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2.
Nurs Adm Q ; 45(4): 311-323, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34469389

RESUMO

The promotion of diversity, equity, and inclusion (DEI) in nursing is a topic of renewed importance, given the civil unrest following the death of George Floyd and identified disparities in health and health outcomes during the COVID-19 pandemic. Despite its progress, the nursing profession continues to struggle with recruiting and retaining a workforce that represents the cultural diversity of the patient population. The authors completed a review of the literature on DEI in nursing and found a scarcity of studies, and that a limitation exists due to the strength of the evidence examined. This article aims to provide a review of the literature on DEI in nursing, outcomes and strategies associated with organizational DEI efforts, and knowledge on how the American Nurses Credentialing Center Pathway to Excellence® Designation Program framework supports DEI initiatives. The authors further provided recommendations for nurse leaders and a checklist of proposed questions for assessing commitment, culture, and structural empowerment initiatives toward a more diverse, equitable, and inclusive organization.


Assuntos
Diversidade Cultural , Equidade em Saúde , Liderança , Enfermagem/normas , Inclusão Social , COVID-19/epidemiologia , Empoderamento , Humanos , Cultura Organizacional , Pandemias , Racismo/prevenção & controle , SARS-CoV-2 , Recursos Humanos/organização & administração
3.
Medicine (Baltimore) ; 100(38): e27353, 2021 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-34559158

RESUMO

OBJECTIVE: The aim of this study was to determine the effect of empowerment-based interventions on glucose metabolism control and psychosocial self-efficacy in people with type 2 diabetes mellitus (T2DM). METHODS: The Cochrane Library, Embase, PubMed, and Web of Science electronic databases were searched up to 22 February 2021 for randomized controlled trials (RCTs) that evaluated the effectiveness of empowerment-based intervention versus conventional treatment in type 2 diabetes cases. At least two investigators independently screened the literature, extracted data and evaluated the methodological quality. We calculated the pooled effect size using the mean difference (MD) or standard mean difference (SMD) with 95% confidence intervals (CIs) through RevMan V 5.4.1. RESULTS: Fifteen randomized controlled trials (RCTs) were eligible for inclusion in the present study. A total of 2344 adults (1128 in the intervention groups and 1216 in the control) were covered. Five of these studies involved 671 cases of psychosocial self-efficacy, and 4 studies included 622 cases of diabetes knowledge. The meta-analysis showed that compared to routine care, empowerment-based intervention was associated with reduced glycated hemoglobin levels (SMD -0.20; 95% CI -0.31 to -0.08; Z = 3.40, P < .001, I2 = 42%), increased diabetes empowerment scores (SMD 0.24; 95% CI 0.10-0.37; Z = 3.42, P < .001, I2 = 0%), and increased diabetes knowledge scores (SMD 0.96; 95% CI 0.55-1.36; Z = 4.61, P < .001, I2 = 80%). CONCLUSIONS: Empowerment-based intervention in adults with T2DM results in improvements in glycated hemoglobin, psychosocial self-efficacy and diabetes knowledge.


Assuntos
Diabetes Mellitus Tipo 2/psicologia , Empoderamento , Hemoglobina A Glicada/metabolismo , Educação de Pacientes como Assunto , Autoeficácia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/terapia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Participação do Paciente/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto
4.
BMC Health Serv Res ; 21(1): 958, 2021 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-34511115

RESUMO

BACKGROUND: Online communities for patients with chronic conditions are becoming healthcare providers. They gather to offer support and services, and to become a collective oppositional force. We found, however, that these communities and their collective power are rarely studied in the health services management literature, which focuses more on the empowering practices of healthcare professionals or patient participation. The aim of this study is thus to build a better understanding of the nature of patients' collective empowerment and the processes underlying it. We carry out two exploratory qualitative studies to examine the motivations that drive chronically ill patients to engage in an individual and then collective empowerment process. METHODS: The first qualitative study involves four semi-structured interviews with experts. The second is a netnographic study carried out over a year on an online forum for people with thyroid disease. The latter has two phases: an immersion phase followed by one that traces the path of 21 forum members from their first message to their recognition as active members or even forum moderators. The data are analyzed through thematic and lexical content analyses. RESULTS: We were able to identify the different stages of the collective patient empowerment process and the criteria for progression though this process. Specifically, the first study sheds light on the unmet individual and collective needs of the patients. The second emphasizes the essential role of active contributors and their impact on the growth and power of the community. CONCLUSIONS: This study looks at patient communities as a self-contained system and identifies the stages of collective empowerment that match the organization's declared priorities: community, collaborative, productive, and societal. These results should help health professionals better take these online communities into account in patient care, improving their practices, and carrying out their policies. We call for future research into collective empowerment and its influence on patient behavior, the transformation of healthcare institutions, and the health services market.


Assuntos
Empoderamento , Participação do Paciente , Pessoal de Saúde , Serviços de Saúde , Humanos , Pesquisa Qualitativa
5.
Nursing ; 51(8): 39-42, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34347753

RESUMO

ABSTRACT: Strengths-based approaches focus on identifying an individual's assets and resources to find solutions that support their health. These principles are already inherent in nursing philosophies and processes. This article presents a call to reshape the current deficit-based, provider-centric model by formalizing inclusion of holistic, strengths-based approaches into nursing care.


Assuntos
Cuidados de Enfermagem/métodos , Cuidados de Enfermagem/organização & administração , Empoderamento , Enfermagem Holística , Esperança , Humanos , Modelos de Enfermagem , Autoeficácia
6.
Artigo em Inglês | MEDLINE | ID: mdl-34360463

RESUMO

This study was conducted to evaluate the competency to consent to the treatment of psychiatric outpatients and to confirm the role of empowerment and emotional variables in the relationship between competency to consent to treatment and psychological well-being. The study participants consisted of 191 psychiatric outpatients who voluntarily consented to the study among psychiatric outpatients. As a result of competency to consent to treatment evaluation, the score of the psychiatric outpatient's consent to treatment was higher than the cut-off point for both the overall and sub-factors, confirming that they were overall good. In addition, the effect of the ability of application on psychological well-being among competency to consent to treatment was verified using PROCESS Macro, and the double mediation effect using empowerment and emotional variables was verified to provide an expanded understanding of this. As a result of the analysis, empowerment completely mediated the relation between the ability of application and psychological well-being, and the relation between the ability of application and psychological well-being was sequentially mediated by empowerment and emotion-related variables. Based on these findings, the implications and limitations of this study were discussed.


Assuntos
Emoções , Empoderamento , Humanos , Consentimento Livre e Esclarecido , Pacientes Ambulatoriais
8.
BMC Public Health ; 21(1): 1328, 2021 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-34229626

RESUMO

BACKGROUND: Women's empowerment has always remained a contested issue in the complex socio-demographic and cultural milieu of Pakistani society. Women are ranked lower than men on all vital human development indicators. Therefore, studying various determinants of women's empowerment is urgently needed in the Pakistani context. METHODS: The study empirically operationalized the concept of women's empowerment and investigated its determinants through representative secondary data taken from the Pakistan Demographic and Health Surveys among women at reproductive age (15-49 years) in 2012-13 (n = 13,558) and 2017-18 (n = 15,068). The study used simple binary logistic and multivariable regression analyses. RESULTS: The results of the binary logistic regression highlighted that almost all of the selected demographic, economic, social, and access to information variables were significantly associated with women's empowerment (p < 0.05) in both PDHS datasets. In the multivariable regression analysis, the adjusted odds ratios highlighted that reproductive-age women in higher age groups having children, with a higher level of education and wealth index, involved in skilled work, who were the head of household, and had access to information were reported to be more empowered. Results of the multivariable regression analysis conducted separately for two empowerment indicators (decision-making and ownership) corroborated the findings of the one indicator of women empowerment, except where ownership did not appear to be significantly associated with number of children and sex of household head in both data sets (2012-13 and 2017-18). CONCLUSIONS: A number of social, economic, demographic, familial, and information-exposure factors determine women's empowerment. The study proposes some evidence-based policy options to improve the status of women in Pakistan.


Assuntos
Empoderamento , Características da Família , Adolescente , Adulto , Criança , Tomada de Decisões , Escolaridade , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão , Direitos da Mulher , Adulto Jovem
9.
Artigo em Inglês | MEDLINE | ID: mdl-34207017

RESUMO

This study examines the associations between women's empowerment and family planning use in Jimma Zone, Western Ethiopia. A total of 746 randomly selected married women of reproductive age were interviewed. The data were employed by structural equation modelling (SEM) to investigate the complex and multidimensional pathways to show women's empowerment domains in family planning utilisation. Results of the study revealed that 72% of married women had used family planning. Younger women, having access to information, having access to health facilities and being aware about family planning methods, living in a rural area, having an older partner and increased household decision-making power were associated with using family planning methods. Women's empowerment is an important determinant of contraceptive use. Women's empowerment dimensions included increased household decision-making power, socio-demographic variables and having access to information about family planning and accessible health facilities. These were found to be important determinants of contraceptive use. Future interventions should focus on integrating women's empowerment into family planning programming, particularly in enhancing women's autonomy in decision making. Further research is warranted on the socio-cultural context of women that influences women's empowerment and family planning use to establish an in-depth understanding and equity of women in society.


Assuntos
Serviços de Planejamento Familiar , Direitos da Mulher , Tomada de Decisões , Empoderamento , Etiópia , Feminino , Humanos , Análise de Classes Latentes
10.
Med Humanit ; 47(3): e8, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34088800

RESUMO

Hunger and inadequate nutrition are ongoing concerns in rural Malawi and are exemplified in traditional proverbs. Traditional proverbs and common expressions offer insight into commonly held truths across societies throughout sub-Saharan Africa. Strong oral traditions allow community beliefs embodied in proverbs to be passed down from generation to generation. In our qualitative study, we conducted 8 individual and 12 focus group interviews with a total of 83 participants across two districts in rural central Malawi with the aim of soliciting context-specific details on men and women's knowledge, attitudes and practices related to nutrition, gender equality and women's empowerment. Each interview began by asking participants to share common proverbs related to nutrition. Our qualitative analysis, informed by an indigenous-based theoretical framework that recognises and centres African indigenous knowledge production, yielded six themes: 'a black dog enters the home', 'don't stay with your hands hanging', 'a man is at the stomach', 'showers have fallen', 'we lack peace in our hearts' and 'the hunger season'. Traditional proverbs can provide insight into the underlying causes of hunger and malnutrition. Physicians, nurses and other allied health professionals around the world have a role to play in addressing hunger and malnutrition, which have been exacerbated by climate change. We have an ethical duty to educate ourselves and others, and change our behaviours, to mitigate the root causes of climate change, which are contributing to food insecurity and resultant poor health outcomes in countries like Malawi.


Assuntos
Fome , Desnutrição , Empoderamento , