlación con el tema actual del trabajo precario. Método: estudio descriptivo y cualitativo basado en el análisis metodológico del discurso, realizado con seis enfermeras del Programa Estratégia de Saúse da Familia (ESF) através de un grupo focal. Resultados: el tema de la lactancia cruzada se presenta como un indicador de conflictos ético-profesionales en el proceso de trabajo, expresándose en los siguientes aspectos: conocimiento de prescripciones de contraindicación, sensación de dificultad para intervenir y transferencia a la madre lactante por cualquier daño a la salud del niño Consideraciones finales: en la comparación entre estos resultados y una organización de trabajo con normas y rutinas institucionalizadas, discutimos los efectos de no utilizar técnicas de asesoramiento, la fragilidad de la autonomía de las enfermeras, reproducida imperceptiblemente por las enfermeras bajo cuidado.


Asunto(s)
Humanos , Femenino , Adulto , Persona de Mediana Edad , Calidad de la Atención de Salud/ética , Condiciones de Trabajo , Lactancia Materna , Rol de la Enfermera , Estrategia de Salud Familiar , Contraindicaciones , Relaciones Laborales , Brasil , Competencia Clínica , Grupos Focales , Investigación Cualitativa
2.
Rev. enferm. UERJ ; 28: e42793, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1118060

RESUMEN

Objetivo: descrever a elaboração de protocolo para a identificação do paciente com transtorno mental agudo. Método: estudo exploratório e qualitativo, realizado de maio 2018 a janeiro 2019, por meio das etapas: revisão integrativa da literatura, questionário online respondido por 17 profissionais de saúde vinculados à Sociedade Brasileira para a Qualidade do Cuidado e Segurança do Paciente, e grupo focal com 04 especialistas em Saúde Mental. Para tratamento dos dados, utilizou-se a análise descritiva e comparativa. Resultados: na revisão não se encontraram artigos sobre identificação do paciente com transtorno mental agudo. Na consulta aos especialistas da segurança do paciente identificou-se que 82,3% não possuíam em suas instituições protocolo específico. No grupo focal evidenciou-se dificuldade na identificação deste paciente. Conclusão: acreditase que o protocolo com a inserção da pulseira fotográfica apresenta-se como uma ferramenta inovadora na redução de riscos associados à identificação deste paciente.


Objective: to describe the development of a protocol for identification of patients with acute mental disorders. Method: this qualitative exploratory study was carried out from May 2018 to January 2019 through an integrative literature review, an online questionnaire answered by 17 health personnel belonging to the Brazilian Society for Quality of Care and Patient Safety, and a focus group of four mental health experts. Results: no articles specifically on identification for patients with acute mental disorders were found in the review. The consultation of patient safety experts found that 82.3% had no specific protocol in their institutions. The focal group highlighted difficulties communicating with these patients. Conclusion: the protocol including the photographic bracelet is believed to constitute an innovative tool for reducing risks associated with identification of these patients.


Objetivo: describir el desarrollo de un protocolo para la identificación de pacientes con trastornos mentales agudos. Método: este estudio exploratorio cualitativo se realizó de mayo de 2018 a enero de 2019 a través de una revisión integradora de la literatura, un cuestionario en línea respondido por 17 miembros del personal de salud pertenecientes a la Sociedad Brasileña de Calidad de Atención y Seguridad del Paciente, y un grupo focal de cuatro personas de salud mental expertos. Resultados: en la revisión no se encontraron artículos específicos sobre identificación de pacientes con trastornos mentales agudos. La consulta de expertos en seguridad del paciente encontró que el 82,3% no tenía un protocolo específico en sus instituciones. El grupo focal destacó las dificultades para comunicarse con estos pacientes. Conclusión: se cree que el protocolo que incluye la pulsera fotográfica constituye una herramienta innovadora para reducir los riesgos asociados a la identificación de estos pacientes.


Asunto(s)
Humanos , Sistemas de Identificación de Pacientes , Calidad de la Atención de Salud , Medidas de Seguridad , Enfermos Mentales , Seguridad del Paciente , Brasil , Encuestas y Cuestionarios , Grupos Focales , Investigación Cualitativa , Innovación
3.
BMC Infect Dis ; 20(1): 814, 2020 Nov 10.
Artículo en Inglés | MEDLINE | ID: mdl-33167885

