Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 82.663
Filtrar
1.
Health Qual Life Outcomes ; 17(1): 113, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31262316

RESUMO

BACKGROUND: Irritable Bowel Syndrome (IBS) is a chronic gastrointestinal disorder characterised by recurrent abdominal pain and disturbed bowel habits and unclear aetiology. IBS is also associated with psychosocial factors, impaired quality of life and lost work productivity. This study sought to determine whether the association between IBS and lost work productivity might be accounted for by poor coping strategies and loss of confidence in the healthcare system. METHODS: Case-control design was employed sampling IBS and non-gastrointestinal (non-GI) primary healthcare seekers in a defined region in Sweden. Non-GI patients were of similar age and sex distribution to the IBS patients. Questionnaires applied in this study included instruments designed to measure confidence in the social security system and in the community, as well as questions about whether gastrointestinal problems might affect working life and Sense of coherence (SOC) questionnaire. The study's primary hypothesis was evaluated via an a priori path model. RESULTS: Statistically significant differences were found between IBS cases (n = 305) and controls (n = 369) concerning abdominal pain or discomfort affecting everyday performance at work (p <  0.0001). IBS cases also showed significantly lower (p = 0.001) confidence in public healthcare. The study's hypothesis was supported with the finding of a statistically significant indirect association via poor coping strategies, although the indirect associations were lesser in magnitude than the direct association. CONCLUSIONS: This study found a clear association between clinically diagnosed IBS status and interference in work by gastrointestinal symptoms in which sense of coherence might be of importance.


Assuntos
Atitude Frente a Saúde , Efeitos Psicossociais da Doença , Emprego/psicologia , Síndrome do Intestino Irritável/psicologia , Qualidade de Vida , Dor Abdominal/etiologia , Dor Abdominal/psicologia , Adaptação Psicológica , Adulto , Estudos de Casos e Controles , Eficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Senso de Coerência , Inquéritos e Questionários , Suécia
2.
Medicine (Baltimore) ; 98(27): e16330, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277181

RESUMO

Nursing educators have the responsibility to equip nursing students with knowledge about the meaning of life, positive beliefs, and well-being in order to enhance their physical, psychological, spiritual, and social health education and promotion. The purpose of this study was to explore nursing students' simulated directed-learning in a life-education intervention on the meaning of life, positive beliefs, and well-being in regard to immediate and delayed effects in improving physical, psychological, spiritual, and social health education and promotion.The method of this study was constituted a quasi-experimental design with experimental and control groups for pre-test, post-test, and post-post-test. Purposive sampling and non-random distribution were used in the study. Assigned to the experimental group, 54 participants were third-year nursing students enrolled in a health education course with simulated directed-learning in a life-education intervention. Assigned to the control group, 56 participants were third-year nursing students enrolled in a caring care course without simulated directed-learning in a life-education intervention. A 56-item questionnaire was utilized, and the content validity index (CVI) was 0.95, as determined by seven expert scholars. The reliability of the questionnaire (n = 45) on Cronbach's α were: meaning of life 0.96, positive beliefs 0.95, and well-being 0.96. The statistical package SPSS 23.0 was used to analyze all of the data in the study. Frequencies, percentages, pre-test mean and SD, post-test mean and SD, post-post-test mean and SD, chi-squared test, t test, and generalized estimating equation (GEE) were employed for data analysis.Nursing students in the experimental group compared with the control group exhibited significant differences in meaning of life on the pre-post-test (ß = 16.40, P < .001) and pre-post post-test (ß = 25.94, P < .001), positive beliefs on the pre-post-test (ß = 5.64, P < .01) and pre-post post-test (ß = 9.21, P < .001), and well-being on the pre-post-test (ß = 14.33, P < .001) and pre-post post-test (ß = 23.68, P < .001).Nursing students in the experimental group showed a significant improvement in the simulated directed-learning with a life-education intervention on meaning of life, positive beliefs, and well-being in the immediate and delayed effects that enhanced their physical, psychological, spiritual, and social health education and promotion.


