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1.
Aust J Gen Pract ; 50(6): 388-393, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34059849

RESUMO

BACKGROUND AND OBJECTIVES: Immunisation uptake in Australian older adults is suboptimal. General practice registrars are responsible for a significant proportion of immunisations in this age group and are also in the process of developing patterns of practice. Despite their role, little is known about general practice registrars' attitudes towards immunisation of older adults, the barriers faced, and the role supervisors play in developing adult immunisation skills. METHOD: This was a qualitative study involving semi-structured interviews with general practice registrars and supervisors purposively sampled from around Australia. Data were analysed using thematic analysis. RESULTS: The five key themes were grouped in terms of perceptions of registrars' role in immunisation of older adults, consultation barriers, health system barriers, managing vaccine hesitancy, and a team approach to vaccination. DISCUSSION: Vaccine positivity is an important attitude to cultivate within the general practice environment as it has an impact on registrar behaviour. Immunisation-skilled nurses could play a role in training general practice registrars in immunisation. Findings from the present study may be useful in improving vaccine uptake in the elderly in the context of the COVID-19 vaccine rollout.


Assuntos
Atitude do Pessoal de Saúde , Vacinas contra COVID-19 , COVID-19/prevenção & controle , Clínicos Gerais/psicologia , Papel do Médico , Idoso , Austrália/epidemiologia , Competência Clínica , Barreiras de Comunicação , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Papel do Profissional de Enfermagem , Aceitação pelo Paciente de Cuidados de Saúde , Equipe de Assistência ao Paciente , Relações Médico-Paciente , Pesquisa Qualitativa , SARS-CoV-2
2.
BMC Med Educ ; 21(1): 324, 2021 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-34092225

RESUMO

BACKGROUND: There is evidence of negative attitudes among health professionals towards people with mental illness but there is also a knowledge gap on what training must be given to these health professionals during their education. The purpose of this study is to compare the attitudes of students of health sciences: nursing, medical, occupational therapy, and psychology. METHODS: A comparative and cross-sectional study in which 927 final-year students from health sciences university programmes were evaluated using the Mental Illness: Clinicians' Attitudes (both MICA-2 and MICA-4) scale. The sample was taken in six universities from Chile and Spain. RESULTS: We found consistent results indicating that stigma varies across university programmes. Medical and nursing students showed more negative attitudes than psychology and occupational therapy students in several stigma-related themes: recovery, dangerousness, uncomfortability, disclosure, and discriminatory behaviour. CONCLUSIONS: Our study presents a relevant description of the attitudes of each university programme for education against stigma in the formative years. Results show that the biomedical understanding of mental disorders can have negative effects on attitudes, and that education based on the psychosocial model allows a more holistic view of the person over the diagnosis.


Assuntos
Atitude do Pessoal de Saúde , Transtornos Mentais , Chile , Estudos Transversais , Humanos , Espanha
3.
BMC Health Serv Res ; 21(1): 561, 2021 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-34098973

RESUMO

BACKGROUND: Although risk prediction has become an integral part of clinical practice guidelines for cardiovascular disease (CVD) prevention, multiple studies have shown that patients' risk still plays almost no role in clinical decision-making. Because little is known about why this is so, we sought to understand providers' views on the opportunities, barriers, and facilitators of incorporating risk prediction to guide their use of cardiovascular preventive medicines. METHODS: We conducted semi-structured interviews with primary care providers (n = 33) at VA facilities in the Midwest. Facilities were chosen using a maximum variation approach according to their geography, size, proportion of MD to non-MD providers, and percentage of full-time providers. Providers included MD/DO physicians, physician assistants, nurse practitioners, and clinical pharmacists. Providers were asked about their reaction to a hypothetical situation in which the VA would introduce a risk prediction-based approach to CVD treatment. We conducted matrix and content analysis to identify providers' reactions to risk prediction, reasons for their reaction, and exemplar quotes. RESULTS: Most providers were classified as Enthusiastic (n = 14) or Cautious Adopters (n = 15), with only a few Non-Adopters (n = 4). Providers described four key concerns toward adopting risk prediction. Their primary concern was that risk prediction is not always compatible with a "whole patient" approach to patient care. Other concerns included questions about the validity of the proposed risk prediction model, potential workflow burdens, and whether risk prediction adds value to existing clinical practice. Enthusiastic, Cautious, and Non-Adopters all expressed both doubts about and support for risk prediction categorizable in the above four key areas of concern. CONCLUSIONS: Providers were generally supportive of adopting risk prediction into CVD prevention, but many had misgivings, which included concerns about impact on workflow, validity of predictive models, the value of making this change, and possible negative effects on providers' ability to address the whole patient. These concerns have likely contributed to the slow introduction of risk prediction into clinical practice. These concerns will need to be addressed for risk prediction, and other approaches relying on "big data" including machine learning and artificial intelligence, to have a meaningful role in clinical practice.


Assuntos
Inteligência Artificial , Médicos , Atitude , Atitude do Pessoal de Saúde , Pessoal de Saúde , Humanos , Pesquisa Qualitativa
4.
Afr J Reprod Health ; 25(1): 20-28, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34077107

RESUMO

Over the past 30 years, the Moroccan government has made enormous strides towards improving maternal health care for Moroccan women, but outcomes for rural women remain much worse than those of their urban counterparts. This study aimed to understand the experiences of women giving birth in rural Morocco, and to identify the barriers they face when accessing facility-based maternity care. Fifty-five participants were recruited from villages in Morocco's rural south to participate in focus group discussions (FGDs), using appreciative inquiry as the guiding framework. Several themes emerged from the analysis of the focus group data. Women felt well-cared for and safe giving birth both at home and in the large, tertiary care hospitals, but not in the small, primary care hospitals. Women who gave birth at the primary care hospitals reported a shortage of some equipment and supplies and poor treatment at the hands of hospital staff. Locating and paying for transportation was identified as the biggest hurdle in accessing maternity care at any hospital. The findings of this study indicate the need for change within primary care health facilities.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde , Serviços de Saúde Materna/organização & administração , Serviços de Saúde Materna/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , Atitude do Pessoal de Saúde , Feminino , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Parto Domiciliar , Humanos , Saúde Materna , Tocologia , Gravidez , Pesquisa Qualitativa , Qualidade da Assistência à Saúde , População Rural
5.
J Pak Med Assoc ; 71(4): 1167-1170, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34125764

RESUMO

OBJECTIVE: To identify the attitudes of medical students towards the clinical importance of embryology. METHODS: The cross-sectional questionnaire-based study was conducted from September to November 2019 at the private-sector Islam Medical College, Sialkot, Pakistan, and comprised first and final year medical students. A validated questionnaire, consisting of 20 statements, was used to collect data. Students had to tick only those statements with which they were in full agreement. Prior to data-collection, a median score was taken of 50 anatomy teachers regarding their opinion on each statement. Data was analysed using Microsoft Excel. RESULTS: Of the 194 subjects, 97(50%) each were from the first and final years. The medical students as well as the faculty were found to be appreciative of the importance of embryology in medical studies, with female students showing better attitudes in both the first and the final year groups (p<0.05). CONCLUSIONS: The attitude of students and faculty was found to be positive towards the importance of embryology in medical education.


Assuntos
Estudantes de Medicina , Atitude , Atitude do Pessoal de Saúde , Estudos Transversais , Feminino , Humanos , Paquistão , Inquéritos e Questionários
6.
BMC Fam Pract ; 22(1): 108, 2021 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-34078281

RESUMO

BACKGROUND: Attempts to manage the COVID-19 pandemic have led to radical reorganisations of health care systems worldwide. General practitioners (GPs) provide the vast majority of patient care, and knowledge of their experiences with providing care for regular health issues during a pandemic is scarce. Hence, in a Danish context we explored how GPs experienced reorganising their work in an attempt to uphold sufficient patient care while contributing to minimizing the spread of COVID-19. Further, in relation to this, we examined what guided GPs' choices between telephone, video and face-to-face consultations. METHODS: This study consisted of qualitative interviews with 13 GPs. They were interviewed twice, approximately three months apart in the initial phase of the pandemic, and they took daily notes for 20 days. All interviews were audio recorded, transcribed, and inductively analysed. RESULTS: The GPs re-organised their clinical work profoundly. Most consultations were converted to video or telephone, postponed or cancelled. The use of video first rose, but soon declined, once again replaced by an increased use of face-to-face consultations. When choosing between consultation forms, the GPs took into account the need to minimise the risk of COVID-19, the central guidelines, and their own preference for face-to-face consultations. There were variations over time and between the GPs regarding which health issues were dealt with by using video and/or the telephone. For some health issues, the GPs generally deemed it acceptable to use video or telephone, postpone or cancel appointments for a short term, and in a crisis situation. They experienced relational and technical limitations with video consultation, while diagnostic uncertainty was not regarded as a prominent issue CONCLUSION: This study demonstrates how the GPs experienced telephone and video consultations as being useful in a pandemic situation when face-to-face consultations had to be severely restricted. The GPs did, however, identify several limitations similar to those known in non-pandemic times. The weighing of pros and cons and their willingness to use these alternatives shifted and generally diminished when face-to-face consultations were once again deemed viable. In case of future pandemics, such alternatives seem valuable, at least for a short term.


Assuntos
Atitude do Pessoal de Saúde , COVID-19/prevenção & controle , Medicina Geral/tendências , Padrões de Prática Médica/tendências , Consulta Remota/tendências , COVID-19/epidemiologia , Tomada de Decisão Clínica/métodos , Dinamarca/epidemiologia , Medicina Geral/métodos , Medicina Geral/organização & administração , Humanos , Entrevistas como Assunto , Pandemias , Relações Médico-Paciente , Padrões de Prática Médica/organização & administração , Pesquisa Qualitativa , Consulta Remota/métodos , Consulta Remota/organização & administração , Telefone , Comunicação por Videoconferência
7.
BMJ Open ; 11(6): e044372, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34078635

RESUMO

OBJECTIVES: To determine the level of knowledge and practice of evidence-based medicine (EBM) and the attitudes towards it and to identify the factors associated with its practice among primary care practitioners in Selangor, Malaysia. SETTING: This cross-sectional study was conducted in randomly selected health clinics in Selangor. Data were collected from primary care physicians using self-administered questionnaires on knowledge, practice and attitudes regarding EBM. PARTICIPANTS: The study included 225 respondents working in either government or private clinics. It excluded house officers and those working in public and private universities or who were retired from practice. RESULTS: A total of 32.9% had a high level of EBM knowledge, 12% had a positive attitude towards EBM and 0.4% had a good level of its practice. The factors significantly associated with EBM practice were ethnicity, attitude, length of work experience as a primary care practitioner and quick access to online reference applications on mobile phones. CONCLUSIONS: Although many physicians have suboptimal knowledge of EBM and low levels of practising it, majority of them have a neutral attitude towards EBM practice. Extensive experience as a primary care practitioner, quick access to online references on a mobile phone and good attitude towards EBM were associated with its practice.


Assuntos
Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Estudos Transversais , Medicina Baseada em Evidências , Humanos , Malásia , Atenção Primária à Saúde , Inquéritos e Questionários
8.
Br J Community Nurs ; 26(6): 278-282, 2021 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-34105372

RESUMO

Vaccination is an important public health intervention, but its effectiveness depends upon the uptake of vaccination reaching sufficient levels to yield 'herd' immunity. While the majority of the UK hold positive attitudes about vaccination, some people, including health professionals, decline vaccinations. This article reviews the evidence relating to vaccine hesitancy, its underlying factors and the sociodemographic variations. A second article will review the evidence relating to strategies to address vaccine hesitancy and promote vaccination acceptance.


Assuntos
Vacinas contra COVID-19 , COVID-19/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Vacinação em Massa/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Atitude do Pessoal de Saúde , Saúde Global , Pessoal de Saúde/psicologia , Humanos , Medição de Risco , Reino Unido
9.
Artigo em Inglês | MEDLINE | ID: mdl-34070763

RESUMO

BACKGROUND: During the COVID-19 pandemic, more than ever, optimal influenza vaccination coverage among healthcare workers (HCWs) is crucial to avoid absenteeism and disruption of health services, as well as in-hospital influenza outbreaks. The aim of this study is to analyze the 2020 influenza vaccination campaign, comparing it with the previous year's in a research and teaching hospital in Northern Italy. METHODS: adopting an approach based on combined strategies, three interventions were deployed: a promotional and educational campaign, vaccination delivery through both ad hoc and on-site ambulatories, and a gaming strategy. Personal data and professional categories were collected and analyzed using univariate logistic regression. Vaccinated HCWs were asked to fill in a questionnaire to describe their reasons for vaccination adherence. RESULTS: the vaccination coverage rate (VCR) was 43.1%, compared to 21.5% in 2019. The highest increase was registered among administrative staff (308.3%), while physicians represent the most vaccinated category (n = 600). Moreover, residents (prevalence ratio (PR): 1.12; 95% CI 1.04-1.20), as well as intensive care (PR: 1.44; 95% CI: 1.24-1.69) and newborn workers (PR: 1.41; 95% CI: 1.20-1.65) were, respectively, the categories most frequently vaccinated for the first time. CONCLUSION: the significant increase in vaccination coverage rate confirms the suitability of the combined strategy of delivering the flu vaccination campaign and represents a first step towards reaching WHO recommended vaccination rates.


Assuntos
COVID-19 , Vacinas contra Influenza , Influenza Humana , Atitude do Pessoal de Saúde , Pessoal de Saúde , Hospitais de Ensino , Humanos , Programas de Imunização , Recém-Nascido , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Itália/epidemiologia , Pandemias/prevenção & controle , SARS-CoV-2 , Inquéritos e Questionários , Vacinação
10.
Rev Esp Salud Publica ; 952021 Jun 02.
Artigo em Espanhol | MEDLINE | ID: mdl-34075016

RESUMO

OBJECTIVE: Breast cancer is a commonly diagnosed disease in nurses that, from recent years, has been linked to shift work and night work. Also, different components of work stress have such an impact on the nurses' health and work, family and social conciliation. The objective of this research was to analyze the family and working characteristics of Spanish nurses who perform shift work (including night shifts) in search of possible associations with manifestations of psychosomatic stress and the risk of breast cancer. METHODS: A cross-sectional descriptive study was conducted through a virtual questionnaire in a sample of 966 Registered Nurses in Spain between December 2019 and November 2020. A descriptive analysis of sociodemographic and occupational variables was performed, and statistically significant differences and associations were contrasted by estimating risks and confidence intervals. RESULTS: The number of night shifts throughout life and the number of years worked were statistically significant for the association with breast cancer. In addition, other psychosomatic manifestations such as insomnia, palpitations or extreme tiredness were highlighted. Among the most appreciated aspects to generate job satisfaction, co-worker's relationship was underlined. CONCLUSIONS: Rotating shift work can cause multiple clinical alterations that could lead to problems related to family conciliation, self-care or employment wellness. It is important to control the physical, psychological and emotional overload of nurses.


Assuntos
Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Família/psicologia , Enfermeiras e Enfermeiros/psicologia , Trabalho/psicologia , Adulto , Neoplasias da Mama/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Enfermeiras e Enfermeiros/estatística & dados numéricos , Jornada de Trabalho em Turnos , Espanha/epidemiologia , Inquéritos e Questionários
11.
Afr J Prim Health Care Fam Med ; 13(1): e1-e8, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34082553

RESUMO

INTRODUCTION: The novel coronavirus 2019 or COVID-19 pandemic has brought about a global public health crisis. Primary care (PC) nurses render first line care, or refer for more specialised services. AIM: To investigate the preparedness of PC nurses for COVID-19 in the Western Cape. SETTING: The Western Cape province of South Africa. METHODS: We administered an online survey, with closed and open-ended questions, to 83 Stellenbosch University postgraduate PC nursing students and alumni working in the Western Cape, between 03 July and 01 September 2020. RESULTS: The results indicated that 43.3% of participants were confident about the infection, prevention, and control (IPC) training they received and 56.7% felt prepared to provide direct care to suspected cases of COVID-19. Primary care nurses were more comfortable to triage (78.3%) than to manage persons with COVID-19 (42.2%), indicating that they may not be functioning to the full capacity of their education and training. Adequate infrastructure was reported by less than a third of the participants (30.1%) and 59.1% reported that personal protective equipment (PPE) was always available. Primary care nurses needed support in coping with stress (57.8%) although few (14.5%) reported access to mental health services. CONCLUSION: Primary care nurses were not prepared optimally for the COVID-19 pandemic. Challenges included adequate training, infrastructure, the availability of personal protective equipment, COVID-19 testing of health care workers and management support. Primary care nurses need comprehensive support to manage stress and anxiety.


Assuntos
Atitude do Pessoal de Saúde , COVID-19/enfermagem , Competência Clínica/estatística & dados numéricos , Enfermagem de Atenção Primária/métodos , Adulto , COVID-19/diagnóstico , COVID-19/prevenção & controle , Teste para COVID-19/métodos , Educação em Enfermagem , Feminino , Humanos , Masculino , Pandemias , Equipamento de Proteção Individual , SARS-CoV-2 , Inquéritos e Questionários
12.
Rev Esp Salud Publica ; 952021 Jun 07.
Artigo em Espanhol | MEDLINE | ID: mdl-34092784

RESUMO

OBJECTIVE: Hospital emergency services have specific care characteristics that make them more vulnerable to the risk of legal claims. The fact of suffering a legal claim for professional practice is a very traumatic event. The objective of this study was to find out the opinion of the professionals of the hospital emergency services in Spain on the importance of practices associated with defensive medicine. METHODS: Survey of 1,449 professionals from public and private hospital emergency services throughout the national territory was made, in the period between March 13th and April 3rd, 2017. A univariate analysis was performed to identify variables in relation to the practice of defensive medicine, and the determination of the groups of greater association (chi2 test) to evaluate these variables. RESULTS: 96.1% expressed the need to strengthen their medical-legal training. 91.3% of the cases felt more legal pressure and 88.7% declared that they act conditioned by the threat of judicial claim. Regarding patient treatments, 89.8% stated that they perform diagnostic tests that may not be necessary and 63% of professionals stated that they extend the stay of patients in the emergency department. As for the healthcare organization, 88% declared that they do not feel protected by the structure and 79.1% do not felt support from the center's management. CONCLUSIONS: Practices associated with defensive medicine are frequent in our country, with a high proportion of criminal proceedings, and the two main causes are dispensable diagnostic tests and unnecessary prolongation of length of stay.


Assuntos
Atitude do Pessoal de Saúde , Medicina Defensiva/organização & administração , Serviço Hospitalar de Emergência/organização & administração , Recursos Humanos em Hospital/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recursos Humanos em Hospital/estatística & dados numéricos , Espanha , Inquéritos e Questionários
13.
J Pak Med Assoc ; 71(6): 1704-1708, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34111106

RESUMO

OBJECTIVE: To determine the awareness and practices of doctors and dentists in detecting and reporting suspected cases of child physical abuse. METHODS: The cross-sectional study was conducted from November 2017 to June 2018 at the Hamdard College of Medicine and Dentistry, Karachi, and comprised doctors and dentists practising in public and private hospitals across Pakistan. Data was collected using a predesigned questionnaire to assess knowledge of the social indicators of child physical abuse, response to child physical abuse, and actions taken by the professionals when they believed a child abuse case had been detected. Data was analysed using SPSS 22. RESULTS: Of the 575 healthcare professionals, 371(64.5%) were doctors and 204(35.5%) were dentists; 347(60.3%) were males; 446(77.6%) were working in private hospitals; 384(66.8%) had <10 years of experience; and 99(17.2%) had received formal training of child abuse. While 450(78.3%) subjects strongly agreed on the value of identifying and documenting child physical abuse, 336(58%) did not take any action in suspected cases. CONCLUSIONS: Although doctors and dentists had a positive attitude regarding child physical abuse, the majority preferred to remain silent in suspected cases.


Assuntos
Maus-Tratos Infantis , Abuso Físico , Atitude do Pessoal de Saúde , Criança , Maus-Tratos Infantis/diagnóstico , Estudos Transversais , Odontólogos , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Paquistão , Inquéritos e Questionários
17.
BMC Med Inform Decis Mak ; 21(1): 173, 2021 05 31.
Artigo em Inglês | MEDLINE | ID: mdl-34059025

RESUMO

BACKGROUND: The promotion of early diagnosis is undoubtedly effective in reducing the burden of disease. Contrast-enhanced ultrasound (CEUS) is a diagnostic technology for liver cancer, but its implementation faces some challenges. Understanding the influencing factors of CEUS utilization is crucial for its successful implementation. However, such research is rare. The aims of this study were to investigate the status of CEUS utilization and its predictors in China. METHODS: Through multistage random sampling, a cross-sectional study design was conducted among physicians in charge of direct use of CEUS working at liver disease-related departments of sampled health institutions. To access the potential influencing factors of physicians' CEUS utilization, a structured questionnaire was developed based on the theoretical model, which was developed by integration of the Theory of Planned Behavior (TPB) and Technology Acceptance Model (TAM). Structural equation modeling was used to verify the proposed hypotheses, and analyze the relationship and mechanism between the factors. RESULTS: A total of 309 physicians were enrolled. The mean score of utilization behavior was 2.04 (SD = 1.07), and 37.22% above the mean. The favorable fitting results demonstrated that the integration of TAM and TPB was an acceptable model. SEM results also identified physicians' intentions to use CEUS was directly associated with utilization behavior (ß = 0.287, P < 0.001). Attitude (ß = 0.272, P < 0.001), subjective norm (ß = 0.172, P = 0.013), perceived behavioral control (ß = 0.491, P < 0.001) and perceived usefulness (ß = 0.108, P = 0.027) significantly influenced physicians' intentions. Besides, subjective norm (ß = 0.065, P = 0.021), perceived behavioral control (ß = 0.141, P = 0.003), and perceived ease of use (ß = 0.022, P = 0.033) indirectly affected physicians' CEUS utilization. CONCLUSIONS: The findings provide a reference for understanding the factors associated with physicians' utilization of CEUS. Additionally, the proposed measures such as building innovative and incentive environment, providing high quality and adequate training, etc., will help promote the utilization of CEUS, thereby increasing the detection rate of liver cancer, and improving the survival rate and the quality of life for liver cancer patients.


Assuntos
Médicos , Qualidade de Vida , Atitude do Pessoal de Saúde , China , Estudos Transversais , Humanos , Intenção , Análise de Classes Latentes , Inquéritos e Questionários , Tecnologia
18.
BMJ Open ; 11(6): e044213, 2021 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-34130958

RESUMO

OBJECTIVES: The primary objective of this study was to evaluate the effectiveness of a half-day training on de-escalation of violence against healthcare personnel regarding prevention and management of violence incidents versus a similar tertiary-level hospital with no such training. Secondary objectives were to compare the overall satisfaction, burnout, fear of violence and confidence in coping with patients' aggression of the healthcare personnel in the two hospitals. DESIGN: Mixed method design, with a comparative cross-sectional (quantitative) and focus group discussions (qualitative) components. SETTING: Emergency departments of the two tertiary care hospitals in district Peshawar over 6 months starting from May 2018. PARTICIPANTS: Healthcare personnel in the emergency departments of the two hospitals (trained vs untrained). OUTCOME MEASURES: Violence exposure (experienced/witnessed) assessed through a previously validated tool in the past 5 months. Burnout, confidence in coping with patient aggression and overall job satisfaction were also assessed through validated tools. The qualitative component explored the perceptions of healthcare personnel regarding the management of violence and the importance of training on de-escalation of violence through focus group discussions in the two hospitals. RESULTS: The demographic characteristics of the healthcare personnel within the two hospitals were quite similar. The de-escalation training did not lead to a reduction in the incidences of violence; however, confidence in coping with patient aggression and the overall satisfaction were significantly improved in the intervention hospital. The de-escalation training was lauded by the respondents as led to an improvement in communication skills, and the healthcare personnel suggested for scale-up to all the cadres and hospitals. CONCLUSION: The study found significant improvements in the confidence of healthcare personnel in coping with patient aggression, along with better job satisfaction and less burnout in the intervention hospital following the de-escalation training.


Assuntos
Violência , Violência no Trabalho , Agressão , Atitude do Pessoal de Saúde , Estudos Transversais , Serviço Hospitalar de Emergência , Humanos , Paquistão , Violência/prevenção & controle , Violência no Trabalho/prevenção & controle
20.
Med J Malaysia ; 76(3): 284-290, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34031324

RESUMO

INTRODUCTION: The Coronavirus Disease 2019 (COVID-19) has dramatically affected global healthcare systems. We aimed to determine the response of our paediatric surgical fraternity to a disease that overwhelmingly affects adults. MATERIALS AND METHODS: We conducted a cross-sectional questionnaire-based study over 6 weeks during a federally mandated lockdown. Using snowball sampling, we recruited paediatric surgeons, trainees and medical officers from paediatric surgical units in Malaysia. The anonymous online questionnaire covered sociodemographic information, changes in patient care, redeployment, concerns regarding family members, and impact on training. Mental well-being was assessed using the Depression, Anxiety and Stress Scale (DASS-21). Kruskal-Wallis, ANOVA and multiple regression analysis was used, with significance level 0.05. RESULTS: Of the 129 eligible participants, 100(77%) responded. Junior doctors had clinically higher levels of depression, anxiety, and stress. Age <30 years was significantly associated with anxiety. Junior doctors believed that redeployment led to loss of surgical skills (p<0.001) and trainees felt that clinical application of knowledge had reduced (p<0.020). CONCLUSION: Specific to our paediatric surgical community, this study highlights areas of concern, particularly among junior doctors. It is likely that recurrent cycles of the pandemic will occur soon. These issues must be addressed to preserve the mental and emotional well-being of all health care workers.


Assuntos
COVID-19 , Transtornos Mentais/etiologia , Doenças Profissionais/etiologia , Pediatras/psicologia , Pediatria/tendências , Especialidades Cirúrgicas/tendências , Cirurgiões/psicologia , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Ansiedade/etiologia , Atitude do Pessoal de Saúde , COVID-19/epidemiologia , COVID-19/prevenção & controle , COVID-19/psicologia , Criança , Estudos Transversais , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/etiologia , Feminino , Humanos , Malásia/epidemiologia , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/epidemiologia , Saúde Mental , Doenças Profissionais/diagnóstico , Doenças Profissionais/epidemiologia , Saúde do Trabalhador , Estresse Ocupacional/diagnóstico , Estresse Ocupacional/epidemiologia , Estresse Ocupacional/etiologia , Pandemias , Pediatras/educação , Pediatras/tendências , Pediatria/educação , Padrões de Prática Médica , Escalas de Graduação Psiquiátrica , Especialidades Cirúrgicas/educação , Cirurgiões/educação , Cirurgiões/tendências , Inquéritos e Questionários
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