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1.
J. optom. (Internet) ; 13(4): 257-261, oct.-dic. 2020.
Artigo em Inglês | IBECS | ID: ibc-193462

RESUMO

The pandemic of the severe acute respiratory syndrome disease caused by the new coronavirus SARS-CoV-2 (COVID-19), had profound impact in many countries and their health care systems. Regarding Portugal, a suppression strategy with social distancing was adopted, attempting to break the transmission chains, bending the epidemy curve and reducing mortality. These measures seek to prevent an eventual National Health Service over-running, enforcing the suspension of all elective and non-urgent health care. Despite the success in so far, there is a consensus on the need to recover the previous level of health care provision and further enhance it. The Portuguese National Health Service, as a public, universal access, health care system funded by the State proved, in this context, its importance and relevance to the Portuguese population. However, long standing issues, such as the pre pandemic over long waiting lists for hospital ophthalmology attendance, whose determinants are fully identified but still unmet, emerge amplified from this pandemic. The lack of primary eye care in the National Health Service is a significant bottleneck, placing a huge stress on hospital-based care. An exclusive ophthalmologist's center care was over-runned before pandemic and will be even more so. The optometrist's exclusion from differentiated, multisectoral and multidisciplinary eye care teams remains the main hurdle to overcome and insure universal eye care in Portugal. National Health Service highlights the consequences of an overcome model. Universal eye care more than ever demands an evidence-based, integrated approach with primary eye care, in the community, on time and of proximity


La pandemia del síndrome respiratorio agudo grave causado por el nuevo coronavirus SARS-CoV-2 (COVID-19) ha tenido amplias repercusiones en muchos países y en sus sistemas sanitarios. En Portugal, se ha adoptado una estrategia de contención basada en el distanciamiento social, con la cual se ha intentado cortar las cadenas de transmisión, frenar la curva de la epidemia y reducir la mortalidad. Con estas medidas se trataba de evitar un eventual desbordamiento del Servicio Nacional de Salud y se imponía la suspensión de toda la atención médica programada, que no fuera urgente. A pesar del éxito logrado hasta este momento, existe consenso sobre la necesidad de recuperar el nivel anterior de atención médica y fomentar su mejora. El Servicio Nacional de Salud de Portugal, como sistema sanitario público y de acceso universal, a cargo del Estado, ha demostrado, en este contexto, su importancia y pertinencia para la población portuguesa. Sin embargo, los problemas que acarrea desde hace mucho tiempo, como las largas listas de espera, anteriores a la pandemia, en la asistencia oftalmológica hospitalaria, cuyos factores determinantes están completamente identificados, pero que continúan sin solución, se han visto agravados a resultas de esta pandemia. La falta de atención primaria oftalmológica en el Servicio Nacional de Salud es un importante cuello de botella, que ejerce una enorme presión en la atención hospitalaria. La atención de un centro exclusivamente oftalmológico estaba desbordada antes de la pandemia y lo estará aún más después de esta. La exclusión de los optómetras de los equipos de atención oftalmológica diferenciados, multisectoriales y multidisciplinarios continúa siendo el principal obstáculo que debe superar y asegurar la atención oftalmológica universal en Portugal. El Servicio Nacional de Salud hace hincapié en las consecuencias de un modelo superado. La atención oftalmológica universal exige, más que nunca, un enfoque integral basado en la evidencia para abordar la atención primaria oftalmológica en la comunidad, puntual y de proximidad


Assuntos
Humanos , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Pandemias , Sistemas de Saúde , Serviços de Saúde Ocular , Assistência ao Paciente/normas , Portugal/epidemiologia
2.
Texto & contexto enferm ; 29: e20180104, Jan.-Dec. 2020. graf
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1101981

RESUMO

ABSTRACT Objective: To identify work aspects that generate satisfaction for the professionals who work in the Family Health Strategy. Method: This was a qualitative, descriptive study that involved five geographical regions of Brazil, and 27 Family Health Teams from six municipalities. The data were collected from 76 health professionals using semi-structured interviews, and were analyzed articulating the three phases of content analysis using Atlas.ti software resources. Results: The findings showed 129 statement excerpts, with 14 codes, grouped into three categories related to satisfaction. The category, Job Identification and Family Health Strategy Principles, represented 40.3%, with the codes: team work, job affinity, health model, completeness of care, and longitudinality of care. The category, Relationship with Family Health Strategy patients, represented 32.6%, with the following codes: bonding with patient, resoluteness of care, patient satisfaction, and patient care. Finally, the category, Professional and Working Aspects related to the Family Health Strategy, represented 27.1%, with the following codes: relationship with professionals, work recognition, enjoying the profession, team organization, and employment relationship. Conclusion: Professional satisfaction is associated with the work principles of the Family Health Strategy, and with the relationships that are established between patients, professionals and health management. It also has a subjective dimension, with a strong relationship with characteristics of the work process, how it is organized, and under what conditions and relationships this work occurs.


RESUMEN Objetivo: Identificar los aspectos del trabajo, que generan satisfacción en los profesionales de salud que actúan en la estrategia de salud familiar. Método: Estudio cualitativo que incluye 5 regiones geográficas del Brasil, 27 equipos de salud familiar de 6 municipios. Los datos fueron obtenidos, a través de 76 profesionales de salud por medio de entrevistas semi estructuradas y analizados, articulando las tres frases de Análisis del Contenido y los recursos del software Atlas ti. Resultados: Seleccionaron 129 extractos de conversaciones, 14 códigos agrupados en 3 categorías relacionadas a la satisfacción. La categoría Identificación con el trabajo y principios de la Estrategia salud de la familia, representó 40,3%; tuvo los códigos: trabajo en equipo, afinidad con el trabajo, modelo de salud, integralidad de la asistencia, longitudinalidad del cuidado. La categoría, Relación con los Usuarios en la Estrategia salud de la familia, representó el 32,6% con los siguientes códigos: vinculo con el usuario, resolutividad de la asistencia, satisfacción del usuario y asistencia al usuario. Finalmente, la categoría Aspectos Profesionales y de Trabajo, relacionados con la estrategia salud de la familia, representó 27,1% con los siguientes códigos: Relación con los profesionales, reconocimiento del trabajo, gusto por la profesión, organización del equipo, vinculo del trabajo. Conclusión: La satisfacción del profesional está asociada a los principios del trabajo en la Estrategia Salud de la Familia, a las relaciones que se establecen entre usuarios, profesionales y gestión de la salud. También posee una dimensión subjetiva, fuertemente relacionada con las características del proceso de trabajo, como se encuentra organizado, sus condiciones y relaciones.


RESUMO Objetivo: Identificar os aspectos do trabalho que são geradores de satisfação para os profissionais que atuam na Estratégia Saúde da Família. Método: Estudo qualitativo do tipo descritivo que envolveu 5 regiões geográficas do Brasil, 27 equipes de Saúde da Família de 6 municípios. Os dados foram coletados com 76 profissionais de saúde por meio de entrevistas semiestruturadas e analisados articulando as três fases da Análise de Conteúdo e dos recursos do software Atlas.ti. Resultados: Indicaram 129 trechos de falas e 14 códigos agrupados em 3 categorias relacionadas à satisfação. A categoria Identificação com o trabalho e princípios da Estratégia Saúde da Família representou 40,3% e teve os códigos: trabalho em equipe, afinidade com o trabalho, modelo de saúde, integralidade da assistência, longitudinalidade do cuidado. A categoria relações com os usuários na Estratégia Saúde da Família representou 32,6% com os seguintes códigos: vínculo com o usuário, resolutividade da assistência, satisfação do usuário, assistência ao usuário. Por fim, a categoria aspectos profissionais e trabalhistas relacionados à Estratégia Saúde da Família, representou 27,1% com os seguintes códigos: relação com os profissionais, reconhecimento do trabalho, gostar da profissão, organização da equipe, vínculo de trabalho. Conclusão: A satisfação profissional está associada aos princípios do trabalho na Estratégia Saúde da Família, as conexões que se estabelecem entre usuários, profissionais e gestão em saúde. Possui ainda uma dimensão subjetiva, possuindo forte vínculo com características do processo de trabalho, como esse é organizado e sob que condições e relações o trabalho acontece


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Atenção Primária à Saúde , Condições de Trabalho , Estratégia Saúde da Família , Pesquisa Qualitativa , Satisfação no Emprego , Equipe de Assistência ao Paciente , Trabalho , Sistema Único de Saúde , Saúde da Família , Pessoal de Saúde , Continuidade da Assistência ao Paciente , Gestão em Saúde , Assistência ao Paciente , Recursos em Saúde
3.
Comunidad (Barc., Internet) ; 22(2): 0-0, jul.-oct. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-192934

RESUMO

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


Assuntos
Humanos , Infecções por Coronavirus/epidemiologia , Síndrome Respiratória Aguda Grave/epidemiologia , Vírus da SARS/patogenicidade , Serviço Social/organização & administração , Assistência ao Paciente/tendências , Serviços de Saúde Comunitária/organização & administração , Participação da Comunidade/tendências , Pandemias/estatística & dados numéricos , Estudos Transversais , Pesquisa sobre Serviços de Saúde/tendências
5.
Rev. SOBECC ; 25(3): 159-170, 30-09-2020.
Artigo em Português | LILACS | ID: biblio-1122703

RESUMO

Objetivo: Discutir a implementação dos protocolos para o cuidado ao paciente na sala de recuperação pós-anestésica, considerando a disposição afetiva da equipe de enfermagem no seu cotidiano, em um hospital da região oeste de Santa Catarina. Método: Pesquisa qualitativa, com base na etnografia e na observação participante. Os sujeitos da pesquisa foram nove profissionais da enfermagem. Os dados foram coletados no primeiro semestre de 2019, considerando-se a análise de conteúdo de Bardin, de onde emergiram três categorias. Resultados: Os profissionais de enfermagem compreendem a importância da disposição afetiva no cuidado aos pacientes na recuperação, elencando a alta demanda de atividades e cirurgias e o número de funcionários insuficiente como dificuldades para um cuidado afetivo, efetivo e empático em seu cotidiano. Há baixa adesão aos protocolos assistenciais disponibilizados no setor, apesar do reconhecimento de sua importância no cuidado direcionado aos pacientes. Conclusão: Como fatores determinantes apresentaram-se a alta demanda diária do setor, o quantitativo de funcionários inadequado e o atendimento a pacientes críticos por longos períodos na recuperação anestésica


Objective: The aim of this study was to discuss the implementation of protocols for patient care in the postanesthesia care unit, considering the provision of compassionate care by the nursing team in their daily routine, in a hospital in the western region of Santa Catarina, Brazil. Method: Qualitative study based on ethnography and participant observation. The research subjects were nine nursing professionals. Data were collected in the first half of 2019, considering Bardin's content analysis, from which three categories emerged. Results: Nursing professionals understand the importance of providing compassion in patient care during recovery, listing the high demand for activities and surgeries and the insufficient staff as difficulties for providing compassionate and effective care in their daily routine. There is low adherence to the assistance protocols available in this unit, despite the recognition of their importance in patient care. Conclusion: Limiting factors for compassionate care of patients in postanesthesia recovery were the high daily demand in this unit, inadequate staff and care of critical patients for long periods.


Objetivo: Discutir la implementación de protocolos para el cuidado del paciente en la sala de recuperación postanestésica, considerando la disposición afectiva del equipo de enfermería en su vida diaria, en un hospital en el oeste de Santa Catarina. Método: Investigación cualitativa, basada en etnografía y observación participante. Los sujetos de investigación fueron nueve profesionales de enfermería. Los datos se recopilaron en la primera mitad de 2019, considerando el análisis de contenido de Bardin, del cual surgieron tres categorías. Resultados: Los profesionales de enfermería entienden la importancia de la disposición afectiva en la atención al paciente en recuperación, enumerando la alta demanda de actividades y cirugías y el número insuficiente de empleados, como dificultades para la atención afectiva, efectiva y empática en su vida diaria; baja adherencia al uso de protocolos de atención disponibles en el sector, a pesar del reconocimiento de su importancia en la atención dirigida a los pacientes. Conclusión: Como factores determinantes fueron la alta demanda diaria en el sector, el número inadecuado de empleados y la atención de pacientes críticos durante largos períodos en la recuperación anestésica.


Assuntos
Humanos , Período de Recuperação da Anestesia , Enfermagem , Profissionais de Enfermagem , Sala de Recuperação , Protocolos , Assistência ao Paciente
6.
Tex Med ; 116(7): 33-36, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32872706
8.
Int J Radiat Oncol Biol Phys ; 108(2): 416-420, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32890524

RESUMO

PURPOSE: Telemedicine was rapidly and ubiquitously adopted during the COVID-19 pandemic. However, there are growing discussions as to its role postpandemic. METHODS AND MATERIALS: We surveyed patients, radiation oncology (RO) attendings, and RO residents to assess their experience with telemedicine. Surveys addressed quality of patient care and utility of telemedicine for teaching and learning core competencies. Satisfaction was rated on a 6-point Likert-type scale. The quality of teaching and learning was graded on a 5-point Likert-type scale, with overall scores calculated by the average rating of each core competency required by the Accreditation Council for Graduate Medical Education (range, 1-5). RESULTS: Responses were collected from 56 patients, 12 RO attendings, and 13 RO residents. Patient feedback was collected at 17 new-patient, 22 on-treatment, and 17 follow-up video visits. Overall, 88% of patients were satisfied with virtual visits. A lower proportion of on-treatment patients rated their virtual visit as "very satisfactory" (68.2% vs 76.5% for new patients and 82.4% for follow-ups). Only 5.9% of the new patients and none of the follow-up patients were dissatisfied, and 27% of on-treatment patients were dissatisfied. The large majority of patients (88%) indicated that they would continue to use virtual visits as long as a physical examination was not needed. Overall scores for medical training were 4.1 out of 5 (range, 2.8-5.0) by RO residents and 3.2 (range, 2.0-4.0) by RO attendings. All residents and 92% of attendings indicated they would use telemedicine again; however, most indicated that telemedicine is best for follow-up visits. CONCLUSIONS: Telemedicine is a convenient means of delivering care to patients, with some limitations demonstrated for on-treatment patients. The majority of both patients and providers are interested in using telemedicine again, and it will likely continue to supplement patient care.


Assuntos
Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Internato e Residência/estatística & dados numéricos , Assistência ao Paciente/estatística & dados numéricos , Radioterapia (Especialidade) , Telemedicina , Infecções por Coronavirus/epidemiologia , Humanos , Pandemias , Pneumonia Viral/epidemiologia
9.
J Alzheimers Dis ; 77(2): 539-541, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32925073

RESUMO

The ongoing coronavirus disease 2019 (COVID-19) pandemic has substantially affected patients with dementia and their caregivers. However, we found not all Alzheimer's disease (AD) patients were afraid of COVID-19 infection. Therefore, we investigated the association between rate of awareness of COVID-19 and depressive tendency in AD. 126 consecutive outpatients with AD were enrolled in this study from May 25, on the day when the declaration of emergency was lifted in Japan, through June 30, 2020. In addition to routine psychological tests, the participants were asked the following two questions: "Do you know COVID-19?" and "Why are you wearing a face mask?". Moderate to severe AD patients were found to have a low COVID-19 recognition rate and did not fully understand why they were wearing face masks. In addition, because they did not understand the seriousness of the COVID-19 outbreak, their Geriatric Depression Scale scores were also substantially lower. These results may appear to simply indicate that people with severe dementia are unaware of current events. However, these results provide insights into how to care for patients with dementia and how to allocate the time and support of our limited staff during the COVID-19 outbreak.


Assuntos
Doença de Alzheimer , Conscientização , Infecções por Coronavirus , Competência Mental , Pandemias , Assistência ao Paciente , Pneumonia Viral , Idoso , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/psicologia , Doença de Alzheimer/virologia , Betacoronavirus , Cuidadores/psicologia , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Feminino , Humanos , Japão/epidemiologia , Masculino , Pandemias/prevenção & controle , Assistência ao Paciente/métodos , Assistência ao Paciente/tendências , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Sistemas de Apoio Psicossocial , Índice de Gravidade de Doença
10.
Einstein (Sao Paulo) ; 18: eAO5032, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-32876090

RESUMO

Objective To describe the implementation of a care protocol based on rapid response teams, for management and resolution of bleeding. Methods A hospital protocol called Hemorrhage Code (Code H) was devised and developed. In a flow line, a multidisciplinary team provides comprehensive, fast and effective care to the patient with a severe hemorrhagic condition. In another flow line, professionals based at the hospital pharmacy focus on identifying patients at risk of bleeding, to avoid this event. Several hospital professionals and sectors were trained, each with specific roles, ensuring full support to the medical and nursing staffs. Results After implementing this protocol, we were able to significantly reduce the number of catastrophic events related to failure in bleeding management. Conclusion Code H is an example of a value-based medicine and precision medicine project by delivering comprehensive and multidisciplinary care, in addition to point-of-care testing introduced in clinical practice, optimizing patient safety and care practices at the hospital. Furthermore, it will be possible to minimize the risk of lawsuits for the hospital and physicians, as well as rationalizing resources with benefits for administrators and payers.


Assuntos
Transtornos da Coagulação Sanguínea/terapia , Transfusão de Sangue , Hemorragia/terapia , Assistência ao Paciente/normas , Segurança do Paciente , Guias de Prática Clínica como Assunto , Choque Hemorrágico/terapia , Brasil , Hemorragia/prevenção & controle , Humanos , Estudos Retrospectivos
13.
Health Res Policy Syst ; 18(1): 107, 2020 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-32948188

RESUMO

Self-care interventions and remote care offer innovative and equitable ways to strengthen access to sexual and reproductive health services. Self-isolation during COVID-19 provided the opportunity for obstetric facilities and healthcare providers to integrate and increase the usage of interventions for self-care and remote care for pregnant women and to improve the quality of care overall.


Assuntos
Infecções por Coronavirus , Acesso aos Serviços de Saúde , Serviços de Saúde Materna , Pandemias , Assistência ao Paciente/métodos , Pneumonia Viral , Gestantes , Isolamento Social , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Feminino , Instalações de Saúde , Pessoal de Saúde , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Gravidez , Autocuidado
15.
N Engl J Med ; 383(14): 1349-1357, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32997909

RESUMO

BACKGROUND: The gender gap in physician pay is often attributed in part to women working fewer hours than men, but evidence to date is limited by self-report and a lack of detail regarding clinical revenue and gender differences in practice style. METHODS: Using national all-payer claims and data from electronic health records, we conducted a cross-sectional analysis of 24.4 million primary care office visits in 2017 and performed comparisons between female and male physicians in the same practices. Our primary independent variable was physician gender; outcomes included visit revenue, visit counts, days worked, and observed visit time (interval between the initiation and the termination of a visit). We created multivariable regression models at the year, day, and visit level after adjustment for characteristics of the primary care physicians (PCPs), patients, and types of visit and for practice fixed effects. RESULTS: In 2017, female PCPs generated 10.9% less revenue from office visits than their male counterparts (-$39,143.2; 95% confidence interval [CI], -53,523.0 to -24,763.4) and conducted 10.8% fewer visits (-330.5 visits; 95% CI, -406.6 to -254.3) over 2.6% fewer clinical days (-5.3 days; 95% CI, -7.7 to -3.0), after adjustment for age, academic degree, specialty, and number of sessions worked per week, yet spent 2.6% more observed time in visits that year than their male counterparts (1201.3 minutes; 95% CI, 184.7 to 2218.0). Per visit, after adjustment for PCP, patient, and visit characteristics, female PCPs generated equal revenue but spent 15.7% more time with a patient (2.4 minutes; 95% CI, 2.1 to 2.6). These results were consistent in subgroup analyses according to the gender and health status of the patients and the type and complexity of the visits. CONCLUSIONS: Female PCPs generated less visit revenue than male colleagues in the same practices owing to a lower volume of visits, yet spent more time in direct patient care per visit, per day, and per year. (Funded in part by the Robert Wood Johnson Foundation.).


Assuntos
Médicos de Atenção Primária/economia , Atenção Primária à Saúde/economia , Estudos Transversais , Registros Eletrônicos de Saúde , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Masculino , Assistência ao Paciente , Atenção Primária à Saúde/organização & administração , Fatores Sexuais , Fatores de Tempo , Estados Unidos , Carga de Trabalho
16.
Infect Dis Poverty ; 9(1): 131, 2020 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-32938497

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) has emerged as a global health and economic security threat with staggering cumulative incidence worldwide. Given the severity of projections, hospitals across the globe are creating additional critical care surge capacity and limiting patient routine access to care for other diseases like tuberculosis (TB). The outbreak fuels panic in sub-Saharan Africa where the healthcare system is fragile in withstanding the disease. Here, we looked over the COVID-19 containment measures in Ethiopia in context from reliable sources and put forth recommendations that leverage the health system response to COVID-19 and TB. MAIN TEXT: Ethiopia shares a major proportion of the global burden of infectious diseases, while the patterns of COVID-19 are still at an earlier stage of the epidemiology curve. The Ethiopian government exerted tremendous efforts to curb the disease. It limited public gatherings, ordered school closures, directed high-risk civil servants to work from home, and closed borders. It suspended flights to 120 countries and restricted mass transports. It declared a five-month national state of emergency and granted a pardon for 20 402 prisoners. It officially postponed parliamentary and presidential elections. It launched the 'PM Abiy-Jack Ma initiative', which supports African countries with COVID-19 diagnostics and infection prevention and control commodities. It expanded its COVID-19 testing capacity to 38 countrywide laboratories. Many institutions are made available to provide clinical care and quarantine. However, the outbreak still has the potential for greater loss of life in Ethiopia if the community is unable to shape the regular behavioral and sociocultural norms that would facilitate the spread of the disease. The government needs to keep cautious that irregular migrants would fuel the disease. A robust testing capacity is needed to figure out the actual status of the disease. The pandemic has reduced TB care and research activities significantly and these need due attention. CONCLUSIONS: Ethiopia took several steps to detect, manage, and control COVID-19. More efforts are needed to increase testing capacity and bring about behavioral changes in the community. The country needs to put in place alternative options to mitigate interruptions of essential healthcare services and scientific researches of significant impact.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Tuberculose/terapia , Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Assistência à Saúde , Monitoramento Epidemiológico , Etiópia/epidemiologia , Feminino , Humanos , Masculino , Assistência ao Paciente , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Quarentena , Viagem/estatística & dados numéricos , Tuberculose/diagnóstico , Tuberculose/epidemiologia
17.
J Prim Care Community Health ; 11: 2150132720959860, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32959714

RESUMO

Patient care often refers to the broad spectrum of care, prevention, and treatment that a provider delivers, while the point of a differential diagnosis is to make a distinction between 2 or more conditions that share similar signs or symptoms. A broad differential should be considered for every single patient who is currently ill (eg, all patients with respiratory illnesses); without it, there will likely be an increase of misdiagnosis, unnecessary patient suffering, and an influx of patients to the emergency department. The COVID-19 response has forced many of these basic medical values aside, like providing differential diagnosis or practicing bedside manner through social interaction, while physicians struggle to continue care for patients. As a result, newly formed hospital and clinical policies may have dangerously traded everyday diagnosis and treatment of patients for the pandemic and quarantine recommendations. This type of assumptive medicine is based on a singular differential that can be detrimental to patients, who are more likely affected with more common illnesses, like bronchitis or pneumonia-or perhaps, even more threatening illnesses, like a pulmonary embolism, COPD exacerbation, congestive heart failure and even lung cancer. Although these new policies and reactions to COVID-19 are proactive, these actions could be at the cost of providing quality patient care for people who have not contracted COVID-19.


Assuntos
Infecções por Coronavirus/diagnóstico , Assistência ao Paciente/métodos , Pneumonia Viral/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Diagnóstico Diferencial , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle
18.
Rev Infirm ; 69(263): 30-31, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32993902

RESUMO

The body at the boundaries of care and ethics. The body is the site of a variety of explorations, from the most basic to the most sophisticated imaging examinations, to provide a diagnosis, monitor the evolution of a pathology or decide on a therapy. For the patient, the examination is an ordeal, as is the wait for the results. In their role in providing images for clinicians, medical imaging professionals must ensure that they adopt an ethical approach showing compassion towards the person whose body is undergoing investigation.


Assuntos
Empatia , Corpo Humano , Humanos , Assistência ao Paciente
19.
Endocr Relat Cancer ; 27(9): R357-R374, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32744242

RESUMO

Substantial management changes in endocrine-related malignancies have been required as a response to the COVID-19 pandemic, including a draconian reduction in the screening of asymptomatic subjects, delay in planned surgery and radiotherapy for primary tumors deemed to be indolent, and dose reductions and/or delays in initiation of some systemic therapies. An added key factor has been a patient-initiated delay in the presentation because of the fear of viral infection. Patterns of clinical consultation have changed, including a greater level of virtual visits, physical spacing, masking, staffing changes to ensure a COVID-free population and significant changes in patterns of family involvement. While this has occurred to improve safety from COVID-19 infection, the implications for cancer outcomes have not yet been defined. Based on prior epidemics and financial recessions, it is likely that delayed presentation and treatment of high-grade malignancy will be associated with worse cancer outcomes. Cancer patients are also at increased risk from COVID-19 infection compared to the general population. Pandemic management strategies for patients with tumors of breast, prostate, thyroid, parathyroid and adrenal gland are reviewed.


Assuntos
Infecções por Coronavirus/prevenção & controle , Neoplasias das Glândulas Endócrinas/terapia , Controle de Infecções/organização & administração , Pandemias/prevenção & controle , Assistência ao Paciente/normas , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto/normas , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Gerenciamento Clínico , Neoplasias das Glândulas Endócrinas/virologia , Feminino , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia
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