Assuntos
Atitude Frente a Saúde , Satisfação Pessoal , Qualidade de Vida , Treinamento por Simulação/métodos , Estudantes de Enfermagem/psicologia , Adolescente , Feminino , Humanos , Masculino , Adulto Jovem
3.
J Glob Health ; 9(1): 011101, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31275570

RESUMO

Background: Measures of quality of care in low- and middle-income countries (LMICs) rarely include experience of care. This gap in service quality metrics may be driven by a lack of understanding of client and provider perspectives. Understanding these perspectives is a critical first step in not only improving metrics, but also in improving service delivery. This study identifies the items antenatal care (ANC) clients and health care providers in Tanzania associate with a quality ANC service and explores the experience of care domain from both client and provider perspectives. Methods: We conducted semi-structured interviews with15 providers and 35 clients in Tanzania that included a free-listing activity to elicit items clients and providers associate with quality ANC services. We analyzed the free-listing for rank order and frequency to identify the most salient items, which were included in the second phase of data collection. We then conducted semi-structured interviews with a pile sort activity with the same 15 providers and 32 new clients to understand the importance of the items identified in the free-listing. We used a thematic analysis driven by the framework approach to analyze interview data. Results: Both clients and providers perceived quality of ANC as being comprised of items related to experience of care, provision of care, and cross-cutting essential physical and human resources. The free-listing findings illuminated that the experience of care was equally important to clients and providers as the availability of physical and human resources and the content of the care delivered. In addition, clients and providers perceived that a positive patient care experience - marked by good communication, active listening, keeping confidentiality, and being spoken to politely - increased utilization of health services and improved health outcomes. Conclusions: The experience of care in LMICs is an overlooked, yet critically important topic. Understanding the experience of care from those who receive and deliver services is key to measuring and improving the quality of ANC. Our research highlights the importance of incorporating experience of care into future quality improvement activities and quality measures. By doing so, we identify barriers and facilitating factors of practical use to policy-makers and governments in LMICs.


Assuntos
Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Pessoal de Saúde/psicologia , Cuidado Pré-Natal , Qualidade da Assistência à Saúde , Adolescente , Adulto , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Gravidez , Pesquisa Qualitativa , Tanzânia , Adulto Jovem
4.
Am J Orthod Dentofacial Orthop ; 156(1): 67-74, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31256841

RESUMO

INTRODUCTION: The objective of this study was to determine how different people perceive distinct malocclusions with the use of eye tracking and to compare the results with scores from the subjective visual attractiveness scale (VAS) following 3 grades obtained from the Aesthetic Component of the Index of Orthodontic Treatment Need (AC-IOTN) scale. METHODS: Ninety participants were equally distributed into 3 groups-dentists, orthodontists, and laypeople-and underwent 1 eye-tracking session. After being positioned and calibrated, they were shown 3 dental images. The images reflected the AC-IOTN grades of 1 (close to ideal), 5 (borderline need for treatment), and 8 (definite need for treatment). During the viewing, eye-tracker data were collected for fixation points, duration, and attractiveness (according to the VAS) for each image. The variables were statistically tested with the use of 2-way analysis of variance and complete factorial model (between groups, grades, and for the interactions between them). RESULTS: Grade 1 received the highest subjective score independently from the participant group. This was in contrast to grades 5 and 8, which received similar scores, although the means of fixation points and duration were not significantly different among the grades (P > 0.05). The scores obtained from the dentist group were significantly higher than those from the other groups when the comparison was independent from the grade. In terms of fixation points, there were differences between dentists and orthodontists and between orthodontists and laypeople. The fixation point mean was higher for orthodontists than for dentists and was similar to that for laypeople. CONCLUSIONS: Orthodontists were able to closely analyze the occlusal problems presenting with more severe malocclusions, and the specialists noticed more fixation points. Duration times, however, were not significantly different, because the orthodontists had greater interest, even in situations of unfavorable esthetics.


Assuntos
Estética Dentária , Índice de Necessidade de Tratamento Ortodôntico , Má Oclusão/terapia , Percepção Visual , Adolescente , Adulto , Idoso , Análise de Variância , Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Odontólogos/psicologia , Feminino , Humanos , Má Oclusão/diagnóstico por imagem , Pessoa de Meia-Idade , Ortodontia Corretiva , Ortodontistas/psicologia , Reprodutibilidade dos Testes , Projetos de Pesquisa , Adulto Jovem
5.
Clin Interv Aging ; 14: 925-933, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31190778

RESUMO

Introduction: The factors that influence the rehabilitation process among older adults remain unclear. The aim of the study was to assess the acceptance of illness and related factors (socio-demographic data, cognitive status, depression symptoms and functional status) among patients living in a nursing home who are undergoing rehabilitation. Sample and methods: A total of 119 elderly patients were examined, of whom 96 were included in the research project. All participants were assessed using the following tests: Mini Mental State Examination, Acceptance of Illness Scale, Geriatric Depression Scale and Barthel Index. Tests were conducted at two time points, the first upon admission to the ward and the second after 3 months of regular rehabilitation. Results: The study group showed relatively low scores for illness acceptance. After 3 months of rehabilitation, the acceptance of illness had significantly improved, but still remained at a low level. The results showed a relationship between acceptance of illness and patients' depression symptoms, functional status and cognitive status. Conclusions: The results suggest that assessment of the acceptance of illness among patients living in Nursing Home is important during treatment and rehabilitation process; however, further studies are necessary.


Assuntos
Atitude Frente a Saúde , Transtornos Cognitivos/epidemiologia , Depressão/epidemiologia , Nível de Saúde , Casas de Saúde/estatística & dados numéricos , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Feminino , Avaliação Geriátrica , Humanos , Masculino , Testes de Estado Mental e Demência , Fatores Socioeconômicos
6.
BMC Public Health ; 19(1): 796, 2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31226971

RESUMO

BACKGROUND: This study assesses how tuberculosis (TB) screening is perceived by immigrants in Norway. Screening is mandatory for people arriving from high incidence countries. To attend screening, immigrants have to contact the health system after receiving an invitation by letter. The proportion of non-attenders is not known, and there are no sanctions for not attending. Generally, only persons who test positive receive test results. The study explores users' experiences, attitudes and motivations for attending or not attending TB screening, and perceived barriers and enablers. METHODS: We conducted six focus group discussions and three individual interviews with 34 people from 16 countries in Africa, Asia and Europe. Interviews were recorded and transcribed, and data was coded following a general inductive approach: All transcribed text data was closely read through, salient themes were identified and categories were created and labelled. The data was read through several times and the category system was subsequently revised. RESULTS: Most appreciated the opportunity to be tested for a severe disease and were generally positive towards the healthcare system. At the same time, many were uncomfortable with screening, particularly due to the fear and stigma attached to TB. All experienced practical problems related to language, information, and accessing facilities. Having to ask others for help made them feel dependent and vulnerable. Positive and negative attitudes simultaneously created ambivalence. Many wanted "structuring measures" like sanctions to help attendance. Many said that not receiving results left them feeling anxious. CONCLUSIONS: In order to adapt the system and improve trust and patient uptake, all aspects of the screening should be taken into account. Ambivalence towards screening probably has a negative impact on screening uptake and should be sought reduced. A combination of ambivalence and a wish for "structuring measures" leads the authors to conclude that mandatory screening is a reasonable measure. However, since mandatory screening negatively impacts patient autonomy, and because of fear, stigma and practical problems, the health system should empower users by improving communication and access to services. In addition, it is recommended that negative test results are also communicated to the users.


Assuntos
Atitude Frente a Saúde , Emigrantes e Imigrantes/psicologia , Programas de Rastreamento/psicologia , Tuberculose/prevenção & controle , Adulto , África/etnologia , Ásia/etnologia , Emigrantes e Imigrantes/estatística & dados numéricos , Europa (Continente)/etnologia , Feminino , Grupos Focais , Acesso aos Serviços de Saúde , Humanos , Masculino , Motivação , Noruega , Pesquisa Qualitativa
7.
Artigo em Russo | MEDLINE | ID: mdl-31251854

RESUMO

The purpose of survey is to identify behavioral characteristics in family life-style and intra-family educational practices in dynamics of observation as health indicator. The life-style is analyzed according the results of questionnaire survey of 297 respondents, fostering school age children. The comparative analysis of behavior of adults and children is carried out based on the results of questionnaire surveys in 2007 and 2013. The verbal affirmations concerning importance of health and observance of healthy life-style in family have no concordance with actual behavior. The deterioration of of family function in healthy generation fostering is established. About 36,7% of parents pay no attention to their children. The passivity concerning organization of comfortable domestic conditions and inadequate medical activity in children health support are manifested by parents. The responsibility of parents for health of their children decreases too. The changing of priorities in hierarchy of life values occurs. The health loses its primary value. The decreasing of health in adults and children is logical due to effect relationship between life-style and health.


Assuntos
Atitude Frente a Saúde , Saúde da Família , Estilo de Vida , Pais , Adulto , Criança , Humanos , Inquéritos e Questionários
8.
BMC Public Health ; 19(1): 733, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31186020

RESUMO

BACKGROUND: When communicating risks to the general population, the format of the epidemiological results may affect individual reactions. In environmental epidemiology, no study has compared the use of different statistical formats in communicating results to the population. The aim of this paper is to investigate whether the degree of concern expressed by residents of a high environmental risk site, regarding epidemiological results on cancer mortality in the area where they live, is influenced by the statistical indicator used in communication. METHODS: A sample of residents in the high environmental risk area of Livorno (Italy) was randomized to respond to different questionnaires, in which the same epidemiological results were expressed by two alternative risk indexes: percent excess risk and time needed to harm, defined as the number of days that one has to wait for, on average, to observe 1 death in excess in respect to the baseline. Participants were asked to express their concern on a quantitative scale or to rank different diseases according to their impressions. The statistical analysis was performed using an Inverse Probability of Treatment Weighting approach based on propensity score, in order to account for sample stratification and adjust for unbalance between groups occurring despite randomization. RESULTS: The probability of high concern levels was larger under time needed to harm than under percent excess, with a difference between proportions of 6.7% (95% Confidence Interval, 0.6,12.8%). Mortality from sexual glands cancer was ranked as more worrisome and mortality from thyroid gland cancer as less worrisome under time needed to harm than under percent excess. No rank change was found for lung cancer. Larger differences between the two indicators arose in subjects with higher education or better numerical skills. CONCLUSIONS: Communicating epidemiological results to the population is not a neutral task. The degree of concern and judgments when comparing results on different diseases may depend on the risk indicators used. Translating scientific results into lay language should not exempt from careful evaluation of the impact of this translation on lay people.


Assuntos
Atitude Frente a Saúde , Saúde Ambiental/métodos , Comunicação em Saúde/métodos , Indicadores Básicos de Saúde , Neoplasias Pulmonares/psicologia , Adulto , Feminino , Humanos , Itália/epidemiologia , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Fatores de Risco
9.
BMC Public Health ; 19(Suppl 4): 544, 2019 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-31196033

RESUMO

BACKGROUND: Mental illness rates among young people is high, yet the frequency of help-seeking is low, especially among those from lower socioeconomic backgrounds. Understanding factors influencing help-seeking, such as mental illness beliefs, stigma and literacy among B40 individuals is important, but past studies are sparse. Hence, we aimed to examine the factors associated with mental help-seeking attitude among students from the B40 income bracket. Differences in beliefs toward mental illness, stigma and help-seeking attitudes among university and secondary school students were also investigated. METHODS: University and secondary school students from low-income households (N = 202) were involved in this cross-sectional study. Participants completed the Depression Literacy Questionnaire (D-Lit), General Help Seeking Questionnaire (GHSQ), Mental Help Seeking Attitudes Scale (MHSAS), Self-Stigma of Seeking Help Scale (SSOSH), and Beliefs toward Mental Illness (BMI). RESULTS: Mental help-seeking attitude had a significant relationship with self-stigma on seeking help (r = -.258, p < .001), general help-seeking attitude (r = .156, p = .027), and age (r = .187, p < .001). However, the strongest predictor for mental help-seeking attitude was self-stigma on seeking help (F (2,199) = 8.207, p < .001 with R2 of .076). University students had better depression literacy and lower levels of self-stigma and negative beliefs toward mental illness compared to secondary school students. CONCLUSION: Higher self-stigma and younger age were associated with negative mental help-seeking attitudes among students from low-income households. As self-stigma may be a barrier to actual mental help-seeking, efforts to reduce self-stigma in this population need to be intensified.


Assuntos
Alfabetização em Saúde , Transtornos Mentais/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Estigma Social , Estudantes/psicologia , Adolescente , Atitude Frente a Saúde , Estudos Transversais , Depressão/psicologia , Feminino , Humanos , Malásia , Masculino , Saúde Mental , Instituições Acadêmicas , Inquéritos e Questionários , Universidades , Adulto Jovem
10.
BMC Infect Dis ; 19(1): 496, 2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31170921

RESUMO

BACKGROUND: HIV testing serves as a critical gateway for linkage and retention to care services, particularly in sub-Saharan African countries with high burden of HIV infections. However, the current progress towards addressing the first cascade of the 90-90-90 programme is largely contributed by women. This study aimed to map evidence on the intervention strategies to improve HIV uptake among men in sub-Saharan Africa. METHODS: We conducted a scoping review guided by Arksey and O'Malley's (2005) framework and Levac et al. (2010) recommendation for methodological enhancement for scoping review studies. We searched for eligible articles from electronic databases such as PubMed/MEDLINE; American Doctoral Dissertations via EBSCO host; Union Catalogue of Theses and Dissertations (UCTD); SA ePublications via SABINET Online; World Cat Dissertations; Theses via OCLC; and Google Scholar. We included studies from January 1990 to August 2018. We used the PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. The Mixed Method Appraisal Tool version 2018 was used to determine the methodological quality of the included studies. We further used NVivo version 11 to aid with content thematic analysis. RESULTS: This study revealed that teaching men about HIV; Community-Based HIV testing; Home-Based HIV testing; Antenatal Care HIV testing; HIV testing incentives and HIV Self-testing are important strategies to improving HIV testing among men in sub-Saharan Africa. The need for improving programmes aimed at giving more information to men about HIV that are specifically tailored for men, especially given their poor uptake of HIV testing services was also found. This study further revealed the need for implementing Universal Test and Treat among HIV positive men found through community-based testing strategies, while suggesting the importance of restructuring home-based HIV testing visits to address the gap posed by mobile populations. CONCLUSION: The community HIV testing, as well as, HIV self-testing strategies showed great potential to increase HIV uptake among men in sub-Saharan Africa. However, to address poor linkage to care, ART should be initiated soon after HIV diagnosis is concluded during community testing services. We also recommend more research aimed at addressing the quality of HIV self-testing kits, as well as, improving the monitoring systems of the distributed HIV self-testing kits.


Assuntos
Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Programas de Rastreamento , Participação do Paciente/estatística & dados numéricos , Adulto , África ao Sul do Saara/epidemiologia , Atitude Frente a Saúde , Demografia/estatística & dados numéricos , Prática Clínica Baseada em Evidências , Feminino , Geografia , HIV , Infecções por HIV/transmissão , Humanos , Masculino , Programas de Rastreamento/métodos , Programas de Rastreamento/organização & administração , Programas de Rastreamento/estatística & dados numéricos , Programas Nacionais de Saúde/organização & administração , Programas Nacionais de Saúde/normas , Programas Nacionais de Saúde/estatística & dados numéricos , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Testes Sorológicos
11.
Am J Orthod Dentofacial Orthop ; 155(6): 826-831, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31153503

RESUMO

INTRODUCTION: "Upstream" decisions by patients are important in determining whether they seek orthodontic care for their children and for themselves and whether they seek care from general dentists or from orthodontists. Classic marketing theory suggests that purchase decisions naturally progress through a sequence beginning with awareness and proceeding to information, emotional preferences, and final purchase commitment. METHODS: A survey was used to assess patient demographics and care history, motives for seeking care for themselves and their children, perceived barriers to care, trust in various sources of information, and preference for treatment by a general dentist or by an orthodontist. Three hundred fifty-two responses were received from patients in all states in the United Sates attending their general dentists. RESULTS: Care for children was most often initiated in response to a suggestion from the family dentist, and traditional treatment with braces was expected. Adults were slightly more likely to make a decision for care themselves and for appearance reasons, often with "invisible" braces. Cost was the principal barrier to seeking care for either functional or appearance reasons. More personal and individualized sources of information, such as the family dentist or referral to a specialist were strongly more influential, with indirect sources, such as dentist Web pages or advertisements, being least influential. There was a preference for care by orthodontists compared with general dentists for functional reasons and when complications were anticipated. Orthodontists were seen as being better at identifying complications, managing complications, and delivering reliable results. Orthodontic care provided by general dentists was favored for convenience and based on established relationships. Patients with more education, higher incomes, and more preventive oral habits preferred treatment by orthodontists. Although it was expected that orthodontists would charge more, income and cost were not factors among those considering treatment. CONCLUSIONS: This study suggests that orthodontists should focus on educating potential patients about the functional health features of treatment for malocclusions, especially for children. Furthermore, orthodontists would benefit from working with general dentists, given their role as gatekeepers in the sequential process of reaching an upstream decision about seeking orthodontic care.


Assuntos
Tomada de Decisões , Ortodontia , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , Atitude Frente a Saúde , Feminino , Humanos , Masculino , Motivação , Estados Unidos
12.
Sante Publique ; Vol. 31(1): 125-135, 2019 January February.
Artigo em Francês | MEDLINE | ID: mdl-31210508

RESUMO

OBJECTIVES: Involving citizens-patients in decisions regarding telehealth services could allow a better match between the services offered and the needs and contexts of individuals and communities. This study aims to explore the organizational and systemic conditions that can influence citizen-patient involvement in the development of telehealth in Quebec. METHODS: A qualitative study based on semi-structured interviews with 29 key informants was conducted. A deductive-inductive thematic analysis was performed based on an integrative framework derived from diffusion of innovation theories. RESULTS: Citizen-patient involvement in the development of telehealth remains dependent on many organizational and systemic conditions. At the organizational level, it could affect the dynamics, process, cultures, rules and operations in organizations; hence the needs for adequate human and material resources as well as the availability of support for change. At the systemic level, the ideology, the sociopolitical context and the decisions in favor (or not) of a citizen appropriation of the decision-making are central. Concerns about scientific evidence, training, as well as the roles of professional federations, and citizen-patient groups have also emerged. Organizational and systemic levels are interdependent. CONCLUSION: The organizational and systemic contexts may explain part of the contrast between the discourse in favor of citizen-patient involvement in telehealth decision-making and the reality observed in Quebec. This study provides a basis for analyzing citizen-patient involvement in services development from the perspective of organizational and systemic changes.


Assuntos
Difusão de Inovações , Serviços de Saúde , Participação do Paciente , Telemedicina , Atitude Frente a Saúde , Política de Saúde , Humanos , Pesquisa Qualitativa , Quebeque
13.
Postgrad Med ; 131(5): 357-365, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31155994

RESUMO

Objective: Our aim was to explore how differing attitudes, expectations, and experiences among people with obesity (PwO) and healthcare providers (HCPs) might have an impact on effectively implementing current obesity treatment guidelines. Methods: Online surveys were conducted among 3,008 adult PwO (BMI≥30 by self-reported height and weight) and 606 HCPs. Results: PwO with weight loss ≥ 10% during the previous three years were more likely to have been diagnosed with obesity and to have discussed a weight loss plan with an HCP. However, only 21% believe HCPs have a responsibility to actively contribute to their obesity treatment. Further, HCPs tend not to effectively communicate the diagnosis of obesity, its nature as a serious and chronic disease, the full range of treatment options, and obesity's implications for health and quality of life. Regarding treatment goals, HCPs more often focus on BMI reduction, while PwO's goals focus on improved functioning, energy, and appearance. HCPs also tend to underestimate their patients' motivation to address their obesity. Twenty-eight percent of HCPs 'completely agreed' that losing weight was a high priority for PwO, whereas more than half of PwO 'completely agreed' that losing weight was a high priority for them. When asked how their HCP could better support them, PwO most often expressed a desire for helpful resources, as well as assistance with specific and realistic goal-setting to improve health. Conclusions: HCPs can more effectively implement obesity treatment guidelines by more clearly and proactively communicating with PwO about their diagnosis, health implications of obesity, desired treatment goals, and the full range of treatment options. HCPs should understand that most PwO believe that managing their disease is solely their own responsibility. HCPs can also encourage more effective conversations by better appreciating their patients' motivation and treatment goals.


Assuntos
Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Pessoal de Saúde/psicologia , Obesidade/patologia , Autorrelato , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/terapia , Autogestão/psicologia , Apoio Social , Perda de Peso
14.
BMC Public Health ; 19(1): 701, 2019 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-31170950

RESUMO

BACKGROUND: Parental support is an important element in overweight prevention programs for children. The purpose of this study was to examine everyday life situations in which mothers encounter difficulties encouraging healthy energy balance-related behavior in their school-age children. METHODS: We formed four focus groups containing 6-9 participants each. The participants were mothers of Dutch, Turkish, or Moroccan descent with a child 8-13 years of age. All focus group sessions were recorded, transcribed, and coded. Content was analyzed conventionally using ATLAS.ti 6. RESULTS: Twenty-seven difficult everyday life situations were identified in 14 settings. The five most frequently reported situations were a daily struggle regarding eating vegetables, eating breakfast on time before going to school, eating candy and snacks between meals, and spending excessive time watching television and using the computer. A perceived loss of parental control, the inability to establish rules and the failure to consistently enforce those rules were the most commonly cited reasons for why the mothers experience these situations as being difficult. CONCLUSIONS: We identified five difficult everyday life situations related to healthy energy balance-related behavior. These five difficult situations were used as the input for developing a web-based parenting program designed to prevent children from becoming overweight. We reasoned that if we use these situations and the underlying reasons, many parents would recognize these situations and are willing to learn how to deal with them and complete the e-learning.


Assuntos
Comportamento Infantil/psicologia , Comportamentos Relacionados com a Saúde , Mães/psicologia , Relações Pais-Filho , Poder Familiar/psicologia , Adolescente , Adulto , Atitude Frente a Saúde , Criança , Comportamento Infantil/etnologia , Ingestão de Alimentos/psicologia , Feminino , Grupos Focais , Humanos , Masculino , Refeições/psicologia , Marrocos/etnologia , Países Baixos/etnologia , Sobrepeso/prevenção & controle , Sobrepeso/psicologia , Poder Familiar/etnologia , Percepção , Turquia/etnologia
16.
Int J Surg ; 66: 84-88, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31055078

RESUMO

BACKGROUND: In 2015-16, the National Health Service (NHS) Litigation Authority received 10,965 claims for clinical negligence, with surgery having the highest number of claims. Currently a sum amounting to 25% of the annual NHS budget has been ring-fenced to meet extant claims. Claims made on a basis of inadequate informed consent are increasingly seen with many achieving a successful plaintiff outcome. There are presently no UK guidelines for thyroidectomy consent. METHOD: A prospective study was performed to investigate current consent practice among the British Association of Endocrine and Thyroid Surgeons (BAETS) membership and patients having previously undergone thyroidectomy. For surgeons, the Bolam legal test applied where surgeons declared what risks and complications they routinely consented for during their practice. A study was also undertaken in patients who had previously undergone thyroidectomy for cancer applying the rule of Montgomery. RESULTS: Consent practice from 193 surgeons and data from 415 patients was analysed. In total thyroidectomy for cancer, 95% of surgeons consent for Recurrent Laryngeal Nerve (RLN) injury and temporary or permanent voice change. 70% specifically consent for External Laryngeal Nerve (ELN) injury, 50% for tracheostomy and 55% for general anaesthetic associated complications. Analysis of patient data showed they would like to be consented for far more risks than they are presently informed about in general medical practice. There was significant variation in the consenting practice in BAETS surgeons. CONCLUSION: A BAETS approved consensus guideline to standardise UK consent practice would be appropriate. This may reduce complaints, litigation claims and guide expert witnesses.


Assuntos
Consentimento Livre e Esclarecido/legislação & jurisprudência , Tireoidectomia/efeitos adversos , Tireoidectomia/normas , Adulto , Anestesia Geral/efeitos adversos , Atitude Frente a Saúde , Feminino , Humanos , Traumatismos do Nervo Laríngeo/etiologia , Masculino , Imperícia/legislação & jurisprudência , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Prospectivos , Traumatismos do Nervo Laríngeo Recorrente/etiologia , Medicina Estatal/legislação & jurisprudência , Medicina Estatal/normas , Inquéritos e Questionários , Reino Unido
18.
BMC Public Health ; 19(1): 600, 2019 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-31101099

RESUMO

BACKGROUND: Kamrangirchar and Hazaribagh are the largest slum areas in Dhaka, Bangladesh. In 2013, Médecins Sans Frontières initiated an urban healthcare programme in these areas providing services for factory workers and responding to the sexual and reproductive health needs of young women. Little in-depth information is available on perceptions of health and health seeking behaviour in this population. We aimed to provide a better understanding of community perceptions toward health and health care in order to inform programme strategies. METHODS: In-depth interviews were conducted with women (n = 13); factory workers (n = 14); and key informants (n = 13). Participants were selected using purposive maximum variation sampling and voluntarily consented to take part. Topic guides steered participant-led interviews, which were audio-recorded, translated and transcribed from Bangla into English. By comparing cases, we identified emerging themes, patterns and relationships in the data. NVivo11© was used to sort and code the data. RESULTS: Emerging themes indicated that in Kamrangirchar and Hazaribagh, health is seen as an asset necessary for work and, thus, for survival. Residents navigate a highly fragmented health system looking for 'quick fixes' to avoid time off work, with the local pharmacy deemed 'good enough' for 'common' health issues. Health care seeking for 'serious' conditions is characterised by uncertainty, confusion, and unsatisfactory results. Decisions are made communally and shaped by collective perceptions of quality care. People with limited socio-economic capital have few options for care. 'Quality care' is perceived as comprehensive care 'under one roof,' including predictive biomedical diagnostics and effective medication, delivered through a trusting relationship with the care provider. CONCLUSIONS: Health seeking behaviour of slum dwellers of Kamrangirchar and Hazaribagh is based on competing priorities, where quick and effective care is key, focussed on the ability to work and generate income. This takes place in a fragmented healthcare system characterised by mistrust of providers, and where navigation is informed by word-of-mouth experiences of peers. Improving health in this context demands a comprehensive and integrated approach to health care delivery, with an emphasis on rapid diagnosis, effective treatment and referral, and improved trust in care providers. Health education must be developed in collaboration with the community to identify knowledge gaps, support decision-making, and be channelled through existing networks. Further research should consider the effectiveness of interventions aiming to improve the practice of pharmacists.


Assuntos
Atitude Frente a Saúde , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Pobreza/psicologia , Trabalho/psicologia , Adulto , Bangladesh , Tomada de Decisões , Assistência à Saúde , Feminino , Humanos , Pessoa de Meia-Idade , Áreas de Pobreza , Relações Profissional-Paciente , Pesquisa Qualitativa , Confiança
19.
Br J Nurs ; 28(9): 552-557, 2019 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-31070960

RESUMO

BACKGROUND: person-centred care should be responsive to the needs of older adults in long-term care. It is central to collaborative and high-quality healthcare delivery. AIM: to explore the perceptions of older Irish adults aged 65 years of age or more regarding the person-centred climate of the long-term care setting in which they live. METHOD: a cross-sectional study design using the Person-centered Climate Questionnaire-Patient (PCQ-P) was used to survey 56 older adults in a long-term care setting. RESULTS: overall, residents considered the setting to be hospitable, welcoming, clean and safe; the mean (SD) scale score was 5.39 (0.520). Psychosocial concerns about adapting to living in long-term care environments need to be addressed, particularly among the younger male residents when compared with older male residents (53.8% v 86.7%, P=0.018). CONCLUSION: older people in long-term care may prioritise different facets of person-centredness to staff. Further research of approaches used in Irish older adult long-term person-centred care delivery is warranted.


Assuntos
Atitude Frente a Saúde , Necessidades e Demandas de Serviços de Saúde , Instituição de Longa Permanência para Idosos/organização & administração , Casas de Saúde/organização & administração , Assistência Centrada no Paciente/organização & administração , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Irlanda , Assistência de Longa Duração , Masculino , Pessoa de Meia-Idade
20.
Br J Nurs ; 28(9): 588-589, 2019 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-31070963

RESUMO

Emeritus Professor Alan Glasper, University of Southampton, reflects on media coverage of the use of vaccines and discusses a range of initiatives to address public fears around immunisation through vaccination.


Assuntos
Atitude Frente a Saúde , Medo , Vacinação/psicologia , Educação em Saúde , Humanos , Meios de Comunicação de Massa , Pais/psicologia , Sociedades , Reino Unido , Vacinas/administração & dosagem , Vacinas/efeitos adversos , Organização Mundial da Saúde
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA