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1.
Nursing ; 51(4): 58-61, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33759867

RESUMO

ABSTRACT: Patients who learn they carry breast cancer genes 1 and 2 (BRCA1/2) must decide if, when, and how they want to disclose this information to family members who may be affected. This article discusses the psychosocial factors that may influence patient decisions to disclose positive BRCA1/2 results to family members, as well as the role of nurses in educating and advocating for patients and their families.


Assuntos
Neoplasias da Mama/genética , Tomada de Decisões , Revelação , Relações Familiares/psicologia , Genes BRCA1 , Genes BRCA2 , Pacientes/psicologia , Neoplasias da Mama/enfermagem , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Papel do Profissional de Enfermagem , Relações Enfermeiro-Paciente , Defesa do Paciente , Educação de Pacientes como Assunto , Pacientes/estatística & dados numéricos
2.
Nat Med ; 27(4): 601-615, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33753937

RESUMO

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the coronavirus disease 2019 (COVID-19) pandemic, which has resulted in global healthcare crises and strained health resources. As the population of patients recovering from COVID-19 grows, it is paramount to establish an understanding of the healthcare issues surrounding them. COVID-19 is now recognized as a multi-organ disease with a broad spectrum of manifestations. Similarly to post-acute viral syndromes described in survivors of other virulent coronavirus epidemics, there are increasing reports of persistent and prolonged effects after acute COVID-19. Patient advocacy groups, many members of which identify themselves as long haulers, have helped contribute to the recognition of post-acute COVID-19, a syndrome characterized by persistent symptoms and/or delayed or long-term complications beyond 4 weeks from the onset of symptoms. Here, we provide a comprehensive review of the current literature on post-acute COVID-19, its pathophysiology and its organ-specific sequelae. Finally, we discuss relevant considerations for the multidisciplinary care of COVID-19 survivors and propose a framework for the identification of those at high risk for post-acute COVID-19 and their coordinated management through dedicated COVID-19 clinics.


Assuntos
/complicações , Doença Aguda , /etnologia , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/terapia , Humanos , Defesa do Paciente , Síndrome , Síndrome de Resposta Inflamatória Sistêmica/epidemiologia , Síndrome de Resposta Inflamatória Sistêmica/terapia , Tromboembolia Venosa/epidemiologia , Tromboembolia Venosa/prevenção & controle
6.
Z Evid Fortbild Qual Gesundhwes ; 161: 28-32, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33454231

RESUMO

INTRODUCTION: Healthcare provision for the multimorbid elderly is complex. Care and Case Managers (CCMs) can help to coordinate and structure outpatient care for these patient groups. This approach will be realized in the project RubiN ("Continuous Care in Regional Networks"), which is funded by the Federal Joint Committee. The aim of the present qualitative study was to explore the motivation to work as a CCM. METHODS: As part of the qualitative study framework, semi-structured interviews with CCMs were conducted as part of a joint kick-off event. The interviews were focused on the reasons and motivation for participating in the RubiN project. The transcribed interviews were analyzed using qualitative content analysis. RESULTS: Eight of 20 CCMs agreed to take part in the interviews. One of the main motivations for taking part in RubiN was to shift away from working conditions that were perceived as stressful and towards an activity that was experienced as appreciative. The CCMs felt that their professional expertise was recognized by other service providers, and that appreciation of their role increased through their active involvement in the care of geriatric patients. CONCLUSIONS: Care and Case Management as a practical application with extensive coordination services for geriatric patients may contribute to an increase in appreciation and recognition through establishing a separate area of responsibility and scope as well as working in an interdisciplinary team.


Assuntos
Gerentes de Casos , Idoso , Assistência à Saúde , Alemanha , Humanos , Defesa do Paciente , Pesquisa Qualitativa
7.
Community Ment Health J ; 57(3): 442-445, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33452947

RESUMO

COVID 19 pandemic has posed challenges for public mental healthcare delivery, particularly in LAMI countries such as India. However, this unique situation has also brought in opportunities to revisit the health system and optimally utilize the available resources. In this brief report, we report one such new initiative in which existing community health workers (CHWs), known as ASHAs (Accredited Social Health Activist) acted as a bridge between patients with mental illness and the District Mental Health Program (DMHP) of Ramanagara district of Karnataka State, India. They maintained continuity of care of 76 patients by delivering mental healthcare services to the patients' doorstep. This has paved the way to rethink and revisit their role in public mental healthcare delivery not only during COVID 19 times, but also beyond.


Assuntos
Serviços de Saúde Comunitária/organização & administração , Agentes Comunitários de Saúde/psicologia , Saúde Mental , Defesa do Paciente , Acreditação , Agentes Comunitários de Saúde/normas , Assistência à Saúde/organização & administração , Feminino , Programas Governamentais/organização & administração , Humanos , Índia , Pandemias , Avaliação de Programas e Projetos de Saúde
9.
J Pediatr Nurs ; 57: 111-112, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33358278
11.
Ann Surg ; 273(4): e125-e126, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33351468

RESUMO

The SARS-CoV-2 pandemic has highlighted existing systemic inequities that adversely affect a variety of communities in the United States. These inequities have a direct and adverse impact on the healthcare of our patient population. While civic engagement has not been cultivated in surgical and anesthesia training, we maintain that it is inherent to the core role of the role of a physician. This is supported by moral imperative, professional responsibility, and a legal obligation. We propose that such civic engagement and social justice activism is a neglected, but necessary aspect of physician training. We propose the implementation of a civic advocacy education agenda across department, community and national platforms. Surgical and anesthesiology residency training needs to evolve to the meet these increasing demands.


