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2.
Comunidad (Barc., Internet) ; 22(2): 0-0, jul.-oct. 2020. tab
Artículo en Español | IBECS | ID: ibc-192934

RESUMEN

INTRODUCCIÓN: ¿cómo seguir trabajando la orientación y participación comunitaria en Atención Primaria durante la pandemia por COVID-19?. OBJETIVOS Y MÉTODOS: observar, describir, reflexionar y documentar aspectos relativos a la atención comunitaria en el momento actual de pandemia por COVID-19 en los equipos de Atención Primaria (EAP) de Aragón. Estudio exploratorio-descriptivo observacional transversal con enfoque cualitativo, con dos fases. 1ª: recopilación de experiencias comunitarias y localización de informantes clave. 2ª: descripción de acciones comunitarias. Análisis descriptivo y tipo DAFO. RESULTADOS: se detectaron 47 iniciativas. Participaron 11 expertas y 54 informantes clave. El 66,6% consideró el rol de los EAP como consultores/colaboradores. El 64,9% de las iniciativas contempló la diversidad. El 49,1% no sabía si valoraron diferencias por género. Destacaron la importancia de lo comunitario para superar la crisis y la cooperación y coordinación con la comunidad e instituciones locales. DISCUSIÓN: protocolos con orientación biomédica, miedo e incertidumbre por la COVID-19 dificultaron el desarrollo de iniciativas comunitarias; frente a esto, fue clave la trayectoria comunitaria previa de los EAP, el trabajo en equipo, con especial relevancia el de las trabajadoras sociales, y su motivación. La participación del EAP como colaborador refuerza la importancia del liderazgo compartido. Son necesarios espacios colaborativos, apoyo institucional y coordinación intersectorial. CONCLUSIÓN: durante la pandemia, las comunidades deben ser parte de la respuesta; la orientación comunitaria de los EAP es clave. Es preciso visibilizar, acompañar y reforzar el trabajo comunitario y estimular la coordinación con Salud Pública


INTRODUCTION: How to continue working on community guidance and participation in Primary Care during the COVID-19 pandemic?. OJECTIVES AND METHODS: To observe, report, reflect and document autonomous community experiences of Aragonese Primary Care Teams (PCT) during the COVID-19 pandemic. A two-phase exploratory-descriptive observational, cross-sectional study with a qualitative approach. Phase 1: compilation of experiences in community health and location of key informants. Phase 2: description of community actions. Descriptive and SWOT analysis. RESULTS: A total of 47 initiatives were detected; 11 experts and 54 key informants took part. A total of 66.6% considered the role of the PCT as consultants or collaborators; 64.9% of initiatives considered diversity. A total of 49.1% did not know whether they evaluated differences by sex. They highlighted the importance of the community to overcome the crisis, and cooperation and coordination with community and local institutions. DISCUSSION: Protocols with biomedical guidance, fear and uncertainty due to COVID-19 hindered development of community initiatives. In light of this, the previous community trajectory of PCTs, teamwork with special relevance of social workers and their motivation were fundamental. PCT involvement as a partner strengthens the importance of shared leadership. Collaborative spaces, institutional support and intersectoral coordination are all necessary. CONCLUSION: During the pandemic, communities must be part of the response; PCT community guidance is essential. Visibility, working alongside and strengthening community work and stimulating public health coordination are all necessary requirements


Asunto(s)
Humanos , Infecciones por Coronavirus/epidemiología , Síndrome Respiratorio Agudo Grave/epidemiología , Virus del SRAS/patogenicidad , Servicio Social/organización & administración , Atención al Paciente/tendencias , Servicios de Salud Comunitaria/organización & administración , Participación de la Comunidad/tendencias , Pandemias/estadística & datos numéricos , Estudios Transversales , Investigación sobre Servicios de Salud/tendencias
3.
MMWR Morb Mortal Wkly Rep ; 69(42): 1549-1551, 2020 Oct 23.
Artículo en Inglés | MEDLINE | ID: mdl-33090979

RESUMEN

Namibia is an upper-middle income country in southern Africa, with a population of approximately 2.5 million (1). On March 13, 2020, the first two cases of coronavirus disease 2019 (COVID-19) in Namibia were identified among recently arrived international travelers. On March 17, Namibia's president declared a state of emergency, which introduced measures such as closing of all international borders, enactment of regional travel restrictions, closing of schools, suspension of gatherings, and implementation of physical distancing measures across the country. As of October 19, 2020, Namibia had reported 12,326 laboratory-confirmed COVID-19 cases and 131 COVID-19-associated deaths. CDC, through its Namibia country office, as part of ongoing assistance from the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) provided technical assistance to the Ministry of Health and Social Services (MoHSS) for rapid coordination of the national human immunodeficiency virus (HIV) treatment program with the national COVID-19 response.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Infecciones por VIH/tratamiento farmacológico , Pandemias/prevención & control , Neumonía Viral/prevención & control , Desarrollo de Programa , Fármacos Anti-VIH/uso terapéutico , Servicios de Salud Comunitaria/organización & administración , Infecciones por Coronavirus/epidemiología , Humanos , Namibia/epidemiología , Neumonía Viral/epidemiología
4.
JMIR Mhealth Uhealth ; 8(10): e20419, 2020 10 16.
Artículo en Inglés | MEDLINE | ID: mdl-33006942

RESUMEN

BACKGROUND: Telehealth has emerged as a crucial component of the SARS-CoV-2 pandemic emergency response. Simply stated, telehealth is a tool to provide health care from a distance. Jefferson Health has leveraged its acute care telehealth platform to screen, order testing, and manage patients with COVID-19-related concerns. OBJECTIVE: This study aims to describe the expansion and results of using a telehealth program to increase access to care while minimizing additional potential exposures during the early period of the COVID-19 pandemic. METHODS: Screening algorithms for patients with SARS-CoV-2-related complaints were created, and 150 new clinicians were trained within 72 hours to address increased patient demand. Simultaneously, Jefferson Health created mobile testing sites throughout eastern Pennsylvania and the southern New Jersey region. Visit volume, the number of SARS-CoV-2 tests ordered, and the number of positive tests were evaluated, and the volume was compared with preceding time periods. RESULTS: From March 8, 2020, to April 11, 2020, 4663 patients were screened using telehealth, representing a surge in visit volume. There were 1521 patients sent to mobile testing sites, and they received a telephone call from a centralized call center for results. Of the patients who were tested, nearly 20% (n=301) had a positive result. CONCLUSIONS: Our model demonstrates how using telehealth for a referral to central testing sites can increase access to community-based care, decrease clinician exposure, and minimize the demand for personal protective equipment. The scaling of this innovation may allow health care systems to focus on preparing for and delivering hospital-based care needs.


Asunto(s)
Técnicas de Laboratorio Clínico/métodos , Servicios de Salud Comunitaria/organización & administración , Telemedicina , Infecciones por Coronavirus/diagnóstico , Humanos , New Jersey/epidemiología , Pennsylvania/epidemiología
5.
Rev Esp Salud Publica ; 942020 Oct 30.
Artículo en Español | MEDLINE | ID: mdl-33124619

RESUMEN

This paper aims to share the reflections related to the community actions in which the Agència de Salut Pública de Barcelona has been involved during the emergency of COVID-19. The tasks carried out can be arranged in three stages, frequently overlapping: detection of needs and problems; contact with key stakeholders to assess what to do and how to do it; adaptation of the interventions to the "new normal" and generation of new responses. The emerging problems included: not being able to do the confinement (due to homelessness, material conditions, living in a situation of violence); digital gap (lack of knowledge, devices, access to Wifi); greater exposure to COVID-19 in the essential but precarious, feminized and racialized jobs (care, cleaning, food shops) that are the most frequent in the neighborhoods in where we work; language and cultural barriers that preclude to follow recommendations; to lose employment; insufficient income to cover basic needs; social isolation; and the deterioration of emotional health caused by the situation. During the process, some interventions were adapted to be delivered on-line. Solidarity networks and local resources were key to meet basic needs, but also other needs related to lack of digital knowledge or device. Community action in health, from a critical, intersectional and local perspective, and with intersectoral work and community participation, can contribute to: facilitate a contextualized response in the event of a health crisis; mitigate the effects derived from its economic and social crisis.


