ABSTRACT
Family-centered care is an approach to promote the health and well-being of children with chronic diseases and their families. This study aims to explore the knowledge components, structures, and research trends related to family-centered care for children with chronic conditions. We conducted the keyword network analysis in three stages using the keywords provided by the authors of each study: (1) search and screening of relevant studies, (2) keyword extraction and refinement, and (3) data analysis and visualization. The core keywords were child, adolescence, parent, and disabled. Four cohesive subgroups were identified through degree centrality. Research trends in the three phases of a recent decade have been changed. With the systematic understanding of the context of the knowledge structure, the future research and effective strategy establishment are suggested based on family-centered care for children with chronic disease.
Subject(s)
Patient-Centered Care , Humans , Chronic Disease/therapy , Child , Adolescent , Patient-Centered Care/trends , Family/psychologyABSTRACT
INTRODUCTION: The second COPD Biennial organized by the COPD working group of the French Society of Respiratory Diseases took place in Paris (Cochin) on 13th December 2023. STATE OF THE ART: Major trends in 2023 were discussed; they encompassed concepts, definitions, biologics, care pathways, pulmonary rehabilitation and complex situations entailed by respiratory infections, cardiovascular comorbidities and pulmonary hypertension, and modalities of oxygen therapy and ventilation. PERSPECTIVES: The different talks underlined major changes in COPD including the concepts of pre-COPD, etiotypes, health trajectories and new definitions of exacerbation. Recent results in biologics for COPD open the door to new pharmacological options. Assessment of current care pathways in France highlighted some causes for concern. For example, pulmonary rehabilitation is a key but insufficiently practiced element. Respiratory infections require careful assessment and treatments. Diagnosis and treatment of cardiovascular comorbidities and pulmonary hypertension are of paramount importance. As of late, oxygen therapy and ventilation modalities have evolved, and are beginning to afford more personalized options. CONCLUSIONS: As regards COPD, a personalized approach is crucial, placing the patient at the center of the care pathway and facilitating coordination between healthcare providers.
Subject(s)
Critical Pathways , Pulmonary Disease, Chronic Obstructive , Societies, Medical , Humans , Pulmonary Disease, Chronic Obstructive/therapy , Pulmonary Disease, Chronic Obstructive/epidemiology , Pulmonary Disease, Chronic Obstructive/rehabilitation , France/epidemiology , Critical Pathways/organization & administration , Critical Pathways/standards , Critical Pathways/trends , Societies, Medical/organization & administration , Societies, Medical/standards , Patient-Centered Care/organization & administration , Patient-Centered Care/trends , Patient-Centered Care/standards , Pulmonary Medicine/organization & administration , Pulmonary Medicine/trends , Pulmonary Medicine/methods , Pulmonary Medicine/standards , Congresses as TopicABSTRACT
Las guías de práctica clínica han contribuido a resolver un problema al sintetizar la evidencia y ponerla al alcance del profesional sanitario, pero su desarrollo e implementación creciente en los últimos años ha dado lugar a nuevos inconvenientes que aún no han sido resueltos. En este artículo editorial, la autora repasa cuestiones no tenidas en cuenta por las guías de práctica clínica, incluso aquellas consideradas de buena calidad de acuerdo a los estándares actuales, y reflexiona en especial sobre el uso del tiempo de los médicos en la consulta, aspecto desatendido que atenta contra la sustentabilidad del modelo actual de cuidado propuesto por estas recomendaciones. (AU)
Clinical practice guidelines have contributed to solving a problem by synthesizing the evidence and making it available to healthcare professionals, but their development and increasing implementation in recent years has given rise to new problems that have not yet been resolved. In this editorial article, the author reviews issues not taken into account by clinical practice guidelines, even those considered to be of good quality according to current standards, and reflects inparticular on the use of physicians' time in the consultation, a neglected aspect that undermines the sustainability of the current care model proposed by these recommendations. (AU)
Subject(s)
Humans , Quality of Health Care , Practice Guidelines as Topic , Patient Participation/trends , Patient-Centered Care/trends , Decision Making , Evidence-Based Practice/trends , Patient Preference , MultimorbidityABSTRACT
En este artículo los autores explican la evolución histórica del estigma de la obesidad y las consecuencias de su internalización sobre la salud de las personas que lo sufren. Hacen especial hincapié en las conductas del equipo de salud que refuerzan este estigma, basadas en la gordofobia que también afecta a este colectivo profesional como integrante de nuestra sociedad. Por último, describen algunas iniciativas políticas destinadas a modificar la opresión, la discriminación y la vulneración de los derechos humanos que sufren las personas obesas, como lo son el activismo gordo y una propuesta canadiense para el equipo de salud que pretende ofrecer un marco de atención de las personas con sobrepeso u obesidad orientado a la persona y su entorno, alentándolas a desarrollar autoestima y autoeficacia. (AU)
In this article, the authors explain the historical evolution of the stigma of obesity and the consequences of its internalization on the health of people who suffer from it. They place special emphasis on the behaviors of the health team that reinforce this stigma, based on the fatphobia that also affects this professional group as a member of our society. Finally, they describe some political initiatives aimed at modifying the oppression, discrimination and violation of human rights suffered by obese people, such asfat activismand a Canadian proposal for the health team that aims to offer a framework of carefor overweight or obese people oriented to the person and their environment, encouraging them to develop self-esteemand self-efficacy. (AU)
Subject(s)
Humans , Attitude of Health Personnel , Patient-Centered Care/trends , Weight Prejudice/trends , Human Rights Abuses , Social Discrimination , Obesity/psychologyABSTRACT
Este libro intenta compartir los aportes técnicos de los enfoques con las vivencias emocionales recogidas en múltiples relatos. Contiene descripciones rigurosas de las dos disciplinas que confluyen, la medicina narrativa y los cuidados humanizados, así como de las medidas adoptadas en la organización del hospital y la asistencia. Suma a esos contenidos el relato de la experiencia en todo el enfoque humanístico de la crisis, de la reflexión grupal en los talleres, las estrategias adoptadas para la resolución de problemas complejos como las visitas, el aislamiento y los cuidados del final de la vida. En cada tema, aporta textos comprometidos y personales de los actores y diversos profesionales de la salud que comparten sus emociones y conmociones en la circunstancia extrema de la pandemia. (AU)
Subject(s)
Patient-Centered Care/trends , Pandemics , Narrative Medicine/trends , Patient Care/trends , COVID-19/therapyABSTRACT
OBJETIVO: La calidad en la humanización de la asistencia sanitaria implica el cuidado integral de los pacientes, considerando todas las facetas de la persona, incluida también su dimensión espiritual y religiosa. El objetivo de este estudio fue conocer la visión de los profesionales respecto al cuidado de esta dimensión en los pacientes atendidos en un hospital comarcal. METODOS: Se realizó un estudio descriptivo transversal, mediante una encuesta ad-hoc a profesionales sanitarios con 30 cuestiones (según escala de Likert, de 0=totalmente en desacuerdo a 4=totalmente de acuerdo), realizada en abril de 2017. El tamaño muestral necesario fue de 238. Se analizó con SPSS v19.0, se describieron la frecuencia absoluta y el porcentaje de acuerdos con cada cuestión, y se usó Chi-Cuadrado para valorar la asociación de las respuestas con el sexo y la categoría profesional, y ANOVA para la edad. RESULTADOS: Se reclutaron 302 participantes. El 95,5% de mujeres destacó la importancia de crear un ambiente para que el paciente exprese su dimensión espiritual y/o religiosa, frente al 87,6% de hombres. A mayor edad, los profesionales diferenciaron mejor los conceptos de espiritualidad y religiosidad, y coincidieron en que ambas dimensiones afectaban al enfermo (diferencias entre 5-8 años de edad media). Los médicos estuvieron más de acuerdo con la importancia de la espiritualidad, seguidos de los enfermeros y los auxiliares, con diferencias significativas en 17 cuestiones. CONCLUSIONES: Los profesionales reconocen la importancia de cuidar la dimensión espiritual y/o religiosa, con algunas diferencias entre categorías profesionales, sexo y edad. La formación en estos temas favorecería una atención más integral y de calidad en la asistencia
OBJECTIVE: To treat whole patient, spiritual and religious dimension included, allows improve the quality humanization healthcare. The aim of this study was to know the point of professional view regarding to assess this dimensions in patients attended in regional hospital. METHODS: Cross-sectional descriptive study, through an ad-hoc survey with 30 issues (Likert 0: strongly disagree with 4: strongly agree), to health professionals, conducted in April 2017. Necessary sample size: 238. The SPSS (v19.0) statistical analysis was used. We calculated the absolute frequency and percentage of answers with each question and we used Chi-Square to assess the association of the answers with sex and professional category and ANOVA for age. RESULTS: We recruited 302 participants. 95.5% of women stand out the importance of creating an environment to express their spiritual and/or religious dimension the patient, compared to 87.6% of men (p = 0.017). At an older age, professionals differentiated the concepts of spirituality and religiosity better and agreed that both dimensions affected the patient (differences between 5-8 years of average age). The doctors were more in agreement with the importance of spirituality, followed by nurses and less auxiliaries, with significant differences in 17 issues. CONCLUSIONS: The professionals recognized the importance of taking care of the spiritual and/or religious dimension, with some differences between professional categories, sex and age. Training in these subjects would favor a more comprehensive and quality assistance
