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Sr Care Pharm ; 34(7): 456-463, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31383057


OBJECTIVE: To determine whether the pharmacistled Geriatric Education and Medication Management (GEMM) clinic utilizing the Pharmacists' Patient Care Process (PPCP) improves therapeutic and safety outcomes in ambulatory older adults. DESIGN/PATIENTS: This is a retrospective, case series of veterans newly enrolled into the GEMM clinic from September 2013 to September 2015. SETTING: This study was conducted in an ambulatory pharmacist-led clinic at the Baltimore Veteran Affairs Medical Center in Maryland. INTERVENTION: Demographic, clinical, laboratory, and pharmacy fill data were collected from the computerized patient record system. Medication use patterns were collected using the clinic's supplemental medication reconciliation flowsheet. Descriptive statistics were used to analyze data. MAIN OUTCOME MEASURE(S): Change in adherence rate, number of potentially inappropriate medications, and number of care transitions within the 12-month study period. RESULTS: The primary outcome of medication adherence was high throughout the 12-month study period; beginning at 91.1% at baseline and increasing to 99.0% by the fourth quarter. There was a 36.4% decrease in number of potentially inappropriate medications (PIMs) from 22 at baseline to 14 at 12 months. Medication-related, short-term care transitions decreased from 10 to 4 in the pre- to post-clinic enrollment time frame. Only one subject experienced a long-term care transition during the study period. CONCLUSIONS: Implementing the PPCP in the pharmacist-led GEMM clinic improved medication adherence and persistence, decreased number of PIMs, and assisted in preventing care transitions in ambulatory older adults with multimorbidity and polypharmacy.

Assistência ao Paciente , Farmacêuticos , Idoso , Baltimore , Humanos , Adesão à Medicação , Multimorbidade , Estudos Retrospectivos
West Afr J Med ; 36(2): 138-143, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31385600


BACKGROUND: Holistic ward round (HWR) is a polyadic, multiphasic, holistic model of neurosurgical patient care. It is a multidisciplinary ward round where all healthcare providers involved in patients care, the patients, the relations, as well as clergymen (depending on the patients' faith and need) collectively work to review patient's condition and make decisions in the patient's best interest. OBJECTIVES: The study assessed the effectiveness of the holistic model of care and identified the challenges facing this model of healthcare delivery. METHODS: The study was qualitative in design and In-depth Interviews (IDIs) were conducted with eighteen (18) participants who were purposively selected. They include neurosurgeons, nurses, medical social workers and physiotherapists. The data were thematically content analysed with the help of ATLAS.ti (v.7) software. RESULTS: The study found that patients and relations have immensely benefitted from the model of care through psychosocial support. The major challenges facing HWR were logistic, timing and common problems found in the Nigerian healthcare system. CONCLUSION: It was concluded that for HWR to effectively help spinal cord injured patients further, the healthcare providers, patients and their families require support in different forms from outside the hospital.

Saúde Holística , Equipe de Assistência ao Paciente , Assistência ao Paciente , Assistência Centrada no Paciente/métodos , Adulto , Feminino , Hospitais Universitários , Humanos , Relações Interprofissionais , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Neurocirurgiões , Neurocirurgia , Nigéria , Fisioterapeutas , Pesquisa Qualitativa , Assistentes Sociais
Stud Health Technol Inform ; 264: 1194-1198, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438114


The implementation of the electronic health record (EHR) across the globe has increased significantly in the last decade. Motivations for this trend include patient safety, regulatory requirements, and healthcare cost containment. However, the impact of regulatory requirements and new EHRs on clinicians has increased the incidence of documentation burden and may lead to burnout syndrome. It is important to understand the extent of documentation burden and potential solutions such as EHR user-interface redesign and the use of scribes to assist healthcare providers across the world.

Esgotamento Psicológico , Documentação , Registros Eletrônicos de Saúde , Humanos , Assistência ao Paciente
Stud Health Technol Inform ; 264: 824-828, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438039


Health facilities are care centers that receive patients with different requirements. The management of patients falls to the clinical staff trained for this activity. However, given the demands of the population, the task of managing beds is sometimes too complicated when carried out manually. In this work, we propose the design and implementation of a technological platform that provides an improved optimization approach. It manages the patient-bed allocation efficiently, by considering hospital resources given the number of units and patient diagnosis. This tool was deployed in hospitals of the Atacama regional health service in Chile, boosting the work of the clinical staff of the health facility.

Hospitais , Assistência ao Paciente , Leitos , Chile , Humanos , Software
Stud Health Technol Inform ; 264: 1419-1420, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438160


Health informatics as a young, interdisciplinary discipline lacks a unified terminology in some areas. This is especially true when trying to properly describe health informatics interventions developed and deployed to improve quality and efficiency of patient care. We aim at developing a health IT ontology which allows systematically describing health IT interventions. To achieve this, we combine a deductive and an inductive approach. First results are promising and may later be extended by a folksonomy.

Informática Médica , Humanos , Assistência ao Paciente
Rev. SOBECC ; 24(2): 99-106, abr-.jun.2019.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1006174


Objetivo: Analisar a literatura científica a respeito da comunicação por meios eletrônicos entre profissionais de saúde. Método: Revisão integrativa da literatura, realizada nas bases de dados e/ou portais PubMed, Biblioteca Virtual em Saúde e Cochrane, até agosto de 2018, com descritores combinados, que respondem à pergunta norteadora: "Como ocorre a comunicação eletrônica entre os profissionais de saúde na assistência ao paciente? ”. Resultados: Seis artigos foram incluídos, publicados de 2011 a 2016, no idioma Inglês. Os recursos foram smartphone, pager e tablet. Os aplicativos utilizados foram WhatsApp, Medigram e Serviço de Mensagens Curtas (SMS). Agilidade, facilidade de uso e auxílio na tomada de decisão foram as vantagens encontradas no uso desse recurso na comunicação dos profissionais; dentre as desvantagens estão ausência de privacidade e de confidencialidade das informações, interrupções na assistência e inabilidade no uso do recurso tecnológico. Conclusão: O uso de aplicativos para troca de mensagens e comunicação interdisciplinar de fato proporciona agilidade na comunicação, mas a confidencialidade desses dados ainda é uma questão a ser tratada. Assim, cabe ao enfermeiro conduzir a comunicação com os demais profissionais, preservando a privacidade do paciente.

Purpose: To analyze scientific literature regarding the communication via electronic means between health professionals. Method: Integrative revision of the literature carried through databases and/or portals PubMed, Virtual Health Library and Cochrane, until August 2018, with combined describers, who answer to the leading question: "How does the electronic communication between health professionals in patient assistance occur?". Results: Six articles were included, published from 2011 to 2016 in the English language. Features were smartphone, pager and tablet. The applications used were WhatsApp, Medigram and Short Message Service (SMS). Agility, ease of use and support in decision-making were the advantages found in the use of this resource in the communication of professionals; among the disadvantages are lack of privacy and confidentiality of information, interruptions in assistance and inability to use the technological resource. Conclusion: The use of applications for messaging and interdisciplinary communication does indeed provide agility in communication, but the confidentiality of such data is still an issue to be addressed. Thus, it is up to the nurse to conduct communication with the other professionals, preserving the patient's privacy

Objetivo: Analizar la literatura científica acerca de la comunicación por medios electrónicos entre profesionales de salud. Método: Revisión integrativa de la literatura, realizada en las bases de datos y/o portales PubMed, Biblioteca Virtual em Salud y Cochrane, hasta agosto de 2018, con descriptores combinados, que responden a la pregunta orientadora: "¿Cómo ocurre la comunicación electrónica entre los profesionales de salud en la asistencia al paciente?". Resultados: Seis artículos fueron incluidos, publicados de 2011 a 2016, en el idioma Inglés. Los recursos fueron teléfono inteligente,pager y tablet. Las aplicaciones utilizadas fueron Whatsapp, Medigram y Servicio de mensajes cortos (SMS). Agilidad, facilidad de uso y ayuda em la tomada de decisión fueron las ventajas encontradas en el uso de ese recurso en la comunicación de los profesionales; entre las desventajas están la ausencia de privacidad y de confidencialidad de las informaciones, interrupciones em la asistencia e inhabilidad en el uso del recurso tecnológico. Conclusión: El uso de aplicaciones para el intercambio de mensajes y la comunicación interdisciplinaria de hecho proporciona agilidad en la comunicación, per la confidencialidad de estos datos sigue siendo una cuestión a tratar. Así, corresponde al enfermero conducir la comunicación con os demás profesionales, preservando la privacidad del paciente.

Humanos , Assistência ao Paciente , Enfermagem , Revisão , Comunicação , Confidencialidade
Horiz. méd. (Impresa) ; 19(2): 49-56, Jun. 2019. graf
Artigo em Espanhol | LILACS, LIPECS | ID: biblio-1007041


Objetivo: Determinar la satisfacción de la atención de los pacientes con cáncer de tiroides en el Servicio de Medicina Nuclear del Hospital Nacional Guillermo Almenara Irigoyen.Materiales y métodos: Estudio con diseño no experimental, descriptivo, de corte transversal. La población de estudio estuvo conformada por pacientes con cáncer de tiroides y la muestra fue de 267 participantes. El instrumento utilizado fue tomado de la "Guía Técnica para la Evaluación de la Satisfacción del Usuario Externo", aprobada por el Ministerio de Salud del Perú, que consta de dos componentes (percepciones y expectativas), cinco dimensiones y 22 preguntas por cada componente, con validación metodológica y operativa. Resultados: La edad media de los pacientes fue 52,5 años, con predominio del sexo femenino. La dimensión fiabilidad presentó un 86,09 % de insatisfacción, en la dimensión capacidad de respuesta se obtuvo un 84,3 % de insatisfacción, la dimensión seguridad reportó 78,4 % de insatisfacción, la dimensión empatía mostró 79,7 % de insatisfacción y la dimensión aspectos tangibles obtuvo 82,2 % de insatisfacción. Conclusiones: La dimensión fiabilidad obtuvo la mayor puntuación de insatisfacción, mientras que la dimensión seguridad obtuvo mejores resultados de satisfacción. La puntuación final correspondió a 81 % de insatisfacción.

Objective: To determine the satisfaction at care of patients with thyroid cancer at the Nuclear Medicine Service of the Hospital Nacional Guillermo Almenara Irigoyen.Materials and methods: A non-experimental, descriptive, cross-sectional study was carried out with a study population consisting of 267 patients with thyroid cancer. The instrument was taken from the "Technical Guide for the Evaluation of Outpatients' Satisfaction", approved by the Ministry of Health of Peru, and made up of two components (perceptions and expectations), five dimensions and 22 questions for each component, with methodological and operational validation. Results: The patients' average age was 52.5 years and the female sex prevailed. Regarding patient dissatisfaction, the reliability dimension showed 86.09 %, the response capacity dimension 84.3 %, the safety dimension 78.4 %, the empathy dimension 79.7 %, and the tangible aspects dimension 82.2 %.Conclusions: The reliability dimension obtained the highest dissatisfaction score, while the safety dimension had the best satisfaction results. The final dissatisfaction score accounted for 81 %.

Humanos , Satisfação do Paciente , Neoplasias da Glândula Tireoide , Assistência ao Paciente
Notas enferm. (Córdoba) ; 19(33): 18-28, jun.2019.
Artigo em Espanhol | LILACS | ID: biblio-1008056


De igual importancia como es el cuidado de la enfermera en el entorno clínico de la enfermedad lo es el abordaje de cuidar de las necesidades emocionales de los pacientes, esta realidad a la que debe hacer frente la enfermera evidencia lo difícil de la situación en el manejo del paciente oncológico en recidiva. Objetivo: Interpretar las experiencias y los modos de afrontamiento de las enfermeras oncológicas frente al paciente en recidiva. Para la realización de este estudio se utilizó un diseño de investigación cualitativa de tipo fenomenológico, una entrevista dialógica a 17 enfermeros del servicio de Onco hematología. Resultados: Después de analizar las entrevistas, se identifcaron dos temas principales: Emociones y Actitudes, con categorías, entre ellas: Impotencia, Frustración, Ira, Angustia, Tristeza, Compasión y Lástima Represión- Silencio, Aceptación-Escucha activa, Humor, Negación e Indiferencia. Conclusión: Al fnalizar el análisis de todos los hallazgos se puede concluir que: las Emociones y Sentimientos de las Enfermeras ante la realidad de cuidar un paciente en recidiva fueron: Impotencia y Frustración - Ira e Insatisfacción ­ Angustia y Tristeza - Lastima y Compasión. Las Actitudes y Modos de Afrontamientos identifcados en las mayorías de las profesionaless son: Represión y Silencio, Aceptación - Escucha y humor y Negación e Indiferencia(AU)

Equally important is the care of the nurse in the clinical environment of the disease is the approach of taking care of the emotional needs of patients, this reality a the one that the nurse must face reveals the diffcult situation in the management of the patient oncology in relapse. Objective: To interpret the experiences and coping methods of oncological nurses with respect to relapsing patients. Methodology: to carry out this study we used a qualitative research design of phenomenological type in which a colloquial or dialogical interview was used to 17 nurses from the Onco hematology service. Results: After analyzing the interviews, two main themes were identifed: emotions and attitudes each with categories, among them: impotence, frustration, anger, anguish, sadness, compassion and hurts, repression-silence, active acceptanceListening, Humor, Negation and indifference. Conclusion: At the end of the analysis of all the fndings, it can be concluded that: the emotions and feelings of the nurses, before the reality of taking care of a patient in relapse were: impotence and frustration - anger and dissatisfaction - anguish and sadness - hurt and compassion. Attitudes and modes of confrontations identifed in the majorities of proffesion are: repression and silence, acceptance - listening and humor and negation and indifference(AU)

Igualmente importante é o cuidado do enfermeiro no ambiente clínico da doença ser a abordagem de cuidar das necessidades emocionais dos pacientes, essa realidade a que o enfermeiro deve enfrentar revela a difícil situação no manejo do paciente. oncologia na recaída. Objetivo: Interpretar as experiências e modos de enfrentamento dos enfermeiros oncológicos em relação aos pacientes recidivantes. Metodologia: para realizar este estudo utilizou-se um delineamento de pesquisa qualitativa do tipo fenomenológico em que foi utilizada uma entrevista coloquial ou dialógica para 17 enfermeiros do serviço de hematologia Onco. Resultados: Após a análise das entrevistas, foram identifcados dois temas principais: emoções e atitudes cada uma com categorias, entre elas: impotência, frustração, raiva, angústia, tristeza, compaixão e mágoa, repressão-silêncio, aceitação ativa-Escuta, Humor, Negação e Conclusão: Ao fnal da análise de todos os achados, pode-se concluir que: as emoções e sentimentos das enfermeiras diante da realidade de cuidar de um paciente em recaída foram: impotência e frustração - raiva e insatisfação - angústia e tristeza - mágoa e compaixão. As atitudes e os modos de confrontos identifcados nas maiorias da profssão são: repressão e silêncio, aceitação - escuta e humor e negação e indiferença(AU)

Humanos , Enfermagem Oncológica , Recidiva , Conhecimentos, Atitudes e Prática em Saúde , Psico-Oncologia , Assistência ao Paciente
Stud Health Technol Inform ; 261: 253-258, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31156125


Anxiety and stress are very common symptoms of patients facing a forthcoming surgery. However, limited time and resources within healthcare systems make the provision of stress relief interventions difficult to provide. Research has shown that provision of preoperative stress relief and educational resources can improve health outcomes and speed recovery. Information and Communication Technology (ICT) can be a valuable tool in providing stress relief and educational support to patients and family before but also after an operation, enabling better self-management and self-empowerment. To this direction, this paper reports on the design of a novel technical infrastructure for a resilience support tool for improving the health condition of patients, during the care path, using Virtual Reality (VR). The designed platform targets, among others, at improving the knowledge on the patient data, effectiveness and adherence to treatment, as well as providing for effective communication channels between patients and clinicians.

Autogestão , Realidade Virtual , Comunicação , Humanos , Assistência ao Paciente , Poder (Psicologia)
BMC Public Health ; 19(1): 827, 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31242877


BACKGROUND: Depression, prevalent among people living with HIV (PLWH) in Malawi, is associated with negative HIV patient outcomes and likely affects HIV medical management. Despite the high prevalence of depression, its management has not been integrated into HIV care in Malawi or most low-income countries. METHODS: This study employs a pre-post design in two HIV clinics in Lilongwe, Malawi, to evaluate the effect of integrating depression management into routine HIV care on both mental health and HIV outcomes. Using a multiple baseline design, this study is examining mental health and HIV outcome data of adult (≥18 years) patients newly initiating ART who also have depression, comparing those entering care before and after the integration of depression screening and treatment into HIV care. The study is also collecting cost information to estimate the cost-effectiveness of the program in improving rates of depression remission and HIV treatment engagement and success. DISCUSSION: We anticipate that the study will generate evidence on the effect of depression management on HIV outcomes and the feasibility of integrating depression management into existing HIV care clinics. The results of the study will inform practice and policy decisions on integration of depression management in HIV care clinics in Malawi and related settings, and will help design a next-step strategy to scale-up integration to a larger scale. TRIAL REGISTRATION: ID [ NCT03555669 ]. Retrospectively registered on 13 June 2018.

Depressão/terapia , Gerenciamento Clínico , Infecções por HIV/psicologia , Saúde Mental , Assistência ao Paciente , Adolescente , Adulto , Análise Custo-Benefício , Depressão/etiologia , Transtorno Depressivo/etiologia , Transtorno Depressivo/terapia , Feminino , HIV , Infecções por HIV/complicações , Infecções por HIV/terapia , Humanos , Malaui , Masculino , Programas de Rastreamento , Projetos de Pesquisa , Estudos Retrospectivos
J Clin Pathol ; 72(7): 482-486, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31088937


AIMS: The National Institute for Health and Care Excellence advocated the development of specialist skin cancer multidisciplinary teams (SSMDTs) for the management of higher risk invasive skin cancers in the UK. The interobserver variability in the histopathological assessment of primary cutaneous malignant melanoma (PCMM) is well recognised. METHODS: We evaluated the discordance rates in the assessment of the histopathological criteria of PCMM based on the eighth American Joint Committee on Cancer (AJCC) melanoma staging system and subsequent change in prognosis and management following pathology review by an SSMDT. RESULTS: 353 cases of PCMM were referred to our SSMDT between April 2015 and May 2016. Cases in which there was a discrepancy in one or more histological parameters following expert review were collected retrospectively. Of 341 eligible cases, there were 94 (27.6%) in which there was an alteration in any parameter. There was interobserver agreement in final diagnosis in 96.8%, Breslow thickness in 86.8%, ulceration in 98.2%, microsatellites in 98.5%, tumour mitotic rate in 88.9%, histological subtype in 92.4%, growth phase in 98.5%, angiolymphatic invasion in 97.7%, perineural invasion in 98.8%, regression in 95.3% and tumour-infiltrating lymphocytes in 95.0%. A corresponding change in AJCC stage occurred in 23 cases (6.7%), with a resulting change in clinical management in 10 cases (2.9%). CONCLUSIONS: Disagreements in the pathological assessment of PCMM can have significant clinical implications for a small number of patients. Our findings highlight the value of the SSMDT for high-quality care of patients with melanoma in the UK.

Melanoma/patologia , Variações Dependentes do Observador , Neoplasias Cutâneas/patologia , Dermatologistas , Feminino , Humanos , Linfócitos do Interstício Tumoral , Melanoma/diagnóstico , Estadiamento de Neoplasias , Patologistas , Assistência ao Paciente , Equipe de Assistência ao Paciente , Prognóstico , Encaminhamento e Consulta , Estudos Retrospectivos , Neoplasias Cutâneas/diagnóstico , Reino Unido
Malawi Med J ; 31(1): 31-38, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-31143394


Background: Heart disease is one of the leading chronic conditions posing a major and growing threat to the public. Studies on quality of care given to patients with heart diseases in Nigeria are not available. The purpose of this study was to explore healthcare professionals' perception of quality of care of patients with heart disease at a tertiary hospital in Nigeria. Methods: A mixed method design was utilized in this study. Twenty eight healthcare professionals consisting of cardiologists, nurses, physiotherapists and dieticians were recruited into the study through purposive sampling technique. A questionnaire developed and validated from existing questionnaire was used to survey the health care professionals' perception of care and qualitative design was further used to explore their perceptions of care. The data were analyzed using descriptive statistics of percentages and graphs. The qualitative data were analyzed using thematic analysis. Quality of care was assessed through structure, process and outcome of care indices. Results: The mean age of the healthcare professionals was 38.46±8.988 years. 19 (66.7%) reported that there were treatment guidelines for cardiac disease management but there was no system for internal quality assurance. 18 (95%) out of these 19 healthcare professionals reported that the treatment guidelines were either never applied or not applied regularly during treatment. Other areas that were perceived as poor were poor teamwork, poor staff strength, inadequate equipment, and inadequate consultation with staff during procurement of medical supplies. Conclusion: Quality of care for cardiac patients in a Nigerian tertiary hospital was perceived as sub-optimal. There is a need for the improvement of the structure and process of quality of care to enhance quality of care for cardiac patients in Nigeria.

Atitude do Pessoal de Saúde , Competência Clínica , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Cardiopatias/terapia , Assistência ao Paciente/normas , Qualidade da Assistência à Saúde , Adulto , Educação Profissionalizante , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Percepção , Guias de Prática Clínica como Assunto , Pesquisa Qualitativa
Maturitas ; 124: 39-42, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31097177


OBJECTIVE: We previously conducted an audit of the care provided for survivors of sexual violence seen at our emergency department and observed that 90% of them did not receive optimal care. This study analysed whether the implementation of a new protocol and educational sessions for staff increased the proportion of such patients who received optimal medical care. METHODS: A computerized chart detailing a new care protocol was developed specifically for rape survivors. Educational sessions focusing on the use of the new protocol were organized for healthcare providers. We then conducted another audit that reviewed retrospectively the charts of all survivors of sexual violence who were cared for at a public university hospital. MAIN OUTCOME MEASURE: Optimal medical care was defined as including systematic investigations for sexually transmitted diseases, and the provision of prophylactic antibiotics, a pregnancy test, emergency contraception, and psychological and medical follow-up. RESULTS: We analysed the charts of 362 survivors of sexual violence and observed that all of the required procedures were completed for 337 patients (93%) and the required preventive measures were provided to 325 patients (90%). CONCLUSION: After the implementation of the new protocol and educational sessions, the proportion of survivors who received optimal medical care increased from 10% to 90%. Nevertheless, optimal management also implies social, psychological and legal support. We hope that the establishment of specialist sexual assault centres will further improve management.

Pessoal de Saúde/educação , Assistência ao Paciente/métodos , Estupro , Sobreviventes , Adolescente , Adulto , Idoso , Antibacterianos/uso terapêutico , Protocolos Clínicos , Anticoncepção Pós-Coito , Serviço Hospitalar de Emergência , Feminino , Humanos , Pessoa de Meia-Idade , Assistência ao Paciente/normas , Testes de Gravidez , Estudos Retrospectivos , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/prevenção & controle , Adulto Jovem
BMC Health Serv Res ; 19(1): 323, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31118012


BACKGROUND: The substitute or complementary effect of formal care on informal care service used by the elderly has been tested in Western countries. However, this effect is excluded from the discussion in the Chinese context. The identification of the relationship between informal care and formal care may imply different directions in policy-making. Thus, this study contributes to understanding the relationship between informal care and formal care among Chinese older adults. METHODS: Using the dataset from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2014, this study uses regression models and instrumental variable (IV) method to examine the impact of formal care on informal care. RESULTS: The results primarily show that formal care does not substitute informal care among Chinese older adults. In fact, formal care is a supplement to informal care in China. CONCLUSION: It is expected that informal care will become less available in the future in China. Thus, policymakers should be concerned about the underdevelopment of formal care for the elderly in China.

Cuidadores/estatística & dados numéricos , Serviços de Saúde para Idosos/estatística & dados numéricos , Serviços de Assistência Domiciliar/estatística & dados numéricos , Assistência ao Paciente/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , China , Utilização de Instalações e Serviços , Feminino , Assistência Domiciliar/estatística & dados numéricos , Humanos , Longevidade , Estudos Longitudinais , Masculino
Malar J ; 18(1): 170, 2019 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-31088466


BACKGROUND: The present study aimed to evaluate the management of severe malaria at Gezira State hospitals in Sudan by assessing hospital readiness, health care provider knowledge and the care received by severe malaria patients. METHODS: A cross-sectional descriptive study was performed to assess the severe malaria management practices at hospitals level in Gezira State. The study population included hospitals, health care providers and patients. Data was collected using checklists and structured questionnaires. RESULTS: A total of 20 hospitals, 158 health care providers and 370 patients were included in the study. Out of the total hospitals, 95% (19/20) were providing 24 h outpatient services, 65% (13/20) had ICU units, while triage system was found in only 35% (7/20) of hospitals. From all hospitals evaluated, 90% (18/20) were suffering from shortage of staff, especially doctors. About half of the health care providers (46.7%) did not receive severe malaria management training. The average knowledge score among health care providers was 55.4%. Microscopy was available in all hospitals (100%), while rapid diagnostic test, complete blood count and renal function test were available in 15 hospitals (75%). Fever was the most presenting symptom (97.8%) followed by repeated vomiting (51.4%), convulsion in children (24.3%) and prostration in adult (57.9%). Correctly diagnosed patients were 68.9%. Essential tests were done for only 11.1% of patients. Majority of patients (91.7%) were treated with quinine, 5.9% received artemether, while 2.4% were treated with artemether-lumefantrine. Those who received both the correct dose and dosing regimen were 53.8%. The overall compliance to guidelines was 2.2%. CONCLUSION: This study highlights the fact that management of severe malaria at hospital level was suboptimal with serious shortcomings in the different aspects of care particularly in specialized hospitals. Technical staff was inadequate, hospitals were anguish from defective emergency services, and most patients were not treated according to the national guidelines.

Gerenciamento Clínico , Hospitais/estatística & dados numéricos , Malária/epidemiologia , Malária/prevenção & controle , Antimaláricos/uso terapêutico , Artemisininas/uso terapêutico , Estudos Transversais , Testes Diagnósticos de Rotina , Feminino , Pessoal de Saúde , Humanos , Malária/tratamento farmacológico , Masculino , Assistência ao Paciente/estatística & dados numéricos , Sudão/epidemiologia , Inquéritos e Questionários
Stud Health Technol Inform ; 260: 178-185, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31118335


In-patient care of the elderly is currently being put to the test in all developed industrial nations. The aim is to make the resident-centered and nursing-related care more professional. In addition to the organizational and interdisciplinary orientation, the use of socially assistive robot technologies and artificial intelligence is increasingly coming to the fore. By means of literature research, expert interviews and an online survey of Upper Austrian nursing home directors, current and future challenges and challenges for the use of socially assistive robots (SAR) in in-patient care for the elderly were identified and prioritized. It becomes clear that the technological and application-oriented maturity of SAR as well as the modular adaptation of the hybrid SAR services to the existing structures and processes from the point of view of the nursing home management are in the foreground. In the future, it will be increasingly important to bring the process-related and technological support of human-machine interaction through SAR to a value-adding level.

Assistência ao Paciente , Robótica , Equipamentos de Autoajuda , Idoso , Áustria , Humanos
Int J Pharm Compd ; 23(3): 188-191, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31085786


Compounding pharmacists and technicians are experiencing an increased need for quality continuing pharmacy education. Areas pertaining to changing federal and state laws and regulations, along with the updates in drug and disease state knowledge, are all viable continuing pharmacy education opportunities. In addition to the areas listed above, today's pharmacists are serving in a more clinical role, which increases the amount of individualized patient care that is provided. To meet these increased needs, compounding pharmacists rely on at least six different types of continuing pharmacy education providers: 1) academia, 2) educational companies, 3) healthcare networks, 4) associations (local, state, national), 5) publishers/Government, and 6) other. In 2017, 18% of all continuing pharmacy education activities were provided by educational companies. This 18% includes pharmaceutical manufactures of which many serve as compounding support companies. Prescribers are turning more and more to compounding pharmacists to create personalized medicines for those patients who are not served by mass-produced drugs. Pharmacists should take advantage of continuing pharmacy education offerings provided by compounding support companies to remain competent with patient care regarding pharmaceutical compounding. This article serves as a review to explore what topics and types of continuing pharmacy education are offered by industry-leading compounding support companies.

Composição de Medicamentos/normas , Educação em Farmácia , Educação Continuada em Farmácia , Humanos , Assistência ao Paciente , Farmacêuticos
Expert Rev Clin Pharmacol ; 12(5): 481-489, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30961406


INTRODUCTION: The potentials of Africa for growth and economic transformation through science remains challenging because of existing gaps in knowledge and infrastructure. The Africa Pharmacological Science Gateway project and the Medicines Utilization Research in Africa Group seek to meet the research needs of African pharmacologists. This study aimed at identifying priority needs that might be met by access to information and tools through e-infrastructure. METHODS: A web-based cross-sectional study among 472 members of pharmacological societies in Africa to obtain information on their research interests and skills, available resources, needs, and knowledge gaps. Descriptive analyses were done. RESULTS: A total of 118 responses from 13 countries were received, mostly from Nigeria (48.3%) and South Africa (21.3%). Respondents had wide ranges of research interests predominantly in drug utilization research. The desired resources included drug utilization research training and tools, pharmacokinetics and pharmacometrics modeling training and tools, drug-drug interaction and medicine prices resources, statistical analysis resources, access to journals, training in specific laboratory techniques, equipment and funding for research-related activities. CONCLUSIONS: Key areas of needs not currently provided by the African Pharmacological Science Gateway e-infrastructure were identified to guide the further provision of resources on the e-infrastructure and potentially enhance research capacity within the continent.

Acesso à Informação , Conhecimentos, Atitudes e Prática em Saúde , Farmacologia/organização & administração , Pesquisa/organização & administração , África , Estudos Transversais , Assistência à Saúde/tendências , Humanos , Internet , Assistência ao Paciente/tendências , Projetos Piloto , Competência Profissional , Inquéritos e Questionários