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1.
Rev. enferm. UERJ ; 28: e48849, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1119635

RESUMEN

Objetivo: descrever o atual processo de convocação de pacientes para procedimento cirúrgico, bem como a comunicação entre a equipe multiprofissional e o paciente no período pré-operatório e identificar a linha de cuidados prestados pela equipe multiprofissional no período pré-operatório. Método: pesquisa exploratória, descritiva e qualitativa. Amostra contemplou 28 participantes, membros da equipe multidisciplinar da clínica cirurgia geral de um hospital universitário do Rio de Janeiro. Os dados foram coletados por dois roteiros de entrevista semiestruturada, de fevereiro a abril de 2019, após autorização do Comitê de Ética em Pesquisa. Resultados: a falta de planejamento, protocolos e fluxo intenso de pacientes levou a dúvidas, estresse, cancelamento de cirurgias no decorrer da internação. Conclusão: a ausência de protocolos articulados com ações e treinamentos prejudicou o processo de internação, bem como a comunicação entre a equipe multiprofissional e paciente. Fizeram parte da linha de cuidados: anamnese, sinais vitais, conciliação medicamentosa e orientações gerais.


Objective: to describe the current process of calling patients in for surgical-clinic unit, as well as communication between multidisciplinary team and patient in the preoperative period. Method: in this exploratory, qualitative, descriptive study, the 28 participants were members of the multidisciplinary team of surgical-clinic unit of a university hospital in Rio de Janeiro. Data were collected from February to April 2019 using two semi-structured interview scripts. The study was authorized by the research ethics committee. Results: the lack of planning and protocols and the intense flow of patients led to doubts, stress, and cancellation of surgeries during hospitalization. Conclusion: the absence of protocols coupled with actions and training impaired the hospitalization process, as well as communication between multidisciplinary team and patient. The line of care comprised: anamnesis, vital signs, medication reconciliation and general guidelines.


Objetivo: describir el proceso actual de convocatoria de pacientes para unidad clínica quirúrgica, así como la comunicación entre equipo multidisciplinario y paciente en el período preoperatorio. Método: en este estudio exploratorio, cualitativo, descriptivo, los 28 participantes eran miembros del equipo multidisciplinario de la unidad clínica quirúrgica de un hospital universitario de Río de Janeiro. Los datos se recopilaron de febrero a abril de 2019 mediante dos guiones de entrevistas semiestructurados. El estudio fue autorizado por el comité de ética en investigación. Resultados: la falta de planificación y protocolos y el intenso flujo de pacientes generó dudas, estrés y cancelación de cirugías durante la hospitalización. Conclusión: la ausencia de protocolos sumados a acciones y formación perjudicó el proceso de internación, así como la comunicación entre equipo multidisciplinar y paciente. La línea de atención comprendió: anamnesis, constantes vitales, conciliación de medicamentos y pautas generales.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Adulto Joven , Admisión del Paciente , Cuidados Preoperatorios/métodos , Hospitales Universitarios , Grupo de Atención al Paciente , Relaciones Profesional-Paciente , Brasil , Epidemiología Descriptiva , Investigación Cualitativa , Hospitalización , Relaciones Interprofesionales
2.
Rev. enferm. UERJ ; 28: e47321, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1116094

RESUMEN

Objetivo: analisar a produção científica nacional e internacional, buscando as interfaces existentes entre os princípios bioéticos e os cuidados em saúde prestados ao fim da vida às pessoas idosas. Método: revisão integrativa, cuja busca ocorreu entre outubro e novembro de 2019 nas bases de dados Medline via Pubmed, Lilacs e Scopus com os descritores: "Palliative Care", "Aged" e "Bioethics" de 2014-2019. Resultados: a partir dos artigos selecionados, emergiram as seguintes categorias: condutas terapêuticas frente aos cuidados ao fim da vida; tomada de decisão nos cuidados ao fim da vida; e desafios nos cuidados ao fim da vida. Conclusão: destaca-se a relevância dos profissionais manterem o compromisso com a pessoa idosa e sua família de forma a considerar suas subjetividades e preferências e os instrumentalizar para que os cuidados sejam pautados em princípios bioéticos, para assim proporcionar um processo de morte e de morrer com dignidade.


Objective: to examine the Brazilian and international scientific production for connections between bioethical principles and the health care provided to older adults at the end of their lives. Method: between October and November 2019 this integrative review searched the Medline (Pubmed), Lilacs, and Scopus databases using the descriptors: "Palliative Care", "Aged", and "Bioethics" for the period 2014-2019. Results: the following categories emerged from the selected articles: therapeutic conducted with regard to end-of-life care; decision making on end-of-life care; and challenges in end-of-life care. Conclusion: of particular importance is for health professionals to uphold their commitment to older adults and their families, consider their subjectivities and preferences, and empower and equip them so that care is guided by bioethical principles in order to assure a dignified process of dying and death.


Objetivo: examinar la producción científica brasileña e internacional en busca de conexiones entre los principios bioéticos y la atención médica brindada a los adultos mayores al final de sus vidas. Método: entre octubre y noviembre de 2019, esta revisión integradora buscó en las bases de datos Medline (Pubmed), Lilacs y Scopus utilizando los descriptores: "Cuidados paliativos", "Envejecido" y "Bioética" para el período 2014-2019. Resultados: las siguientes categorías surgieron de los artículos seleccionados: terapéutico realizado con respecto a la atención al final de la vida; toma de decisiones sobre la atención al final de la vida; y desafíos en la atención al final de la vida. Conclusión: es de particular importancia que los profesionales de la salud mantengan su compromiso con los adultos mayores y sus familias, consideren sus subjetividades y preferencias, y los empoderen y equipen para que la atención se guíe por principios bioéticos para asegurar un proceso digno de muerte y muerte.


Asunto(s)
Humanos , Anciano , Anciano de 80 o más Años , Actitud del Personal de Salud , Cuidados Paliativos al Final de la Vida/ética , Discusiones Bioéticas , Personeidad , Muerte , Relaciones Profesional-Familia/ética , Relaciones Profesional-Paciente/ética , Actitud Frente a la Muerte , Valor de la Vida
3.
Soins Psychiatr ; 41(329): 31-35, 2020.
Artículo en Francés | MEDLINE | ID: mdl-33129403

RESUMEN

Mental health facilities, despite the evolution of recent decades, remain in part places in which patients are deprived of their liberty. For elderly people with mental health issues, spirituality and freedom of expression are even more legitimate. Religious tolerance is a challenge for caregivers, and a patient's request to practise their religion must be acknowledged. The provision of dedicated spaces and the presence of chaplains must favour the respect of cultural liberties.


Asunto(s)
Cuidadores , Trastornos Mentales , Relaciones Profesional-Paciente , Religión , Respeto , Anciano , Cuidadores/psicología , Humanos , Trastornos Mentales/terapia , Espiritualidad
4.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 1512-1515, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-33018278

RESUMEN

The patient-clinician relationship is known to significantly affect the pain experience, as empathy, mutual trust and therapeutic alliance can significantly modulate pain perception and influence clinical therapy outcomes. The aim of the present study was to use an EEG hyperscanning setup to identify brain and behavioral mechanisms supporting the patient-clinician relationship while this clinical dyad is engaged in a therapeutic interaction. Our previous study applied fMRI hyperscanning to investigate whether brain concordance is linked with analgesia experienced by a patient while undergoing treatment by the clinician. In this current hyperscanning project we investigated similar outcomes for the patient-clinician dyad exploiting the high temporal resolution of EEG and the possibility to acquire the signals while patients and clinicians were present in the same room and engaged in a face-to-face interaction under an experimentally-controlled therapeutic context. Advanced source localization methods allowed for integration of spatial and spectral information in order to assess brain correlates of therapeutic alliance and pain perception in different clinical interaction contexts. Preliminary results showed that both behavioral and brain responses across the patient-clinician dyad were significantly affected by the interaction style.Clinical Relevance- The context of a clinical intervention can significantly impact the treatment of chronic pain. Effective therapeutic alliance, based on empathy, mutual trust, and warmth can improve treatment adherence and clinical outcomes. A deeper scientific understanding of the brain and behavioral mechanisms underlying an optimal patient-clinician interaction may lead to improved quality of clinical care and physician training, as well as better understanding of the social aspects of the biopsychosocial model mediating analgesia in chronic pain patients.


Asunto(s)
Encéfalo , Dolor Crónico , Manejo del Dolor , Relaciones Profesional-Paciente , Encéfalo/fisiología , Humanos , Imagen por Resonancia Magnética , Percepción del Dolor
5.
Yakugaku Zasshi ; 140(10): 1275-1284, 2020.
Artículo en Japonés | MEDLINE | ID: mdl-32999206

RESUMEN

In April 2018, as part of their fifth-year pre-clinical education curriculum, pharmacy students at Setsunan University attended a lecture presented by hepatitis B patients and their lawyer entitled "Lecture by Hepatitis B Patients". This lecture was intended to help the students to understand the circumstances and difficulties encountered by hepatitis B patients on a daily basis. For this study, we conducted questionnaire surveys of the pharmacy students before and after the lecture. The survey items pertained to students' knowledge about hepatitis B (e.g., its spread and infection possibility in daily life). Students' responses before and after the lecture varied depending on the survey topic. Hepatitis B knowledge acquired by the students in their junior year increased after the lecture; moreover, attitudes to hepatitis B patients and understanding of the difficulties and prejudice that they experienced showed a significant change. For example, responses to the items, "Feel sympathy for patients suffering from discrimination and prejudice" and "Hard to work…" were much more sympathetic after the lecture; additionally, students were less likely to "Fear infection when near patients" and more likely "… to associate with patients". Thus, the "Lecture by Hepatitis B Patients" had a significant impact on the pharmacy students' perceptions of these patients, allowing them to cultivate greater empathy. From an educational standpoint, it is of the utmost importance for pharmacy/medical students to develop their humanity as members of healthcare teams. Educational real-world experiences, such as the "Lecture by Hepatitis B Patients", provide opportunities for this development.


Asunto(s)
Actividades Cotidianas , Educación en Farmacia/métodos , Empatía , Hepatitis B/psicología , Participación del Paciente/métodos , Pacientes/psicología , Aprendizaje Basado en Problemas/métodos , Relaciones Profesional-Paciente , Estudiantes de Farmacia/psicología , Actitud Frente a la Salud , Curriculum , Humanos , Conocimiento , Encuestas y Cuestionarios
6.
J Gerontol Nurs ; 46(11): 7-11, 2020 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-33095888

RESUMEN

Mandated face mask use for health care providers, secondary to COVID-19, creates an additional communication barrier for older adults with cognitive, communication, and/or hearing challenges. Face masks can soften a speaker's voice, conceal vocal tone, and hide facial expressions that relay essential non-verbal information. An inability to understand health care information or words of support can lead to frustration, anxiety, and decreased quality of life. Therefore, the purpose of this article is to review the current research, provide clinical examples, and highlight communication strategies, supports (i.e., written, gestural, and picture supports), and modifications to personal protective equipment that health care providers can implement, in isolation or combined, to improve communication with older adults. [Journal of Gerontological Nursing, 46(11), 7-11.].


Asunto(s)
Betacoronavirus/aislamiento & purificación , Barreras de Comunicación , Comunicación , Infecciones por Coronavirus/prevención & control , Máscaras , Pandemias/prevención & control , Neumonía Viral/prevención & control , Anciano , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Humanos , Neumonía Viral/epidemiología , Neumonía Viral/virología , Relaciones Profesional-Paciente , Calidad de Vida
11.
Sante Publique ; 32(2): 171-182, 2020.
Artículo en Francés | MEDLINE | ID: mdl-32985833

RESUMEN

INTRODUCTION: Pregnant women are heavy users of Internet and this has an impact on their medical follow-up. The purpose of this study is to highlight the ethical issues related to the use of the Internet by women in their medical care.Methode: Through a systematic literature review conducted on PubMed/Medline, Web of Science, CINAHL and Embase between June and July 2019, 10 670 results were obtained, and 79 articles were included in the post-selection study. A thematic analysis was conducted on these articles. RESULTS: More than 90% of pregnant women use Internet, particularly to find medical information and social support, mainly on pregnancy and childbirth. This research allows them more equitable access to knowledge and develops their empowerment, which modifies the relationship between caregiver and patient, through the acquisition of greater autonomy for women and the development of experiential knowledge. This access offers a central and active role to pregnant women in their medical care. However, many authors also agree on the possible abuses of this use: misinformation, disproportionate information and the presence of judgment that undermine empowerment, but also digital divide and inequity in understanding information, stigmatization of women, and risks of privacy breaches on data acquired online. CONCLUSION: In order to provide pregnant women with the central and active place they seek, the authors recommend involving caregivers in the referral to reliable sites, encouraging them to develop online content, and educating pregnant women in the search for health information on Internet.


Asunto(s)
Internet/ética , Internet/estadística & datos numéricos , Mujeres Embarazadas/psicología , Información de Salud al Consumidor/normas , Femenino , Humanos , Conducta en la Búsqueda de Información , Educación del Paciente como Asunto , Embarazo , Relaciones Profesional-Paciente , Apoyo Social
13.
BMC Public Health ; 20(1): 1337, 2020 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-32878612

RESUMEN

BACKGROUND: People who are houseless (also referred to as homeless) perceive high stigma in healthcare settings, and face disproportionate disparities in morbidity and mortality versus people who are housed. Medical students and the training institutions they are a part of play important roles in advocating for the needs of this community. The objective of this study was to understand perceptions of how medical students and institutions can meet needs of the self-identified needs of the houseless community. METHODS: Between February and May 2018, medical students conducted mixed-methods surveys with semi-structured qualitative interview guides at two community-based organizations that serve people who are houseless in Portland, Oregon. Medical students approach guests at both locations to ascertain interest in participating in the study. Qualitative data were analyzed using thematic analysis rooted in an inductive process. RESULTS: We enrolled 38 participants in this study. Most participants were male (73.7%), white (78.9%), and had been houseless for over a year at the time of interview (65.8%). Qualitative themes describe care experiences among people with mental health and substance use disorders, and roles for medical students and health-care institutions. Specifically, people who are houseless want medical students to 1) listen to and believe them, 2) work to destigmatize houselessness, 3) engage in diverse clinical experiences, and 4) advocate for change at the institutional level. Participants asked healthcare institutions to use their power to change laws that criminalize substance use and houselessness, and build healthcare systems that take better care of people with addiction and mental health conditions. CONCLUSIONS: Medical students, and the institutions they are a part of, should seek to reduce stigma against people who are houseless in medical systems. Additionally, institutions should change their approaches to healthcare delivery and advocacy to better support the health of people who are houseless.


Asunto(s)
Prestación de Atención de Salud , Personas sin Hogar , Trastornos Mentales , Defensa del Paciente , Relaciones Profesional-Paciente , Estigma Social , Estudiantes de Medicina , Adulto , Actitud Frente a la Salud , Conducta Adictiva , Femenino , Necesidades y Demandas de Servicios de Salud , Personas sin Hogar/psicología , Vivienda , Humanos , Masculino , Trastornos Mentales/complicaciones , Salud Mental , Persona de Mediana Edad , Oregon , Salud Poblacional , Investigación Cualitativa , Cambio Social , Apoyo Social , Trastornos Relacionados con Sustancias/complicaciones , Encuestas y Cuestionarios
14.
Soins Pediatr Pueric ; 41(315): 17-19, 2020.
Artículo en Francés | MEDLINE | ID: mdl-32951690

RESUMEN

The representation that parents have of their child has an impact on their child's future. Similarly, what the therapist understands of his patient has an impact on the therapeutic process. Through the presentation of clinical situations put into perspective with theoretical elements, it is possible to propose a model of understanding of these effects via the concept of anticipatory illusion.


Asunto(s)
Anticipación Psicológica , Desarrollo Infantil , Ilusiones/psicología , Niño , Humanos , Modelos Psicológicos , Padres/psicología , Relaciones Profesional-Paciente
15.
Rech Soins Infirm ; (141): 70-77, 2020 06.
Artículo en Francés | MEDLINE | ID: mdl-32988193

RESUMEN

Patient education prior to discharge from hospital is a practice developed under the name of "discharge education" (DE) in the Anglo-Saxon countries. This new form of patient education targets acute and sometimes chronic patients and concerns all hospital specialties ; it aims to facilitate the transition "hospitalhome" and avoid early readmissions. In this article we want to outline a framework of indications and effects of DE, starting from an analysis of the international literature, and identify its quality criteria in order to forecast the conditions of its application to our context. A scoping review allowed us to examine 43 scientific studies specifically related to the description, analysis and evaluation of discharge education, as well as some recommendations. Almost half of the studies are published in Nursing Science journals. DE is an intense and short educational intervention (30 minutes to an hour) delivered mainly in acute situations. Paediatrics has the largest number of publications together with post-operative care. In most studies, DE is effective in improving clinical and psychosocial parameters, reducing early admissions, increasing skills and patient compliance. To achieve its goals, DE must be structured and include systematic follow up. Focused on the patient's needs and his learning ability, it uses a specific interactive pedagogy to which caregivers must be trained. The analysis of the international research leaves no doubt about the positive contributions of DE. It would be important for caregivers and policymakers to look at it as an opportunity to improve the quality of care and to humanize it.


Asunto(s)
Alta del Paciente , Educación del Paciente como Asunto , Cuidadores/psicología , Humanos , Relaciones Profesional-Paciente , Calidad de la Atención de Salud
17.
Soins ; 65(845): 10-13, 2020 May.
Artículo en Francés | MEDLINE | ID: mdl-32862956

RESUMEN

There is a close link between care and communication. The purpose of the study is to evaluate therapeutic communication when bed washing patients, which dependent patients may experience as an aggressive treatment. Improved comfort, improved serenity, less intense pain, lower pulse and blood pressure have been observed in patients looked after by caregivers practising therapeutic communication.


Asunto(s)
Baños , Cuidadores/psicología , Comunicación , Relaciones Profesional-Paciente , Humanos , Resultado del Tratamiento
19.
J Pain Symptom Manage ; 60(5): e7-e10, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32911039

RESUMEN

CONTEXT: Reports from patients and health care workers dealing with coronavirus disease 2019 (COVID-19) underscore experiences of isolation and fear. Some of this experience results from the distancing effect of masks, gloves, and gowns known as personal protective equipment (PPE). One approach to bridging the divide created by PPE is the use of PPE portraits, postcard-sized pictures affixed to PPE. OBJECTIVES: Our confidential electronic mail-based survey aimed to quantify provider attitudes toward PPE portraits. METHODS: PPE portraits were piloted at an academic safety-net health system experiencing a COVID-19 patient surge during April-May 2020, necessitating use of full PPE for COVID-positive patients and surgical masks in all hospital settings. Our survey assessed staff exposure to PPE portraits, attitudes toward PPE portraits, and potential program expansion. For staff wearing PPE portraits, we also assessed perceptions of interactions with other staff and patients/families and impact on personal well-being. The University of Massachusetts Medical School's Institutional Review Board designated this as a quality improvement project (#H00020279). RESULTS: More than half of survey respondents (n = 111 of 173; 64%) reported exposure to PPE portraits. Attitudes toward PPE portraits were positive overall, with agreement that PPE portraits were a good idea (89%), improved provider mood (79%), enhanced perception of team connection (72%), and more positive among those who reported exposure. Open-ended responses (n = 41) reinforced positive survey data and also raised concerns about infection control (n = 6), cost/logistics (n = 5), and provider vulnerability (n = 3). CONCLUSION: Providers report that PPE portraits may represent a positive patient-centered idea that helps reassure patients, is well received by interdisciplinary staff, and may enhance patient and team interactions. Potential adaptations to address concerns include photo pins and donor/patient and family experience department support for costs.


Asunto(s)
Infecciones por Coronavirus , Personal de Salud , Pandemias , Equipo de Protección Personal , Neumonía Viral , Relaciones Profesional-Paciente , Humanos
20.
Sante Publique ; 32(2): 171-182, 2020 09 15.
Artículo en Francés | MEDLINE | ID: mdl-32989946

RESUMEN

INTRODUCTION: Pregnant women are heavy users of Internet and this has an impact on their medical follow-up. The purpose of this study is to highlight the ethical issues related to the use of the Internet by women in their medical care.Methode: Through a systematic literature review conducted on PubMed/Medline, Web of Science, CINAHL and Embase between June and July 2019, 10 670 results were obtained, and 79 articles were included in the post-selection study. A thematic analysis was conducted on these articles. RESULTS: More than 90% of pregnant women use Internet, particularly to find medical information and social support, mainly on pregnancy and childbirth. This research allows them more equitable access to knowledge and develops their empowerment, which modifies the relationship between caregiver and patient, through the acquisition of greater autonomy for women and the development of experiential knowledge. This access offers a central and active role to pregnant women in their medical care. However, many authors also agree on the possible abuses of this use: misinformation, disproportionate information and the presence of judgment that undermine empowerment, but also digital divide and inequity in understanding information, stigmatization of women, and risks of privacy breaches on data acquired online. CONCLUSION: In order to provide pregnant women with the central and active place they seek, the authors recommend involving caregivers in the referral to reliable sites, encouraging them to develop online content, and educating pregnant women in the search for health information on Internet.


Asunto(s)
Internet/ética , Internet/estadística & datos numéricos , Mujeres Embarazadas/psicología , Información de Salud al Consumidor/normas , Femenino , Humanos , Conducta en la Búsqueda de Información , Educación del Paciente como Asunto , Embarazo , Relaciones Profesional-Paciente , Apoyo Social
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