Asunto(s)
Betacoronavirus , Servicios de Salud Comunitaria/métodos , Infecciones por Coronavirus/prevención & control , Política de Salud , Promoción de la Salud/métodos , Evaluación de Necesidades , Pandemias/prevención & control , Neumonía Viral/prevención & control , Salud Pública/métodos , Servicios de Salud Comunitaria/organización & administración , Participación de la Comunidad , Promoción de la Salud/organización & administración , Humanos , España
6.
Artículo en Inglés | MEDLINE | ID: mdl-33092053

RESUMEN

Background-Communities played a key role in preventing the spread of coronavirus, not only during the threshold period of the epidemic but also in the normal stage of prevention. Scientifically evaluating the community's work is necessary for prevention in the normal period of the epidemic and can provide a reference for the management of different countries. Methods-Based on data envelopment analysis (DEA), this article used community worker data to evaluate the matching of service supply and demand during the epidemic period and used co-word analysis to analyze the content and the residents' demands for community service from the threshold period to the normal period of the epidemic. Results-According to the results of the DEA model, early in the epidemic, 13 of the 15 districts' DEA values were invalid, indicating that there was a shortage in community workers in Wuhan. The results of public opinion analysis showed that from the threshold to the normal period of the epidemic, the emphasis on community service gradually transformed from epidemic prevention to an integrated service, which effectively met the composite service needs of community residents for both prevention and life. Conclusions-In the face of public health emergencies, the government should ensure an adequate number of service personnel, mobilize the service resources, refine the service content, and adjust the incentive policy, which can help to improve the quality of residents' lives and the coordination degree of the prevention and control as part of the epidemic control in the emergency period and the social and economic recovery after the epidemic.


Asunto(s)
Servicios de Salud Comunitaria/organización & administración , Epidemias/prevención & control , China/epidemiología , Humanos , Modelos Teóricos
7.
Healthc (Amst) ; 8(3): 100449, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32919586

RESUMEN

Given the predicted need for continued SARS-CoV-2 diagnostic testing, as well as the evolving availability and types of diagnostic tests, off-site COVID-19 testing centers (OSCTC) leaders need timely guidance to ensure they are meeting the needs of their unique populations. This research discusses the challenges and offers considerations for healthcare organizations and others when setting up and running OSCTCs. It also provides a springboard to engage policy makers and leaders in the healthcare community in a discussion about emergency preparedness, and how to better respond to testing needs going forward.


Asunto(s)
Técnicas de Laboratorio Clínico/métodos , Servicios de Salud Comunitaria/organización & administración , Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Betacoronavirus , Estudios de Evaluación como Asunto , Humanos , Pandemias , Estados Unidos
8.
WHO South East Asia J Public Health ; 9(2): 100-103, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32978340

RESUMEN

The Government of Thailand was prompt to launch social and economic measures to mitigate the effects on the general population following lockdown measures to counter coronavirus disease 2019 (COVID-19). However, sex workers were one of the vulnerable groups who were unable to access state support. A rapid survey of sex workers in Thailand showed that almost all had become unemployed and lost their income as a consequence of the lockdown, restrictions on international flights into the country and the closure of entertainment venues. Most were unable to cover the costs of food and shelter for themselves and their dependents. COVID-19 had also disrupted testing and treatment for sexually transmitted infections and HIV services for sex workers. As in other countries, community-based organizations were essential to providing an immediate, short-term COVID-19 response for sex workers. Also as in other countries, the pandemic has demonstrated that many people's health and well-being depends on very fragile foundations. This presents a clear opportunity to build back better by committing to a longer-term vision for the overall societal inclusion of sex workers. Thailand should advocate for decriminalization of sex work and ensure sex workers are entitled to equal labour rights and inclusion in the government social protection programme. Progress in innovative government initiatives aimed at ending HIV stigma and discrimination show how structural change can come about through harnessing community-based organizations. In turn, HIV services for sex workers need to expand and incorporate targeted interventions to reduce sex workers' occupational susceptibility to COVID-19.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Trabajadores Sexuales , Servicios de Salud Comunitaria/organización & administración , Femenino , Financiación Gubernamental/organización & administración , Infecciones por VIH/prevención & control , Humanos , Masculino , Trabajadores Sexuales/legislación & jurisprudencia , Trabajadores Sexuales/estadística & datos numéricos , Encuestas y Cuestionarios , Tailandia/epidemiología
9.
J Prim Health Care ; 12(3): 207-214, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32988442

RESUMEN

INTRODUCTION Sweden is unique in adopting a 'no-lockdown' public health approach to the SARS-CoV-2 (COVID-19) outbreak. There were fears that health services would not be able to care for high numbers of COVID-19 patients. AIM To describe and review the emergency response of a public primary and community health-care organisation in Stockholm, Sweden, to the demand for care for COVID-19 and non-COVID-19 patients during March-July 2020, and summarise preparations for the months to follow. METHODS This was a rapid implementation action research case study, which also draws on one author's experience as Chief Executive Officer and other members' experience in an emergency management group. RESULTS Sweden experienced similar mortality per million population to the UK, despite the different public health strategy used to address the COVID-19 outbreak. The Stockholm-integrated public primary and community health-care service, serving a population of 2.3 million, made many changes quickly. One change included coordinating non-acute private health-care services, following the local government emergency directive to do so. DISCUSSION It is possible that the fast and effective response by management and services in primary and community health care reduced infection and hospital demand, which contributed to a lower mortality than otherwise expected. The actions and preparations described for Stockholm's response may provide ideas for other health-care systems. The partnership research approach between the Karolinska Medical University and the Region Stockholm health-care system used in this project shows that rapid research methods have advantages for both partners in an emergency situation.


Asunto(s)
Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus/mortalidad , Necesidades y Demandas de Servicios de Salud , Neumonía Viral/mortalidad , Servicios de Salud Comunitaria/organización & administración , Infecciones por Coronavirus/epidemiología , Brotes de Enfermedades , Femenino , Investigación sobre Servicios de Salud , Humanos , Masculino , Pandemias , Neumonía Viral/epidemiología , Atención Primaria de Salud/organización & administración , Síndrome Respiratorio Agudo Grave , Suecia/epidemiología
10.
J Public Health Manag Pract ; 26(6): 613-621, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32969951

RESUMEN

CONTEXT: The coronavirus disease 2019 (COVID-19) pandemic has placed a strain on health care systems worldwide. Many hospitals experienced severe bed shortages; some had to turn patients away. In Singapore, the widespread outbreak, especially among the dormitory-based population, created a pressing need for alternative care sites. PROGRAM: The first massive-scale community care facility (CCF) was started in Singapore to address the pandemic. It served as a low-acuity primary care center that could isolate and treat COVID-19-positive patients with mild disease. This allowed decompression of the patient load in hospitals, ensuring that those with more severe disease could receive timely medical attention. IMPLEMENTATION: Various groups from the private and public sectors, including health care, construction, security, hotel management, and project coordination, were involved in the setup and operations of the CCF. A large exhibition center was converted into the care facility and segregated into zones to reduce cross-contamination. State-of-the-art technological infrastructure for health management was used. Several paraclinical services were made available. EVALUATION: The CCF was a timely and robust response that fulfilled several crucial functions, including cohort isolation, triage, basic medical care, and timely reviews and escalation of patients. It placed a unique focus on promoting patient ownership, responsibility, and mental well-being. It was largely successful, with a low hospital transfer rate of 0.37%. DISCUSSION: The success of the CCF could be attributed to the use of a facility of opportunity, strong interorganizational and cross-sector cooperation, an integrated and robust clinical system, and clear communication channels. It allows for efficient resource utilization and is valuable in future pandemics with similar disease characteristics.


Asunto(s)
Servicios de Salud Comunitaria/organización & administración , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Instituciones de Salud , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Betacoronavirus , Humanos , Control de Infecciones/organización & administración , Pandemias , Cuarentena , Singapur/epidemiología , Triaje
13.
Rev Soc Bras Med Trop ; 53: e20200048, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32997048

RESUMEN

INTRODUCTION: Malaria case management is a pivotal intervention in malaria elimination. However, many remote areas in Brazil still lack access to basic health services. This study describes a community-based approach (CBA) for malaria case management in the large remote area of the Jaú National Park (JNP), Amazonas, Brazil. METHODS: In 2001, a general health CBA was initiated with a motor group (MG); a participative community health diagnosis (PCHD) was subsequently implemented between 2001 and 2005. In 2006, a CBA for malaria case management started with an expanded MG including all sectors with a stake in malaria control, from the local residents to the federal government. In 2008, community microscopists were selected and trained to diagnose hemoparasites. A full malaria strategy was implemented in 2009 with subsequent quality control follow-up. RESULTS: Two educational materials were co-created with local communities. The MG identified malaria as a major health problem and the malaria MG planned the control activities. Ten communities selected a resident to become malaria microscopists, and ten solar-operated health centers were built. The number of slide readings increased from 923 in 2006 to 1,900 in 2009, while malaria infections decreased from 354 cases in 2005 to 20 cases in 2015. The excess time (≥ 48 hours) between first symptoms and diagnosis/treatment decreased from 68.9% of cases in 2005 to 14.3% in 2010. CONCLUSIONS: While many factors were likely involved in the reduction of malaria transmission in the JNP, the CBA played an important role in the sustained success of the initiative.


Asunto(s)
Manejo de Caso , Servicios de Salud Comunitaria/organización & administración , Malaria , Población Rural , Brasil , Investigación Participativa Basada en la Comunidad , Humanos , Malaria/diagnóstico , Malaria/tratamiento farmacológico , Salud Pública
14.
Washington; Organización Panamericana de la Salud; ago. 5, 2020. 4 p.
No convencional en Español | LILACS | ID: biblio-1116507

RESUMEN

Con la intención de abordar la emergencia a nivel de los Territorios Indígenas, el Gobierno de la República convocó a un equipo de trabajo en asuntos indígenas y salud. El equipo está conformado por funcionarias y funcionarios del Ministerio de Salud, la Caja Costarricense de Seguro Social, la Comisión Nacional de Emergencia, la Comisión Nacional de Asuntos Indígenas, el Ministerio de Justicia y Paz y el Viceministerio de la Presidencia en Asuntos Políticos y Diálogo Ciudadano. Asimismo, cuenta con el apoyo de Sistema de Naciones Unidas en Costa Rica. A partir del trabajo de este equipo, se elabora el "Plan de acción para el abordaje del Covid19 en territorios indígenas", el cual considera como objetivo general implementar acciones estratégicas para la contención, prevención y atención de la emergencia del Covid-19, en los 24 territorios indígenas de Costa Rica, de acuerdo con los lineamientos técnicos para la prevención del Covid-19 en territorios indígenas. Para apoyar integralmente la implementación de este plan, la Organización Panamericana de la Salud/Organización Mundial de la Salud (OPS/OMS), agencia técnica en las temáticas de salud del Sistema de Naciones Unidas, ha iniciado un proceso de contratación de profesionales comunitarios de salud que apoyen el abordaje de la Covid-19 en los territorios indígenas del país.


Asunto(s)
Humanos , Neumonía Viral/epidemiología , Personal de Salud/organización & administración , Infecciones por Coronavirus/epidemiología , Servicios de Salud Comunitaria/organización & administración , Salud de Poblaciones Indígenas , Pandemias/prevención & control , Betacoronavirus , Costa Rica/epidemiología
15.
J Rehabil Med ; 52(8): jrm00089, 2020 Aug 24.
Artículo en Inglés | MEDLINE | ID: mdl-32830284

RESUMEN

OBJECTIVE: COVID-19 is a multisystem illness that has considerable long-term physical, psychological, cognitive, social and vocational sequelae in survivors. Given the scale of this burden and lockdown measures in most countries, there is a need for an integrated rehabilitation pathway using a tele-medicine approach to screen and manage these sequelae in a systematic and efficient way. METHODS: A multidisciplinary team of professionals in the UK developed a comprehensive pragmatic telephone screening tool, the COVID-19 Yorkshire Rehabilitation Screen (C19-YRS), and an integrated rehabilitation pathway, which spans the acute hospital trust, community trust and primary care service within the National Health Service (NHS) service model. RESULTS: The C19-YRS telephone screening tool, developed previously, was used to screen symptoms and grade their severity. Referral criteria thresholds were applied to the output of C19-YRS to inform the decision-making process in the rehabilitation pathway. A dedicated multidisciplinary COVID-19 rehabilitation team is the core troubleshooting forum for managing complex cases with needs spanning multiple domains of the health condition. CONCLUSION: The authors recommend that health services dealing with the COVID-19 pandemic adopt a comprehensive telephone screening system and an integrated rehabilitation pathway to manage the large number of survivors in a timely and effective manner and to enable the provision of targeted interventions.


Asunto(s)
Betacoronavirus , Servicios de Salud Comunitaria/organización & administración , Infecciones por Coronavirus/rehabilitación , Vías Clínicas/organización & administración , Prestación de Atención de Salud/organización & administración , Grupo de Atención al Paciente/organización & administración , Neumonía Viral/rehabilitación , Telemedicina/organización & administración , Servicios de Salud Comunitaria/métodos , Prestación de Atención de Salud/métodos , Humanos , Pandemias , Derivación y Consulta/organización & administración , Medicina Estatal/organización & administración , Sobrevivientes , Telemedicina/métodos , Reino Unido
16.
Pflege ; 33(4): 219-227, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32811324

RESUMEN

Background: COVID-19 has led to a change in care for patients with chronic conditions, involving a transfer of drug administration from an outpatient to a community setting. AIM: To investigate patient preferences for treatment settings in the light of the current pandemic. METHODS: Patients, who prior to the pandemic had attended two different outpatient clinics in a university hospital for their infusions or injections, were interviewed by telephone. The semi-structured interviews were analyzed using qualitative and quantitative methods. RESULTS: Out of 49 patients with either anti-inflammatory or immunoglobulin treatments (response rate: 83 %), 24 (49.0 %) switched from subcutaneous (sc) injections in the hospital to the community setting, 18 (36.7 %) from intravenous infusions (iv) in the hospital to sc administration at home and 7 (14.3 %) moved to iv at home. During the pandemic 38 (80.9 %) wanted to continue their treatment at home, but after the pandemic 22 (46.8 %) would opt to go back to the hospital. Satisfaction was high with both settings, slightly favoring drug administration in hospital. Qualitative data shows that patients while emphasizing the importance of the relationship with the healthcare team, had increased concerns about safety as a result of COVID-19. CONCLUSIONS: The experience during the COVID-19 pandemic has increased self-management-skills in some patients, but long-term follow-up is needed. It has repercussions for future shared decision making for patients and their healthcare teams.


Asunto(s)
Atención Ambulatoria/organización & administración , Enfermedad Crónica/terapia , Servicios de Salud Comunitaria/organización & administración , Infecciones por Coronavirus/epidemiología , Pandemias , Neumonía Viral/epidemiología , Humanos , Prioridad del Paciente/estadística & datos numéricos , Investigación Cualitativa , Medición de Riesgo
17.
AIDS Educ Prev ; 32(3): 181-195, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32749876

RESUMEN

The twin epidemics of HIV and incarceration impact Puerto Rico, which has limited resources to address the social and structural determinants of health in incarcerated populations. A Special Programs of National Significance grant supported a Puerto Rican community-based organization to implement the evidence-informed Transitional Care Coordination intervention among incarcerated persons living with HIV, targeting changes at the individual, organization, and systems levels. After implementation (November 2015-July 2018; n = 69), 93.1% of eligible clients were linked to community-based HIV care, 86.3% remained in care for 6 months, and 78.6% remained for 12 months. A greater proportion reported consistent HIV care, ART adherence, food security, and transportation to access care. Integrating HIV case management with housing and employment services, and developing buy-in and collaboration from partners across systems of care, including after a natural disaster, led to positive client outcomes. This intervention shows promise for adaptation to other HIV care and service delivery systems.


Asunto(s)
Fármacos Anti-VIH/uso terapéutico , Servicios de Salud Comunitaria/organización & administración , Continuidad de la Atención al Paciente , Infecciones por VIH/tratamiento farmacológico , Cumplimiento de la Medicación/estadística & datos numéricos , Prisioneros/estadística & datos numéricos , Cuidado de Transición , Adulto , Femenino , Abastecimiento de Alimentos , Infecciones por VIH/psicología , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Programas y Proyectos de Salud , Puerto Rico , Determinantes Sociales de la Salud
18.
Medicine (Baltimore) ; 99(27): e20967, 2020 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-32629706

RESUMEN

BACKGROUND: Hypertension is a silent disease of the masses with an increasing prevalence and poor control rates. This study aims to establish and test the efficacy of a nurse-led hypertension management model in the community. METHODS: A single-blind, randomized controlled trial was performed. 156 hypertensive patients with uncontrolled blood pressure were equally and randomly allocated into 2 groups. Patients in the study group received a 12-week period of hypertension management. Blood pressure, self-care behaviors, self-efficacy, and satisfaction were assessed at the start of recruitment, 12 and 16 weeks thereafter. RESULTS: After the intervention, blood pressure of patients in the study group had greater improvement in self-care behaviors and a higher level of satisfaction with the hypertensive care compared to the control group (both P < .05). CONCLUSIONS: The nurse-led hypertension management model is feasible and effective for patients with uncontrolled blood pressure in the community.


Asunto(s)
Servicios de Salud Comunitaria/organización & administración , Hipertensión/enfermería , Pautas de la Práctica en Enfermería/normas , Anciano , Antihipertensivos/uso terapéutico , Femenino , Humanos , Hipertensión/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Autocuidado , Autoeficacia , Método Simple Ciego
19.
Clin Med (Lond) ; 20(5): e165-e169, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32680837

RESUMEN

We describe the London community testing programme developed for COVID-19, audit its effectiveness and report patient acceptability and patient adherence to isolation guidance, based upon a survey conducted with participants.Any patients meeting the Public Health England (PHE) case definition for COVID-19 who did not require hospital admission were eligible for community testing. 2,053 patients with suspected COVID-19 were tested in the community between January and March 2020. Of those tested, 75 (3.6%) were positive. 88% of patients that completed a patient survey felt safe and 82% agreed that community testing was preferable to hospital admission. 97% were able to remain within their own home during the isolation period but just 41% were able to reliably isolate from other members of their household.The London community testing programme allowed widespread testing for COVID-19 while minimising patient transport, hospital admissions and staff exposures. Community testing was acceptable to patients and preferable to admission to hospital. Patients were able to reliably isolate in their home but not from household contacts. The authors believe in the importance, feasibility and acceptability of community testing for COVID-19 as a part of a package of interventions to mitigate a second wave of infection.


Asunto(s)
Técnicas de Laboratorio Clínico/estadística & datos numéricos , Servicios de Salud Comunitaria/organización & administración , Infecciones por Coronavirus/diagnóstico , Tamizaje Masivo/organización & administración , Cooperación del Paciente/estadística & datos numéricos , Neumonía Viral/diagnóstico , Infecciones por Coronavirus/epidemiología , Estudios Transversales , Inglaterra , Femenino , Humanos , Londres , Masculino , Pandemias , Neumonía Viral/epidemiología , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Salud Pública
20.
PLoS One ; 15(7): e0235264, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32658921

RESUMEN

OBJECTIVE: To identify health systems-level barriers to treatment for women who screened positive for high-risk human papillomavirus (hrHPV) in a cervical cancer prevention program in Kenya. METHODS: In a trial of implementation strategies for hrHPV-based cervical cancer screening in western Kenya in 2018-2019, women underwent hrHPV testing offered through community health campaigns, and women who tested positive were referred to government health facilities for cryotherapy. The current analysis draws on treatment data from this trial, as well as two observational studies that were conducted: 1) periodic assessments of the treatment sites to ascertain availability of resources for treatment and 2) surveys with treatment providers to elicit their views on barriers to care. Bivariate analyses were performed for the site assessment data, and the provider survey data were analyzed descriptively. RESULTS: Seventeen site assessments were performed across three treatment sites. All three sites reported instances of supply stockouts, two sites reported treatment delays due to lack of supplies, and two sites reported treatment delays due to provider factors. Of the 16 providers surveyed, ten (67%) perceived lack of knowledge of HPV and cervical cancer as the main barrier in women's decision to get treated, and seven (47%) perceived financial barriers for transportation and childcare as the main barrier to accessing treatment. Eight (50%) endorsed that providing treatment free of cost was the greatest facilitator of treatment. CONCLUSION: Patient education and financial support to reach treatment are potential areas for intervention to increase rates of hrHPV+ women presenting for treatment. It is also essential to eliminate barriers that prevent treatment of women who present, including ensuring adequate supplies and staff for treatment.


Asunto(s)
Crioterapia/estadística & datos numéricos , Detección Precoz del Cáncer/estadística & datos numéricos , Tamizaje Masivo/estadística & datos numéricos , Infecciones por Papillomavirus/terapia , Neoplasias del Cuello Uterino/prevención & control , Adulto , Servicios de Salud Comunitaria/economía , Servicios de Salud Comunitaria/organización & administración , Servicios de Salud Comunitaria/estadística & datos numéricos , Crioterapia/economía , Detección Precoz del Cáncer/economía , Femenino , Asignación de Recursos para la Atención de Salud/economía , Asignación de Recursos para la Atención de Salud/organización & administración , Asignación de Recursos para la Atención de Salud/estadística & datos numéricos , Conocimientos, Actitudes y Práctica en Salud , Implementación de Plan de Salud/economía , Implementación de Plan de Salud/organización & administración , Implementación de Plan de Salud/estadística & datos numéricos , Promoción de la Salud/economía , Promoción de la Salud/organización & administración , Promoción de la Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/economía , Accesibilidad a los Servicios de Salud/organización & administración , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Fuerza Laboral en Salud/organización & administración , Fuerza Laboral en Salud/estadística & datos numéricos , Humanos , Kenia/epidemiología , Tamizaje Masivo/economía , Tamizaje Masivo/organización & administración , Estudios Observacionales como Asunto , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/epidemiología , Infecciones por Papillomavirus/virología , Educación del Paciente como Asunto , Derivación y Consulta/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Neoplasias del Cuello Uterino/epidemiología , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/virología
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