Assuntos
Anestesiologia/educação , Educação de Pós-Graduação em Medicina/métodos , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Papel do Médico , Justiça Social/educação , Especialidades Cirúrgicas/educação , Anestesiologia/ética , Educação de Pós-Graduação em Medicina/ética , Política de Saúde , Disparidades em Assistência à Saúde/ética , Humanos , Defesa do Paciente/educação , Defesa do Paciente/ética , Justiça Social/ética , Especialidades Cirúrgicas/ética , Estados Unidos
12.
Radiol Clin North Am ; 59(1): 13-17, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33222995

RESUMO

In an increasingly competitive and passionate health care environment, radiology advocacy is imperative, now more than ever. Arguably, it is particularly more crucial in the world of breast cancer, as we as a breast cancer community are tirelessly assembling to advocate for our patients on a variety of levels, whether it is including but not limited to, breast cancer screening, diagnosis, and treatment, access-to-care, education, or research funding. As breast radiologists, it is no longer simply enough to clock in our normal work hours; we must ALL make a concerted effort to vociferously advocate for our patients and profession.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Comunicação em Saúde/métodos , Acesso aos Serviços de Saúde/legislação & jurisprudência , Mamografia , Defesa do Paciente/legislação & jurisprudência , Mama/diagnóstico por imagem , Detecção Precoce de Câncer , Feminino , Humanos
13.
Eur Psychiatry ; 64(1): e5, 2020 12 21.
Artigo em Inglês | MEDLINE | ID: mdl-33342457

RESUMO

BACKGROUND: Responses to anticipateddiscrimination are common among mental health service users and can have adetrimental impact on their recovery. Since 2009, the Time to Change (TTC)anti-stigma program in England has aimed to improve service users' empowerment,reducing public stigma and discrimination. In this paper, we aim to evaluatewhether service users' awareness of TTC is associated with fewer responses toanticipated discrimination. METHODS: We used data collected for the evaluation of TTC from samples of mental health service users interviewed by telephone in annual surveys 2009-2014. RESULTS: Five thousand and nine hundredand twenty-three participants completed the survey, mainly suffering from mooddisorders (depression, 28.4%, n = 1,681) and schizophrenia related disorders(15.4%, n = 915).In 23.2% of cases,participants were aware of any aspects of the TTC program, while participationin TTC was reported by 2.6%. Being aware of the TTC program was notsignificantly associated with responses to anticipated discrimination, exceptfor those participating in the TTC campaign in 2013. Stopping oneself fromapplying for work was significantly associated with experienced discriminationin both finding (p < 0.001) and keeping (p < 0.001) a job.Concealing mental health problems was associated with a general experience ofbeing shunned (p < 0.001). CONCLUSIONS: Awareness of a nationalanti-stigma program may not be sufficient to encourage people to seek work/educationor to be open about their illness in situations in which they currentlyanticipate discrimination. There is the need to identify new multi-levelstrategies for challenging anticipated discrimination, even focusing ondifferent target groups.


Assuntos
Transtornos Mentais/psicologia , Serviços de Saúde Mental/estatística & dados numéricos , Defesa do Paciente/psicologia , Preconceito/prevenção & controle , Preconceito/psicologia , Estigma Social , Adulto , Inglaterra , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/psicologia , Esquizofrenia , Inquéritos e Questionários
14.
Artigo em Inglês | MEDLINE | ID: mdl-33321718

RESUMO

Rural populations in the United States are faced with a variety of health disparities that complicate access to care. Community health workers (CHWs) and their Spanish-speaking counterparts, promotores de salud, are well-equipped to address rural health access issues, provide education, and ultimately assuage these disparities. In this article, we compare community health workers in the states of Indiana and Texas, based on the results of two separate research studies, in order to (1) investigate the unique role of CHWs in rural communities and (2) understand how their advocacy efforts represent a central form of caregiving. Drawing on ethnographic, qualitative data-including interviews, photovoice, and participant observation-we analyze how CHWs connect structurally vulnerable clients in rural areas to resources, health education, and health and social services. Our primary contribution to existing scholarship on CHWs is the elaboration of advocacy as a form of caregiving to improve individual health outcomes as well as provoke structural change in the form of policy development. Finally, we describe how CHWs became especially critical in addressing disparities among rural populations in the wake of COVID-19, using their advocacy-as-caregiving role that was developed and well-established before the pandemic. These frontline workers are more vital than ever to address disparities and are a critical force in overcoming structural vulnerability and inequities in health in the United States.


Assuntos
Agentes Comunitários de Saúde , Disparidades nos Níveis de Saúde , Defesa do Paciente , Serviços de Saúde Rural , População Rural , Humanos , Indiana , Texas , Estados Unidos , Populações Vulneráveis
17.
Afr J Prim Health Care Fam Med ; 12(1): e1-e3, 2020 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-33054263

RESUMO

For Africa, the backdrop1 against which COVID-19 emerged is a stark one. Although sub-Saharan Africa accounts for 11% of the world's population, it bears 24% of the global disease burden. The continent is home to 60% of the people with human immunodeficiency virus (HIV), and over 90% of malarial patients. In this region, infectious diseases such as malaria and HIV cause 69% of deaths. As states respond to COVID-19, we need to keep our eyes open to what effective responses are notifying us about our healthcare systems, so that we can craft sustainable interventions as a result and uphold the right to health. This is especially true in the light of the ongoing nature of pandemics on the continent, making urgent the need to maximise the value of our health system and its resources, as we seek lasting transformation.


Assuntos
Infecções por Coronavirus , Acesso aos Serviços de Saúde , Pandemias , Pneumonia Viral , Pobreza , Privatização , Direito à Saúde , África ao Sul do Saara/epidemiologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Infecções por Coronavirus/virologia , Assistência à Saúde/métodos , Infecções por HIV/epidemiologia , Humanos , Malária/epidemiologia , Defesa do Paciente , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Pneumonia Viral/virologia
18.
Am Surg ; 86(7): 757-761, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32916074

RESUMO

From the onset of the COVID-19 global pandemic of 2020, the American College of Surgeons (ACS) has been a leader in disseminating credible information on the clinical and scientific aspects of the disease. As governmental regulations enforced the closure of hospitals and operating rooms to elective surgical cases as part of its "shelter-in-place" public lockdown policies, the ACS brought specialty societies together to create guidelines to protect patients and preserve surgical quality. Federal agencies made available financial aid programs to mitigate the economic impact of the outbreak. The division of advocacy and health policy of the ACS made certain that the interests of surgeons and their patients were served. Steven Wexner, member of the Board of Regents of the ACS interviewed the medical directors of the division, Frank Opelka in quality and health policy, and Patrick Bailey in advocacy, for their stories of how the College responded to the many health and public policy issues that came before Congress and governmental agencies during the pandemic.


Assuntos
Infecções por Coronavirus/prevenção & controle , Controle de Infecções/organização & administração , Pandemias/prevenção & controle , Defesa do Paciente , Pneumonia Viral/prevenção & controle , Política Pública , Cirurgiões/organização & administração , Comitês Consultivos , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Masculino , Inovação Organizacional , Avaliação de Resultados em Cuidados de Saúde , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Sociedades Médicas/organização & administração , Estados Unidos
19.
BMC Public Health ; 20(1): 1337, 2020 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-32878612

RESUMO

BACKGROUND: People who are houseless (also referred to as homeless) perceive high stigma in healthcare settings, and face disproportionate disparities in morbidity and mortality versus people who are housed. Medical students and the training institutions they are a part of play important roles in advocating for the needs of this community. The objective of this study was to understand perceptions of how medical students and institutions can meet needs of the self-identified needs of the houseless community. METHODS: Between February and May 2018, medical students conducted mixed-methods surveys with semi-structured qualitative interview guides at two community-based organizations that serve people who are houseless in Portland, Oregon. Medical students approach guests at both locations to ascertain interest in participating in the study. Qualitative data were analyzed using thematic analysis rooted in an inductive process. RESULTS: We enrolled 38 participants in this study. Most participants were male (73.7%), white (78.9%), and had been houseless for over a year at the time of interview (65.8%). Qualitative themes describe care experiences among people with mental health and substance use disorders, and roles for medical students and health-care institutions. Specifically, people who are houseless want medical students to 1) listen to and believe them, 2) work to destigmatize houselessness, 3) engage in diverse clinical experiences, and 4) advocate for change at the institutional level. Participants asked healthcare institutions to use their power to change laws that criminalize substance use and houselessness, and build healthcare systems that take better care of people with addiction and mental health conditions. CONCLUSIONS: Medical students, and the institutions they are a part of, should seek to reduce stigma against people who are houseless in medical systems. Additionally, institutions should change their approaches to healthcare delivery and advocacy to better support the health of people who are houseless.


Assuntos
Assistência à Saúde , Pessoas em Situação de Rua , Transtornos Mentais , Defesa do Paciente , Relações Profissional-Paciente , Estigma Social , Estudantes de Medicina , Adulto , Atitude Frente a Saúde , Comportamento Aditivo , Feminino , Necessidades e Demandas de Serviços de Saúde , Pessoas em Situação de Rua/psicologia , Habitação , Humanos , Masculino , Transtornos Mentais/complicações , Saúde Mental , Pessoa de Meia-Idade , Oregon , Saúde da População , Pesquisa Qualitativa , Mudança Social , Apoio Social , Transtornos Relacionados ao Uso de Substâncias/complicações , Inquéritos e Questionários
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