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2.
BMJ ; 367: l6322, 2019 12 09.
Artigo em Inglês | MEDLINE | ID: mdl-31818913

RESUMO

OBJECTIVE: To study the effects of recent political events on mood among young physicians. DESIGN: Prospective cohort study. SETTING: United States medical centres. PARTICIPANTS: 2345 medical interns provided longitudinal mood data as part of the Intern Health Study between 2016 and 2018. MAIN OUTCOME MEASURES: Mean mood score during the week following influential political and non-political events as compared with mean mood during the preceding four week control period. RESULTS: We identified nine political events and eight non-political events for analysis. With the start of internship duties in July, the mean decline in mood for interns was -0.30 (95% confidence interval -0.33 to -0.27, t=-17.45, P<0.001). The decline in mood was of similar magnitude following the 2016 presidential election (mean mood change -0.32, 95% confidence interval -0.45 to -0.19, t=-4.73, P<0.001) and subsequent inauguration (mean mood change -0.25, 95% confidence interval -0.37 to -0.12, t=-3.93, P<0.001). Further, compared with men, women reported greater mood declines after both the 2016 election (mean gender difference 0.31, 95% confidence interval 0.05 to 0.58, t=2.33, P=0.02) and the inauguration (mean gender difference 0.25, 95% confidence interval 0.01 to 0.49, t=2.05, P=0.04). Overall, there were statistically significant changes in mood following 66.7% (6/9) of political events assessed. In contrast, none of the non-political events included in the analysis were statistically significantly associated with a change in mood. CONCLUSIONS: Macro level factors such as politics may be correlated with the mood of young doctors. This finding signals the need for further evaluation of the consequences of increasing entanglement between politics and medicine moving forward for young physicians and their patients.


Assuntos
Afeto , Corpo Clínico Hospitalar/psicologia , Política , Centros Médicos Acadêmicos/estatística & dados numéricos , Adulto , Estudos de Coortes , Correlação de Dados , Feminino , Humanos , Internato e Residência , Masculino , Saúde Mental , Pesquisa Qualitativa , Fatores Sexuais , Estados Unidos
3.
Hosp Pract (1995) ; 47(5): 241-248, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31682467

RESUMO

Objectives: One of the current concerns of hospitals is how to become a health promoting hospital (HPH). This qualitative research aimed at exploring the views of members of the medical staff in two Iran hospitals about the defined standards to transform the hospitals into a health promoting one.Methods: The research reported in this paper was a content analysis qualitative study. The license numbered (IR.UMSHA.REC.1395.388) was obtained from the ethics committee of Hamadan Medical Science University. Sampling was carried out through the snowballing method. Also, 55 interviews were conducted with the members of the medical staff. To collect data, the semi-structured interview guide was used based on the standards of HPHs. The framework analysis method was used to analyze the data qualitatively.Results: From three central questions on the basis of the main study question, nine themes were earned. Policies governing the hospitals were in the direction of converting them to health promoting organizations including the creation of a health promoting work environment, empowering personnel and health promoting corporate culture. Also, suggestions to create a HPH included improving management, paying attention to patients and their satisfaction, as well as increasing effective interpersonal relationships in the hospital.Conclusion: The findings showed that it can be a key strategy in this field to use staff's solutions for the existing problems and their opinions on the challenges against establishing the standards for HPHs. People usually accept more comfortable and easy changes in decision-making and implementing processes of which they are involved.


Assuntos
Atitude do Pessoal de Saúde , Promoção da Saúde , Corpo Clínico Hospitalar/psicologia , Feminino , Humanos , Entrevistas como Assunto , Irã (Geográfico) , Masculino , Cultura Organizacional , Pesquisa Qualitativa
4.
Rev Infirm ; 68(254): 25-26, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31587846

RESUMO

The aim of the East Hérault (34) and Sud Aveyron (12) hospital group was to pave the way for patients and organise their management. A reflection process demonstrated interest in digital technology. Its common use will ensure maintenance of the relationship between all actors involved with the same patient.


Assuntos
Tecnologia Biomédica , Relações Interprofissionais , Corpo Clínico Hospitalar/psicologia , França , Hospitais , Humanos
5.
Rev Infirm ; 68(254): 32, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31587849

RESUMO

The inauguration of a fitness path at the Carémeau University Hospital Campus was an opportunity for teams at the Nîmes University Hospital Centre to participate in an inter-service Nordic walking challenge. It was an opportunity to discover a particular sporting discipline, promote team cohesion in services and enjoy physical activity in a friendly atmosphere.


Assuntos
Exercício , Promoção da Saúde/organização & administração , Relações Interprofissionais , Corpo Clínico Hospitalar/psicologia , França , Hospitais Universitários , Humanos
6.
Glob Health Action ; 12(1): 1656452, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31512960

RESUMO

In low- and middle-income countries, nutrition support strategies are often suboptimal or non-existent in hospital settings. This is further compounded by high rates of malnutrition in these countries. The first four dietitians graduated in Malawi in 2017 providing a new opportunity to build capacity to introduce nutrition support in an acute care setting. A paediatric nutrition support program was implemented at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi including the hiring of a local dietitian. This capacity building paper explains the development and introduction of the nutrition support program including a description of perceptions of health professionals at QECH working alongside the dietitian. In the first four months of the program at QECH, the dietitian provided nutrition support to 183 different patients across paediatric wards. Nutritional interventions predominantly included infant formula and breastmilk fortification, provision of therapeutic feeds orally or via nasogastric tubes, increased dietary protein intake for children identified to be at high risk, and nutritional counselling to caregivers. More complex nutritional interventions were also given such as the insertion of gastrostomy tubes to deliver nutrition directly to the stomach. Following the introduction of the program, qualitative interviews were done with health professionals at QECH including nurses (n = 5) and physicians (n = 11). All participants emphasized the importance and impact of the nutrition support program in enhancing the care of hospitalized children, therefore improving outcomes such as tolerability of clinical interventions, decreased duration of stay, and reduced risk of hospital readmission. In conclusion, there is a need for nutrition support provided by a dietitian for different paediatric patients which was corroborated by positive feedback from health professionals at QECH. Integration of dietitians into the healthcare system by respective Ministries of Health will require advocacy around the potential for nutrition support to strengthen the quality of care of vulnerable children. A Chichewa abstract for this paper is available in a supplementary file.


Assuntos
Aconselhamento , Recursos em Saúde/provisão & distribução , Estado Nutricional , Nutricionistas , Criança , Humanos , Lactente , Entrevistas como Assunto , Malaui , Corpo Clínico Hospitalar/psicologia , Pesquisa Qualitativa , Qualidade da Assistência à Saúde
7.
Pediatrics ; 144(3)2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31395622

RESUMO

A 530-g girl born at 22 weeks and 6 days' gestation (determined by an ultrasound at 11 weeks) was admitted to the NICU. Her mother had received prenatal steroids. At 12 hours of age, she was stable on low ventilator settings. Her blood pressure was fine. Her urine output was good. After counseling, her parents voiced understanding of the risks and wanted all available life-supporting measures. Many nurses were distressed that doctors were trying to save a "22-weeker." In the past, 4 infants born at 22 weeks' gestation had been admitted to that NICU, and all had died. The attending physician on call had to deal with many sick infants and the nurses' moral distress.


Assuntos
Idade Gestacional , Cuidado do Lactente/ética , Lactente Extremamente Prematuro , Unidades de Terapia Intensiva Neonatal/ética , Corpo Clínico Hospitalar/ética , Decepção , Feminino , Humanos , Lactente , Recém-Nascido , Futilidade Médica/ética , Corpo Clínico Hospitalar/psicologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Gravidez , Estresse Psicológico , Confiança
8.
Hosp Pract (1995) ; 47(3): 155-162, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31328589

RESUMO

Introduction: Currently in emergency department (ED) of educational medical centers of Iran there are generally two models for between unit hand-off process based on the time of transferring the responsibility (during stay vs. while departure). There is no comprehensive study available to compare the policies. Thus, the present qualitative study was designed to compare these two methods of hand-off via performing interviews by specialist physicians who involving the process in the hospitals to express the advantages and disadvantages of the two policies from their point of view. Methods: This qualitative study was done by using opinions of experts throughout 2015 and 2016. Interviews were performed using a one-on-one and in-depth semi-structured approach. Before asking the questions, the definitions of the two models of hand-off as well as the aims of the study were briefly explained to the interviewee. Thematic and content analysis strategies were used to identify core concepts and to develop categories. Qualitative content analytical approaches focus on analyzing both the explicit content of a text and the latent content that can be extrapolated from the text. Results: In the present study, a total of 25 individuals were interviewed. The mean age of the participants was 34 years and their mean working experience was 7 years. By analyzing the interviews performed, the results were categorized in four main themes including 'resident training', 'patient management in ED', 'quality and process of diagnosis and treatment of patients' and finally, 'satisfaction with the process among specialist'. Conclusion: Although the two methods have advantages and disadvantages, it is likely that during stay, model was more favorable than while departure model from the viewpoints of interviewees. However, it seems that choosing any of the methods depends on various situations such as workload, academic matters, availability of resources, etc.


Assuntos
Serviço Hospitalar de Emergência , Política Organizacional , Transferência da Responsabilidade pelo Paciente , Humanos , Entrevistas como Assunto , Irã (Geográfico) , Corpo Clínico Hospitalar/educação , Corpo Clínico Hospitalar/psicologia , Administração dos Cuidados ao Paciente , Pesquisa Qualitativa , Qualidade da Assistência à Saúde
9.
BMC Health Serv Res ; 19(1): 522, 2019 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-31345212

RESUMO

BACKGROUND: Liaison psychiatry services provide mental health care for patients in physical healthcare (usually acute hospital) settings including emergency departments. Liaison work involves close collaboration with acute hospital staff so that high quality care can be provided. Services however are patchy, relatively underfunded, heterogeneous and poorly integrated into acute hospital care pathways. METHODS: We carried out in-depth semi-structured interviews with 73 liaison psychiatry and acute hospital staff from 11 different acute hospitals in England. The 11 hospitals were purposively sample to represent hospitals in which four different types of liaison services operated. Staff were identified to ensure diversity according to professional background, sub-specialism within the team, and whether they had a clinical or managerial focus. All interviews were audio-recorded and transcribed. The data were analysed using a best-fit framework analysis. RESULTS: Several key themes emerged in relation to facilitators and barriers to the effective delivery of integrated services. There were problems with continuity of care across the secondary-primary interface; a lack of mental health resources in primary care to support discharge; a lack of shared information systems; a disproportionate length of time spent recording information as opposed to face to face patient contact; and a lack of a shared vision of care. Relatively few facilitators were identified although interviewees reported a focus on patient care. Similar problems were identified across different liaison service types. CONCLUSIONS: The problems that we have identified need to be addressed by both liaison and acute hospital teams, managers and funders, if high quality integrated physical and mental health care is to be provided in the acute hospital setting.


Assuntos
Atitude do Pessoal de Saúde , Prestação Integrada de Cuidados de Saúde/organização & administração , Corpo Clínico Hospitalar/psicologia , Serviços de Saúde Mental/organização & administração , Estudos Transversais , Inglaterra , Pesquisa sobre Serviços de Saúde , Humanos , Pesquisa Qualitativa , Qualidade da Assistência à Saúde
10.
BMC Health Serv Res ; 19(1): 461, 2019 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-31286954

RESUMO

BACKGROUND: Blunt chest injury can lead to significant morbidity and mortality if not treated appropriately. A blunt chest injury care bundle was to be implemented at two sites to guide care. AIM: To identify facilitators and barriers to the implementation of a blunt chest injury care bundle and design strategies tailored to promote future implementation. METHODS: 1) A mixed-method survey based on the theoretical domains framework (TDF) was used to identify barriers and facilitators to the implementation of a blunt chest injury care bundle. This survey was distributed to 441 staff from 12 departments across two hospitals. Quantitative data were analysed using SPSS and qualitative using inductive content analysis. 2) The quantitative and qualitative results from the survey were integrated and mapped to each of the TDF domains. 3) The facilitators and barriers were evaluated using the Behaviour Change Wheel to extract specific intervention functions, policies, behaviour change techniques and implementation strategies. Each phase was assessed against the Affordability, Practicability, Effectiveness and cost-effectiveness, Acceptability, Side-effects or safety and Equity (APEASE) criteria. RESULTS: One hundred ninety eight staff completed the survey. All departments surveyed were represented. Nine facilitators and six barriers were identified from eight domains of the TDF. Facilitators (TDF domains) were: understanding evidence-informed patient care and understanding risk factors (Knowledge); patient assessment skills and blunt chest injury management skills (Physical skills); identification with professional role (Professional role and identity); belief of consequences of care bundle (Belief about consequences); provision of training and protocol design (Environmental context and resources); and social supports (Social influences). Barriers were: not understanding the term 'care bundle' (Knowledge); lacking regional analgesia skills (Physical skills); not remembering to follow protocol (Memory, attention, and decision processes); negative emotions relating to new protocols (Emotions); equipment and protocol access (Environmental context and resources). Implementation strategies were videos, education sessions, visual prompt for electronic medical records and change champions. CONCLUSIONS: Multiple facilitators and barriers were identified that may affect the implementation of a blunt chest injury care bundle. Implementation strategies developed through this process have been included in a plan for implementation in the emergency departments of two hospitals. Evaluation of the implementation is underway.


Assuntos
Corpo Clínico Hospitalar/psicologia , Pacotes de Assistência ao Paciente , Traumatismos Torácicos/terapia , Adulto , Feminino , Pesquisa sobre Serviços de Saúde , Humanos , Masculino , Corpo Clínico Hospitalar/estatística & dados numéricos , Pessoa de Meia-Idade , Pesquisa Qualitativa , Inquéritos e Questionários
11.
Cir Cir ; 87(4): 416-422, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31264986

RESUMO

Objective: The aim was to explore how in-training junior physicians perceive their surgical performance compared with the one externally rated by their senior surgeon trainers, using a general learning curve model. Methods: Between April and June 2018, a prospective study was conducted at a community hospital associated with a school of medicine. To assess how in-training physicians estimated their surgical performance, 48 surgical residents and fellows were invited to choose one among six options using a scale ranging from "novice" to "automatic expert." In addition, five senior surgeons who supervised the residents/fellows were asked to give their own opinions on each surveyed physician's expertise level, according to the same categories. Concordance analysis was done to compare residents' and fellows' self-perceived skills and their actual performance as estimated by senior surgeons. Results: Self-assessments tended to overestimate residents' and fellows' position on the learning curve; particularly for "proficient" over "competent," and for "automatic expert" over "expert" categories (p = 0.025). The average degree of agreement among senior physicians was 50.0%. Comparison between residents' and fellows' perceived skills and their performances as estimated by senior surgeons showed a weak concordance (kappa = 0.494, 95% confidence interval 0.359-0.631, p < 0.0001). Conclusions: Nearly 51% of the residents/fellows included in some surgical specialty training program overestimated his/her actual performance as evaluated by classical learning curve categories. Underestimation of self-assessed performance was also observed in 17% of respondents. A better feedback from expert observers to in-training surgeons could result in a more accurate self-perception of their real surgical skills and competencies.


Assuntos
Competência Clínica , Internato e Residência , Curva de Aprendizado , Corpo Clínico Hospitalar/educação , Autoimagem , Cirurgiões/educação , Adulto , Argentina , Método Duplo-Cego , Bolsas de Estudo , Feminino , Humanos , Masculino , Corpo Clínico Hospitalar/psicologia , Estudos Prospectivos , Cirurgiões/psicologia
12.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(5): 574-579, 2019 May 10.
Artigo em Chinês | MEDLINE | ID: mdl-31177741

RESUMO

Objective: To analyze the mental health status of the Chinese Medical Team (CMT) members and its influencing factors. Methods: A total of 1 015 members of the CMT were recruited and surveyed by using a self-administered questionnaire and 12-item General Health Questionnaire (GHQ-12) from May 10 to June 10, 2018. Multivariable logistic regression models were used to identify risk factors for mental health problems. Results: A total of 808 subjects completed the questionnaire and an estimated 25.9% of them were suspected to have mental health problems (GHQ-12≥3). Logistic model analysis indicated that family life (OR=1.928, 95%CI: 1.162-3.197), domestic work status (OR=2.069, 95%CI: 1.210-3.538), father's health status (OR=1.703, 95%CI: 1.060-2.736), disease symptoms (OR=2.087, 95%CI: 1.363-3.194), captain (OR=1.996, 95%CI: 1.128-3.532), cultural differences (OR=2.439, 95%CI: 1.621-3.671) were the risk factors for mental health. Age (OR=0.736, 95%CI: 0.571-0.949), leisure activities (OR=0.654, 95%CI: 0.490-0.872) were the protective factors. Drinking habits (OR=7.439, 95%CI: 1.290- 42.900), loneliness (OR=4.094, 95%CI: 2.438-6.875), and respect from the hospital (OR=0.783, 95%CI: 0.610-1.004) were relative to mental health problems. Conclusion: CMT members have certain mental health problems, especially young members and captains. Therefore, interventions should be implemented to improve the mental health of CMT members and to promote the development of foreign aid work.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Nível de Saúde , Corpo Clínico Hospitalar/psicologia , Saúde Mental , Estudos Transversais , Humanos , Fatores de Risco , Inquéritos e Questionários
13.
Rev Infirm ; 68(252): 30-31, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31208596

RESUMO

The hospital is a healthcare setting in which staff often manage acute health situations. Patients, families and healthcare professionals constantly interact, often against a background of emergencies and anxiety. In such contexts, communication plays an important role in establishing a compassionate relationship. Does humour have a place in this relationship? If so, in what form and what are the benefits for the teams and the patients?


Assuntos
Corpo Clínico Hospitalar/psicologia , Relações Profissional-Família , Relações Profissional-Paciente , Senso de Humor e Humor como Assunto , Ansiedade , Comunicação , Cuidados Críticos/psicologia , Empatia , Humanos
14.
Afr J Prim Health Care Fam Med ; 11(1): e1-e15, 2019 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-31038332

RESUMO

BACKGROUND:  Cardiovascular disease (CVD)-related deaths in sub-Saharan Africa (SSA) are on the rise, and primary care physicians could facilitate the reversal of this trend through treatment and prevention strategies. AIM:  The aim of this study was to determine the relationship between physician lifestyle practices, CVD prevention knowledge and patient CVD counselling practices among family physicians (FPs) and family medicine (FM) trainees affiliated to FM colleges and organisations in SSA. SETTING:  FPs and FM trainees affiliated to FM colleges and organisations in Anglophone SSA. METHODS:  A web-based cross-sectional analytical study was conducted using validated, self-administered questionnaires. Following collation of responses, the relationship between the participants' CVD prevention knowledge, lifestyle practices and CVD counselling rates was assessed. RESULTS:  Of the 174 participants (53% response rate), 83% were married, 51% were females and the mean age was 39.2 (standard deviation [SD] 7.6) years. Most of the participants responded accurately to the CVD prevention knowledge items, but few had accurate responses on prioritising care by 10-year risk. Most participants had less than optimal lifestyle practices except for smoking, vegetable or fruit ingestion and sleep habits. Most participants (65%) usually counselled patients on nutrition, but less frequently on weight management, exercise, smoking and alcohol. The region of practice and physicians with poor lifestyle were predictive of patient counselling rates. CONCLUSION:  Training on patient counselling and self-awareness for CVD prevention may influence patient counselling practice. Promoting quality training on patient counselling among FPs as well as a healthy self-awareness for CVD prevention is thus needed. The complex relationship between physician lifestyle and patient counselling warrants further study.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Aconselhamento/estatística & dados numéricos , Medicina de Família e Comunidade/estatística & dados numéricos , Corpo Clínico Hospitalar/psicologia , Médicos de Família/psicologia , Padrões de Prática Médica/estatística & dados numéricos , Adulto , África ao Sul do Saara , Doenças Cardiovasculares/psicologia , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Médicos de Família/educação , Inquéritos e Questionários
15.
Trials ; 20(1): 275, 2019 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-31109343

RESUMO

BACKGROUND: Inappropriate staff behaviour during surgical procedures may disrupt the surgical performance and compromise patient safety. We developed an innovative monitoring and feedback system combined with an adaptive approach to optimise staff behaviour intraoperatively and prevent post-operative complications (POC) in orthopaedic surgery. METHODS/DESIGN: This protocol describes a parallel-group, cluster randomised, controlled trial with orthopaedic centre as the unit of randomisation. The intervention period will last 6 months and will be based on the monitoring of two surrogates of staff behaviour: the frequency of doors opening and the level of noise. Both will be collected from incision to wound closure, using wireless sensors and sonometers, and recorded and analysed on a dedicated platform (Livepulse®). Staff from centres randomised to the intervention arm will be informed in real time on their own data through an interactive dashboard available in each operating room (OR), and a posteriori for hip and knee replacement POC. Aggregated data from all centres will also be displayed for benchmarking. A lean method will be applied in each centre by a local multidisciplinary team to analyse baseline situations, determine the target condition, analyse the root cause(s), and take countermeasures. The education and awareness of participants on the impact of their behaviour on patient safety will assist the quality improvement process. The control centres will be blinded to monitoring data and quality improvement approaches. The primary outcome will be any POC occurring during the 30 days post operation. We will evaluate this outcome using local and national routinely collected data from hospital discharge and disease databases. Thirty orthopaedic centres will be randomised for a total of 9945 hip and knee replacement surgical procedures. DISCUSSION: The field of human factors and behaviour in the OR seems to offer potential room for improvement. An intervention providing goal-setting, monitoring, feedback and action planning may reduce the traffic flow and interruptions/distractions of the surgical team during procedures, preventing subsequent POCs. The results of this trial will provide important data on the impact of OR staff behaviour on patient safety, and promote best practice during surgical procedures. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03158181 .


Assuntos
Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Corpo Clínico Hospitalar/psicologia , Complicações Pós-Operatórias/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Análise por Conglomerados , Humanos , Salas Cirúrgicas , Segurança do Paciente , Melhoria de Qualidade , Tamanho da Amostra
16.
BMC Med Educ ; 19(1): 174, 2019 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-31142306

RESUMO

BACKGROUND: Feedback is an essential part of clinical teaching and learning, yet it is often perceived as unsatisfactory in busy clinical settings. Clinical teachers need to balance the competing demands of clinical duty and feedback provision. The influence of the clinical environment and the mutual relationship between feedback giving and seeking has been inadequately investigated. This study therefore aimed to quantify the adequacy, perceptions, and influential factors of feedback provision during resident training in emergency departments (EDs). METHODS: A multicenter online questionnaire study was undertaken. The respondents comprised ED residents and clinical teachers from four teaching hospitals in Taiwan. The questionnaire was developed via an expert panel, and a pilot study ensured validity. Ninety clinical teachers and 54 residents participated. RESULTS: The respondents reported that the majority of feedback, which usually lasted 1-5 min, was initiated by the clinical teachers. Feedback satisfaction was significantly lower for the clinical teachers than for the residents (clinical teachers M = 13.8, SD = 1.83; residents M = 15.3, SD = 2.14; p < 0.0001), and positive feedback was provided infrequently in clinical settings (31.1%). Both groups of participants admitted hesitating between providing/seeking feedback and completing clinical work. Being busy, the teachers' clinical abilities, the learners' attitudes, and the relationship between both parties were reported as the most influential factors in feedback provision. CONCLUSION: ED clinical feedback provision is often short, circumstantial, and initiated by clinical teachers. Providing or seeking feedback appears to be an important part of clinical learning in the context of uncertainty. The importance of the relationship between the feedback seeker and the provider highlights the interactive, reciprocal nature of clinical feedback provision.


Assuntos
Atitude do Pessoal de Saúde , Serviço Hospitalar de Emergência , Feedback Formativo , Internato e Residência/estatística & dados numéricos , Corpo Clínico Hospitalar/educação , Adulto , Feminino , Humanos , Internato e Residência/métodos , Masculino , Corpo Clínico Hospitalar/psicologia , Corpo Clínico Hospitalar/estatística & dados numéricos , Inquéritos e Questionários
17.
J Nurs Adm ; 49(6): 310-314, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31135638

RESUMO

OBJECTIVE: Assess the relationship between educating caregivers about high-reliability principles and reporting of potential adverse safety events. BACKGROUND: Persuading caregivers to report potential safety events is challenging. Learning high-reliability principles may help caregivers identify and report potential safety problems. METHODS: Event reports submitted by caregivers 6 months before and after high-reliability training were examined for event types, event significance, and shift when events occurred. χ Tests assessed relationships between variables. RESULTS: The number and type of caregiver event reports before and after training were not significantly different; however, clinical process error reports significantly decreased (χ = 9.251, P = .003). There was a significant difference in reports submitted by day and night shifts (χ = 5.942, P = .02). CONCLUSIONS: Trends suggest staff report actual, rather than potential, events regardless of training. Further research is needed to determine what motivates caregivers to report safety concerns.


Assuntos
Erros Médicos/estatística & dados numéricos , Corpo Clínico Hospitalar/educação , Corpo Clínico Hospitalar/psicologia , Humanos , Motivação , Segurança do Paciente , Avaliação de Programas e Projetos de Saúde , Estudos Retrospectivos , Gestão de Riscos
19.
G Ital Med Lav Ergon ; 41(1): 45-51, 2019 03.
Artigo em Italiano | MEDLINE | ID: mdl-30946548

RESUMO

OBJECTIVES: Working in such circumstances can lead to a typical emotional stress called "burnout". The aim of this study was to evaluate the perceived state of physical and mental health, and verify the existence of burnout among health care workers of Hematology unit in a Teaching Hospital. METHODS: Anonymous questionnaires were administered to healthcare professionals (physicians, nurses, health care workers). It includes socio demographic variables, the Maslach Burnout Inventory (MBI) and SF12 also. The MBI captures three dimensions of burnout: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (RP); whereas the SF12 defines two quality of life scores: Mental Score (MCS) and Physical Score (PCS). RESULTS: Of 120 operators 70 individuals responded to the study. The questionnaire shows that the burnout levels were high in the followed part of the sample: 40% have high level of EE; 24% of DP; 15% of RP. The correlation analysis between SF12 and MBI undelines followed significance: r = -0.576 with p minor than 0.001 between EE and MCS; r = 0.557 with p minor than 0.001 between EE and DP. The three multivariate analysis refer that: the EE is associated indirectly to PCS and MCS with p mionr than 0.05; the DP is directly and significantly (p minor than 0.05) associated to MCS, "years of work" and to female gender. The RP dimension no underlines significant associations with variables studied. CONCLUSIONS: The findings were consistent with the type of work and assisted patients (chronic patient, often with poor prognosis and low expectations in terms of care and survival) that contribute to stressful situations. Personal fulfillment, instead, seems to be quite high in this contest. The relatively small sample couldn't represent the world of health care workers in hematological units, but there is no doubt that a systematic assessment of burnout, to investigate the causes of burnout are main elements to identify the potential solutions to address the phenomenon. Additional investigations of the MBI dimensions using biggest samples would be useful to confirm the results in order to generate burnout reduction measures by institutional and national policies.


Assuntos
Esgotamento Profissional/epidemiologia , Corpo Clínico Hospitalar/psicologia , Recursos Humanos de Enfermagem no Hospital/psicologia , Estresse Ocupacional/epidemiologia , Recursos Humanos em Hospital/psicologia , Adolescente , Adulto , Feminino , Hematologia , Hospitais de Ensino , Humanos , Masculino , Satisfação Pessoal , Qualidade de Vida , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
20.
Br J Nurs ; 28(8): 509-515, 2019 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-31002549

RESUMO

An online survey of parents and staff was conducted to assess the effect of an animal-assisted intervention (AAI) service at a UK children's university teaching hospital. Three volunteer handlers with five golden retriever dogs provided AAIs across all eight paediatric wards including day, medical, surgical, oncology and intensive care. Interventions ranged from 'meet and greet' to assisting nursing care, physiotherapy and occupational therapy, as well as providing distraction during blood taking and other tests including radiology examinations. Two hundred surveys were completed and there was an overwhelmingly positive response to the service. No concerns were recorded with respect to the presence, cleanliness and behaviour of the dogs. There was a 100% recommendation that similar services should be supported across the UK.


Assuntos
Terapia Assistida por Animais , Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Corpo Clínico Hospitalar/psicologia , Pais/psicologia , Animais , Criança , Cães , Pesquisas sobre Serviços de Saúde , Hospitais Pediátricos , Hospitais de Ensino , Hospitais Universitários , Humanos , Resultado do Tratamento , Reino Unido
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