RESUMEN

BACKGROUND: Anthrax is the second most highly prioritized zoonotic disease in Ethiopia due to its negative impact at the household level, causing disease and production losses in livestock and severe disease in humans. This study seeks to assess the knowledge of, attitudes towards, and practices addressing (KAPs) anthrax in the communities of Eastern Tigray, Northern Ethiopia. METHODS: A cross-sectional survey was conducted concurrently with focus group discussions (FGDs) and key informant interviews (KIIs) between May 2019 and April 2020. A total of 862 respondents participated in the questionnaire survey. Of these, 800 were local community members while 62 were professionals working at health service institutions. In addition, qualitative data were collected using six FGDs and 11 KIIs. RESULTS: Sixty-two percent (496/800) of the community respondents said that they were aware of anthrax while 38% (304/800) of them did not. Only 9.3% (74/800) of the respondents reported that the causative agent of anthrax is germs/microbial. About 56.5% (35/62) of professional respondents said that it is bacterial. More than 60% (64.1%, 513/800) of the respondents did not know that whether the disease was zoonotic or not. Regarding clinical signs, 26.3 (210/800) and 36.8% (294/800) of the respondents could identify at least one in animals and humans, respectively, while 21.3 (170/800) and 20.1% (161/800) knew one or more transmission routes in animals and humans, respectively. Moreover, 43.4% (347/800) and 45.6% (365/800) of the respondents mentioned one or more control/prevention method(s) in animals and humans, respectively. Regarding qualitative results, some of the participants knew the disease (in animals) by their local names: Lalish and Tafia (splenomegaly), and Gulbus (abdominal cramps and shivering). Some reported that anthrax was exclusively a human disease while others recognized its zoonotic potential after the clinical signs in both animals and humans were listed. CONCLUSION: The KAP of the participants regarding anthrax was low. There was no consistent understanding of the disease among the participants. The study also revealed that the participants did not receive consistent, adequate, and continuous education regarding the disease.


Asunto(s)
Carbunco/psicología , Concienciación , Bacillus anthracis , Conocimientos, Actitudes y Práctica en Salud , Zoonosis/psicología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Carbunco/epidemiología , Carbunco/microbiología , Estudios Transversales , Etiopía/epidemiología , Composición Familiar , Femenino , Grupos Focales , Personal de Salud , Humanos , Ganado , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven , Zoonosis/epidemiología
4.
N C Med J ; 81(6): 348-354, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33139462

RESUMEN

BACKGROUND Resettled refugees are at increased risk of poor health outcomes due to acculturation challenges, logistical barriers, experiences of trauma, and other barriers to care that are poorly understood. Refugee children may be particularly vulnerable due to disruptions in health, well-being, education, and nutrition during the resettlement process.METHOD To describe the health care barriers facing refugees in the North Carolina Triangle area (comprised of Durham, Chapel Hill, Raleigh, and their surrounding areas), we conducted three focus group interviews (in Arabic, French, and Swahili) with 25 refugee parents from Syria, Iraq, Central African Republic, the Democratic Republic of the Congo, and Chad. We also administered a survey to nine organizations that provide services for refugees.RESULTS Focus group responses highlighted the multidimensional nature of health care barriers for refugee families and children, encompassing challenges with acculturation, communication, transportation, finances, and health literacy. Organizations emphasized similar challenges and described their efforts to improve access to services through increased communication, coordination, and seeking new financial support for programs.LIMITATIONS Given the geographic focus of the study, results may not be generalizable to other populations and settings. Men spoke more than women in some focus groups, and participants may have been influenced by more vocal contributors. Furthermore, this study is limited by a lack of health outcomes data.CONCLUSIONS This study suggests that the health care needs of refugees living in the North Carolina Triangle area can be better met by providing comprehensive, coordinated, and culturally relevant care. This could include minimizing the number of visits by integrating multiple services under one roof, providing trauma-informed interpreters, and offering accessible transportation services.


Asunto(s)
Accesibilidad a los Servicios de Salud , Refugiados , Niño , Familia , Femenino , Grupos Focales , Humanos , Masculino , North Carolina
5.
Aust J Gen Pract ; 49(10): 625-629, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33015676

RESUMEN

BACKGROUND: The availability of a COVID-19 vaccine is being heralded as the solution to control the current COVID-19 pandemic, reduce the number of infections and deaths and facilitate resumption of our previous way of life. OBJECTIVE: The aim of this article is to provide a framework for primary care of what will be needed to optimise COVID-19 vaccine confidence and uptake in Australia once the vaccine prioritisation schedule and key target groups are known. DISCUSSION: While a number of vaccines are currently under development, with at least seven undergoing phase III trials (28 August 2020), it is hoped that an effective COVID-19 vaccine will become available to the public in 2021. Ensuring public confidence in vaccine safety and effectiveness will be crucial to facilitate uptake. General practitioners are at the forefront of public health, and one of the most trusted sources for patients. In this article, the authors discuss the expedited vaccine development process for COVID-19 vaccines; the likely vaccine prioritisation schedule and anticipated key target groups; the behavioural and social drivers of vaccination acceptance, including the work required to facilitate this; and the implications for general practice.


Asunto(s)
Infecciones por Coronavirus , Médicos Generales/psicología , Programas de Inmunización/organización & administración , Pandemias , Neumonía Viral , Salud Pública/métodos , Vacunación , Vacunas Virales/farmacología , Australia , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Grupos Focales , Accesibilidad a los Servicios de Salud/organización & administración , Humanos , Pandemias/prevención & control , Aceptación de la Atención de Salud , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Atención Primaria de Salud/métodos , Autoimagen , Vacunación/métodos , Vacunación/psicología
6.
J Prim Care Community Health ; 11: 2150132720967514, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33089729

RESUMEN

INTRODUCTION: Predominantly, studies on COVID-19 report quantitative data that often miss the social implications and other determinants of health. The objective of this study was to explore the experiences and perceptions of health care workers (HCWs) in primary health care in the management of COVID-19 with respect to medical response experiences, socio-cultural and religious reforms, psychological impressions, and lessons learned. METHODS: This was a qualitative study using an empirical phenomenological approach. Six focus group discussions were conducted across various stakeholders working frontline in the management of COVID-19 (managerial, public health/field/community and primary care health centers). They participated in semi-structured, in-depth group discussions from 11th to 20th May 2020. All discussions were audio-recorded, transcribed verbatim and analyzed using thematic analysis. RESULTS: Forty participants were involved in this study. Three themes emerged related to the medical response experiences, including the rapid re-structuring of the PHC services, use of technology and challenges of working on COVID-19. Perceptions on the socio-cultural and religious reforms included changes in social and religious norms, and anticipated gaps in accessing health care among the vulnerable groups (elderly, expatriates, and individuals with low economic status). Perceptions on psychological disturbances were themed as consequences of social distancing, management of dead bodies, exhaustion among the health care workers, and risk of exposure. Finally, lessons learned were centered around building on the existing epidemiological and public health capacities, improving access to health care and overcoming resistance to change. Most participants labelled their experience in COVID-19 as an "experience of wisdom" in which learning was a continuous process. CONCLUSION: This qualitative study amongst primary HCWs revealed certain aspects of response to COVID-19 in Muscat, Oman. Results has unfolded various aspects of COVID-19. The situation was perceived by primary HCWs as a new experience that challenged the primary health care; enforced the utilization of public health/epidemiological skills, and linked to unfavorable socio-religious and psychological events.


Asunto(s)
Infecciones por Coronavirus/terapia , Personal de Salud/psicología , Pandemias , Neumonía Viral/terapia , Atención Primaria de Salud/organización & administración , Adulto , Anciano , Infecciones por Coronavirus/epidemiología , Femenino , Grupos Focales , Personal de Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Omán/epidemiología , Neumonía Viral/epidemiología , Investigación Cualitativa
7.
PLoS One ; 15(10): e0239747, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33052914

RESUMEN

This study provides an exploration of the meanings of leisure for humanitarian migrants in regional Australia and these meanings' implications for health. It uses mixed-methods to explore leisure-time physical activity participation and day-to-day experiences of leisure and health. A sample representing approximately one third of the Coffs Coast adult humanitarian migrant population completed the survey, as well as 32 individuals who participated in interviews and focus groups. Findings were organised into three themes and explored issues around mental health and time for leisure, cultural differences in experiencing leisure, and the connections with experiences of other disadvantaged groups. We conclude by arguing that leisure needs to be brought to the fore of discussions around service provision and policy making concerned with the wellbeing of the refugee migrant population, particularly focusing on support for the (re)development of a vocabulary for recreation, as a step forward in the journey to healing and belonging.


Asunto(s)
Altruismo , Ejercicio Físico/fisiología , Actividades Recreativas/psicología , Recreación/fisiología , Recreación/psicología , Adulto , Australia , Femenino , Grupos Focales , Humanos , Masculino , Salud Mental , Persona de Mediana Edad , Refugiados/psicología , Migrantes/psicología , Vocabulario , Adulto Joven
8.
Acad Med ; 95(10): 1529-1538, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33006870

RESUMEN

Though overt sexism is decreasing, women now experience subtle, often unconscious, gender bias as microaggressions. The authors sought to explore the prevalence and impact of the sexist microaggressions female surgeons experience, using a sequential exploratory mixed methods approach (January 2018-April 2018), to identify opportunities for education and prevention. First, all resident, fellow, and attending female surgeons at the University of New Mexico Health Sciences Center (UNM HSC) were invited to participate in focus groups conducted by experienced moderators using a semistructured interview guide based on the 7 Sexist Microaggressions Experiences and Stress Scale (Sexist MESS) domains. Qualitative analysis was performed using line-by-line manual coding to identify themes aligned with the Sexist MESS domains as well as other gender bias experiences of female surgeons. Next, a survey was sent to all resident, fellow, and attending female surgeons at the UNM HSC, which included the Sexist MESS questionnaire and questions related to surgeon-specific experiences of gender bias that the authors developed based on major thematic categories from the focus groups.Four focus groups of 23 female surgeons were conducted, revealing 4 themes: exclusion, increased effort, adaptation, and resilience to workplace slights. The survey response rate was 64% (65/101 surgeons). Across Sexist MESS domains, the frequency and severity of microaggressions was higher for trainees than attendings. The variables of non-White race/ethnicity, having children under 18, and fellowship training generally did not demonstrate statistical significance. This exploratory study adds to the growing body of evidence that gender bias in surgery continues and frequently manifests as microaggressions. Trainees reported the highest rates and severity of microaggressions and bias experiences. Further research should investigate how to address microaggressions, the experiences of male surgeons, the perspectives of medical students and groups who were reported as often perpetuating gender bias, and the efficacy of possible interventions.


