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Br J Community Nurs ; 25(4): 162-166, 2020 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-32267767


Nurses in primary care are often the first point of access for those seeking health care, and it is well known that accessing health services can be difficult for some, especially those on a low income. A charity initiative has been developed in a low-income area in England to help such individuals, wherein volunteers help local residents to access local services and support. This study explores the experiences of service users in order to understand their perceptions and feelings about the service, using an instrumental case study method with semi-structured interviews. Qualitative data were collected from six service users and transcribed by the researcher for subsequent thematic analysis. The participants' experiences were characterised by reduced social isolation, reduced emotional distress, improved mobility and transport options, improved confidence and control over life, and effective management of memory issues. Various aspects of advocacy and empowerment were also observed. Further, the coping strategies used by the participants while facing the challenges of social isolation and ageing were highlighted. The findings provide important insight into the support needs of populations on low income, the ways in which they access healthcare and how the volunteer service can best support them.

Acesso aos Serviços de Saúde/estatística & dados numéricos , Defesa do Paciente , Pobreza/estatística & dados numéricos , Atenção Primária à Saúde , Inglaterra , Humanos , Enfermagem de Atenção Primária , Pesquisa Qualitativa , Voluntários
Nurs Clin North Am ; 55(1): 11-20, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32005360


Nurses need to actively embrace strategies to improve population health outcomes and reduce health and other disparities. Effective strategies include a focus on the broad range of factors and conditions that have a strong influence on health, advocacy directed at reducing barriers to improved population health, and engagement in policy making. Media engagement is an important tool for amplifying messages about societal problems amenable to public policy, educating stakeholders, bringing diverse stakeholders together for a common purpose, and promoting policy change.

Assistência à Saúde/legislação & jurisprudência , Assistência à Saúde/normas , Política de Saúde , Papel do Profissional de Enfermagem , Defesa do Paciente/normas , Formulação de Políticas , Saúde da População , Mídias Sociais , Adulto , Feminino , Promoção da Saúde/métodos , Humanos , Masculino , Guias de Prática Clínica como Assunto
Acad Med ; 95(3): 330, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32097150
Am J Health Syst Pharm ; 77(5): 378-382, 2020 02 19.
Artigo em Inglês | MEDLINE | ID: mdl-31907546
Int J Cancer ; 146(5): 1316-1323, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-31509608


Due to the increasing incidence and prevalence of neuroendocrine tumors (NETs), there is a need to assess any gaps in awareness and care. A survey was undertaken in 2017 to identify perceived unmet needs from the perspectives of patients/families, patient advocates and health care professionals (HCPs). The survey consisted of 33-37 questions (depending on type of respondent) across four areas: information, care, treatments and research. In total, 443 participants from 26 countries responded: 338 patients/families, 35 advocates and 70 HCPs. Perceived unmet needs regarding provision of information at diagnosis differed between groups. While 59% of HCPs believed they provided sufficient information, informational needs were mostly/fully met for only 30% of patients and 18% of advocates. Additionally, 91% of patients and 97% of advocates felt that patients had to search for information themselves. Availability of Gallium-68-Dotatate PET/CT scan was limited for the majority of patients (patients: 73%; advocates: 85%; HCP: 86%), as was access to treatments, particularly peptide receptor radionuclide therapy (patients: 42%; advocates: 95%; HCPs: 77%). All groups felt that standards of care, including psychological needs and diagnosis of mental health, were not fully met. Although about two-thirds of patients were managed by a multidisciplinary team, 14% of patients reportedly did not have enough contact. All groups supported more patient involvement in research; patients and advocates prioritized improvement in diagnosis and HCPs focused on clinical trials. This survey revealed significant unmet needs but differing perceptions regarding these among the groups. There is a need for investigation and collaboration to improve standards of care for NET patients.

Saúde Global , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Tumores Neuroendócrinos/terapia , Participação do Paciente/estatística & dados numéricos , Lacunas da Prática Profissional/estatística & dados numéricos , Adolescente , Adulto , Carga Global da Doença , Comunicação em Saúde , Pessoal de Saúde/estatística & dados numéricos , Humanos , Incidência , Comportamento de Busca de Informação , Oncologia/organização & administração , Oncologia/estatística & dados numéricos , Pessoa de Meia-Idade , Tumores Neuroendócrinos/diagnóstico , Tumores Neuroendócrinos/epidemiologia , Neuroendocrinologia/organização & administração , Neuroendocrinologia/estatística & dados numéricos , Defesa do Paciente/estatística & dados numéricos , Prevalência , Relações Profissional-Paciente , Inquéritos e Questionários/estatística & dados numéricos , Adulto Jovem
Med J Aust ; 211(11): 514-517, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31813173


OBJECTIVES: To determine whether gendered symbols on patient call bells are restricted to our hospital or are examples of an international practice that perpetuates gender stereotypes and occupational segregation. SETTING: Multicentre, international study of hospital equipment, 2018. MAIN OUTCOME MEASURE: Types of symbols on patient call bells. RESULTS: We received 56 responses from 43 hospitals in eight countries across five continents: 37 devices included female-specific images, nine included gender-neutral images, and ten did not use imagery (for example, button-only devices). No call bells included male-specific images. CONCLUSION: Female symbols on patient call bells are an international phenomenon. Only female or gender-neutral images are used, indicating bias in their design, manufacture, and selection. Female symbols may reinforce gender stereotypes and contribute to occupational segregation and reduced equity of opportunity. We suggest alternative symbols. Individual action with coloured marker pens may provide a pragmatic short term, albeit provocative, solution. While call bell design has only a minor impact on patients, everyday bias affects all staff and society in general.

Sistemas de Comunicação no Hospital/estatística & dados numéricos , Defesa do Paciente/estatística & dados numéricos , Sexismo , Viés , Feminino , Saúde Global , Humanos , Masculino , Preferência do Paciente/estatística & dados numéricos , Satisfação do Paciente
BMJ ; 367: l6694, 2019 12 12.
Artigo em Inglês | MEDLINE | ID: mdl-31831471


OBJECTIVE: To understand and report on the nature of patient group interactions with the pharmaceutical industry from the perspective of patient group representatives by exploring the range of attitudes towards pharmaceutical industry sponsorship and how, why, and when interactions occur. DESIGN: Empirical qualitative interview study informed by ethics theory. SETTING: Australian patient groups. PARTICIPANTS: 27 participants from 23 Australian patient groups that represented diverse levels of financial engagement with the pharmaceutical industry. Groups were focused on general health consumer issues or disease specific topics, and had regional or national jurisdictions. ANALYSIS: Analytic techniques were informed by grounded theory. Interview transcripts were coded into data driven categories. Findings were organised into new conceptual categories to describe and explain the data, and were supported by quotes. RESULTS: A range of attitudes towards pharmaceutical industry sponsorship were identified that are presented as four different types of relationship between patient groups and the pharmaceutical industry. The dominant relationship type was of a successful business partnership, and participants described close working relationships with industry personnel. These participants acknowledged a potential for adverse industry influence, but expressed confidence in existing strategies for avoiding industry influence. Other participants described unsatisfactory or undeveloped relationships, and some participants (all from general health consumer groups) presented their groups' missions as incompatible with the pharmaceutical industry because of fundamentally opposing interests. Participants reported that interactions between their patient group and pharmaceutical companies were more common when companies had new drugs of potential interest to group members. Patient groups that accepted industry funding engaged in exchanges of "assets" with companies. Groups received money, information, and advice in exchange for providing companies with marketing, relationship building opportunities with key opinion leaders, coordinated lobbying with companies about drug access and subsidy, assisting companies with clinical trial recruitment, and enhancing company credibility. CONCLUSIONS: An understanding of the range of views patient groups have about pharmaceutical company sponsorship will be useful for groups that seek to identify and manage any ethical concerns about these relationships. Patient groups that receive pharmaceutical industry money should anticipate they might be asked for specific assets in return. Selective industry funding of groups where active product marketing opportunities exist might skew the patient group sector's activity towards pharmaceutical industry interests and allow industry to exert proxy influence over advocacy and subsequent health policy.

Conflito de Interesses , Indústria Farmacêutica/economia , Política de Saúde , Marketing/ética , Defesa do Paciente/ética , Pesquisa Qualitativa , Austrália , Humanos
BMC Med Ethics ; 20(1): 96, 2019 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-31847854


BACKGROUND: Much like academic-industry partnerships, industry financial support of patient advocacy organizations (PAOs) has become very common in recent years. While financial conflicts of interest (FCOI) between PAOs and industry have received more attention in recent years, robust efforts to mitigate these conflicts are still limited. MAIN BODY: The authors outline the possible benefits and ethical concerns that can result from financial interactions between biomedical companies and PAOs. They argue that the use of novel strategies, such as the creation of a standing ethics committee, could be helpful in managing FCOIs and ensuring the warranted trust of PAO's constituents. Although ethics committees to address FCOIs are common in the academic context, its use by PAOs is still limited. The authors conclude by describing the process of development and implementation of such an ethics committee at the Crohn's & Colitis Foundation. CONCLUSIONS: While collaborations with industry can result in conflicts of interest, PAOs can develop strategies to address those conflicts. One such strategy is the creation of a standing independent ethics committee to guide PAOs on new and/or existing programs and protocols as they pertain to their industry relationships.

Conflito de Interesses , Comitês de Ética em Pesquisa , Apoio Financeiro/ética , Fundações , Defesa do Paciente , Ensaios Clínicos como Assunto/economia , Conflito de Interesses/economia , Indústria Farmacêutica , Estudos de Casos Organizacionais
Rev. enferm. UERJ ; 27: e43570, jan.-dez. 2019.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1050639


Objetivo: conhecer as percepções de enfermeiros acerca do exercício de advocacy sob perspectiva filosófica gadameriana. Método: estudo descritivo, com abordagem qualitativa, com base no referencial teórico da Hermenêutica Filosófica. Participaram treze enfermeiros de duas unidades de internação de um hospital de ensino na região sul do Brasil. A coleta de dados ocorreu entre abril a junho de 2019, com utilização da técnica de entrevista semiestruturada e tratados por análise textual discursiva. O estudo foi aprovado pelo Comitê de Ética em Pesquisa. Resultados: da análise dos depoimentos emergiram duas categorias: formação ética e o exercício de advocacy por enfermeiros: fragilidades ou fortalezas? e situações de conflitos emergentes do exercício de advocacy. Conclusão: a formação profissional e a experiência prática constituem a base para o exercício de advocacy em enfermagem, fortalecendo-se com a consolidação de conhecimento e o tempo de atuação profissional.

Objective: to know nurses' perceptions about the practice of advocacy from a Gadamerian philosophical perspective. Method: descriptive study with qualitative approach, based on the Philosophical Hermeneutics' theoretical framework. Thirteen nurses from two inpatient units at a teaching hospital in southern Brazil participated. Data collection took place between April and June 2019, using the semi-structured interview technique and treated by discursive textual analysis. Conclusion: vocational training and practical experience are the basis for the practice of advocacy in nursing, strengthening with the consolidation of knowledge and the time of professional practice.

Objetivo: conocer las percepciones de las enfermeras sobre la práctica del advocacy desde una perspectiva filosófica gadameriana. Método: estudio descriptivo con enfoque cualitativo, basado en el marco teórico de la hermenéutica filosófica. Participaron trece enfermeras de dos unidades de hospitalización de un hospital universitario en el sur de Brasil. La recopilación de datos tuvo lugar entre abril y junio de 2019, utilizando la técnica de entrevista semiestructurada y tratada mediante análisis textual discursiva. Resultados: del análisis de los datos surgieron dos categorías: la formación ética y la práctica de la defensa de las enfermeras: ¿debilidades o fortalezas? y situaciones de conflicto que surgen de la práctica del derecho. Conclusión: la formación profesional y la experiencia práctica son la base para la práctica del advocacy en enfermería, fortaleciéndose con la consolidación del conocimiento y el tiempo de la práctica profesional.

Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Defesa do Paciente , Direitos do Paciente , Advocacia em Saúde , Ética em Enfermagem , Epidemiologia Descritiva , Pesquisa Qualitativa