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3.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 37(4): 503-509, Oct.-Dec. 2019. graf
Artículo en Inglés | LILACS | ID: biblio-1041359

RESUMEN

ABSTRACT Objective: To carry out a review of the literature on adolescents' participation in decision making for their own health. Data sources: Review in the Scientific Electronic Library Online (SciELO), Latin American and Caribbean Health Sciences Literature (LILACS) and PubMed databases. We consider scientific articles and books between 1966 and 2017. Keywords: adolescence, autonomy, bioethics and adolescence, autonomy, ethics, in variants in the English, Portuguese and Spanish languages. Inclusion criteria: scientific articles, books and theses on clinical decision making by the adolescent patient. Exclusion criteria: case reports and articles that did not address the issue. Among 1,590 abstracts, 78 were read in full and 32 were used in this manuscript. Data synthesis: The age at which the individual is able to make decisions is a matter of debate in the literature. The development of a cognitive and psychosocial system is a time-consuming process and the integration of psychological, neuropsychological and neurobiological research in adolescence is fundamental. The ability to mature reflection is not determined by chronological age; in theory, a mature child is able to consent or refuse treatment. Decision-making requires careful and reflective analysis of the main associated factors, and the approach of this problem must occur through the recognition of the maturity and autonomy that exists in the adolescents. To do so, it is necessary to "deliberate" with them. Conclusions: International guidelines recommend that adolescents participate in discussions about their illness, treatment and decision-making. However, there is no universally accepted consensus on how to assess the decision-making ability of these patients. Despite this, when possible, the adolescent should be included in a serious, honest, respectful and sincere process of deliberation.


RESUMO Objetivo: Realizar uma revisão da literatura sobre a participação do adolescente na tomada de decisão sobre a sua saúde. Fonte de dados: Revisão nos bancos Scientific Electronic Library Online (SciELO), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e PubMed. Consideramos artigos científicos e livros entre 1966 e 2017. Palavras-chave: adolescência, autonomia, bioética e adolescência, autonomia, ética, em línguas inglesa, portuguesa e espanhola. Critérios de inclusão: artigos científicos, livros e dissertações que contemplassem a tomada de decisão clínica pelo paciente adolescente. Critérios de exclusão: relatos de caso e artigos que não abordavam a questão norteada nesta pesquisa. Do total de 1.590 resumos, 78 foram lidos na íntegra, e 36, utilizados neste manuscrito. Síntese dos dados: A idade em que o indivíduo é capaz para tomar decisões é motivo de debate na literatura. O desenvolvimento de um sistema cognitivo e psicossocial é um processo demorado, e faz-se fundamental a integração da investigação psicológica, neuropsicológica e neurobiológica na adolescência. A capacidade de reflexão madura não é determinada pela idade cronológica; em teoria, um menor maduro seria capaz de consentir ou recusar um tratamento. A tomada de decisão exige análise cuidadosa e reflexiva dos principais fatores associados, e a abordagem desse problema deve ocorrer por meio do reconhecimento da maturidade e da autonomia que existe no adolescente. Para tanto, é necessário "deliberar" com ele. Conclusões: Diretrizes internacionais recomendam que os adolescentes participem de discussões sobre sua doença, tratamento e tomada de decisão, entretanto não há nenhum consenso universalmente aceito sobre como avaliar a capacidade de decisão desses pacientes. Apesar disso, quando possível, o adolescente deve ser incluído em um processo sério, honesto, respeitoso e sincero de deliberação.


Asunto(s)
Humanos , Adolescente , Participación del Paciente/métodos , Participación del Paciente/psicología , Relaciones Profesional-Paciente/ética , Servicios de Salud del Adolescente/ética , Desarrollo del Adolescente , Consentimiento Informado de Menores/psicología , Consentimiento Informado de Menores/ética , Toma de Decisiones Clínicas/métodos , Toma de Decisiones Clínicas/ética , Autonomía Personal
4.
N Z Med J ; 132(1503): 83-92, 2019 10 04.
Artículo en Inglés | MEDLINE | ID: mdl-31581185

RESUMEN

Genomic analysis of tissues from rapid autopsy programmes has transformed our understanding of cancer. However, these programmes are not yet established in New Zealand. Our neuroendocrine tumour research group, NETwork!, received a request from a patient wishing to donate tumour tissues post-mortem. This viewpoint article summarises the ethical, logistical and social process undertaken to accept this patient's generous donation, and highlights the scientific and educational value of such a gift.


Asunto(s)
Investigación Genética , Neoplasias/genética , Participación del Paciente , Variantes Farmacogenómicas , Manejo de Especímenes , Bancos de Tejidos , Protocolos Clínicos , Bases de Datos Genéticas , Heterogeneidad Genética , Humanos , Neoplasias/terapia , Nueva Zelanda , Participación del Paciente/legislación & jurisprudencia , Participación del Paciente/métodos , Manejo de Especímenes/ética , Manejo de Especímenes/métodos , Bancos de Tejidos/ética , Bancos de Tejidos/legislación & jurisprudencia , Bancos de Tejidos/organización & administración
5.
J Autism Dev Disord ; 49(12): 4867-4876, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31485815

RESUMEN

The pediatric developmental passport was created to aid service navigation for children with autism spectrum disorder (ASD). A pilot-randomized-control trial was conducted at two developmental clinics. The intervention group received the Passport card versus the control group who received the placebo card. Primary outcome was the proportion of families who contacted ASD services 1-year following diagnosis. Of 40 families, 95% in the intervention group contacted services versus 70% in the control (p = 0.04). All families at the academic site contacted services; at the community site 90% in the intervention group contacted versus 40% in the control (p = 0.02). The Passport shows promise aiding families of children with ASD in service navigation, particularly at community clinics where specialist follow-up is not readily available.


Asunto(s)
Trastorno del Espectro Autista/terapia , Terapia Conductista/métodos , Educación del Paciente como Asunto/métodos , Participación del Paciente/métodos , Trastorno del Espectro Autista/rehabilitación , Cuidadores/educación , Cuidadores/psicología , Niño , Preescolar , Femenino , Humanos , Masculino , Padres/educación , Padres/psicología
6.
Surg Infect (Larchmt) ; 20(7): 535-540, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31429644

RESUMEN

Background: As the use of patient-owned devices, including smartphones and tablets, to manage day-to-day activities grows, so does healthcare industry's interest to better leverage technology to engage patients. For surgical care, a unique opportunity exists to capture patient-generated health data (PGHD) including photographs. As part of a broader initiative to evaluate PGHD for surgical site infection (SSI) surveillance, we sought evidence regarding patient involvement and experience with PGHD for SSI monitoring and surveillance. Methods: Through a scoping review of the literature and semi-structured stakeholder interviews we gathered evidence on what is currently known about patient perspectives of and experiences with mobile health (mHealth) interventions for post-operative recovery. We presented findings to and discussed with the ASSIST PGHD Stakeholder Advisory Group (PSAG) to generate priorities for further examination. Results: Our scoping review yielded 34 studies that addressed post-discharge use of PGHD for monitoring and surveillance of SSI. Of these, 16 studies addressed at least one outcome regarding patient experience; the most commonly measured outcome was patient satisfaction. Only three studies reported on patient involvement in the development of PGHD tools and interventions. We conducted interviews (n = 24) representing a range of stakeholder perspectives. Interviewees stressed the importance of patient involvement in tool and program design, noting patient involvement ensures the "work" that patients do in their daily lives to manage their health and healthcare is recognized. Discussion of evidence with the ASSIST PSAG resulted in formal recommendations for direct involvement of patients and caregivers for future work. Conclusions: While mHealth initiatives to advance post-operative management offer the ability to improve patient engagement, work is needed to ensure the patient voice is reflected. Active engagement with patients and caregivers in the development of new technology, the design of new workflows, and the conduct of research and evaluation ensures that the patient experiences and values are incorporated.


Asunto(s)
Pruebas Diagnósticas de Rutina/métodos , Monitoreo Epidemiológico , Participación del Paciente/métodos , Infección de la Herida Quirúrgica/diagnóstico por imagen , Telemedicina/métodos , Procesamiento Automatizado de Datos/métodos , Humanos , Datos de Salud Generados por el Paciente
7.
Nurs Child Young People ; 31(3): 21-25, 2019 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-31468862

RESUMEN

Asthma is a common condition, but there is evidence that it is not always managed well in the UK and deaths from asthma still occur. Locally non-medical prescribers are expected to reflect on prescribing decisions and submit them for peer review. This article arose from a local peer review, when the reviewers - who were all non-medical prescribers - suggested the learning should be more widely shared. Change in children's care can take a long time as can be seen from the age of some of the references, but this reflection shows that some of these older recommendations are still not yet embedded in practice widely.


Asunto(s)
Asma/terapia , Atención Plena/métodos , Asma/psicología , Niño , Servicios de Salud del Niño , Manejo de la Enfermedad , Humanos , Participación del Paciente/métodos
8.
Psychooncology ; 28(11): 2233-2239, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31461197

RESUMEN

OBJECTIVE: Previous research has demonstrated the importance of eliciting patients' goals and values during shared decision-making (SDM), but this does not occur in most SDM conversations. Understanding challenges to eliciting patients' goals and values is crucial. This study assessed how clinicians balanced sharing medical information and considering patients' goals and values during breast cancer surgery consultation in an integrated health care system. METHODS: We conducted interviews with clinicians (n = 6) and patients (n = 11) and conducted naturalistic, ethnographic observations of eight surgical consultations in a multidisciplinary breast cancer clinic. We analyzed the data following the template method using the qualitative software NVivo 10. RESULTS: Clinicians prioritized sharing medical information. We identified four patient factors necessary to integrate patients' values and goals into the conversation in addition to sharing medical information: ability to process large quantities of information quickly, willingness to embrace swift decision-making, ability to quickly formulate one's values, and prioritization of surgical choice as the goal of the conversation. CONCLUSIONS: We found that SDM implementation results in practices that emphasize information and choice, with less focus on patient goals and values. More research is needed to explore factors that may encourage the elicitation of patients' goals and values.


Asunto(s)
Neoplasias de la Mama/psicología , Neoplasias de la Mama/cirugía , Toma de Decisiones , Satisfacción del Paciente/etnología , Adulto , Antropología Cultural , Neoplasias de la Mama/etnología , Comunicación , Femenino , Metas , Encuestas de Atención de la Salud , Conocimientos, Actitudes y Práctica en Salud , Humanos , Persona de Mediana Edad , Participación del Paciente/métodos , Derivación y Consulta
9.
Surg Infect (Larchmt) ; 20(7): 577-580, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31298620

RESUMEN

Background: Within the United States, surgical site infections (SSIs) have now become the most common hospital-acquired infection and impact 2%-5% of all surgical patients. It is estimated that approximately 60% of SSIs could be prevented through improved adherence to pre-existing practice guidelines. Methods: The myriad of contributing factors leading to SSIs highlights the need for a multi-faceted approach. Although collaboration and coordination among providers and patients represents a requirement of any sustainable solution, it also creates a space and possible role for innovative technologies and mobile applications utilizing patient-generated health data (PGHD). Results: Upon analysis of hospital practice, we have identified substantial variability in documentation, peri-operative care, and post-discharge instruction with regard to SSI prevention and incision care techniques. This variability is further exacerbated by a loss of information within each transition of patient care. As a result, a patient's risk of SSI often becomes dictated by their provider's preferred (and sometimes arbitrary) peri-operative practices and their own initiative in following poorly explained pre-operative instructions. The quality and efficiency of any subsequent SSI treatment similarly rests on a seemingly inconsistent approach with poor patient instruction for the post-discharge setting. Conclusions: Surgical site infection risk can be mitigated successfully through reliable performance of several evidence-based process measures within the operating room, which are now at the guideline level. However, optimal performance only happens when teams and patients are aligned and truly believe both that the evidence is correct, and that SSIs are preventable. The journey toward this goal will be an iterative process that may take months to years. Although technology can be complementary, it cannot replace human passion for harm prevention.


Asunto(s)
Comunicación en Salud/métodos , Control de Infecciones/métodos , Participación del Paciente/métodos , Infección de la Herida Quirúrgica/diagnóstico , Infección de la Herida Quirúrgica/prevención & control , Telemedicina/métodos , Humanos , Estados Unidos
10.
Urology ; 132: 94-100, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31299329

RESUMEN

OBJECTIVE: To evaluate barriers to implementation of patient decision aids (PDAs) issued in an electronic medical record (EMR). We undertook an implementation outcomes analysis focused on what proportion of men eligible for the PDA received it (penetration), and of the men who received it, how many used it as intended (fidelity). We also evaluated various patient-centered outcomes related to decision-making. MATERIALS AND METHODS: Men with incident localized prostate cancer were recruited from at UCLA from 2013 to 2017. PDA eligibility was determined via weekly EMR review. We also performed a retrospective chart review of all patients seen in clinic for one sample week to identify patients that were missed by the initial eligibility algorithm, and investigated the cause for miscategorization. We analyzed differences in patient-centered outcomes between those who did and did not receive the PDA. RESULTS: About 314/374 men with incident prostate cancer completed the PDA conferring 84% fidelity. PDA penetration under initial identification prospective algorithm was assessed at 100% (n = 2/n = 2). However, penetration assessed by manual retrospective chart review was 20% (n = 2/n = 10). Improvements to the identification algorithm, including new EMR visit types, were identified. PDA completion was associated with less decisional conflict and higher perceived Shared decision-making (all P<.03). CONCLUSION: No previous studies have investigated the challenges of implementing a PDA facilitated by the EMR. We identified modifiable system and EMR-related factors that limited program penetration. Our PDA showed decisional quality benefits.


Asunto(s)
Toma de Decisiones , Técnicas de Apoyo para la Decisión , Participación del Paciente/métodos , Neoplasias de la Próstata/terapia , Humanos , Masculino , Evaluación de Programas y Proyectos de Salud , Estudios Retrospectivos
11.
Home Healthc Now ; 37(4): 198-207, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31274582

RESUMEN

Transitions of care between settings and clinicians are a time of vulnerability for patients, and can result in fragmented care, medication errors, avoidable readmissions, and patient/nurse dissatisfaction. Through the use of technology and a structured face-to-face handoff, the patient and family can be engaged in the transition across settings. The purpose of this project was to determine the feasibility and effectiveness of videoconference handoffs between inpatient, case management, and home care nurses, and the patients/families during transitions of care from hospital to home care. Videoconferences were conducted for 2 months with patients transitioning from two pediatric inpatient units to the hospital-based home care agency. The nurses and patient/family connected through a secure cloud-based videoconferencing platform. Participants discussed the patient's status, safety concerns, ongoing plan of care, what the patient/family could expect at home, and the coordination of equipment/supply needs and postdischarge visits. Videoconference handoffs (n = 10) were found to be feasible and address gaps in communication, coordination of care, and patient/family engagement during transitions from hospital to home care. Postpilot, nurses agreed the videoconference handoffs should continue with minimal modifications.


Asunto(s)
Cuidadores , Continuidad de la Atención al Paciente , Pase de Guardia , Participación del Paciente , Videoconferencia , Adolescente , Cuidadores/educación , Niño , Preescolar , Comunicación , Estudios de Factibilidad , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Alta del Paciente , Participación del Paciente/métodos , Satisfacción del Paciente , Evaluación de Programas y Proyectos de Salud
13.
Patient Educ Couns ; 102(12): 2223-2230, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31262673

RESUMEN

OBJECTIVE: Transition education programs dedicated to adolescents and young adults with congenital heart disease (CHD) aim to facilitate transfer to adult cardiology and bring more autonomy to teenagers. This prospective controlled multicentre study analysed the factors influencing the participation in a transition education program. METHODS: CHD patients aged 13-25 y were offered to participate in the transition program. A multiple linear regression identified the explanatory factors for participation in the program. RESULTS: A total of 123 patients (mean age 19.6 ±â€¯3.4 y) were included in the study, with 57 participants and 66 non-participants. Both groups showed similar socio-demographic and quality of life characteristics, low level of physical activity with muscular deconditioning and high exposure to risk behaviours (71% patients with ≥1 risk factor). Patients with complex CHD (OR = 4.1, P = 0.03), poor disease knowledge (OR = 0.3, P = 0.02), risk behaviours (body piercing, OR = 5.53, P = 0.01; alcohol, OR = 3.12, P = 0.06), and aged <20 y (OR = 0.29, P = 0.03), were more likely to join the program. CONCLUSION: Many risk factors influencing the participation of adolescents and young adults with CHD in transition education programs are controllable. PRACTICE IMPLICATION: Further randomized studies are necessary to evaluate the impact of transition education program on quality of life, successful transfer to adult centre and, ultimately, prognosis.


Asunto(s)
Continuidad de la Atención al Paciente/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Cardiopatías Congénitas/terapia , Educación del Paciente como Asunto/métodos , Participación del Paciente/métodos , Transición a la Atención de Adultos , Adolescente , Adulto , Cardiología/estadística & datos numéricos , Estudios Transversales , Femenino , Cardiopatías Congénitas/diagnóstico , Cardiopatías Congénitas/psicología , Humanos , Masculino , Estudios Prospectivos , Calidad de Vida , Adulto Joven
14.
Int J Ment Health Nurs ; 28(5): 1195-1205, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31325221

RESUMEN

Involving mental health consumers in nursing handover is a recent introduction to practise in acute mental health units. However, implementation must recognize that mental health care is complex and the approach needs to include recovery-focused philosophies of practice. Evidence shows that nurses and other health professionals consider poor handover practices may be the source of adverse events; however, the views of mental health nurses about involving consumers in nursing handover have not been previously reported. The aim of this study was to identify nurses' attitudes towards consumer involvement in handover and to measure the effect of a training programme upon these attitudes. A single-group pre-post-test intervention study was undertaken. The study was conducted on the adult acute mental health inpatient unit of a major metropolitan hospital in Victoria, Australia, 2016-2017. Questionnaires were developed to capture the views of the nurses about proposed changes in the afternoon nursing handover process. A questionnaire was administered before and after the training intervention, an innovative, multi-media education handover package. We found that training had a significant influence on mental health nurses' attitudes towards involving consumers in the handover. Therapeutic engagement improved following training and miscommunication reduced when all players are informed and have the opportunity to engage with the information. This study has demonstrated that well-planned education can influence nurses' attitudes about involving consumers in the nursing handover processes.


Asunto(s)
Actitud del Personal de Salud , Pase de Guardia , Participación del Paciente , Enfermería Psiquiátrica , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Participación del Paciente/métodos , Participación del Paciente/psicología , Enfermería Psiquiátrica/educación , Encuestas y Cuestionarios , Adulto Joven
15.
BMC Pregnancy Childbirth ; 19(1): 253, 2019 Jul 22.
Artículo en Inglés | MEDLINE | ID: mdl-31331285

RESUMEN

BACKGROUND: During pregnancy and postnatally, women seek information from a variety of sources. The potential to incorporate educational pregnancy and parenting resources into conventional health services is underexplored. In 2014-2016, UK-based charity Best Beginnings used an embedding model to embed three of their resources - the Baby Buddy app, Baby Express magazine, and 'From Bump to Breastfeeding' DVD - into maternity and early years care pathways at three sites in the north of England. A mixed-methods evaluation comprising an impact evaluation and a process evaluation was undertaken. Here we report findings from the process evaluation that aimed to understand the embedding process, explore maternity and early years' professionals' views and use of the resources, explore women's engagement with and views of the resources, and identify barriers and facilitators to the embedding process. METHODS: We carried out semi-structured interviews with stakeholders (professionals involved in embedding) and observations of embedding activities to understand how embedding worked. Surveys of postnatal women were conducted over a two-month period both prior to, and after, the resources had been embedded, to ascertain engagement with and views of the resources. A survey of professionals was carried out post-embedding to understand how, where and when the resources were used in practice, and professionals' views. Descriptive and thematic analyses were undertaken. RESULTS: Thirty stakeholders took part in interviews. Surveys were completed by 146 professionals, and by 161 and 192 women in the pre and post-embedding phases respectively. Themes derived from analysis of qualitative data were 'Implementation of the embedding model', 'Promotion and distribution of, and engagement with, the resources', 'Fit with care pathways', and 'Perceptions of the resources'. While survey responses indicated that embedding of the resources into practice was not yet complete, those who had used the resources believed that they had helped increase knowledge, build confidence and support relationship-building. CONCLUSIONS: Incorporating supportive parenting resources into maternity and early years' care pathways requires a planned embedding approach, committed champions, and senior management support. Findings indicate largely positive views of women and professionals, and suggest the resources can be a beneficial aid for families.


Asunto(s)
Promoción de la Salud , Conducta Materna/psicología , Educación Prenatal , Adulto , Femenino , Conocimientos, Actitudes y Práctica en Salud , Promoción de la Salud/métodos , Promoción de la Salud/organización & administración , Humanos , Conducta en la Búsqueda de Información , Servicios de Salud Materna , Participación del Paciente/métodos , Embarazo , Educación Prenatal/métodos , Educación Prenatal/organización & administración , Evaluación de Programas y Proyectos de Salud/métodos , Evaluación de Programas y Proyectos de Salud/estadística & datos numéricos , Apoyo Social , Reino Unido
16.
Int J Technol Assess Health Care ; 35(4): 266-272, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31337453

RESUMEN

OBJECTIVES: As more health technology assessment (HTA) bodies seek to implement patient involvement, there is a desire to learn from other HTA bodies about their experiences and understand what approaches can be used and which ones make a real difference to HTA. This is difficult, as the impact of patient involvement in HTA is not well documented. This study aims to promote further discussion about the ways in which patient involvement can impact HTAs by studying stories of impact. METHODS: In a multi-stakeholder workshop, experts leading patient involvement in four HTA bodies shared examples of HTAs where they believed patient involvement made a difference, then they reflected on these impact stories within the wider context of impact evaluation. RESULTS: The HTA bodies drew on patient input and patient-based evidence to inform their HTAs. The patient involvement was observed to elucidate patients' experiences, needs and preferences which, in turn, was observed to influence the HTA recommendations about optimal use of technologies, including taking account of issues for sub-groups, outcomes that matter to patients and educational needs. CONCLUSIONS: Personal stories of patient involvement may enable a wider understanding of different approaches to and impact of patient involvement. The examples relate to both patient input and patient-based evidence and highlight the role that patient involvement can play in reducing uncertainties and complementing the clinical and economic evidence in HTA. They suggest that impact can be seen in recommendations about how and when a technology is used.


Asunto(s)
Práctica Clínica Basada en la Evidencia/organización & administración , Participación del Paciente/métodos , Evaluación de la Tecnología Biomédica/organización & administración , Vendajes/normas , Humanos , Apnea Obstructiva del Sueño/terapia , Evaluación de la Tecnología Biomédica/normas , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Factor de Necrosis Tumoral alfa/uso terapéutico
17.
Surg Infect (Larchmt) ; 20(7): 588-591, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31347988

RESUMEN

Background: Patients increasingly use mobile devices to send text messages and photographic data to surgeons. There is potential to harness this patient-generated health data (PGHD) for clinical and public health surveillance of surgical site infection (SSI). Leveraging PGHD collected via remote monitoring in the post-operative period has the potential to produce important benefits for patients, surgeons, care teams, and infection surveillance and prevention. Methods: We conducted a health technology assessment (HTA), drawing heavily on stakeholder engagement to better understand current and potential uses of PGHD in post-operative care. Stakeholder engagement activities included assembling an advisory board composed of stakeholder experts, interviewing key informants, and seeking out stakeholder guidance to synthesize evidence from interviews, literature review, and technical app review in order to develop recommendations on the use of PGHD in SSI surveillance. Results: We conducted a review of the published literature, a technical/market scan of available apps for capturing post-operative PGHD, and two rounds of key informant interviews with stakeholders. In addition, we held a day-long workshop to solicit stakeholder feedback on initial findings of the project and to guide additional work. These activities culminated in an HTA report that provides guidance and recommendations on the use of PGHD in SSI surveillance, including practice, research, and public health surveillance, and identifies open issues on post-operative use of PGHD for which additional evidence and experience are needed to optimize application of those data for clinical and public health purposes. Conclusion: Stakeholders, individuals with direct experience, or interest in a given topic are critical to the HTA process. They provide insight to guide the work conducted, ensure that the topics addressed are relevant and important, and that products of the work are accessible and meaningful to the individuals who will be most impacted.


Asunto(s)
Monitoreo Epidemiológico , Investigación sobre Servicios de Salud/métodos , Investigación sobre Servicios de Salud/organización & administración , Datos de Salud Generados por el Paciente , Participación del Paciente/métodos , Infección de la Herida Quirúrgica/diagnóstico por imagen , Procesamiento Automatizado de Datos , Humanos , Periodo Posoperatorio , Participación de los Interesados
18.
Rev Mal Respir ; 36(5): 625-632, 2019 May.
Artículo en Francés | MEDLINE | ID: mdl-31221484

RESUMEN

Counseling and pharmacotherapy are smoking cessation interventions whose effectiveness has been widely demonstrated. Different pharmacologic treatment options exist with similar efficacy : notably nicotine replacement therapy, varenicline and bupropion. Providers can promote therapeutic adherence and the chances of successful quitting by involving patients in the choice of medication and incorporating their preferences in the decision process. The concept of shared decision-making is based on an exchange between doctor and patient in medical situations with several reasonable options. Decision aids support this approach by facilitating the transmission of information, communication and patient involvement. Despite opportunities for shared decision-making during the smoking cessation process, few decision aids are available. This article summarizes current knowledge in this field and its application to the process of smoking cessation. Shared decision making in smoking cessation is illustrated by a decision aid created to facilitate the choice between different smoking cessation medications.


Asunto(s)
Conducta de Elección/fisiología , Participación del Paciente/métodos , Cese del Hábito de Fumar/métodos , Bupropión/uso terapéutico , Consejo , Humanos , Nicotina/uso terapéutico , Participación del Paciente/psicología , Participación del Paciente/estadística & datos numéricos , Selección de Paciente , Cese del Hábito de Fumar/psicología , Dispositivos para Dejar de Fumar Tabaco , Vareniclina/uso terapéutico
19.
Med Sci Monit ; 25: 4602-4608, 2019 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-31223134

RESUMEN

BACKGROUND The management of quality of life (QoL) in patients with cirrhosis is important due to the chronic nature of compensated cirrhosis. The aim of the study was to evaluate the effect of health education using health empowerment theory in patients with liver cirrhosis. MATERIAL AND METHODS Between January 2014 and November 2014, 30 patients who were hospitalized with liver cirrhosis patients were recruited to the study, as the study group. Health education was conducted using the principles of health empowerment theory. Between January 2013 and November 2013, 30 hospitalized cirrhosis patients were recruited as the control group, who were given conventional health education. The QoL scores and Health-Promoting Lifestyle Profile II (HPLP II) scores were evaluated at hospital discharge and at two-month follow-up. The health knowledge awareness rate, activity of daily living (ADL), and health-promoting lifestyles were evaluated. RESULTS On discharge from the hospital, understanding of the major clinical symptoms, etiology, diet and nutrition, use of medication, treatment, and disease awareness rates were significantly higher in the study group compared with the control group (all P<0.05). There were significant differences in ADL scores between the two groups at two-month follow-up (81.5±15.5 vs. 68.5±15.4; P=0.006). All HPLP II scores were higher in the study group compared with the control group at hospital discharge and at two-month follow-up (all P<0.05). CONCLUSIONS Patient health empowerment can improve the cognitive level and health behaviors of patients with liver cirrhosis, improve their ability to perform ADL, and improve their QoL.


Asunto(s)
Cirrosis Hepática/psicología , Participación del Paciente/métodos , Actividades Cotidianas/psicología , Anciano , China , Dieta , Femenino , Conductas Relacionadas con la Salud , Educación en Salud/métodos , Humanos , Masculino , Persona de Mediana Edad , Estado Nutricional , Educación del Paciente como Asunto/métodos , Participación del Paciente/psicología , Calidad de Vida/psicología , Encuestas y Cuestionarios
20.
JMIR Mhealth Uhealth ; 7(6): e12245, 2019 06 27.
Artículo en Inglés | MEDLINE | ID: mdl-31250833

RESUMEN

BACKGROUND: Social media is currently becoming a new channel for information acquisition and exchange. In China, with the growing popularity of WeChat and WeChat official accounts (WOAs), health promotion agencies have an opportunity to use them for successful information distribution and diffusion online. OBJECTIVE: We aimed to identify features of articles pushed by WOAs of Chinese provincial Centers for Disease Control and Prevention (CDC) that are associated with user engagement. METHODS: We searched and subscribed to 28 WOAs of provincial CDCs. Data for this study consisted of WeChat articles on these WOAs between January 1, 2017 and December 31, 2017. We developed a features frame containing title type, article content, article type, communication skills, number of marketing elements, and article length for each article and coded the data quantitatively using a coding scheme that assigned numeric values to article features. We examined the descriptive characteristics of articles for every WOA and generated descriptive statistics for six article features. The amount of reading and liking was converted into the level of reading and liking by the 75% position. Two-category univariate logistic regression and multivariable logistic regression were conducted to explore associations between the features of the articles and user engagement, operationalized as reading level and liking level. RESULTS: All provincial CDC WOAs provided a total of 5976 articles in 2017. Shanghai CDC articles attracted the most user engagement, and Ningxia CDC articles attracted the least. For all articles, the median reading was 551.5 and the median liking was 10. Multivariable logistic regression analysis revealed that article content, article type, communication skills, number of marketing elements, and article length were associated with reading level and liking level. However, title type was only associated with liking level. CONCLUSIONS: How social media can be used to best achieve health information dissemination and public health outcomes is a topic of much discussion and study in the public health community. Given the lack of related studies based on WeChat or official accounts, we conducted this study and found that article content, article type, communication skills, number of marketing elements, article length, and title type were associated with user engagement. Our study may provide public health and community leaders with insight into the diffusion of important health topics of concern.


Asunto(s)
Difusión de la Información/métodos , Participación del Paciente/psicología , Mensaje de Texto/normas , China , Programas de Gobierno/métodos , Humanos , Participación del Paciente/métodos , Participación del Paciente/estadística & datos numéricos , Mensaje de Texto/instrumentación
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