Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 97.113
Filtrar
1.
Rev. Esc. Enferm. USP ; 53: e03495, Jan.-Dez. 2019.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1020381

RESUMO

RESUMO Objetivo Descrever o ambiente de trabalho e reconhecer os riscos ocupacionais a que a equipe do Consultório na Rua está exposta, bem como as medidas preventivas aplicáveis segundo a percepção dos profissionais integrantes da equipe. Método Pesquisa qualitativa, exploratória, descritiva, realizada com profissionais representantes das seis equipes de Consultório na Rua existentes em um estado do Nordeste brasileiro. As informações foram coletadas a partir da técnica de grupo focal, e os dados foram analisados à luz da análise temática. Resultados Participaram 14 profissionais. O ambiente de trabalho foi descrito como de tensões, dificuldades e vulnerabilidades, mas também de crescimento pessoal. Foram reconhecidos riscos ocupacionais ocasionados por fatores físicos, biológicos, químicos, de acidentes e psicossociais. As medidas de prevenção utilizadas foram predominantemente tecnologias leves. Sugeriu-se a inclusão de novos equipamentos de proteção individual. Conclusão A reflexão grupal sobre o ambiente e processo de trabalho permitiu o reconhecimento de seus riscos, dificuldades e desafios, demonstrando a necessidade de implementação de medidas de enfrentamento dos fatores identificados.


RESUMEN Objetivo Describir el ambiente laboral y reconocer los riesgos ocupacionales a que está expuesto el equipo del Consultorio en la Calle, así como las medidas preventivas aplicables según la percepción de los profesionales integrantes del equipo. Método Investigación cualitativa, exploratoria, descriptiva, realizada con profesionales representantes de los seis equipos del Consultorio en la Calle existentes en un Estado del Nordeste brasileño. Las informaciones fueron recogidas mediante la técnica de grupo focal, y los datos fueron analizado a la luz del análisis temático. Resultados Participaron 14 profesionales. El ambiente de trabajo fue descrito como de tensiones, dificultades y vulnerabilidades, pero también de crecimiento personal. Fueron reconocidos los riesgos ocupacionales ocasionados por factores físicos, biológicos, químicos, de accidentes y psicosociales. Las medidas de prevención utilizadas fueron predominantemente tecnologías ligeras. Se sugirió la inclusión de nuevos equipos de protección individual. Conclusión La reflexión en grupo acerca del ambiente y el proceso laboral permitió el reconocimiento de sus riesgos, dificultades y retos, demostrando la necesidad de implementación de medidas de enfrentamiento de los factores identificados.


ABSTRACT Objective To describe the work environment and recognize the occupational hazards to which Street Medical Consultation teams are exposed, as well as the applicable preventive measures according to the perception of the professionals who are part of the team. Method A qualitative, exploratory and descriptive study carried out with professionals representing the six Street Medical Consultation teams existing in a Northeast Brazilian state. The information was collected from the focus group technique, and the data were analyzed by the thematic analysis technique. Results Fourteen (14) professionals participated. The work environment was described as stressful, with difficulties and vulnerabilities, but also enabling personal growth. Occupational risks caused by physical, biological, chemical, accident and psychosocial factors were recognized. Implemented preventive measures were predominantly light technologies. New personal protective equipment was suggested to be included/used. Conclusion The group reflection on the environment and work process enabled recognizing its risks, difficulties and challenges, demonstrating the need to implement measures to address the identified factors.


Assuntos
Humanos , Ambiente de Trabalho , Pessoas em Situação de Rua , Riscos Ocupacionais , Saúde do Trabalhador , Grupos Focais/métodos , Assistência à Saúde , Pesquisa Qualitativa , Enfermagem de Atenção Primária
2.
J Clin Ethics ; 30(3): 251-261, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31573970

RESUMO

Our aim in this article is to define the difficulties that clinical ethics services encounter when they are asked to demonstrate the value a clinical ethics service (CES) could and should have for an institution and those it serves. The topic emerged out of numerous related presentations at the Un-Conference hosted by the Cleveland Clinic in August 2018 that identified challenges of articulating the value of clinical ethics work for hospital administrators. After a review these talks, it was apparent that the field of clinical ethics may be at a crisis of sorts due to increased pressure to provide explicit measures to healthcare institutions to concretely demonstrate that CESs make a valuable difference in healthcare delivery. In this article we grapple with how to satisfy the need for demonstrable value in a field in which metrics alone may not capture the scope of clinical ethics practice. We suggest that capturing the value of a CES has been difficult because the benefits of ethics consultation may be overt or attributable to the CES, but are often hidden due to the systems-level and process-oriented nature of clinical ethics work. Part of the difficulty in demonstrating the value of CESs is capturing and conveying all of the ways the integration of a CES throughout an institution positively affects patients, families, visitors, healthcare professionals, administrators, and the institution itself. Our aim is to (1) elucidate the multifaceted value added by a CES, including value that tends to be hidden and (2) suggest how to demonstrate value to others in a way that is not simplistic or reductionistic.


Assuntos
Consultoria Ética , Ética Clínica , Administradores Hospitalares , Assistência à Saúde , Humanos
3.
J Clin Ethics ; 30(3): 262-269, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31573971

RESUMO

Debates regarding clinical ethicists' scope of practice are not novel and will continue to evolve. Rapid changes in healthcare delivery, outcomes, and expectations have necessitated flexibility in clinical ethicists' roles whereby hospital-based clinical ethicists are expected to be woven into the institutional fabric in a way that did not exist in more traditional relationships. In this article we discuss three emerging roles: the ethicist embedded in the interdisciplinary team, the ethicist with an expanded educational mandate, and the ethicist as a therapeutic presence in the patient care space. Such expanded capacities offer more robust, positive contributions to institutional culture, stakeholders' relationships, and patient-centered care.


Assuntos
Eticistas , Hospitais , Assistência Centrada no Paciente , Assistência à Saúde , Humanos , Assistência Centrada no Paciente/ética
4.
J Clin Ethics ; 30(3): 284-296, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31573973

RESUMO

Scholars and professional organizations in bioethics describe various approaches to "quality assessment" in clinical ethics. Although much of this work represents significant contributions to the literature, it is not clear that there is a robust and shared understanding of what constitutes "quality" in clinical ethics, what activities should be measured when tracking clinical ethics work, and what metrics should be used when measuring those activities. Further, even the most robust quality assessment efforts to date are idiosyncratic, in that they represent evaluation of single activities or domains of clinical ethics activities, or a range of activities at a single hospital or healthcare system. Countering this trend, iin this article we propose a framework for moving beyond our current ways of understanding clinical ethics quality, toward comprehensive quality assessment. We first describe a way to conceptualize quality assessment as a process of measuring disparate, isolated work activities; then, we describe quality assessment in terms of tracking interconnected work activities holistically, across different levels of assessment. We conclude by inviting future efforts in quality improvement to adopt a comprehensive approach to quality assessment into their improvement practices, and offer recommendations for how the field might move in this direction.


Assuntos
Bioética , Ética Clínica , Assistência à Saúde , Humanos , Melhoria de Qualidade
5.
Pan Afr Med J ; 33: 159, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31565121

RESUMO

Introduction: Hospital-based surveillance programs only capture people presenting to facilities and may underestimate disease burden. We conducted a healthcare utilisation survey to characterise healthcare-seeking behaviour among people with common infectious syndromes in the catchment areas of two sentinel surveillance hospitals in Johannesburg, South Africa. Methods: A cross-sectional survey was conducted within three regions of Johannesburg from August to November 2015. Premises were randomly selected from an enumerated list with data collected on household demographics and selected syndromes using a structured questionnaire. Fisher's exact or chi-square tests were used to determine association of characteristics among different regions. Results: Of 3650 selected coordinates, 3358 were eligible dwellings and 2930 (87%) households with 9850 individuals participated. Four percent of participants (431/9850) reported influenza-like illness (ILI) in the last 30 days; equal numbers of participants (0.2%, 20/9850) reported pneumonia or tuberculosis symptoms in the last year and <1% reported diarrhoea or meningitis symptoms. Sixty eight percent (295/431) of participants who reported ILI, 75% (6/8) of children with diarrhoea and all participants who reported pneumonia (20), tuberculosis (20) or meningitis (6) sought healthcare. For all syndromes most sought care at registered healthcare providers. Of these only 10% (24/237) attended sentinel hospitals, predominantly those that lived closer to the hospitals. In contrast, of patients with meningitis, 50% (3/6) sought care at sentinel hospitals. Conclusion: Patterns of seeking healthcare differed by syndrome and distance from facilities. Surveillance programs are still relevant in collecting information on infectious syndromes and reflect a proportion of the hospital's catchment area.


Assuntos
Doenças Transmissíveis/epidemiologia , Assistência à Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Vigilância de Evento Sentinela , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Doenças Transmissíveis/terapia , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , África do Sul/epidemiologia , Inquéritos e Questionários , Síndrome , Adulto Jovem
6.
Ther Umsch ; 76(5): 267-272, 2019.
Artigo em Alemão | MEDLINE | ID: mdl-31577184

RESUMO

Functional body disorders Abstract. By definition, functional disorders cannot be conceptualized bio-morphologically at the organ level. They originate on the basis of dysregulated control processes and perceptional alterations at a superordinate level of the organism. Under excessive stress, any vegetatively regulated system might develop functional disorders. Hence they can also be observed in veterinary medicine. The «incongruence¼ between the organic findings and the symptoms reported represents a diagnostic challenge, which general practitioners, due to the high prevalence of functional disorders are confronted with on a daily basis. Therefore a comprehensible explanatory model is needed in order to build trust and to motivate the patient for treatment. The new S3 guidelines «functional disorders¼ provide constructive and pragmatic information for the adequate treatment of patients with functional disorders.


Assuntos
Clínicos Gerais , Transtornos Somatoformes , Assistência à Saúde , Humanos , Prevalência
10.
N C Med J ; 80(5): 306-311, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31471516

RESUMO

Given the known impacts of social, behavioral, and economic factors on health and longevity, health policy reforms are being developed and deployed at both the state and federal levels that support the integration and alignment of health care and social services.


Assuntos
Acesso aos Serviços de Saúde/organização & administração , Determinantes Sociais da Saúde , Assistência à Saúde/organização & administração , Política de Saúde , Humanos , Programas de Rastreamento , North Carolina , Encaminhamento e Consulta , Serviço Social/organização & administração , Estados Unidos
11.
Schmerz ; 33(5): 443-448, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31478141

RESUMO

BACKGROUND: Since March 2017 the law amending narcotics and other legal regulations has made it possible for doctors to prescribe cannabis and cannabis-derived medicines. The introduction of § 31 para 6 of the Social Code Book V (SGB V) allows that patients can be treated with cannabis-derived medicines at the expense of the statutory health insurance if they have a severe illness. COURT DECISIONS: The law requires the approval of a prescription of cannabis for medical purposes by the health insurance before the granting of benefits. Due to denied permission, numerous cases are pending before the social tribunals. The article presents which legal issues are decided and why there is still no case law from the Federal Social Court on the essential questions. OUTLOOK: The possibility of prescribing cannabis as medicine at the expense of the health insurance is an important advance in social law. The § 31 para 6 SGB V should be evaluated as soon as possible. The provisions of SGB V for the reimbursement of off-label treatment should be harmonized with § 31 para 6 SGB V.


Assuntos
Cannabis , Seguro Saúde , Médicos , Prescrições , Assistência à Saúde/legislação & jurisprudência , Alemanha , Humanos , Seguro Saúde/economia , Seguro Saúde/legislação & jurisprudência , Médicos/legislação & jurisprudência , Prescrições/estatística & dados numéricos
12.
Med Probl Perform Art ; 34(2): 122-123, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31482176

RESUMO

Medical Problems of Performing Artists has addressed the needs of clinicians for many decades, providing evidence and opinion pieces on performing artists' healthcare regarding a wide range of health issues that may either affect or cause problems when performing. Traditionally, two major challenges facing the best approaches to managing the health of performing artists has been (i) limited scientific research evidence supporting preventative approaches, specific assessments and treatment methods for the vast array of conditions seen, and (ii) a lack of training programs specifically targeting performing artists' healthcare. Not only are there many important differences between general healthcare and managing the health of performing artists, but there are variations between individuals performing on the same instrument, and a vast array of styles and genres of performing arts that create very different demands on performers. In relation to the first point, a previous lack of available scientific literature has hindered evidence-informed performing arts medicine practice; however, high-quality research has recently progressed rapidly. This edition of MPPA also highlights the incredible breadth of information emerging, recognising the complex and multiple health demands facing diverse performing arts domains.


Assuntos
Arte , Assistência à Saúde , Humanos
13.
Rev Saude Publica ; 53: 62, 2019 Sep 02.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31483004

RESUMO

OBJECTIVE: To evaluate the " Energía, la justa " program, aimed at reducing energy poverty in the city of Barcelona, from the point of view of the target population and the workers involved in the intervention. METHODS: A qualitative, descriptive and exploratory pilot study was carried out, with a phenomenological approach. Twelve semi-structured interviews were conducted: to three users, three energy agents who performed interventions in the homes, and six professionals who participated in the program coordination. A thematic content analysis was carried out using Atlas-ti software . Interviews were conducted between October 2016 and March 2017. RESULTS: Trust in a contact person (e.g. social workers) facilitated the participation, although there were difficulties reaching people who had illegal energy supplies, immigrant women or immigrants who subrent properties. Regarding implementation, home visits, energy efficiency advice and the relationship with energy agents were the best assessed aspects. However, not being able to carry out reforms in deteriorated dwellings was considered a limitation. The program also contributed to raise awareness on energy rights, to save on utility bills and to generate tranquility and social support. CONCLUSIONS: Programs such as this one can promote energy empowerment and improve psychosocial status. However, strategies with a gender and equity perspective should be considered to reach other vulnerable groups.


Assuntos
Fontes Geradoras de Energia , Assistência à Saúde , Eletricidade , Emigrantes e Imigrantes , Fontes Geradoras de Energia/economia , Acesso aos Serviços de Saúde , Humanos , Pobreza , Pesquisa Qualitativa , Espanha , Inquéritos e Questionários
14.
Niger J Clin Pract ; 22(9): 1180-1188, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31489851

RESUMO

Background: Assessment of health-related quality of life (HRQOL) in resource-limited settings is critical to evaluate and improve the burden of morbidity and mortality associated with chronic medical disorders. There is a dearth of data on HRQOL among patients suffering from chronic medical disorders in Nigeria. This study assessed the HRQOL of participants with diabetes mellitus (DM), human immunodeficiency virus (HIV) infection, and cancer in a hospital setting with limited resources and highlighted associated factors. Methods: The WHOQOL-BREF instrument was used to study a cross section of the participants at the University of Nigeria Teaching Hospital, Enugu. Data were analyzed using Statistical Package for Social Sciences (SPSS). Results: The distribution of the 613 study population was diabetes mellitus 120, HIV 389, and various cancers 104. Majority (67.9%) earned less than $1 per day and only 7.5% had any form of health insurance. The HIV group had higher QoL scores. Younger age, higher educational status, being employed, and having a care giver were positively associated with higher QoL. Patients with no comorbidities (76.6%) had an overall higher QoL score. Conclusion: Majority of the patients living with chronic medical diseases in Enugu, Nigeria were poor, vulnerable, and without access to health insurance. People living HIV generally had better quality life than those with other health conditions. There is a huge unmet need for people living with chronic medical conditions in Nigeria, which require strategies to counteract.


Assuntos
Doença Crônica/terapia , Assistência à Saúde/métodos , Diabetes Mellitus Tipo 2/psicologia , Infecções por HIV/psicologia , Neoplasias/psicologia , Qualidade de Vida , Adolescente , Adulto , Idoso , Doença Crônica/psicologia , Comorbidade , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Feminino , Infecções por HIV/epidemiologia , Recursos em Saúde , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Nigéria/epidemiologia , Inquéritos e Questionários , Adulto Jovem
15.
Soins ; 64(838): 51-52, 2019 Sep.
Artigo em Francês | MEDLINE | ID: mdl-31542123

RESUMO

By integrating artificial intelligence (AI) to their practice, healthcare professions will evolve towards more efficient patient management and better quality of care. These changes require new competencies to which all professionals must be trained. A methodology to quantify the impact of AI on healthcare occupations can be used to support and anticipate these changes.


Assuntos
Inteligência Artificial , Assistência à Saúde/organização & administração , Pessoal de Saúde/organização & administração , Humanos
17.
Soins ; 64(838): 30-32, 2019 Sep.
Artigo em Francês | MEDLINE | ID: mdl-31542116

RESUMO

The digital transformation is already under way in our health system. The deployment of data-driven management and artificial intelligence supports the transition towards treatment methods oriented more towards chronic diseases. Understanding the ethical issues associated with this transformation is a key priority for the future of our health system.


Assuntos
Tecnologia Biomédica , Assistência à Saúde , Humanos
18.
Soins ; 64(838): 33-35, 2019 Sep.
Artigo em Francês | MEDLINE | ID: mdl-31542117

RESUMO

Artificial intelligence (AI) is rapidly being extended across health systems with multiple cases of its use already reported. The most operational technique is machine learning with image recognition in imaging. Solutions derived from this approach, as well as other applications of AI, are presented in two major fields: cancer management and geriatric care.


Assuntos
Inteligência Artificial , Assistência à Saúde/organização & administração , Difusão de Inovações , Humanos , Aprendizado de Máquina
19.
Soins ; 64(838): 48-50, 2019 Sep.
Artigo em Francês | MEDLINE | ID: mdl-31542122

RESUMO

Artificial intelligence and its applications in healthcare inevitably raise ethical questions. The 'human guarantee' is at the heart of the discussions. Interview with Cynthia Fleury-Perkins, member of the French national advisory ethics committee and holder of the Humanities and Health Chair of the Conservatoire national des arts et métiers.


Assuntos
Inteligência Artificial/ética , Assistência à Saúde , Comissão de Ética/organização & administração , França , Humanos
20.
Crim Behav Ment Health ; 29(4): 207-217, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31478274

RESUMO

BACKGROUND: Care pathway approaches were introduced into health care in the 1980s and have become standard international practice. They are now being introduced more specifically for health care in the criminal justice system. Care pathway delivery has the theoretical advantage of encouraging a whole-systems approach for health and social care within the criminal justice system, but how well is it supported by empirical evidence? AIMS: The aim of this study is to review the nature and extent of evidence streams supporting health care delivery within interagency pathway developments since 2000. METHOD: We used an exploratory narrative method to review the nature and extent of evidence streams supporting health care delivery within interagency pathway developments since 2000. The available literature was reviewed using a keyword search approach with three databases: PubMed, Medline, and Google Scholar. FINDINGS: Research in this field has covered police custody, courts, prisons, and the wider community, but there is little that follows the entire career through all these elements of offender placement. Main themes in the research to date, regardless of where the research was conducted, have been counting the disorder or the need, development and evaluation of screening tools, and evaluation of clinical intervention styles. Most evidence to date is simply observational, although the possibility of conducting randomised controlled trials of interventions within parts of the criminal justice system, especially prisons, is now well established. CONCLUSIONS: Access to health care while passing through the criminal justice system is essential because of the disproportionately high rates of mental disorder among offenders, and the concept of structured pathways to ensure this theoretically satisfying, but as yet empirically unsupported. Further, substantial cuts in services, generally following government economies, are largely unresearched. Considerable investment in new possibilities, driven by both pressure groups and government, tend to be informed by good will and theory rather than hard evidence and are often not evaluated even after introduction. This must change.


Assuntos
Direito Penal , Criminosos/psicologia , Assistência à Saúde/organização & administração , Acesso aos Serviços de Saúde , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Saúde Mental , Humanos , Aplicação da Lei , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Polícia/organização & administração , Prisioneiros/psicologia , Prisões
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA