Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 29.472
Filtrar
1.
Int J Public Health ; 66: 1604298, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34795555

RESUMEN

Objectives: To identify the proportion of the population that had experienced that alcohol was addressed in health care the previous year, to explore experiences and perceived effects of addressing alcohol, and to investigate the proportion of risky drinkers in the population. Methods: Cross-sectional national web-based survey with 1,208 participants. Socio-demographic data, alcohol consumption (AUDIT-C), and experiences with alcohol conversations were investigated. Results: Approximately four in five respondents had visited health care the past 12 months, and one in six reported having experienced addressing alcohol. Women and older respondents were less likely to report having experienced alcohol conversations compared to other groups. Risky drinkers were not more likely to have experienced an alcohol conversation, but reported longer duration of alcohol conversations and more frequently perceived addressing alcohol as awkward or judgmental. Almost a third of respondents were classified as risky drinkers. Conclusion: The proportion experiencing addressing alcohol in routine health care is low, also among risky drinkers, and risky drinkers more frequently experienced the conversations as judgmental. More sensitive and relevant ways of addressing alcohol in health care is needed.


Asunto(s)
Consumo de Bebidas Alcohólicas , Pacientes , Consumo de Bebidas Alcohólicas/prevención & control , Comunicación , Estudios Transversales , Humanos , Pacientes/psicología , Relaciones Profesional-Paciente
2.
Artículo en Inglés | MEDLINE | ID: mdl-34769766

RESUMEN

The aim of this study was to examine the congruence of adolescent- and therapist-rated therapeutic alliance, and to explore which rating or combination of ratings would predict treatment outcome or premature termination. We also studied whether the alliance changes over the course of treatment and if the change is related to the outcome or dropout. This study comprised 58 adolescents clinically referred for psychotherapeutic interventions. The alliance (Working Alliance Inventory, patient/therapist ratings) and treatment outcomes (Beck Depression Inventory, Clinical Outcomes in Routine Evaluation-Outcome Measure) were measured at baseline and at 3-, 6-, and 12-month follow-ups. The alliance did not change significantly over the course of therapy, but adolescent and therapist ratings did not correlate. Low values in the early assessment of adolescent-rated alliance and discrepancy between the ratings were significant predictors of undesirable treatment outcome. Weak adolescent- or therapist-rated alliance later in treatment and change for the worse in adolescent-rated alliance was associated with treatment dropout. As adolescent-rated alliance predicts treatment outcome better than therapist-rated alliance, therapists should frequently use assessments of therapeutic relationship within the therapy and pay attention if the adolescent feels the alliance is weakening or his/her evaluation is contrary to the therapist's.


Asunto(s)
Alianza Terapéutica , Adolescente , Femenino , Humanos , Masculino , Relaciones Profesional-Paciente , Escalas de Valoración Psiquiátrica , Psicoterapia , Resultado del Tratamiento
4.
Curationis ; 44(1): e1-e7, 2021 Oct 27.
Artículo en Inglés | MEDLINE | ID: mdl-34797104

RESUMEN

BACKGROUND: South Africa has included birth companions in its national guidelines for maternity care and the revised Maternity Case Record, in and effort to improve the quality and experience of care. However, reservations amongst healthcare providers remain about the acceptability of birth companions in the labour ward. OBJECTIVES: To document the experiences and perceptions of birth companions who supported women in labour in a rural hospital in Limpopo Province where a Respectful Maternity Care (RMC) project was piloted. METHOD: An institution-based cross-sectional study design was employed. Purposive sampling was employed where all birth companions who supported a woman during labour and birth were included in the study. The experiences and perceptions of birth companions were captured using a birth companion feedback book during the period of 1st April to 30th August 2019. Thematic analysis was used to analyse the data. RESULTS: Seventy-one (71) of the 73 birth companions only had positive responses about the birthing experience and how both the birth companion and woman in labour were treated. Two birth companions were dissatisfied with the treatment provided by the midwife that supported the birth. CONCLUSION: It is important for healthcare providers to understand the far reaching emotional and psychological impact of their attitudes and behaviour on, not only women in labour but also on others who witness their (healthcare providers) behaviour. Mechanisms to obtain feedback from birth companions should be integrated into strategies to improve the quality and experience of care for women during childbirth.


