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1.
J. Health Biol. Sci. (Online) ; 10(1): 1-5, 01/jan./2022. ilus
Artigo em Inglês | LILACS | ID: biblio-1370898

RESUMO

Introduction: The use of computers, tablets, and cell phones with the Internet by people with quadriplegia from spinal cord injuries is much lower when compared to the general population. The quality of life of these people can be substantially improved through access to these technologies, which would allow a quadriplegic to take advantage of the rapid evolution of information and communication. Many of these individuals have the function of preserved neck and mouth muscles, and it is possible to manipulate intraoral devices as an adaptation tool. Case Report: We report an intraoral device installation in a patient with quadriplegia, a victim of a firearm accident, who had a great desire to reuse the tablet for internet access. A device made of acrylic resin, similar to a myorelaxant plate, was designed to allow the use of a computer that was comfortable and at the same time, the patient could talk and not harm the dental structures. The person responsible agreed to participate in the research and signed the consent form. In addition, the work was submitted to an ethics committee. Considerations: The ideal intra-oral device for patient rehabilitation should be inexpensive, easy to adapt and promote muscle relaxation besides allowing the patient to expand their abilities and digitally increase their autonomy for society.


Introdução: O uso de computadores, tablets e celulares com internet por pessoas com tetraplegia por lesão medular é muito menor quando comparado à população geral. A qualidade de vida dessas pessoas pode ser, substancialmente, melhorada por meio do acesso a essas tecnologias, o que permitiria aos tetraplégicos aproveitar a rápida evolução da informação e da comunicação. Muitos desses indivíduos têm a função de músculos cervicais e bucais preservados, sendo possível a manipulação de dispositivos intraorais como ferramenta de adaptação. Relato de Caso: Relatamos a instalação de um dispositivo intraoral em um paciente com tetraplegia, vítima de acidente com arma de fogo, que tinha grande desejo de reutilizar o tablet para acesso à internet. Um dispositivo feito de resina acrílica, semelhante a uma placa miorrelaxante, foi projetado para permitir o uso de um computador que fosse confortável e, ao mesmo tempo, o paciente pudesse falar e não prejudicar as estruturas dentárias. O responsável concordou em participar da pesquisa e assinou o termo de consentimento. Além disso, o trabalho foi submetido a um comitê de ética. Considerações: O dispositivo intraoral ideal para a reabilitação do paciente deve ser barato, de fácil adaptação e promover o relaxamento muscular, além de permitir que o paciente amplie suas habilidades e aumente sua autonomia pessoal, digitalmente para a sociedade.


Assuntos
Inclusão Digital , Inclusão Social , Quadriplegia , Computadores , Pessoas com Deficiência , Comunicação , Adaptação a Desastres , Autonomia Pessoal
2.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-49144

RESUMO

Programa Revozes, podcast de divulgação científica e entrevistas com os autores da Revista Eletrônica de Comunicação, Informação e Inovação em Saúde (Reciis), da Fundação Oswaldo Cruz. As tensões entre os discursos oficiais e as vivências de mulheres durante o período de amamentação e desmame, foi o assunto discutido no ep. #5 do programa, que teve como convidada a pesquisadora do Instituto de Comunicação e Informação Científica e Tecnológica em Saúde da Fundação Oswaldo Cruz (Icict/Fiocruz), Irene Kalil.


Assuntos
Aleitamento Materno , Desmame , Autonomia Pessoal , Promoção da Saúde
3.
Int J Equity Health ; 21(1): 127, 2022 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-36076199

RESUMO

Alcohol is the leading cause of healthy years lost. There is significant variation in alcohol consumption patterns and harms in Australia, with those residing in the Northern Territory (NT), particularly First Nations Australians, experiencing higher alcohol-attributable harms than other Australians. Community leadership in the planning and implementation of health, including alcohol, policy is important to health outcomes for First Nations Australians. Self-determination, a cornerstone of the structural and social determinants of health, is necessary in the development of alcohol-related policy. However, there is a paucity of published literature regarding Indigenous Peoples self-determination in alcohol policy development. This study aims to identify the extent to which First Nations Australians experience self-determination in relation to current alcohol policy in Alice Springs/Mbantua (Northern Territory, Australia).Semi-structured qualitative yarns with First Nations Australian community members (n = 21) were undertaken. A framework of elements needed for self-determination in health and alcohol policy were applied to interview transcripts to assess the degree of self-determination in current alcohol policy in Alice Springs/Mbantua. Of the 36 elements, 33% were not mentioned in the interviews at all, 20% were mentioned as being present, and 75% were absent. This analysis identified issues of policy implementation, need for First Nations Australian leadership, and representation.Alcohol policy for First Nations Australians in the NT is nuanced and complicated. A conscious approach is needed to recognise and implement the right to self-determination, which must be led and defined by First Nations Australians.First Nations Australians' experiences of current alcohol policy in Central Australia: evidence of self-determination?


Assuntos
Autonomia Pessoal , Política Pública , Humanos , Northern Territory , Formulação de Políticas
4.
Artigo em Inglês | MEDLINE | ID: mdl-36078336

RESUMO

This study examined how intrinsic motivation and its respective underlying mechanism influence people's attitude and intentions of organ donation. The findings revealed the importance of meeting people's customized psychological needs. For the general population, especially non-organ donors, autonomous appeal message will be more effective in promoting their intention of becoming an organ donor. For registered organ donors, competence-based organ donation messages are more effective in increasing their promotion and seeking behavior of organ donation. This study also discovered underlying mechanisms of intrinsic motivation, such as self-integrity, pride, and sympathy. Pairing underlying mechanism with competence-based messages can maximize the message impact.


Assuntos
Obtenção de Tecidos e Órgãos , Humanos , Intenção , Motivação , Autonomia Pessoal , Doadores de Tecidos/psicologia
5.
Artigo em Inglês | MEDLINE | ID: mdl-36078378

RESUMO

Following up on previous research demonstrating the high level of care realized by a paternalistic Mexican physician, the present research further explored the hypothesis that there are cultural differences in preferences for and experiences with physician paternalism vs. patient autonomy in White American culture as compared with Mexican culture. In this research, we interviewed sixty (60) people including twenty (20) Mexican, twenty (20) Mexican American, and twenty (20) White American respondents. We asked these patients about their experiences with and attitudes towards paternalism and patient autonomy in healthcare interactions. With some caveats, our data showed strong support for both hypotheses while also suggesting a high level of care can be realized by paternalistic physicians when "paternalism" is understood in a cultural context. We close with a brief consideration of the implications of these findings.


Assuntos
Preferência do Paciente , Médicos , Tomada de Decisões , Humanos , Paternalismo , Autonomia Pessoal , Relações Médico-Paciente
6.
Artigo em Inglês | MEDLINE | ID: mdl-36078402

RESUMO

This paper analyses the relationship between emotional intelligence (attention, clarity and repair) and motivational mediators (relationships, autonomy and perceived competence) of students of different degrees related to physical activity and sports science. A structural equation model was estimated with a sample of university students. The results of the model are representative of this case study only and are not very generalizable due to the sample size. In any case, the results obtained show that emotional intelligence predicts the satisfaction of psychological needs for autonomy and competence in student athletes. Therefore, these demonstrations point to a relationship between both variables and highlight the importance of addressing this type of content in university classrooms in order to increase the positive effects on the psychosocial development and personal well-being of students.


Assuntos
Atletas , Inteligência Emocional , Atletas/psicologia , Humanos , Motivação , Autonomia Pessoal , Satisfação Pessoal , Estudantes/psicologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-36078437

RESUMO

This study aims to investigate table tennis players' personality traits and motives in the frame of the Big Five personality model and the self-determination theory (SDT) of motivation. A total of 447 Italian table tennis players ranging in level of play between the regional and international levels participated in the study. They completed a self-report questionnaire measuring their personality traits and motives to play table tennis. Findings showed conscientiousness as the most distinctive trait of table tennis players. No differences were detected between elite and non-elite players. Table tennis players are mainly motivated by factors belonging to the intrinsic pole of the self-determination motivational continuum. External reinforcements represent a minimal incentive to play this sport both for elite and non-elite athletes. The current findings help clarify the relationships between personality traits, playing certain types of sports, and achieving different performance levels. We conclude by outlining implications for applied sport psychology.


Assuntos
Esportes , Tênis , Humanos , Motivação , Autonomia Pessoal , Personalidade
8.
Conscious Cogn ; 104: 103382, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35914430

RESUMO

In psychology and neuroscience, opposition to free will has asserted that any degree of perceived self-control or choice is a mere epiphenomenon which provides no meaningful influence on action. The present research tested the validity of this conclusion by designing a paradigm in which the potential effect of self-monitoring on motor output could be investigated. Using a repetitive finger tapping task that evokes automatic patterns in participants tapping responses, we have obtained evidence that (1) participants may voluntarily reduce the predictability of their tapping patterns (2) by exercising cognitive control that (3) modulates response-locked steady-state movement-related potentials over primary and supplementary motor areas. These findings challenge the most radical accounts of the nonexistence of free will and instead provide support for a more balanced model of human behaviour in which cognitive control may constrain automatic response tendencies in response preparation and action execution.


Assuntos
Córtex Motor , Autonomia Pessoal , Cognição , Eletroencefalografia , Potenciais Evocados/fisiologia , Dedos/fisiologia , Humanos , Córtex Motor/fisiologia , Movimento/fisiologia
9.
Dtsch Med Wochenschr ; 147(17): 1121-1127, 2022 09.
Artigo em Alemão | MEDLINE | ID: mdl-36030785

RESUMO

The use of coercion in complex situations, such as intensive care therapy, requires special attention, as patients are in a situation of dependency and often limited self-determination. Coercion can also arise in intensive care situations, including situations where a person's natural will is overcome.Coercion as freedom-restricting, -limiting measures and forced treatment in ICUs exists in the form of formal and informal coercion and is perceived by the patient. Formal coercion includes measures such as restraints, sedation and environment. Informal coercion arises from influence, such as manipulation, inadequate or false information, lack of communication and threat.Longer-term, i. e. > 30 minutes, measures restricting or withdrawing freedom, as well as compulsory treatment, are subject to authorization.The central conflict in the use of coercion is the tension between self-determination of the patient and care, the protection of the patient from harm.In intensive care, phases of agitation, delirium, but also dementia or depressive phases, hypoactivity are commonplace in patients. The use of coercive measures in emergency situations is only possible if it has been examined according to legal and medical-ethical criteria and there are no alternatives (ultima ratio) for the use of coercion.The use of coercion as "ultima ratio" includes the verification of decision-making capacity and the assessment/examination of the critical situation. Only in exceptional cases of incapacity to consent and in the event of "imminent significant damage to health" may measures restricting or withdrawing freedom be used.Treatment in the intensive care unit is based on a current indication with medical evidence, as well as the standards and process structures. To avoid formal and informal coercion, it is crucial to establish an image of humanity in the interprofessional team that respects the patient and his autonomy and implements this in everyday life and training concepts.Concepts to be recognized and name the use of coercion and to avoid coercion include: Recognition of risk situations for coercion, standards to avoid coercion in ICUs, education and training in communication.


Assuntos
Coerção , Autonomia Pessoal , Cuidados Críticos , Humanos
10.
Healthc Manage Forum ; 35(5): 296-300, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35924794

RESUMO

The global pandemic expedited the adoption of AgeTech solutions that aim to help older adults maintain their autonomy and independence. This article examines the negative impact of the Western worldview of autonomy and independence on older adults. Negative impact can manifest as ageism and may be compounded by intersections of identities with race, gender, and culture. We propose an inclusive framework for health leaders, one that is not binary or categorical, but instead, on a continuum: (1) relational autonomy which assumes that relationships form one's identity; therefore, no one is autonomous to the exclusion of others, and (2) interdependence which proposes that one's lifestyle choice is supported by interreliance with aspects of one's environment. We examine two examples of AgeTech from the perspective of relational autonomy and interdependence and discuss how health leaders can use this inclusive framework to ensure that their services do not discriminate against older adults.


Assuntos
Envelhecimento , Autonomia Pessoal , Idoso , Humanos , Tecnologia
12.
J Am Coll Surg ; 235(3): 539-543, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-35972176

RESUMO

As surgical care continues to transition to an outpatient setting, ambulatory surgery centers (ASCs) present favorable options for physician investment. As of 2017, more than 90% of ASCs have at least some physician ownership, with 64% solely physician-owned. Yet, physician ownership creates an inherent conflict of interest known as dual agency, where clinicians have a personal financial stake in addition to their obligation towards patient well-being. Here, we assess the ethical considerations surrounding dual agency in the setting of ASCs through the lens of beneficence, nonmaleficence, autonomy, and justice. We further propose strategies for appropriate navigation of such situations, including disclosure of ownership status, instruction on unfamiliar techniques, and adherence to accepted clinical practice guidelines for materials selection and surgical indications.


Assuntos
Propriedade , Cirurgiões , Procedimentos Cirúrgicos Ambulatórios , Beneficência , Revelação , Humanos , Investimentos em Saúde , Autonomia Pessoal
14.
Perspect Biol Med ; 65(2): 207-212, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35938428

RESUMO

As a clinical ethics consultant, I've received numerous consultation requests from health-care providers that reflect the tension at the heart of the concept of dignity of risk, often presented in this form: "The patient wants to [do something that we think is unsafe]. How can we change their mind or stop them?" These consultation requests are almost always framed within a medicalized conception of risk: each is presented as a medical provider's concern that a patient's behavior or choice will lead to a specific physiological harm that the medical team wishes to avoid. However, this medicalized perspective neglects the subjective nature of self-determined choices and ignores important aspects of how patients integrate their disability or illness into a broader narrative of how their preferences and actions fit within their self-understanding. In this article, I offer ways to reframe provider perspectives as an attempt to foster an empathetic understanding of "risky" patient preferences at the physiological, environmental, and psychosocial levels.


Assuntos
Consultoria Ética , Eticistas , Ética Clínica , Humanos , Narração , Autonomia Pessoal
15.
Perspect Biol Med ; 65(2): 232-241, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35938431

RESUMO

Hospitals have both a regulatory and an ethical mandate to craft a safe discharge plan for all patients. These plans can become a source of conflict between clinicians and patients when they have differing conceptions of safety and best interests. In bioethics principles this conflict can be characterized as the tension between the patient's right to make medical decisions in accordance with their values, or autonomy, and the clinician's obligation to provide best care to their patients, or beneficence. Employed independently, these principles can be limiting and may not accommodate the nuanced narrative of patients who lack decisional capacity but have expressed clear preferences about where they wish to live. Utilizing case-based discussion, this article explores how the inclusion of Robert Perske's dignity of risk principal in bioethics consultation can support clinicians in expanding their conceptions of beneficence and safety, providing the team with the freedom to craft discharge plans that keep the patient at the center of the narrative.


Assuntos
Bioética , Autonomia Pessoal , Beneficência , Humanos , Encaminhamento e Consulta , Respeito
16.
Artigo em Inglês | MEDLINE | ID: mdl-36012028

RESUMO

The objective of this research work was to analyse the different profiles that can be identified, based on levels of responsibility in relation to Self-Determination Theory, school climate and violence in Physical Education classes. For this, a total of 470 students of Compulsory Secondary Education or Baccalaureate were given a questionnaire where aspects related to motivation, basic psychological needs, responsibility, school social climate and violence were analysed. An analysis of these profiles was conducted, taking into account the variables of "personal responsibility" and "social responsibility", with the results leading to the conclusion that three profiles exist: "low responsibility" (n = 89), "moderate responsibility" (n = 187) and "high responsibility" (n = 194). The results reflected statistically significant differences in all the variables between the three profiles. The high responsibility cluster obtained significantly higher values for the different constructs of motivation (except in external regulation, where there were no differences, compared to the "moderate responsibility" group), basic psychological needs and school social climate. On the other hand, it obtained lower values in amotivation and violence, with no differences based on the sex or age of the participants in the distribution of the clusters. It is concluded that the more responsible profile can have positive results in psychological variables in Physical Education classes and in the general educational field. For this reason, the use of active methodologies, which have been extensively studied to promote responsibility in PE classes, could be an appropriate strategy to achieve a more adaptive psychological profile regardless of the gender or age of the students.


Assuntos
Motivação , Educação Física e Treinamento , Humanos , Autonomia Pessoal , Instituições Acadêmicas , Estudantes/psicologia
17.
Percept Mot Skills ; 129(5): 1563-1580, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36028995

RESUMO

Sport performance depends in part on psychological factors. Self-determination theory emphasizes that the satisfisfaction of basic psychological needs and autonomous motivation may be linked to positive behavioral results and positive perceptions of performance. Our main objective in this study was to analyze the predictive power of such variables as perceived autonomy support, the satisfaction of psychological needs, and autonomous motivation on perceived sport performance. We recruited 447 young Portuguese athletes/participants (340 males, 107 females; Mage = 15.72 years, SD = 1.8). We had participants complete Portuguese sport versions of the Perceived Autonomy Support Exercise Climate Questionnaire, the Basic Psychological Needs in Exercise Scale, the Behavior Regulation Sport Questionnaire and the Perceived Performance in Sport Questionnaire. A gender invariant structural equation model showed that the coach's autonomy support significantly predicted the satisfaction of psychological needs for autonomy, competence, and relatedness. The satisfaction of these three psychological needs predicted autonomous motivation. Satisfying the need for competence positively predicted perceived sport performance, but autonomous motivation was not significantly related to perceived performance.


Assuntos
Autonomia Pessoal , Esportes , Atletas/psicologia , Feminino , Humanos , Masculino , Motivação , Satisfação Pessoal , Esportes/psicologia
18.
Int J Circumpolar Health ; 81(1): 2087846, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35979584

RESUMO

Historically, research involving Indigenous peoples has been the scene of power imbalances between Indigenous communities and researchers. Indigenous peoples have often been put in the position of passive subjects of research rather than participants or collaborators with agency, a situation that the current movement of decolonisation of research and practices in the field of Indigenous health aims to counteract. Participatory research seeks a better balance of input, decision-making and power between research participants and research teams and values participants' knowledges. As such, it is a particularly relevant approach for researchers to involve community members and support self-determination of Indigenous people. Yet, if its explicit intentions are aiming at a decolonising approach, the socio-structural context of participatory research initiatives in Indigenous communities brings obstacles to the approach's success. The development and implementation of the participatory project Atautsikut: A Community of Practice in Youth Mental Health and Wellness in Nunavik, has been an occasion to document certain barriers that take place in participatory research. This article describes Atautsikut as a starting point for a reflection on the challenges of decolonising participatory research. It discusses how, despite intentions, structural barriers, blind spots and unexpected contextual elements may challenge the journey towards decolonising research.


Assuntos
Pesquisa Participativa Baseada na Comunidade , Povos Indígenas , Adolescente , Humanos , Autonomia Pessoal , Grupos Populacionais
19.
Artigo em Inglês | MEDLINE | ID: mdl-35886398

RESUMO

The COVID-19 pandemic has put postsecondary students across the world at risk of psychological distress, negatively impacting their basic psychological well-being, including self-determination. Although the concept of self-determination has been widely discussed in literature, it is poorly understood within the context of postsecondary students during the COVID-19 pandemic. This study aimed to examine the concept of self-determination (SD) as it relates to postsecondary students amid the COVID-19 pandemic. The Rodgers' evolutionary method of concept analysis was used. PubMed, CINAHL, PsycINFO, and ERIC were electronically searched using the keywords "postsecondary students" "coronavirus pandemic" and "self-determination." The historical, legal, educational, and health science literature were investigated to generate a holistic definition of SD in the past. This analysis has identified the antecedents, attributes, and consequences of self-determination in postsecondary students during this global health crisis. This analysis adds to the knowledge base regarding the evolution, significance, and application of the concept of SD in the context of postsecondary students amidst the COVID-19 pandemic. Implications for future research were also explored, such as using strategies to promote SD in postsecondary students to develop resilience during the pandemic.


Assuntos
COVID-19 , COVID-19/epidemiologia , Humanos , Pandemias , Autonomia Pessoal , Estudantes
20.
Semin Speech Lang ; 43(4): 277-298, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35896406

RESUMO

On any given day, the social mind is taxed with attending to and making sense of a myriad of social events. The social mind is at work when trying to imagine the experiences of others and their inner mental worlds, and is equally active when people seek to approach, connect with, and sometimes avoid one another. Ultimately, the social mind is responsible for thinking about (social) thinking, or social metacognition. Social metacognitive teaching strategies can be helpful for supporting social learners as they observe social landscapes, interpret what is observed to problem solve, or decide whether and how to produce social responses. This article describes how social metacognitive strategies from the Social Thinking Methodology have been used to support the self-determined social goals of two autistic students. Visual frameworks and their underlying theories are provided as evidence-aligned tools for supporting clinical journeys.


Assuntos
Transtorno Autístico , Metacognição , Adolescente , Transtorno Autístico/terapia , Objetivos , Humanos , Autonomia Pessoal , Estudantes
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