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1.
PLoS One ; 19(5): e0303520, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38768171

RESUMEN

INTRODUCTION: Sickle cell disease (SCD) remains a public health problem especially in sub-Saharan Africa including Ghana. While pilot initiatives in Africa have demonstrated that neonatal screening coupled with early intervention reduces SCD-related morbidity and mortality, only 50-70% of screen-positive babies have been successfully retrieved to benefit from these interventions. Point-of-care testing (POCT) with high specificity and sensitivity for SCD screening can be integrated into existing immunization programs in Africa to improve retrieval rates. This study explored community acceptability of integrating POCT to screen for SCD in children under 5 years of age in primary healthcare facilities in Northern Ghana. METHOD: This was an exploratory study using qualitative research approach where 10 focus group discussions and 20 in-depth interviews were conducted with community members and health workers between April and June 2022. The recorded interviews were transcribed verbatim after repeatedly listening to the recordings. Data was coded into themes using QSR Nvivo 12 software before thematic analysis. RESULTS: Most participants (70.9%) described SCD as serious and potentially life-threatening condition affecting children in the area. Of 148 community members and health workers, 141 (95.2%) said the screening exercise could facilitate diagnosis of SCD in children for early management. However, discrimination, fear of being tested positive, stigmatization, negative health worker attitude linked with issues of maintaining confidentiality were reported by participants as key factors that could affect uptake of the SCD screening exercise. Most participants suggested that intensive health education (78.3%), positive attitude of health workers (69.5%), and screening health workers not being biased (58.8%) could promote community acceptability. CONCLUSION: A large majority of participants viewed screening of SCD in children as very important. However, opinions expressed by most participants suggest that health education and professionalism of health workers in keeping patients' information confidential could improve the uptake of the exercise.


Asunto(s)
Anemia de Células Falciformes , Pruebas en el Punto de Atención , Atención Primaria de Salud , Humanos , Anemia de Células Falciformes/diagnóstico , Anemia de Células Falciformes/psicología , Ghana , Femenino , Masculino , Preescolar , Adulto , Población Rural , Lactante , Aceptación de la Atención de Salud , Personal de Salud/psicología , Tamizaje Masivo/métodos , Persona de Mediana Edad , Recién Nacido , Adulto Joven , Grupos Focales
2.
BMC Prim Care ; 25(1): 173, 2024 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-38769485

RESUMEN

BACKGROUND: Low-quality data presents a significant challenge for community health workers (CHWs) in low and middle-income countries (LMICs). Mobile health (mHealth) applications offer a solution by enabling CHWs to record and submit data electronically. However, the barriers and benefits of mHealth usage among CHWs in informal urban settlements remain poorly understood. This study sought to determine the barriers and benefits of mHealth among CHWs in Banda parish, Kampala. METHODS: This qualitative study involved 12 key informant interviews (KIIs) among focal persons from Kampala City Council Authority (KCCA) and NGOs involved in data collected by CHWs, and officials from the Ministry of Health (MOH) and two mixed-sex Focused Group Discussions (FGDs) of CHWs from Banda parish, Kampala district. Data analysis utilised Atlas Ti Version 7.5.7. Thematic analysis was conducted, and themes were aligned with the social-ecological model. RESULTS: Three themes of institutional and policy, community and interpersonal, and individual aligning to the Social ecological model highlighted the factors contributing to barriers and the benefits of mHealth among CHWs for iCCM. The key barriers to usability, acceptability and sustainability included high training costs, CHW demotivation, infrastructure limitations, data security concerns, community awareness deficits, and skill deficiencies. Conversely, mHealth offers benefits such as timely data submission, enhanced data quality, geo-mapping capabilities, improved CHW performance monitoring, community health surveillance, cost-effective reporting, and CHW empowering with technology. CONCLUSION: Despite limited mHealth experience, CHWs expressed enthusiasm for its potential. Implementation was viewed as a solution to multiple challenges, facilitating access to health information, efficient data reporting, and administrative processes, particularly in resource-constrained settings. Successful mHealth implementation requires addressing CHWs' demotivation, ensuring reliable power and network connectivity, and enhancing capacity for digital data ethics and management. By overcoming these barriers, mHealth can significantly enhance healthcare delivery at the community level, leveraging technology to optimize resource utilization and improve health outcomes. mHealth holds promise for transforming CHW practices, yet its effective integration necessitates targeted interventions to address systemic challenges and ensure sustainable implementation in LMIC contexts.


Asunto(s)
Agentes Comunitarios de Salud , Telemedicina , Humanos , Uganda , Agentes Comunitarios de Salud/educación , Estudios Transversales , Femenino , Masculino , Investigación Cualitativa , Manejo de Caso , Adulto , Niño , Servicios de Salud Comunitaria , Grupos Focales
3.
PLoS One ; 19(5): e0302509, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38718082

RESUMEN

BACKGROUND: Soil-transmitted helminthiasis (STH) and schistosomiasis (SCH) are among the most prevalent neglected tropical diseases (NTDs), affecting 1.5 billion globally, with a significant burden in sub-Saharan Africa, particularly Nigeria. These diseases impair health and contribute to socio-economic challenges, especially in children, undermining educational and future economic prospects. The 2030 NTD Roadmap highlights Mass Drug Administration (MDA) as a critical strategy for controlling these NTDs, targeting vulnerable populations like school-age children. Despite some successes, challenges persist, indicating the need for deeper insights into program implementation. This study focuses on the perspectives of health workers implementing MDA in selected local government areas (LGAs) of Ogun State, Nigeria, aiming to identify challenges and enablers that align with the broader NTD 2030 goals. METHODOLOGY/PRINCIPAL FINDINGS: The study used a qualitative research approach involving focus group discussions and in-depth interviews with health workers engaged in neglected tropical disease control programs in Ogun State, Nigeria, between July and September 2022. A semi-structured questionnaire guided the exploration of ideas, and the data were analyzed using the QRS Nvivo 12 software package. The study found that the school-based MDA control program's efficacy largely relies on strong collaborations and partnerships, particularly with educators, community heads, and other stakeholders. These alliances and strategic communication methods, like town announcements and media campaigns, have been pivotal in reaching communities. However, the program does grapple with hurdles such as parental misconceptions, limited funds, insufficient staffing, and misalignment with the Ministry of Education. It is recommended to boost funding, foster early stakeholder involvement, enhance mobilization techniques, and consider introducing a monitoring card system similar to immunization. CONCLUSIONS/SIGNIFICANCE: The MDA Integrated Control Programs for STH and SCH in Ogun State schools demonstrate a holistic approach, integrating knowledge, collaboration, communication, and feedback. Health workers have shown commitment and adeptness in their roles. However, achieving maximum efficacy requires addressing critical barriers, such as parental misconceptions and funding challenges. Adopting the recommended strategies, including proactive communication, increased remuneration, and introducing a tracking system, can significantly enhance the program's reach and impact. The involvement of all stakeholders, from health workers to community leaders and parents, is essential for the program's sustainability and success.


Asunto(s)
Personal de Salud , Helmintiasis , Administración Masiva de Medicamentos , Esquistosomiasis , Suelo , Humanos , Nigeria/epidemiología , Esquistosomiasis/prevención & control , Esquistosomiasis/epidemiología , Esquistosomiasis/tratamiento farmacológico , Helmintiasis/prevención & control , Helmintiasis/epidemiología , Helmintiasis/tratamiento farmacológico , Suelo/parasitología , Masculino , Femenino , Instituciones Académicas , Adulto , Enfermedades Desatendidas/prevención & control , Enfermedades Desatendidas/epidemiología , Niño , Antihelmínticos/uso terapéutico , Antihelmínticos/administración & dosificación , Grupos Focales
4.
Musculoskeletal Care ; 22(2): e1890, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38727724

RESUMEN

AIM: To develop a better understanding of the perceptions of first point of contact roles within primary care by pre-registration students of the Allied Health Professions (AHPs). BACKGROUND: General practice in the UK is under growing pressure from declining general practitioner (GP) numbers and increased service demand. The National Health Service (NHS) is attempting to mitigate this demand by making more effective use of its highly experienced workforce through the creation of first contact practitioners (FCPs). Working in primary care, FCPs are highly experienced AHPs with three or more years of relevant clinical experience. METHODS: An abductive qualitative research approach underpinned by a descriptive phenomenological methodology was adopted. Thematic analysis was used to analyse the focus group transcripts. FINDINGS: Twenty two final-year pre-registration AHP students participated in three focus groups. Two themes with sub-themes were identified: (1) Understanding of the role-pathway to the role; role clarity; and sources of knowledge. (2) Impact on service-positives and challenges. CONCLUSIONS: This study synthesised new findings from the previously unexplored FCP stakeholder of pre-registration AHP students. Participants generally understood the FCP's purpose of unburdening GPs and perceived the FCP model to contribute to the solution of rising clinical and financial pressures within the NHS, and primary care specifically. However, there was confusion regarding the scope of practice of an FCP. It is vital that the future workforce understand this role through effective education.


Asunto(s)
Grupos Focales , Atención Primaria de Salud , Humanos , Técnicos Medios en Salud/psicología , Técnicos Medios en Salud/educación , Masculino , Femenino , Actitud del Personal de Salud , Investigación Cualitativa , Rol Profesional , Reino Unido , Estudiantes del Área de la Salud/psicología
5.
Span J Psychol ; 27: e13, 2024 May 17.
Artículo en Inglés | MEDLINE | ID: mdl-38757250

RESUMEN

The apparently contradictory co-existence of high levels of gender equality and intimate partner violence against women (IPVAW) found in Nordic countries has been termed the Nordic Paradox. The aim of this study was to examine how the Nordic Paradox is discussed and explained by Spanish professionals working in the IPVAW field. Five focus groups (n = 19) and interviews with key informants (n = 10) were conducted. Four main categories of possible explanations for the Nordic Paradox were identified: Macro-micro disconnect (i.e., discordance between individual beliefs and behaviors and macro-social norms of gender equality), IPVAW as multicausal (i.e., IPVAW defined as a multicausal phenomenon that does not necessarily have to be associated with gender equality), cultural patterns of social relationships (i.e., the role of social relationships and the way people relate to each other in the Nordic countries), and backlash effect (i.e., men's reaction to greater equality for women). Although this study does not provide a final explanation for the Nordic paradox, its results provide us with a better understanding of the phenomenon and can help to advance research in this field.


Asunto(s)
Violencia de Pareja , Humanos , Violencia de Pareja/psicología , Violencia de Pareja/etnología , Masculino , Adulto , España/etnología , Femenino , Equidad de Género , Países Escandinavos y Nórdicos , Normas Sociales , Persona de Mediana Edad , Prevalencia , Grupos Focales , Relaciones Interpersonales
6.
J Phys Ther Educ ; 38(2): 141-149, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38758178

RESUMEN

INTRODUCTION: Effective academic-clinical partnerships require a greater understanding of how academic programs can best support clinical education (CE) faculty. This study aimed to determine resources and support that clinical partners need. REVIEW OF LITERATURE: As the number of physical therapist (PT) programs, cohort sizes, and CE weeks have risen, so has demand for CE sites. Conversely, staffing reductions, increased administrative duties, and rising productivity expectations have decreased the time available for clinical instruction. To promote a successful CE experience, there must be a renewed understanding of CE faculty needs. SUBJECTS: Clinical education faculty affiliated with any of the 8 contributing programs from the Ohio-Kentucky Consortium participated in survey research (n = 24) and subsequent interview (n = 4) and focus group (n = 6) research. METHODS: Constructivist grounded theory design was used to explore the needs of CE faculty. Academic and clinical partners developed the initial survey and used survey results to establish interview questions. The investigators iteratively assessed data saturation and clarity of results of coded survey, interview, and focus group data to determine whether the study's aims of identifying CE faculty needs had been met. RESULTS: The aggregated results yielded 5 main themes of Director of Clinical Education support for CE faculty needs: student readiness for CE experience; effective academic-clinical partner communication; collaborative management of exceptional students; judicious standardization of CE processes; and provision of CE faculty development resources. DISCUSSION AND CONCLUSION: Clinical education faculty have noted challenges that affect their ability to mentor students. They want academic programs to be more collaborative and proactive with communication, resources, and support. Future research should address aids and barriers to proactive communication, resource provision, and academic-clinical partner collaboration.


Asunto(s)
Grupos Focales , Humanos , Encuestas y Cuestionarios , Docentes , Teoría Fundamentada , Fisioterapeutas/educación , Conducta Cooperativa , Ohio
7.
J Perinat Neonatal Nurs ; 38(2): 221-226, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38758277

RESUMEN

AIM: Although infant- and family-centered developmental care (IFCDC) is scientifically grounded and offered in many hospitals to some extent, it has not yet been universally implemented as the standard of care. In this article, we aim to identify barriers to the implementation of IFCDC in Belgian neonatal care from the perspective of neonatal care providers. METHODS: We conducted 8 online focus groups with 40 healthcare providers working in neonatal care services. An inductive thematic analysis was carried out by means of Nvivo. RESULTS: The focus groups revealed barriers related to contextual, hospital, and neonatal unit characteristics. Barriers found in the hospital and neonatal unit were related to financing, staffing, infrastructure, access to knowledge/information and learning climate, leadership engagement, and relative priority of IFCDC. Contextual barriers were related to peer pressure and partnerships, newborn/parent needs and resources, external policy, and budgetary incentives. CONCLUSION: Three main barriers to IFCDC implementation have been identified. Resources (staffing, financing, and infrastructure) must be available and aligned with IFCDC standards, knowledge and information have to be accessible and continuously updated, and hospital management should support IFCDC implementation to create an enabling climate, including compatibility with the existing workflow, learning opportunities, and priority setting.


Asunto(s)
Grupos Focales , Humanos , Recién Nacido , Bélgica , Femenino , Masculino , Atención Dirigida al Paciente/organización & administración , Investigación Cualitativa , Enfermería Neonatal/organización & administración , Enfermería Neonatal/métodos , Enfermería Neonatal/normas , Desarrollo Infantil , Actitud del Personal de Salud , Adulto , Unidades de Cuidado Intensivo Neonatal/organización & administración
8.
JMIR Hum Factors ; 11: e45115, 2024 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-38728071

RESUMEN

BACKGROUND: Health care lags in digital transformation, despite the potential of technology to improve the well-being of individuals. The COVID-19 pandemic has accelerated the uptake of technology in health care and increased individuals' willingness to perform self-management using technology. A web-based service, Directlab Online, provides consumers with direct digital access to diagnostic test packages, which can digitally support the self-management of health. OBJECTIVE: This study aims to identify the facilitators, barriers, and needs of Directlab Online, a self-management service for web-based access to diagnostic testing. METHODS: A qualitative method was used from a potential user's perspective. The needs and future needs for, facilitators of, and barriers to the use of Directlab Online were evaluated. Semistructured focus group meetings were conducted in 2022. Two focus groups were focused on sexually transmitted infection test packages and 2 were focused on prevention test packages. Data analysis was performed according to the principles of the Framework Method. The Consolidated Framework for Implementation Research was used to categorize the facilitators and barriers. RESULTS: In total, 19 participants, with a mean age of 34.32 (SD 14.70) years, participated in the focus groups. Important barriers were a lack of privacy information, too much and difficult information, and a commercial appearance. Important facilitators were the right amount of information, the right kind of tests, and the involvement of a health care professional. The need for a service such as Directlab Online was to ensure its availability for users' health and to maintain their health. CONCLUSIONS: According to the participants, facilitators and barriers were comprehension of the information, the goal of the website, and the overall appearance of the service. Although the service was developed in cocreation with health care professionals and users, the needs did not align. The users preferred understandable and adequate, but not excessive, information. In addition, they preferred other types of tests to be available on the service. For future research, it would be beneficial to focus on cocreation between the involved medical professionals and users to develop, improve, and implement a service such as Directlab Online.


Asunto(s)
Automanejo , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Grupos Focales , Investigación Cualitativa , Automanejo/métodos , Telemedicina/métodos
9.
J Pak Med Assoc ; 74(4): 724-729, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38751269

RESUMEN

Objective: To identify barriers to safe anaesthesia practice across the South Asian region. METHODS: The qualitative study was conducted from September 2020 to August 2021 at the Department of Anaesthesiology at a leading medical university after getting exemption from the ethics review committee of the Pakistan Society of Anaesthesiologists. The sample comprised anaesthetists from 6 countries of the South Asian Association for Regional Cooperation. Data was collected through a focus group discussion held virtually using the Zoom app on September 22, 2020. The proceedings were transcribed and the data was subjected to thematic analysis. RESULTS: Of the 12 anaesthetists, 4(33.3%) were from India, 3(25%) from Pakistan, 2(16.7%) from Bangladesh, and 1(8.3%) each from Sri Lanka, Nepal and Afghanistan. There were 2 main themes identified; Safe anaesthesia and barriers to safe anaesthesia. They had 4 and 6 subthemes, respectively. The participants agreed that fresh medical graduates were not choosing anaesthesia as a preferred career specialty. One major concern raised was that qualified anaesthetists were leaving their countries for better-paid jobs abroad. Conclusion: The lack of a definition describing qualified anaesthetists in South Asian countries was pointed out. Lack of basic monitoring and drugs, brain drain, lack of ownership, lack of training programmes, lack of accountability, weak leadership, and disconnect between professional societies and governments were identified as the main barriers to safe anaesthesia.


Asunto(s)
Anestesiología , Grupos Focales , Investigación Cualitativa , Humanos , Anestesia/métodos , Seguridad del Paciente , Pakistán , Asia Occidental
10.
PLoS One ; 19(5): e0303215, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38739597

RESUMEN

Despite improvement over recent decades, childhood vaccination uptake remains a concern across countries. The World Health Organization observed that over 25 million children missed out on one or more vaccines in 2021, with urban poor and other marginalized groups being the most affected. Given the higher risk of disease transmission and vaccine-preventable diseases (VPD) outbreaks across densely populated urban slums, identifying effective interventions to improve childhood vaccination in this vulnerable population is crucial. This study explored the behavioral and social factors influencing childhood vaccination uptake in urban informal settlements in Nairobi, Kenya. A grounded theory approach was employed to develop a theoretical account of the socio-behavioral determinants of childhood vaccination. Five focus group discussions (FGDs) were conducted with purposively sampled caregivers of children under five years of age residing in informal settlements. The Theory of Planned Behavior guided the structuring of the FGD questions. An iterative process was used to analyze and identify emerging themes. Thirty-nine caregivers (median age 29 years) participated in the FGDs. From the analysis, four main thematic categories were derived. These included attitude factors such as perceived vaccine benefits, cultural beliefs, and emotional factors including parental love. Additionally, subjective norms, like fear of social judgment, and perceived behavioral control factors, such as self-control and gender-based influences, were identified. Furthermore, a number of practical factors, including the cost of vaccines and healthcare providers attitude, also affected the uptake of vaccination. Various social, behavioral, cultural, and contextual factors influence caregiver vaccination decisions in urban poor settings. Community-derived and context-specific approaches that address the complex interaction between socio-behavioral and other contextual factors need to be tested and applied to improve the timely uptake of childhood vaccinations among marginalized populations.


Asunto(s)
Población Urbana , Vacunación , Humanos , Femenino , Masculino , Vacunación/psicología , Vacunación/estadística & datos numéricos , Adulto , Población Urbana/estadística & datos numéricos , Kenia , Preescolar , Investigación Cualitativa , Cuidadores/psicología , Lactante , Grupos Focales , Conocimientos, Actitudes y Práctica en Salud , Áreas de Pobreza , Pobreza , Padres/psicología
11.
JMIR Mhealth Uhealth ; 12: e50851, 2024 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-38743461

RESUMEN

BACKGROUND: Medication nonadherence remains a significant health and economic burden in many high-income countries. Emerging smartphone interventions have started to use features such as gamification and financial incentives with varying degrees of effectiveness on medication adherence and health outcomes. A more consistent approach to applying these features, informed by patient perspectives, may result in more predictable and beneficial results from this type of intervention. OBJECTIVE: This qualitative study aims to identify patient perspectives on the use of gamification and financial incentives in mobile health (mHealth) apps for medication adherence in Australian patients taking medication for chronic conditions. METHODS: A total of 19 participants were included in iterative semistructured web-based focus groups conducted between May and December 2022. The facilitator used exploratory prompts relating to mHealth apps, gamification, and financial incentives, along with concepts raised from previous focus groups. Transcriptions were independently coded to develop a set of themes. RESULTS: Three themes were identified: purpose-driven design, trust-based standards, and personal choice. All participants acknowledged gamification and financial incentives as potentially effective features in mHealth apps for medication adherence. However, they also indicated that the effectiveness heavily depended on implementation and execution. Major concerns relating to gamification and financial incentives were perceived trivialization and potential for medication abuse, respectively. CONCLUSIONS: The study's findings provide a foundation for developers seeking to apply these novel features in an app intervention for a general cohort of patients. However, the study highlights the need for standards for mHealth apps for medication adherence, with particular attention to the use of gamification and financial incentives. Future research with patients and stakeholders across the mHealth app ecosystem should be explored to formalize and validate a set of standards or framework.


Asunto(s)
Grupos Focales , Cumplimiento de la Medicación , Aplicaciones Móviles , Motivación , Investigación Cualitativa , Telemedicina , Humanos , Aplicaciones Móviles/normas , Aplicaciones Móviles/estadística & datos numéricos , Grupos Focales/métodos , Masculino , Femenino , Cumplimiento de la Medicación/psicología , Cumplimiento de la Medicación/estadística & datos numéricos , Persona de Mediana Edad , Adulto , Australia , Telemedicina/métodos , Telemedicina/normas , Anciano , Juegos de Video/normas , Juegos de Video/psicología
12.
Ned Tijdschr Geneeskd ; 1682024 May 16.
Artículo en Holandés | MEDLINE | ID: mdl-38747607

RESUMEN

OBJECTIVE: To gain insight into experiences of women and men who have experienced an unintended pregnancy, along with the perspectives of healthcare providers offering decision-making counseling/consultations concerning an unintended pregnancy or abortion. DESIGN: Semi-structured interviews and focus groups. METHODS: Twenty-five interviews were held with women and men whom experienced an unintended pregnancy, while nineteen healthcare providers participated in four focus groups (May-July 2021). RESULTS: In addition to partners or other family members, healthcare providers also play a significant role in supporting decision-making. Awareness of decision-making counseling was limited among interviewees, a view shared by the participating providers. Both groups highlighted deficiencies in follow-up care post-abortion or unintended pregnancy, as well as the perceived taboo surrounding unintended pregnancies and abortion. CONCLUSION: Decision-making counseling deserves more awareness among the public and healthcare providers. There is also room for improvement regarding follow-up care. Sustained attention to unintended pregnancies and abortions is necessary to reduce the prevailing taboo.


Asunto(s)
Aborto Inducido , Toma de Decisiones , Personal de Salud , Embarazo no Planeado , Humanos , Femenino , Embarazo , Masculino , Embarazo no Planeado/psicología , Personal de Salud/psicología , Aborto Inducido/psicología , Adulto , Consejo , Grupos Focales
13.
Cien Saude Colet ; 29(5): e15552022, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38747777

RESUMEN

The conceptions, values, and experiences of students from public and private high schools in two Brazilian state capitals, Vitória-ES and Campo Grande-MS, were analyzed regarding digital control and monitoring between intimate partners and the unauthorized exposure of intimate material on the Internet. Data from eight focus groups with 77 adolescents were submitted to thematic analysis, complemented by a questionnaire answered by a sample of 530 students. Most students affirmed that they do not tolerate the control/monitoring and unauthorized exposure of intimate materials but recognized that such activity is routine. They point out jealousy, insecurity, and "curiosity" as their main reasons. They detail the various dynamics of unauthorized exposure of intimate material and see it as a severe invasion of privacy and a breach of trust between partners. Their accounts suggest that such practices are gender violence. They also reveal that each platform has its cultural appropriation and that platforms used by the family, such as Facebook, cause more significant damage to the victim's reputation.


Asunto(s)
Grupos Focales , Parejas Sexuales , Estudiantes , Humanos , Brasil , Adolescente , Femenino , Masculino , Encuestas y Cuestionarios , Estudiantes/psicología , Parejas Sexuales/psicología , Internet , Violencia de Pareja/estadística & datos numéricos , Privacidad , Violencia de Género , Relaciones Interpersonales , Celos , Instituciones Académicas , Adulto Joven
14.
Front Public Health ; 12: 1385125, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38689763

RESUMEN

The stillbirth rate among Aboriginal and Torres Strait Islander women and communities in Australia is around double that of non-Indigenous women. While the development of effective prevention strategies during pregnancy and improving care following stillbirth for women and families in communities has become a national priority, there has been limited progress in stillbirth disparities. With community permission, this study aimed to gain a better understanding of community experiences, perceptions, and priorities around stillbirth. We undertook an Indigenous researcher-led, qualitative study, with community consultations guided by a cultural protection protocol and within an unstructured research framework. A total of 18 communities were consulted face-to-face through yarning interviews, focus groups and workshops. This included 54 community member and 159 health professional participants across remote, regional, and urban areas of Queensland, Western Australia, Victoria, South Australia, and Northern Territory. Thematic analysis of consultation data identified common themes across five focus/priority areas to address stillbirth: Stillbirth or Sorry Business Baby care needs to be family-centered; using Indigenous "ways of knowing, being, and doing" to ensure cultural safety; application of Birthing on Country principles to maternal and perinatal care; and yarning approaches to improve communication and learning or education. The results underscore the critical need to co-design evidence-based, culturally appropriate, and community-acceptable resources to help reduce existing disparities in stillbirth rates.


Asunto(s)
Grupos Focales , Nativos de Hawái y Otras Islas del Pacífico , Investigación Cualitativa , Mortinato , Humanos , Mortinato/psicología , Nativos de Hawái y Otras Islas del Pacífico/psicología , Nativos de Hawái y Otras Islas del Pacífico/estadística & datos numéricos , Femenino , Embarazo , Australia , Adulto , Masculino , Entrevistas como Asunto , Aborigenas Australianos e Isleños del Estrecho de Torres
15.
Prim Health Care Res Dev ; 25: e26, 2024 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-38721697

RESUMEN

The authors report on their development of a National Advisory Board (NAB) to guide a funded project: Two in One: HIV + COVID-19 Screening and Testing Model. This project aimed to improve primary care practitioners' capacity to routinize HIV, PrEP/PEP, and COVID-19 vaccine screenings for all their patients while relying on culturally responsive communication with their minoritized patients. To approach their monumental research and education tasks, they created a NAB, drawing from the literature on advisory boards to (a) promote board member engagement and (b) progress successfully through the six stages suggested for successful advisory boards. A midpoint survey and final focus groups with NAB members indicated mixed levels of engagement, a sense of time and work being valued, and pride in the media and academic reach of the project. The authors offer considerations for others considering forming a NAB to guide primary care research and interventions.


Asunto(s)
Comités Consultivos , COVID-19 , Infecciones por VIH , Atención Primaria de Salud , Humanos , Atención Primaria de Salud/métodos , COVID-19/diagnóstico , Infecciones por VIH/diagnóstico , Tamizaje Masivo/métodos , Prueba de COVID-19/métodos , SARS-CoV-2 , Grupos Focales , Investigación sobre Servicios de Salud , Masculino
16.
BMC Med Educ ; 24(1): 528, 2024 May 13.
Artículo en Inglés | MEDLINE | ID: mdl-38741110

RESUMEN

BACKGROUND: Medical students view clinical workplace placements as an inspiring and motivating learning environment where active student participation is pivotal to development of students' identity. The progress from pre-clerkship to clerkship education harbors many challenges which consist of experiential learning, adjusting to the clinical environment, and understanding roles & responsibilities. Workplace learning is underpinned by various adult learning theories including social theories,constructivism, supported participation and legitimate peripheral participation. Workplace learning course was recently initiated for pre-clerkship students at a medical university in UAE, which will enable their smooth entry into the clerkship phase of the curriculum. OBJECTIVES: The research aims to explore students' perceptions of various domains of their clinical learning environment (CLE), highlight the challenges they face, and extract valuable feedback to improve their environment. METHODS: This study was conducted qualitatively by using focus groups method in order to explore students' perceptions of the clinical learning environment. Two focus group discussions were conducted (n = 8 +/-10) to determine the common challenges of workplace learning and its potential solutions. Data were analyzed using thematic analysis. The approach used to carry out this study was phenomenology, as it helps to understand the learning and behavior of these students who are undergoing this pre-clerkship training in order to transition smoothly to the clerkship phase. RESULT: The focus groups helped to deeply explore the perceptions of students about their clinical learning environment. It helped to reveal the challenges encountered by the students including the significance of proper orientation of staff and students, language barrier, availability of learning opportunities, and supervision quality. The focus groups provided worthwhile suggestions to improve the learning opportunities in the clinical learning environment which include orientation of the staff and students what to expect, improved supervision, mentoring and providing learning opportunities to encourage participation. CONCLUSION: This study attempted to identify the pre-clerkship students' perception of their clinical learning environment and the challenges they face over there. Possible suggestions by the students included a formal orientation for the staff and students to be carried out at the beginning. Efforts should be made by clerkship directors to provide students with learning opportunities by increasing patient exposure, encouraging participation, and providing high-quality supervision.


Asunto(s)
Prácticas Clínicas , Grupos Focales , Estudiantes de Medicina , Lugar de Trabajo , Humanos , Estudiantes de Medicina/psicología , Emiratos Árabes Unidos , Femenino , Masculino , Educación de Pregrado en Medicina , Investigación Cualitativa , Aprendizaje Basado en Problemas , Adulto , Aprendizaje , Curriculum , Adulto Joven
17.
BMC Health Serv Res ; 24(1): 621, 2024 May 13.
Artículo en Inglés | MEDLINE | ID: mdl-38741127

RESUMEN

BACKGROUND: The response to the COVID-19 pandemic saw a significant increase in demand for the voluntary, community, faith and social enterprise (VCFSE) sector to provide support to local communities. In Greater Manchester (GM), the VCFSE sector and informal networks provided health and wellbeing support in multiple ways, culminating in its crucial supportive role in the provision of the COVID-19 vaccination rollout across the GM city region. However, the support provided by the VCFSE sector during the pandemic remains under-recognised. The aims of the study were to: understand the views and experiences of marginalised communities in GM during the COVID-19 pandemic; explore how community engagement initiatives played a role during the pandemic and vaccine rollout; assess what can be learnt from the work of key stakeholders (community members, VCFSEs, health-system stakeholders) for future health research and service delivery. METHODS: The co-designed study utilised a participatory approach throughout and was co-produced with a Community Research Advisory Group (CRAG). Focus groups and semi-structured interviews were conducted remotely between September-November 2021, with 35 participants from local marginalised communities, health and care system stakeholders and VCFSE representatives. Thematic framework analysis was used to analyse the data. RESULTS: Local communities in GM were not supported sufficiently by mainstream services during the course of the COVID-19 pandemic, resulting in increased pressure onto the VCFSE sector to respond to local communities' need. Community-based approaches were deemed crucial to the success of the vaccination drive and in providing support to local communities more generally during the pandemic, whereby such approaches were in a unique position to reach members of diverse communities to boost uptake of the vaccine. Despite this, the support delivered by the VCFSE sector remains under-recognised and under-valued by the health system and decision-makers. CONCLUSIONS: A number of challenges associated with collaborative working were experienced by the VSCE sector and health system in delivering the vaccination programme in partnership with the VCFSE sector. There is a need to create a broader, more inclusive health system which allows and promotes inter-sectoral working. Flexibility and adaptability in ongoing and future service delivery should be championed for greater cross-sector working.


Asunto(s)
COVID-19 , Investigación Cualitativa , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Femenino , Masculino , Adulto , SARS-CoV-2 , Pandemias/prevención & control , Persona de Mediana Edad , Vacunas contra la COVID-19/administración & dosificación , Grupos Focales , Inglaterra/epidemiología , Servicios de Salud Comunitaria/organización & administración , Necesidades y Demandas de Servicios de Salud
18.
Adv Emerg Nurs J ; 46(2): 158-168, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38736100

RESUMEN

Human trafficking is a global public health problem affecting millions of people worldwide. In the United States, many trafficking victims seek medical care for physical, sexual, and mental health concerns. Unfortunately, many of these individuals go unrecognized by health care providers as being victims of human trafficking and return to their trafficker without interventions for their safety and protection. To provide effective quality care for this patient population, health care providers must be knowledgeable regarding the identification of signs of trafficking, trauma-informed interventions to ensure the safety and protection of the victim(s), and methods to collaborate with interprofessional partners for the provision of appropriate medical and socioeconomic care following the exit from their trafficking situation. The purpose of this pilot study was to evaluate best practices in teaching Family Nurse Practitioner (FNP) students to identify and implement appropriate interventions for victims of human trafficking. The study was conducted in two phases using a mixed-method research design with repeated measures. In the first phase, education was provided through the validated HOPE Training modules produced by the Safe House Project using a pretest, posttest design. In the second phase, the students observed an interprofessional simulation followed by focus groups using a phenomenological approach to explore students' perceptions. Knowledge and confidence increased significantly following the implementation of this study. The results provide essential information regarding incorporating human trafficking education into FNP curricula. This study also contributes to the body of knowledge regarding the vital role that nurse practitioners play in the interprofessional management of human trafficking victims.


Asunto(s)
Trata de Personas , Enfermeras Practicantes , Humanos , Proyectos Piloto , Enfermeras Practicantes/educación , Femenino , Estados Unidos , Víctimas de Crimen , Estudiantes de Enfermería/psicología , Grupos Focales , Competencia Clínica , Masculino , Adulto
19.
Int J Qual Stud Health Well-being ; 19(1): 2353460, 2024 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38739443

RESUMEN

PURPOSE: Brief Admission by self-referral (BA) is a standardized crisis-management intervention for individuals with self-harm and risk for suicide. This study explored relatives' experiences of BA. Relatives' perspectives may contribute to an increased understanding of the effects of BA given the relatives' role as support and informal caregivers as well as being co-sufferers. METHODS: Fourteen relatives to adults with access to BA within one Swedish region participated in focus groups analysed with reflexive thematic analysis. RESULTS: We generated themes evolving around three meaning-based concepts: access (A low threshold to a safe back-up is crucial and obstacles may easily break faith), independence (Trust in their ability with care and respect), and recovery (The rest and relational recovery we all get are needed and invaluable). CONCLUSIONS: BA brings considerable value to users and relatives, by supporting them to take care of themselves and each other. Communication and involvement of relatives may enhance users' ability to overcome obstacles to accessing BA. Implementation and adherence may be strengthened by supervision of BA staff and education of emergency care staff. Resources are needed to improve access. Mapping hurdles to BA, support through peers and targeted psychoeducation may improve recovery for BA users and their relatives.


Asunto(s)
Intervención en la Crisis (Psiquiatría) , Familia , Grupos Focales , Investigación Cualitativa , Conducta Autodestructiva , Ideación Suicida , Humanos , Masculino , Femenino , Adulto , Suecia , Conducta Autodestructiva/terapia , Conducta Autodestructiva/psicología , Persona de Mediana Edad , Familia/psicología , Anciano , Derivación y Consulta , Cuidadores/psicología , Adulto Joven
20.
BMC Public Health ; 24(1): 1240, 2024 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-38711054

RESUMEN

BACKGROUND: There is evidence that most people are aware of the importance of healthy eating and have a broad understanding regarding types of food that enhance or detract from health. However, greater health literacy does not always result in healthier eating. Andreasen's Social Marketing Model and Community-Based Social Marketing both posit that, in order to change health behaviours, it is crucial to understand reasons for current behaviours and perceived barriers and benefits to improved behaviours. Limited research has been conducted, however, that explores these issues with general populations. This study aimed to help address this gap in the evidence using a qualitative methodology. METHODS: Three group discussions were conducted with a total of 23 participants: (1) young women aged 18-24 with no children; (2) women aged 35-45 with primary school aged children; and (3) men aged 35-50 living with a partner and with pre- or primary school aged children. The discussions took place in a regional centre of Victoria, Australia. Transcriptions were thematically analysed using an inductive descriptive approach and with reference to a recent integrated framework of food choice that identified five key interrelated determinants: food- internal factors; food- external factors; personal-state factors; cognitive factors; and sociocultural factors. RESULTS: We found that food choice was complex, with all five determinants evident from the discussions. However, the "Social environment" sub-category of "Food-external factors", which included family, work, and social structures, and expectations (or perceived expectations) of family members, colleagues, friends, and others, was particularly prominent. Knowledge that one should practice healthy eating, which falls under the "Cognitive factor" category, while seen as an aspiration by most participants, was often viewed as unrealistic, trumped by the need and/or desire for convenience, a combination of Food-external factor: Social environment and Personal-state factor: Psychological components. CONCLUSIONS: We found that decisions regarding what, when, and how much to eat are seen as heavily influenced by factors outside the control of the individual. It appears, therefore, that a key to improving people's eating behaviours is to make it easy to eat more healthfully, or at least not much harder than eating poorly.


Asunto(s)
Pueblos de Australasia , Investigación Cualitativa , Población Rural , Humanos , Femenino , Masculino , Adulto , Población Rural/estadística & datos numéricos , Adulto Joven , Adolescente , Persona de Mediana Edad , Victoria , Conducta Alimentaria/psicología , Preferencias Alimentarias/psicología , Grupos Focales , Dieta Saludable/psicología
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