Asunto(s)
Hospitales de Distrito , Servicios de Salud Materna , Estudios Transversales , Parto Obstétrico , Femenino , Amigos , Humanos , Parto , Percepción , Embarazo , Relaciones Profesional-Paciente , Sudáfrica
5.
MSMR ; 28(8): 22-27, 2021 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-34622900

RESUMEN

This analysis of population-level health care utilization data evaluates changes in monthly counts and rates of medical encounters for mental and behavioral health (MH/BH) conditions and the proportion of care delivered via telehealth among active component military members of the U.S. Armed Forces during the first 6 months (March-September 2020) of the COVID-19 pandemic. Comparisons are also made to the same time period in the previous year (2019). Telehealth usage increased during the early pandemic and was on average 25% higher during March-September 2020 as compared to the previous year. In contrast, MH/BH outpatient visit rates declined modestly between March and May 2020 before rebounding in June and remaining stable through September 2020. The number of bed days attributable to MH/BH conditions also declined during March and April 2020 and was on average 30% lower during March-September 2020 as compared to the same period in the prior year. Continued surveillance is warranted to track MH/BH health care utilization during the later months of the pandemic to ensure that sufficient resources continue to be directed towards MH/BH care to support the health and readiness of active component service members.


Asunto(s)
COVID-19/epidemiología , Salud Mental/estadística & datos numéricos , Medicina Militar/tendencias , Personal Militar/estadística & datos numéricos , Telemedicina/tendencias , Actitud Frente a la Salud , Humanos , Relaciones Profesional-Paciente , Derivación y Consulta/tendencias , Estados Unidos
6.
Medicine (Baltimore) ; 100(37): e27273, 2021 Sep 17.
Artículo en Inglés | MEDLINE | ID: mdl-34664883

RESUMEN

ABSTRACT: The purpose of this study is to investigate the predictive factors of home discharge for rehabilitation patients with cancer bone metastasis.Cancer patients with bone metastasis who underwent rehabilitation between April 2014 and March 2017 were retrospectively enrolled. Data on discharge destination were collected from medical records as outcomes. Multiple regression analyses were carried out to investigate the predictive factors of home discharge.Ninety-eight patients (mean age: 68.6 years, 42 females and 56 males) were included. Fifty patients were discharged home, 38 patients were discharged to other facilities, and 10 patients died. There were no skeletal-related events among these patients during their hospital stay. The receiver-operating curve for the predictive factors for home discharge of the Barthel Index at admission, Eastern Cooperative Oncology Group Performance Status at admission, and number of immediate family members living at home were 60 points (area under the curve [AUC] = 0.74, sensitivity = 0.6400, 1-specificity = 0.2766), 2 score (AUC = 0.65, sensitivity = 0.5400, 1-specificity = 0.2222), and 1 family member (AUC = 0.65, sensitivity = 0.9592, 1-specificity = 0.7222), respectively.In order to plan for cancer patients with bone metastasis to be discharged home, it is important to take into consideration the patients' Barthel Index and Performance Status at the time of hospital admission and the number of immediate family members living at home.


Asunto(s)
Neoplasias Óseas/terapia , Familia/psicología , Alta del Paciente/normas , Relaciones Profesional-Paciente , Rehabilitación/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias Óseas/epidemiología , Neoplasias Óseas/psicología , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Japón/epidemiología , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia/terapia , Alta del Paciente/estadística & datos numéricos , Rehabilitación/psicología , Rehabilitación/normas , Estudios Retrospectivos
9.
BMJ Open ; 11(10): e051220, 2021 10 11.
Artículo en Inglés | MEDLINE | ID: mdl-34635524