Subject(s)
Humans , Male , Female , Young Adult , Adult , Middle Aged , Humanization of Assistance , Spirituality , Comprehensive Health Care/methods , Empathy , Patient-Centered Care/trends , Attitude of Health Personnel , Cross-Sectional Studies , Health Care Surveys/statistics & numerical data , Quality of Health Care/statistics & numerical dataABSTRACT
No disponible
Subject(s)
Humans , Patient-Centered Care/methods , Education, Medical , Patient-Centered Care/trends , Clinical CompetenceABSTRACT
El tratamiento percutáneo de la enfermedad coronaria y determinadas enfermedades cardiovasculares estructurales ha experimentado un desarrollo espectacular. Cada vez se trata a un mayor número de pacientes con diferentes tipos de cardiopatías mediante intervenciones percutáneas o transcatéter, mientras que este incremento no se observa en los pacientes sometidos a cirugía cardiaca. Esta situación ha motivado diferentes posicionamientos que requieren un análisis objetivo que considere todos los aspectos que pueden influir en esta evolución. En este documento se evalúan las 2 situaciones en que el problema es más manifiesto: la revascularización coronaria y el tratamiento de la estenosis aórtica. El artículo analiza la situación de la revascularización coronaria en España y las causas que pueden explicar las diferencias existentes entre el número de pacientes que actualmente se someten a revascularización percutánea respecto a los que se someten a cirugía coronaria. Por otra parte, el implante percutáneo de válvula aórtica mediante catéter en el tratamiento de la estenosis aórtica condicionará una previsible reducción del número de pacientes candidatos a tratamiento mediante recambio quirúrgico. Diferentes sociedades científicas internacionales han publicado los requisitos de formación y experiencia y los volúmenes exigidos a los operadores y centros para desarrollar un programa de implante percutáneo de válvula aórtica, condiciones que la Sociedad Española de Cardiología, situando al paciente en el centro del proceso asistencial, considera como absolutamente imprescindibles. Teniendo en cuenta que ambas formas de intervención (percutánea y quirúrgica) son procedimientos complementarios, la valoración multidisciplinaria de los pacientes (Heart Team) sigue siendo de extrema necesidad para poder ofrecerles la mejor opción de tratamiento. En este escenario de aproximaciones diversas, la figura del cardiólogo clínico adquiere una relevancia clave. Por último, la evolución que está experimentando el tratamiento de la enfermedad estructural obligará en el futuro a realizar procedimientos en los que se requiera la actuación conjunta de profesionales de ambas especialidades. Este acercamiento exigirá un rediseño de los programas de formación actualmente existentes
The percutaneous treatment of coronary artery disease and some structural cardiovascular diseases has undergone spectacular changes. More and more patients with different types of heart disease are being treated by percutaneous or transcatheter interventions, with no such increase in patients undergoing cardiac surgery. This situation has led to different types of approach, requiring an objective analysis that includes all the factors possibly influencing these changes. This document assesses the 2 scenarios where this problem is most evident: coronary revascularization and the treatment of aortic stenosis. The document analyzes the situation of coronary revascularization in Spain, and the causes that may explain the differences between the number of patients who currently undergo percutaneous revascularization and those who undergo coronary surgery. In contrast, treatment of aortic stenosis through transcatheter aortic valve implantation will lead to a foreseeable reduction in the number of candidates for surgical replacement. Several international scientific societies have published the requirements on training and experience and the necessary operator and center volumes to implement a transcatheter aortic valve implantation program, conditions that the Spanish Society of Cardiology, adopting a patient-centered approach, considers absolutely essential. Given that the 2 forms of intervention (percutaneous and surgical) are complementary, multidisciplinary patient assessment (Heart Team) remains crucial to offer the best treatment option. In this scenario of diverse approaches, a key figure is the clinical cardiologist. Finally, the changes currently occurring in the treatment of structural heart disease will, in future, lead to the performance of procedures requiring the participation of professionals from both specialties. This approach will require a redesign of current training programs
Subject(s)
Humans , Percutaneous Coronary Intervention/statistics & numerical data , Cardiac Surgical Procedures/statistics & numerical data , Cardiovascular Diseases/surgery , Coronary Disease/surgery , Aortic Valve Stenosis/surgery , Transcatheter Aortic Valve Replacement/statistics & numerical data , Consensus , Patient-Centered Care/trends , Practice Patterns, Physicians'ABSTRACT
No disponible
Subject(s)
Humans , Humanization of Assistance , Health Services Accessibility/trends , Quality Improvement/organization & administration , Quality of Health Care/trends , Patient Satisfaction , Patient-Centered Care/trendsABSTRACT
No disponible
Subject(s)
Humans , Radiology/trends , Patient-Centered Care/trends , Diagnostic Imaging/trends , Patient Safety , Quality Improvement/trends , Patient Satisfaction , Physician-Patient RelationsABSTRACT
Antecedentes. El modelo biopsicosocial propone que la atención de la salud se centre en las necesidades de las personas.Sin embargo, no siempre los profesionales de la salud conocen adecuadamente lo que esperan de los encuentros clínicos sus pacientes. Objetivo. Explorar las expectativas respecto de sus encuentros clínicos de los/as pacientes atendidos por médicos de familia en un Centro de Salud de Atención Primaria del Conurbano Bonaerense (Buenos Aires, Argentina). Métodos. Estudio observacional descriptivo de corte transversal llevado a cabo sobre una muestra consecutiva de pacientes que acudieron a las consultas médicas de un centro de salud. Se les pidió a los pacientes que de un listado de diez potenciales expectativas, valoraran y priorizaran las más importantes para esa consulta. Resultados. Fueron entrevistadas 146 personas (91 % mujeres) con una mediana de edad de 30 años.Las expectativas más mencionadas (94 % de las personas encuestadas) fueron que el médico demuestre interés y escuche a sus pacientes, y que les brinde explicaciones sobre sus problemas y dudas. Conclusiones. Hemos podido documentar que las expectativas de nuestros pacientes respecto de sus entrevistas clínicas están muy vinculadas a su componente actitudinal (predisposición a escuchar con interés sus problemas) y al de las habilidades comunicacionales del profesional de la salud (explicaciones). (AU)
Background. The biopsychosocial model proposes that health care focus on the needs of people. However, health profes-sionals do not always know what their patients expect from clinical meetings. Objective. To explore the expectations regarding their clinical meetings of the patients attended by family doctors in aPrimary Health Care Center of Buenos Aires, Argentina. Methods. Descriptive cross-sectional observational study carried out on a consecutive sample of patients who attendedthe medical consultations of a health center. Patients were asked to rate and prioritize the most important ones for thatconsultation from a list of ten potential expectations. Results. 146 people (91 % women) with a median age of 30 years were interviewed.The most mentioned expectations (94 % of the people surveyed) were for the doctor to show interest and listen to theirpatients, and to give them explanations about their problems and doubts. Conclusions. We have been able to document that our patients' expectations regarding their clinical interviews are closelylinked to their attitudinal component (predisposition to listen with interest to their problems) and to the communication skillsof the healthcare professional (explanations). (AU)
Subject(s)
Humans , Male , Female , Adult , Young Adult , Patient Satisfaction , Family Practice/trends , Argentina , Physician-Patient Relations , Physicians, Family/trends , Primary Health Care/trends , Quality Assurance, Health Care/trends , Quality of Health Care/trends , Cross-Sectional Studies/statistics & numerical data , Clinical Competence , Patient-Centered Care/trends , Empathy , Patient Preference/psychology , Health Communication/methodsABSTRACT
ABSTRACT Objective: to evaluate the association of Obstetric Nursing in the best practices of delivery and birth care in maternity hospitals. Method: a cross-sectional study, with 666 women selected for delivery. Parturition obstetric practices performed by professionals were categorized into: clearly useful practices that should be encouraged, practices that are clearly harmful or ineffective and that should be eliminated and practices used inappropriately at the time of parturition. Results: clearly useful practices were used in greater proportions in the hospitals that had Obstetric Nursing working, while clearly harmful practices and those used inappropriately were practiced in smaller proportions in hospitals that had Obstetric Nursing, both with statistical difference. Conclusion: institutions with Obstetric Nursing adopt better practices of delivery and birth care, based on scientific evidence, when compared to those that do not act.
RESUMEN Objetivo: evaluar la asociación de la Enfermería Obstétrica en las buenas prácticas de la asistencia al parto y el nacimiento en maternidades. Método: estudio transversal, con 666 mujeres seleccionadas con ocasión de la realización del parto. Las prácticas obstétricas realizadas por los profesionales que asistían al proceso de parturición se clasificaron en: prácticas claramente útiles y que deben ser estimuladas, prácticas claramente perjudiciales o ineficaces y que deben ser eliminadas y prácticas utilizadas de modo inapropiado en el parto. Resultados: las prácticas claramente útiles fueron utilizadas en mayores proporciones en los hospitales que poseían la Enfermería Obstétrica actuante, mientras prácticas claramente perjudiciales y aquellas usadas de modo inapropiado fueron practicadas en menores proporciones en hospitales que poseían la Enfermería Obstétrica, ambas con diferencia estadística. Conclusión: las instituciones con Enfermería Obstétrica adoptan mejores prácticas de atención al parto y nacimiento, basadas en evidencias científicas, cuando comparadas a las que no actúa.
RESUMO Objetivo: avaliar a associação da Enfermagem Obstétrica nas boas práticas da assistência ao parto e nascimento em maternidades. Método: estudo transversal, com 666 mulheres selecionadas por ocasião da realização de parto. As práticas obstétricas realizadas pelos profissionais que assistiam o processo de parturição foram categorizadas em: práticas claramente úteis e que devem ser estimuladas, práticas claramente prejudiciais ou ineficazes e que devem ser eliminadas e práticas usadas de modo inapropriado no momento de parturição. Resultados: práticas claramente úteis foram utilizadas em maiores proporções nos hospitais que possuíam a Enfermagem Obstétrica atuante, enquanto práticas claramente prejudiciais e aquelas usadas de modo inapropriado foram praticadas em menores proporções em hospitais que possuíam a Enfermagem Obstétrica, ambas com diferença estatística. Conclusão: instituições com Enfermagem Obstétrica adotam melhores práticas de atenção ao parto e nascimento, baseadas em evidências científicas, quando comparadas às que ela não atua.
Subject(s)
Humans , Female , Pregnancy , Adult , Practice Guidelines as Topic/standards , Patient-Centered Care/trends , Obstetric Nursing/standards , Cross-Sectional Studies , Perinatal Care , Patient-Centered Care/standards , Obstetric Nursing/trendsABSTRACT
Health systems are moving away from traditional primary care (e.g., by increasingly shifting to group practice and interprofessional teams rather than solo practice primary-care providers), which is often siloed and results in barriers to timely access to care.(1) The Ministry of Health of British Columbia, which requested this rapid synthesis, is undergoing system transformation to better coordinate and potentially integrate primary care with some and community care and public-health services.(2) The transformation presents an important opportunity to improve primary care and preventive care services through improved management of clinical conditions coupled with health promotion and diseaseprevention services.
Subject(s)
Primary Health Care/trends , Patient-Centered Care/trends , Health Promotion/organization & administration , British ColumbiaABSTRACT
En el presente trabajo se analiza el concepto de Experiencia del Paciente (PX) así como las variables que contribuyen a la mejora del mismo. El objetivo es explicar su utilidad clínica en el ámbito de la salud, en concreto sobre la población oncológica, además de demostrar el papel activo que la Psicooncología puede tener en la implementación de esta estrategia, en relación directa con la humanización de la asistencia sanitaria. Para ello, se ha revisado la literatura con evidencia empírica existente hasta el momento y que sitúa la experiencia del paciente como un pilar indispensable a la hora de mejorar la calidad de la atención clínica, junto con la efectividad del tratamiento y la seguridad del paciente. Estos elementos presentan una interacción positiva entre ellos y están moderados por la comunicación médico-paciente, lo que evidencia la necesidad de desarrollar habilidades de comunicación por los profesionales en la práctica clínica, la coordinación de la atención sanitaria, el acceso a los servicios y la percepción del paciente respecto a la atención recibida. La experiencia del paciente resulta clínicamente relevante e influyente en la recuperación del estado de salud del paciente, así como constituye un cambio en la cultura sanitaria, cuyo protagonista es el paciente y en torno a él debe girar dicho cambio de manera multidisciplinar e integral por parte de los profesionales sanitarios implicados en su cuidado. Se concluye con una nueva línea de actuación del psicooncólogo en la experiencia del paciente para promover un servicio oncológico de calidad (AU)
In the present paper, the concept of Patient Experience (PX) is analyzed, as well as the variables that contribute to its improvement. The aim is to explain its clinical utility in the field of health, specifically on the oncology population, in addition to demonstrating the active role that Psychooncology can have in the implementation of this strategy, in direct relation with the humanization of health care. For this, the literature has been reviewed with empirical evidence that has existed up to now and which places the patient's experience as an essential pillar when improving the quality of clinical care, together with the effectiveness of treatment and patient safety. These elements present a positive interaction between them and are moderated by the doctor-patient communication, which evidences the need to develop communication skills by professionals in clinical practice, the coordination of healthcare, access to services and perception of the patient regarding the care received. The patient's experience is clinically relevant and influential in the recovery of the health status of the patient, as well as constitutes a change in the health culture, whose protagonist is the patient and around him must turn this change in a multidisciplinary and integral way of the health professionals involved in their care. It is concluded with a new line of action of the psycho-oncologist in the patients experience to promote a quality oncological service (AU)
Subject(s)
Humans , Neoplasms/psychology , Patient Satisfaction/statistics & numerical data , Patient-Centered Care/trends , Humanization of Assistance , Patient Participation , Patient Compliance/statistics & numerical data , Hospital Communication Systems/trendsABSTRACT
No disponible
Subject(s)
Humans , Family Practice/trends , Physician-Patient Relations , Patient-Centered Care/trends , UncertaintyABSTRACT
Providing care that is person-centred is a key goal for provincial and territorial health systems in Canada.(1) This is demonstrated by a number of provinces having recently put forward legislation or key strategies working towards this aim. For example, in 2014, the Ministry of Health of British Columbia (where this rapid synthesis was requested from) released their strategic plan, Setting Priorities for the B.C. Health System, which posited that the province's health system needed improvement with respect to meeting the needs of key patient populations.(2) The plan listed providing patient-centred care as one of the eight priorities for the healthcare system and reiterated its importance in the 2015 report - B.C. Health System Strategy Implementation.(
Subject(s)
Patient-Centered Care/legislation & jurisprudence , Patient Care/methods , Canada , Patient-Centered Care/trendsABSTRACT
No disponible
Subject(s)
Humans , Digestive System Neoplasms/surgery , Digestive System Surgical Procedures/trends , Patient-Centered Care/trendsABSTRACT
En los 70, la manera en que se escuchaba a los pacientes se basó en medir su satisfacción con un episodio concreto en el que se había recibido asistencia sanitaria. A principios del siglo XXI fue evidente que el papel asignado al paciente en su relación con los profesionales y sistemas sanitarios necesitaba reorientarse. Los enfoques de atención centrada en el paciente supusieron un reto organizativo, actitudinal y profesional, en el que todavía están inmersas las organizaciones sanitarias. En este entorno se desarrolló la medida de experiencia del paciente, que guarda directa relación con el objetivo de las organizaciones sanitarias de proporcionar una atención centrada en el paciente
In the 1970s, patients' satisfaction measures were based on listening to what patients had to say, relating it to a unique procedure. In the 21st century, it became evident that the role assigned to the patient in his/her relationship with health professionals and healthcare organizations needed to be reoriented. The Patient-centered approaches involved an organizational, attitudinal, and professional challenge in which health organizations are still immersed. The patient experience measure was developed according to healthcare organizations goal to provide patient-centered care