Asunto(s)
Médicos Mujeres/psicología , Sexismo/psicología , Cirujanos/psicología , Lugar de Trabajo/psicología , Adulto , Agresión/psicología , Acoso Escolar/psicología , Femenino , Grupos Focales , Humanos , New Mexico , Investigación Cualitativa , Encuestas y Cuestionarios
9.
Afr J AIDS Res ; 19(3): 249-262, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33119459

RESUMEN

Reducing multiple and concurrent partnerships has been identified as a priority in generalised HIV epidemics, yet developing successful interventions to bring about such behaviour change has proven challenging. We offered a three-session intervention aimed to improve couple relationship quality and address HIV risk factors, particularly concurrent sexual partnerships (CSP), in a peri-urban community of Kampala, Uganda. Before launching the intervention, a different group of community members participated in eight single-gender focus group discussions (FGDs) which explored issues of couple relationship quality and satisfaction. Findings from the FGDs guided the intervention. All 162 couples invited to the intervention completed a survey pre- and post-intervention. In FGDs, women and men discussed challenges faced in their relationships, including pervasive dissatisfaction, financial constraints, deception and lack of trust, poor communication, lack of sexual satisfaction, and concurrent sexual partnerships. A difference-in-difference analysis showed no measurable impact of the intervention on relationship quality or sexual risk behaviours over a six-month follow-up among 183 individuals who participated in the intervention, although many stated in response to open-ended questions that they had experienced positive relationship changes. Qualitative findings suggest high demand for couple-focused interventions but also reveal many individual-, couple-, community- and structural-level factors which contribute to women and men seeking concurrent sexual partnerships. More intensive interventions may be needed to overcome these barriers to behaviour change and reduce HIV risk. These findings also raise questions about how to interpret divergent qualitative and quantitative data, a topic which has received little attention in the literature.


Asunto(s)
Infecciones por VIH/prevención & control , Infecciones por VIH/psicología , Relaciones Interpersonales , Parejas Sexuales , Adulto , Femenino , Grupos Focales , Infecciones por VIH/epidemiología , Humanos , Masculino , Factores de Riesgo , Conducta Sexual/fisiología , Parejas Sexuales/psicología , Población Suburbana , Uganda/epidemiología
10.
PLoS One ; 15(9): e0239234, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32931509

RESUMEN

Effective and culturally appropriate hand-hygiene education is essential to promote health-related practices to control and prevent diseases such as Diarrhoea, Ebola and COVID-19. In this paper we outline and evaluate the Co-Creation processes underpinning a handwashing intervention for young children (A Germ's Journey) developed and delivered in India, Sierra Leone and the UK, and consider the implications surrounding Imperialist/Colonial discourse and the White Saviour Complex. The paper focuses both on the ways Co-Creation was conceptualised by our collaborators in all three countries and the catalysts and challenges encountered. Qualitative data have been drawn from in-depth interviews with five key stakeholders, focus group data from 37 teachers in Sierra Leone and responses to open-ended questionnaires completed by teachers in India (N = 66) and UK (N = 63). Data were analysed using thematic analysis and three themes, each with three constituent subthemes are presented. In the theme 'Representations of and Unique Approaches to Co-Creation' we explore the ways in which Co-Creation was constructed in relation to teamwork, innovative practice and more continuous models of evaluation. In 'Advantages of Co-Creation' we consider issues around shared ownership, improved outcomes and more meaningful insights alongside the mitigation of risks and short-circuiting of problems. In 'Challenges of Co-Creation' we discuss issues around timing and organisation, attracting and working with appropriate partners and understanding the importance of local context with inherent social, economic and structural barriers, especially in low-and-middle-income countries. We consider how theoretical elements of Co-Creation can inform effective international public health interventions; crucial during a global pandemic in which handwashing is the most effective method to control the transmission of COVID-19. Finally we reflect on some of the methodological challenges of our own work and in managing the potentially conflicting goals of the ethical and participatory values of Co-Creation with pragmatic considerations about ensuring an effective final 'product'.


Asunto(s)
Control de Enfermedades Transmisibles/métodos , Higiene de las Manos , Betacoronavirus , Niño , Enfermedades Transmisibles/patología , Enfermedades Transmisibles/transmisión , Enfermedades Transmisibles/virología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Grupos Focales , Humanos , India , Entrevistas como Asunto , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Neumonía Viral/virología , Maestros/psicología , Sierra Leona , Encuestas y Cuestionarios , Reino Unido
11.
PLoS Negl Trop Dis ; 14(9): e0008499, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32936792

RESUMEN

Since the prioritization of Lymphatic Filariasis (LF) elimination in 1997, progress has been made in reducing disease transmission and burden. Validation of elimination through Transmission Assessment Surveys (TAS) in implementation units (IUs) that have received at least 5 rounds of mass drug administration (MDA) and achieved minimum threshold of 65% treatment coverage is required. There are IUs that do not qualify for TAS due to achievement of low treatment coverage. This study sought to identify barriers of community participation and access to MDA, develop and test strategies to be recommended for improved uptake. Two wards in Kaloleni sub-county, Kilifi county with an average treatment coverage of 56% in 2015, 50.5% in 2016 were purposively sampled and a quasi-experimental study conducted. Through systematic random sampling, 350 (pre-intervention) and 338 (post-intervention) household heads were selected and interviewed for quantitative data. For qualitative data, 16 Focus Group Discussions (FGDs) with purposively selected community groups were conducted. Participatory meetings were held with county stakeholders to agree on strategies for improved community participation in MDA. The quantitative data were analyzed using STATA version 14.1, statistical significance assessed by chi square test and qualitative data by QSR NVIVO version 10. The identified strategies were tested in experimental sites during the 2018 MDA and the usual MDA strategies applied in control sites. The results showed an increase in community participation and access to MDA in both sites 80.6% (pre-intervention), 82.9% (post-intervention). The proportion of participants who considered the treatment as necessary significantly (p = 0.001) increased to 96.2% from 88.3% and significantly dropped for those with drug swallowing problems associated with: size (p<0.001), number (p<0.027) and taste (p = 0.001). The implemented strategies may have contributed to increased participation and access to MDA and should be applied for improved treatment uptake. Health education on disease aetiology and importance of drug uptake in all rounds is key to program's success.


Asunto(s)
Participación de la Comunidad/métodos , Filariasis Linfática/tratamiento farmacológico , Educación en Salud , Administración Masiva de Medicamentos/métodos , Adulto , Anciano , Anciano de 80 o más Años , Trastornos de Deglución , Filariasis Linfática/prevención & control , Composición Familiar , Femenino , Filaricidas/uso terapéutico , Grupos Focales , Conocimientos, Actitudes y Práctica en Salud , Humanos , Kenia , Masculino , Persona de Mediana Edad
12.
Sante Publique ; 32(2): 229-237, 2020.
Artículo en Francés | MEDLINE | ID: mdl-32985839

RESUMEN

OBJECTIVE: The HIV self-test has been on sale in France since September 2015. What is the point of view of pharmacists and key populations with regard to accessing self-tests in community pharmacies ? METHOD: One year after the HIV self-test came onto the market, the points of view of pharmacists and key populations with regard to HIV were collected during six focus groups: the pharmacists themselves; people who had already used HIV self-tests; potential users from two key populations with regard to HIV: migrants from sub-Saharan Africa and men who have sex with men; potential users from populations with active sex lives but not particularly vulnerable with regard to HIV: young adults (<25 years of age), multi-partner heterosexual adults. RESULTS: The HIV self-test in community pharmacies is perceived by all participants as a significant step forward for accessing screening for HIV. However, issues around discretion and anonymity were seen to create significant tensions with regard to accessing the test itself, but also the information necessary to use it correctly both at a technical level and above all concerning how to interpret test results. CONCLUSION: Although the present study underlines the role of the pharmacist as a significant public health actor in the dispensation of the self-test, the sales price and questions of anonymity are seen as major obstacles. Priority actions include renewing communication campaigns concerning the existence and the use of the product for the upcoming generations of young people but also specific campaigns targeting more vulnerable populations.


Asunto(s)
Actitud del Personal de Salud , Infecciones por VIH/diagnóstico , Tamizaje Masivo/métodos , Farmacéuticos/psicología , Adulto , Femenino , Grupos Focales , Francia , Humanos , Masculino , Farmacias , Autocuidado , Adulto Joven
13.
Soc Work Public Health ; 35(7): 511-522, 2020 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-32970546

RESUMEN

Covid-19 is a virus that has created tension and devastation around the globe. This study is designed to specifically find out the effect of Covid-19 on the socioeconomic well-being of Nigerians, the health sector preparedness to handle the pandemic, and the role of Nigerian social workers in the fight against Covid-19 in Nigeria. The study employed a phenomenological and exploratory research design in its inquiry. Sixteen respondents made up the sample size for the study. A Focus Group Discussion Guide and an In-Depth Interview Guide were the instruments for data collection. The result of the study shows that the Covid-19 pandemic has had a devastating impact on the socioeconomic well-being of Nigerians. Second, the Nigerian health system is ill equipped and underprepared to handle the Covid-19 pandemic. Third, Nigerian social workers, most especially medical social workers, have played a significant role in passing out information on Covid-19 preventive measures to the general public. The study recommends that the Nigerian government should wake up and fix the health sector and make it proactive to handle epidemics/pandemics in the future. Social work practice in Nigeria should be promoted by the government through institutionalization of the profession.


Asunto(s)
Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus/economía , Infecciones por Coronavirus/prevención & control , Pandemias/economía , Pandemias/prevención & control , Neumonía Viral/economía , Neumonía Viral/prevención & control , Rol Profesional , Trabajadores Sociales , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Grupos Focales , Humanos , Nigeria/epidemiología , Neumonía Viral/epidemiología , Factores Socioeconómicos
14.
Rech Soins Infirm ; (141): 49-59, 2020 06.
Artículo en Francés | MEDLINE | ID: mdl-32988189

RESUMEN

A team of multi-specialized professionals meet annually on World Stroke Day, working to prevent and raise awareness of this condition. These professionals contribute to health education despite their lack of official training. Does the process used in the organization and implementation of the day enable the professionals involved to develop their educational skills ?The objectives of this research were to identify and categorize the educational skills developed during the process of organizing and implementing World Stroke Day, as well as to identify the elements of the process contributing to the development of these skills.In this descriptive qualitative study, the data were collected through a focus group with professionals involved in the day, and then subjected to a content analysis. This day enables professionals to develop their educational skills and gives them the opportunity to share what they have learned with others. The organization set up as part of this day is an opportunity to improve professionals' relationship to knowledge and their feeling of belonging. Interprofessionality and the learning context enable an educational attitude to be developed. Further research would help us to understand the transferability conditions of the process.


Asunto(s)
Educación en Salud , Personal de Salud/educación , Accidente Cerebrovascular , Aniversarios y Eventos Especiales , Grupos Focales , Personal de Salud/psicología , Humanos , Aprendizaje
15.
Arch. prev. riesgos labor. (Ed. impr.) ; 23(3): 330-342, jul.-sept. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-194119

RESUMEN

ANTECEDENTES: En abril de 2018 se detectó un número inusualmente elevado de síntomas irritativos de ojos, garganta y nariz, síntomas inespecíficos digestivos y mareos en trabajadores de los laboratorios de microbiología (LAM) y análisis clínicos (LAC) de un hospital de tercer nivel de Mallorca, asociados a olores también inhabituales. OBJETIVO: Confirmar la existencia del brote, identificar sus causas, y contribuir a su control y prevención. MÉTODOS: Estudio epidemiológico del brote con componentes cualitativo y cuantitativo. El primero se basó en la técnica de Grupos Focales. El estudio cuantitativo permitió elaborar las curvas epidémicas, en base a las visitas de los trabajadores por molestias al Servicio de Salud Laboral (SSL) y los episodios de incapacidad temporal (IT). Finalmente, se revisaron los informes higiénicos disponibles, valorando las posibles relaciones con la distribución de los casos. RESULTADOS: Mediante los grupos focales se establecieron dos definiciones operativas de caso, junto a la identificación de las posibles explicaciones del brote según las percepciones de los trabajadores. El estudio cuantitativo confirmó la existencia de un brote en el LAM, descartándolo en el LAC. Los episodios de IT en el LAM entre las semanas 16 y 39 excedieron en cuatro veces el número de casos esperados. El número de visitas al SSL también mostró un exceso de casos en las mismas semanas. CONCLUSIONES: El estudio cuantitativo confirma la existencia de un brote epidémico que ha finalizado, si bien el estudio cualitativo pone de manifiesto la continuación de los malos olores y molestias. La mejora de los sistemas de vigilancia epidemiológica facilitará la monitorización y control de otros posibles brotes en el futuro


BACKGROUND: In April 2018, an unusually high number of eye, throat and nose irritative symptoms, nonspecific gastrointestinal symptoms and dizziness were identified in workers in the microbiology (LAM) and clinical analysis (LCA) laboratories of a tertiary public hospital in Mallorca; these symptoms were also associated with perception of unusual odors. OBJECTIVE: To confirm the presence of an outbreak, identify its causes, and contribute to its prevention and control. METHODS: Epidemiological study of the outbreak involving qualitative and quantitative methods. The qualitative component was based on conducting focus groups The quantitative study allowed us to develop epidemic curves, based on employee visits to the hospital's occupational health service (OHS) due to either symptoms or episodes of sickness absence (SA). Lastly, available industrial hygiene reports were reviewed to examine possible relationships with the distribution of cases. RESULTS:Two operational case definitions were established through the focus groups, along with identification of possible explanations for the outbreak based on employee perception. The quantitative study confirmed the outbreak in the LAM, but not in the LCA. The SA episodes in the LAM between weeks 16 and 39 exceeded the number of expected cases four-fold. We also detected an excess of visits to the OHS during the same time period. CONCLUSIONS: The quantitative study confirmed an epidemic outbreak that has since ended, although the qualitative study indicated the persistence of bad smell and discomfort. The improvement of epidemiological surveillance systems as a result of the study will facilitate the monitoring and control of future possible outbreaks


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Brotes de Enfermedades/prevención & control , Enfermedades Profesionales/epidemiología , Personal de Laboratorio/estadística & datos numéricos , Brotes de Enfermedades/estadística & datos numéricos , Factores Sexuales , Grupos Focales , Incidencia
16.
Afr J AIDS Res ; 19(3): 214-221, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32892703

RESUMEN

In spite of the high HIV burden and high prevalence and incidence of HIV infection among adolescent girls and young women (AGYW) in South Africa, uptake of HIV testing in this population falls short of the UNIADS 90-90-90 targets, leading to late diagnosis, late entry into HIV care and treatment, and poor uptake of prevention services. There is a critical need to update and deepen our understanding of attitudes towards testing in this population, in order to appropriately respond to their specific needs. This article reports on findings from an exploration of perceptions of HIV testing and testing behaviour amongst AGYW in South Africa using a combination of quantitative and qualitative data. Analysis included data on testing behaviour and reasons for never testing from a survey conducted with 4 399 AGYW aged 15-24 years in six provinces. Combined with survey data is qualitative analysis from 63 in-depth interviews and 24 focus group discussions with 237 AGYW from five provinces. Findings revealed complex, dualistic and often contradictory views towards HIV testing in this population, with fear of HIV and the consequences of testing positive existing alongside a lack of concern towards HIV infection because of the availability and accessibility of antiretrovirals. These findings can help to address barriers to HIV testing in this population and ensure appropriateness of future interventions and HIV messaging.


Asunto(s)
Actitud Frente a la Salud , Infecciones por VIH/diagnóstico , Tamizaje Masivo/psicología , Adolescente , Femenino , Grupos Focales , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Infecciones por VIH/psicología , Humanos , Entrevistas como Asunto , Conducta Sexual/estadística & datos numéricos , Sudáfrica/epidemiología , Encuestas y Cuestionarios , Adulto Joven
17.
PLoS One ; 15(9): e0239181, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32936837

RESUMEN

PURPOSE: To examine the use of Normalisation Process Theory (NPT) to establish if, and in what ways, the AMBER care bundle can be successfully normalised into acute hospital practice, and to identify necessary modifications to optimise its implementation. METHOD: Multi-method process evaluation embedded within a mixed-method feasibility cluster randomised controlled trial in two district general hospitals in England. Data were collected using (i) focus groups with health professionals (HPs), (ii) semi-structured interviews with patients and/or carers, (iii) non-participant observations of multi-disciplinary team meetings and (iv) patient clinical note review. Thematic analysis and descriptive statistics, with interpretation guided by NPT components (coherence; cognitive participation; collective action; reflexive monitoring). Data triangulated across sources. RESULTS: Two focus groups (26 HPs), nine non-participant observations, 12 interviews (two patients, 10 relatives), 29 clinical note reviews were conducted. While coherence was evident, with HPs recognising the value of the AMBER care bundle, cognitive participation and collective action presented challenges. Specifically: (1) HPs were unable and unwilling to operationalise the concept of 'risk of dying' intervention eligibility criteria (2) integration relied on a 'champion' to drive participation and ensure sustainability; and (3) differing skills and confidence led to variable engagement with difficult conversations with patients and families about, for example, nearness to end of life. Opportunities for reflexive monitoring were not routinely embedded within the intervention. Reflections on the use of the AMBER care bundle from HPs and patients and families, including recommended modifications became evident through this NPT-driven analysis. CONCLUSION: To be successfully normalised, new clinical practices, such as the AMBER care bundle, must be studied within the wider context in which they operate. NPT can be used to the aid identification of practical strategies to assist in normalisation of complex interventions where the focus of care is on clinical uncertainty in acute hospital settings.


Asunto(s)
Cuidados Críticos , Paquetes de Atención al Paciente , Actitud del Personal de Salud , Interpretación Estadística de Datos , Inglaterra , Grupos Focales , Personal de Salud , Hospitales , Humanos , Investigación Cualitativa , Ensayos Clínicos Controlados Aleatorios como Asunto , Encuestas y Cuestionarios , Incertidumbre
18.
Sante Publique ; 32(2): 229-237, 2020 09 15.
Artículo en Francés | MEDLINE | ID: mdl-32989952

RESUMEN

OBJECTIVE: The HIV self-test has been on sale in France since September 2015. What is the point of view of pharmacists and key populations with regard to accessing self-tests in community pharmacies ? METHOD: One year after the HIV self-test came onto the market, the points of view of pharmacists and key populations with regard to HIV were collected during six focus groups: the pharmacists themselves; people who had already used HIV self-tests; potential users from two key populations with regard to HIV: migrants from sub-Saharan Africa and men who have sex with men; potential users from populations with active sex lives but not particularly vulnerable with regard to HIV: young adults (<25 years of age), multi-partner heterosexual adults. RESULTS: The HIV self-test in community pharmacies is perceived by all participants as a significant step forward for accessing screening for HIV. However, issues around discretion and anonymity were seen to create significant tensions with regard to accessing the test itself, but also the information necessary to use it correctly both at a technical level and above all concerning how to interpret test results. CONCLUSION: Although the present study underlines the role of the pharmacist as a significant public health actor in the dispensation of the self-test, the sales price and questions of anonymity are seen as major obstacles. Priority actions include renewing communication campaigns concerning the existence and the use of the product for the upcoming generations of young people but also specific campaigns targeting more vulnerable populations.


Asunto(s)
Actitud del Personal de Salud , Infecciones por VIH/diagnóstico , Homosexualidad Masculina/psicología , Tamizaje Masivo/métodos , Farmacéuticos/psicología , Autocuidado , Migrantes/psicología , África del Sur del Sahara/etnología , Grupos Focales , Francia , Homosexualidad Masculina/estadística & datos numéricos , Humanos , Masculino , Farmacias , Migrantes/estadística & datos numéricos , Adulto Joven
19.
Sr Care Pharm ; 35(10): 446-464, 2020 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-32972495

RESUMEN

OBJECTIVE: To assess older adults' perceptions and preferences when comparing multi-medication packaging products.
DESIGN: Qualitative study involving focus group interviews (FGIs) and key informant interviews (KIIs).
SETTING: Interviews were conducted in multiple cities within the United States during June-July 2019.
PATIENTS, PARTICIPANTS: FGI participants (N=36) included community dwelling adults, 65 years of age or older, who took 5+ chronic medications, or their caregivers. KII participants (N=15) included health care professionals caring for similar populations.
INTERVENTIONS: Participants were given samples of blister packs and pouches and asked about medication management and appearance and usability of medication packaging. Interviews were audio-recorded with participants' consent, then transcribed and coded using Atlas. ti. Recurrent and emergent themes were identified, and selected quotes served as examples of identified themes.
MAIN OUTCOME MEASURE: Participants' perceptions regarding medication packaging.
RESULTS: Participants' preferences varied for different multi-medication packaging systems. Similarly, most FGI participants did not communicate a strong attitude for or against their existing management systems. However, many FGI participants perceived a need for larger font size than seen on the either of the multimedication packaging samples. KII participants also preferred a larger font size on both packagings. KII participants thought the blister packs offered better visual organization and enabled caregivers to quickly assess adherence. However, KII participants expressed concern about integrating as-needed and short-term use medications and noted difficulty opening both types of packages.
CONCLUSION: Visual appearance is important to both patients and health care providers. Continued research in this area is vital for tailoring packaging types and technology to patients.


Asunto(s)
Cuidadores , Administración del Tratamiento Farmacológico , Anciano , Embalaje de Medicamentos , Grupos Focales , Humanos , Vida Independiente , Estados Unidos
20.
PLoS One ; 15(9): e0239513, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32970730

RESUMEN

INTRODUCTION: Antiretroviral therapy (ART) has revolutionised the care of HIV-positive individuals resulting in marked decreases in morbidity and mortality, and markedly reduced transmission to sexual partners. However, these benefits can only be realised if individuals are aware of their HIV-positive status, initiated and retained on suppressive lifelong ART. Framed using the socio-ecological model, the present study explores factors contributing to poor ART uptake among community members despite high acceptance of HIV-testing within a Treatment as Prevention (TasP) trial. In this paper we identify barriers and facilitators to treatment across different levels of the socio-ecological framework covering individual, community and health system components. METHODS: This research was embedded within a cluster-randomised trial (ClinicalTrials.gov, number NCT01509508) of HIV treatment as Prevention in rural KwaZulu-Natal, South Africa. Data were collected between January 2013 and July 2014 from resident community members. Ten participants contributed to repeat in-depth interviews whilst 42 participants took part in repeat focus group discussions. Data from individual interviews and focus group discussions were triangulated using community walks to give insights into community members' perception of the barriers and facilitators of ART uptake. We used thematic analysis guided by a socio-ecological framework to analyse participants' narratives from both individual interviews and focus group discussions. RESULTS: Barriers and facilitators operating at the individual, community and health system levels influence ART uptake. Stigma was an over-arching barrier, across all three levels and expressed variably as fear of HIV disclosure, concerns about segregated HIV clinical services and negative community religious perceptions. Other barriers were individual (substance misuse, fear of ART side effects), community (alternative health beliefs). Facilitators cited by participants included individual (expectations of improved health and longer life expectancy following ART, single tablet regimens), community (availability of ART in the community through mobile trial facilities) and health system factors (fast and efficient service provided by friendly staff). DISCUSSION: We identified multiple barriers to achieving universal ART uptake. To enhance uptake in HIV care services, and achieve the full benefits of ART requires interventions that tackle persistent HIV stigma, and offer people with HIV respectful, convenient and efficient services. These interventions require evaluation in appropriately designed studies.


Asunto(s)
Terapia Antirretroviral Altamente Activa/tendencias , Infecciones por VIH/tratamiento farmacológico , Accesibilidad a los Servicios de Salud/tendencias , Adulto , Fármacos Anti-VIH/uso terapéutico , Femenino , Grupos Focales , Humanos , Masculino , Tamizaje Masivo , Investigación Cualitativa , Población Rural , Parejas Sexuales , Estigma Social , Sudáfrica/epidemiología
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