RESUMEN

OBJECTIVE: The purpose of this qualitative study was to explore clients' and midwives' perceptions of compassionate and respectful care during facility-based delivery in Bishoftu District, the regional state of Oromia, Ethiopia. SETTING: Public health facilities (two health centres and one district hospital). STUDY DESIGN: A qualitative exploratory descriptive research design was used. STUDY PARTICIPANTS: The research population included purposely sampled women who had given birth in a health facility in the previous 2 weeks and midwifery experts who provided maternity care in the health facility's labour and delivery wards. Data were gathered through an individual interview (with 10 midwives and 12 women in labour). Interviews were audio-recorded and transcribed immediately. For the research, thematic analysis was performed manually. Both a priori codes (from the query guide) and emerging inductive codes were used in the study. In the thematic data analysis, three inter-related stages were involved, namely data reduction, data display and data conclusion. RESULTS: From the analysis of in-depth interviews with labouring women, three themes emerged, namely: dignified and respectful care, neglectful care and unqualified staff. Five main categories emerged from in-depth interviews with midwives: trusting relationships formed with labouring women, compassionate and respect-based behaviour, good communication skills and holistic care, intentional disrespect toward women, and barriers to compassionate and respectful maternity care due to structural factors. These themes were discovered to be a rich and detailed account of midwives' perspectives on compassionate and respectful maternity care. CONCLUSION: The majority of women who witnessed or suffered disrespect and violence during labour and childbirth were dissatisfied with their maternity care during labour and delivery. Despite midwives' accounts showing that they were aware of the importance of compassionate and respectful maternity care, clients face verbal abuse, neglect, and a lack of supportive treatment during labour and childbirth. Clients' human rights were violated by disrespectful or abusive acts, whether perpetrated or observed. It is essential to address structural problems such as provider workload, and all other initiatives aimed at improving midwives' interpersonal relationships with women to provide compassionate and respectful client-centred maternity care.


Asunto(s)
Servicios de Salud Materna , Partería , Actitud del Personal de Salud , Parto Obstétrico , Etiopía , Femenino , Humanos , Parto , Embarazo , Relaciones Profesional-Paciente , Investigación Cualitativa , Respeto
10.
Gen Dent ; 69(6): 5, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34678733
11.
Behav Ther ; 52(6): 1489-1501, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34656201

RESUMEN

The current study employed machine learning to investigate whether the inclusion of observer-rated therapist interventions and skills in early sessions of psychotherapy improved dropout prediction beyond intake assessments. Patients were treated by postgraduate clinicians at a university outpatient clinic. Psychometric instruments were assessed at intake and therapeutic interventions and skills in the third session were routinely rated by independent observers. After variable preselection, an elastic net algorithm was used to build two dropout prediction models, one including and one excluding observer-rated session variables. The best model included observer-rated variables and was significantly superior to the model including intake variables only. Alongside intake variables, two observer-rated variables significantly predicted dropout: therapist use of feedback and summaries and treatment difficulty. Although not retained in the final prediction model, the observer-rated use of cognitive techniques was also significantly correlated with dropout. Observer ratings of therapist interventions and skills in early sessions of psychotherapy improve predictors of dropout from psychotherapy beyond intake variables alone. Future research could work toward personalizing dropout predictions to the specific dyad, thereby improving their validity and aiding therapists to recognize and react to increased dropout risk.


Asunto(s)
Pacientes Ambulatorios , Relaciones Profesional-Paciente , Humanos , Psicometría , Psicoterapia , Universidades
12.
J Nurs Adm ; 51(11): 541-542, 2021 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-34705760

RESUMEN

This month's column is an interview with Dr Janeane N. Anderson, assistant professor, College of Nursing, at the University of Tennessee Health Science Center (UTHSC) in Memphis who is a health communication scholar with a focus on patient-provider communication and healthcare disparities.


Asunto(s)
Comunicación , Disparidades en Atención de Salud , Relaciones Profesional-Paciente , Salud Sexual , Grupos Étnicos , Femenino , Humanos , Minorías Sexuales y de Género , Universidades
14.
JAMA Netw Open ; 4(9): e2123453, 2021 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-34499135

RESUMEN

Importance: Older adults who are homebound can be difficult to reach owing to their functional limitations and social distancing during the COVID-19 pandemic, leaving their health needs unrecognized at an earlier stage. Objective: To determine the effectiveness of a telecare case management program for older adults who are homebound during the COVID-19 pandemic. Design, Setting, and Participants: This randomized clinical trial was conducted among 68 older adults in Hong Kong from May 21 to July 20, 2020, with a last follow-up date of October 20, 2020. Inclusion criteria were being 60 years or older, owning a smartphone, and going outside less than once a week in the previous 6 months. Interventions: Participants in the telecare group received weekly case management from a nurse supported by a social service team via telephone call and weekly video messages covering self-care topics delivered via smartphone for 3 months. Participants in the control group received monthly social telephone calls. Main Outcomes and Measures: The primary outcome was the change in general self-efficacy from before the intervention to after the intervention at 3 months. Self-efficacy was measured by the Chinese version of the 10-item, 4-point General Self-efficacy Scale, with higher scores representing higher self-efficacy levels. Analysis was performed on an intention-to-treat basis. Results: A total of 68 participants who fulfilled the criteria were enrolled (34 in the control group and 34 in the intervention group; 56 [82.4%] were women; and mean [SD] age, 71.8 [6.1] years). At 3 months, there was no statistical difference in self-efficacy between the telecare group and the control group. Scores for self-efficacy improved in both groups (ß = 1.68; 95% CI, -0.68 to 4.03; P = .16). No significant differences were found in basic and instrumental activities of daily living, depression, and use of health care services. However, the telecare group showed statistically significant interactions of group and time effects on medication adherence (ß = -8.30; 95% CI, -13.14 to -3.47; P = .001) and quality of life (physical component score: ß = 4.99; 95% CI, 0.29-9.69; P = .04). Conclusions and Relevance: In this randomized clinical trial, participants who received the telecare program were statistically no different from the control group with respect to changes in self-efficacy, although scores in both groups improved. After the intervention, the telecare group had better medication adherence and quality of life than the control group, although the small sample size may limit generalizability. A large-scale study is needed to confirm these results. Trial Registration: ClinicalTrials.gov Identifier: NCT04304989.


Asunto(s)
Manejo de Caso , Personas Imposibilitadas/psicología , Personas Imposibilitadas/estadística & datos numéricos , Autoeficacia , Telemedicina/métodos , Actividades Cotidianas , Anciano , Anciano de 80 o más Años , COVID-19 , Gestores de Casos , Depresión/epidemiología , Femenino , Hong Kong/epidemiología , Humanos , Masculino , Cumplimiento de la Medicación/estadística & datos numéricos , Enfermeras y Enfermeros , Proyectos Piloto , Relaciones Profesional-Paciente , Calidad de Vida
16.
Public Health Res Pract ; 31(3)2021 Sep 08.
Artículo en Inglés | MEDLINE | ID: mdl-34494073

RESUMEN

INTRODUCTION: Nine different sets of laws govern abortion in Australia, and the criteria for an abortion to be considered lawful varies considerably by jurisdiction. We explored how the criminal status of abortion affected patients' experiences in accessing care in a country where abortion services are widely available. METHODS: We conducted qualitative, in-depth interviews with 22 people who had an abortion in Australia since 2009 across a variety of legal contexts. We audio-recorded all interviews and transcribed them in their entirety. We carried out content and thematic analyses of the interviews using deductive and inductive techniques. RESULTS: At the time of their procedures, more than half of our participants (n = 13) obtained their abortion in a state or territory that had criminal sanctions associated with procuring an abortion and required abortion seekers to meet strict legal requirements to access care. In general, participants reported confusion about the legal status of abortion. Participants who had an abortion in criminalised settings described significant negative emotional impacts that were directly linked to the law. They were often required to fit their abortion story into a state-mandated narrative. Further, the criminalisation of abortion meant that some participants felt they could not be honest with clinicians for fear of being denied care. The participants were overwhelmingly in support of decriminalisation of abortion and increased consistency of the legal status of the procedure across Australia. CONCLUSIONS: The criminalisation of abortion in some Australian states negatively impacts patients' emotional wellbeing, undermines the patient-clinician relationship, and perpetuates abortion stigma. In the absence of legislative reform, training for clinicians - including abortion providers and general practitioners - to explain the implications of the legal status to their patients appears warranted. Patient-centred resources, such as a website with state-specific information, could fill an important knowledge gap for the public.


Asunto(s)
Aborto Inducido/legislación & jurisprudencia , Aborto Inducido/psicología , Adulto , Australia , Crimen , Revelación , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Entrevistas como Asunto , Persona de Mediana Edad , Evaluación del Resultado de la Atención al Paciente , Embarazo , Relaciones Profesional-Paciente , Salud Pública , Investigación Cualitativa , Adulto Joven
17.
Tijdschr Psychiatr ; 63(7): 535-542, 2021.
Artículo en Holandés | MEDLINE | ID: mdl-34523705

RESUMEN

BACKGROUND: The quality of the therapeutic alliance is an important factor in the treatment of both adult and adolescent patients in psychiatry. Little is known about the importance of the therapeutic alliance among youths who seek help for their substance abuse problems in addiction treatment. AIM: We investigated the importance of first treatment session therapeutic alliance for outcome in youth mental health and addiction treatment, considering both the youths' and therapists' perspective. METHOD: 127 adolescents participated in a prospective clinical cohort study, with favorable or unfavorable treatment outcome after 4 months as primary outcome measure. At the end of the first treatment session, youths and their therapists were asked to rate the therapeutic alliance. RESULTS: Youths' and therapists' perceptions about the therapeutic alliance at the start of treatment were predictive of treatment outcome at four months follow-up. In particular, the combined perspective on first-session alliance by both youths and therapists appeared a strong predictor for treatment outcome. If both youths and therapists rated the therapeutic alliance as weak, the percentage of youths showing a favorable treatment outcome was much lower (23%), than if youths and therapists rated the alliance as strong (70%). CONCLUSION: The present study confirms the importance of a combined perspective on the therapeutic alliance for predicting treatment outcome among patients in youth mental health and addiction treatment.


Asunto(s)
Alianza Terapéutica , Adolescente , Adulto , Estudios de Cohortes , Humanos , Relaciones Profesional-Paciente , Estudios Prospectivos , Psicoterapia , Resultado del Tratamiento
19.
Psychodyn Psychiatry ; 49(3): 453-462, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34478321

RESUMEN

Introduction: Most psychotherapists had no choice during the COVID-19 pandemic but to offer teletherapy in order to provide needed treatment. Several psychoanalytic theorists wondered if the very concept of treatment would change without an embodied relationship in an office setting. Methods: To attempt to understand the current concept of effective psychodynamic treatment in the new norm of teletherapy, we surveyed practitioners from 56 countries and regions who remotely treated patients psychodynamically during the beginning months of the pandemic. We asked the practitioners to rank six factors felt to be important to psychodynamic treatment: use of the couch during sessions, session in-office or via teletherapy, cultural similarity between therapist and patient, number of sessions a week, patient factors (motivation, insightfulness, and high functioning) and therapist factors (empathy, warmth, wisdom, and skillfulness). Results: We received 1,490 survey responses. As predicted, we found that the therapist and patient variables were considered much more important (both tied as highest rankings) to effective treatment than any of the other variables, including if the therapy was in-office or by teletherapy. Discussion: Psychodynamic practitioners worldwide confirmed that the empathy, warmth, wisdom, and skillfulness of the therapist and the motivation, insightfulness, and level of functioning of the patient are most important to treatment effectiveness regardless if the treatment is remote or embodied.


Asunto(s)
COVID-19/prevención & control , Encuestas de Atención de la Salud/métodos , Internacionalidad , Terapia Psicoanalítica/métodos , Telemedicina/métodos , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Relaciones Profesional-Paciente , SARS-CoV-2 , Resultado del Tratamiento
20.
Artículo en Inglés | MEDLINE | ID: mdl-34574364

RESUMEN

A large body of research suggests that establishing and strengthening patient-provider relationships, characterized by transparency, respect, trust, and empathy, is highly beneficial for patients, their caregivers, and healthcare providers [...].


Asunto(s)
Personal de Salud , Relaciones Profesional-Paciente , Humanos , Poder Psicológico , Calidad de la Atención de Salud , Confianza
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...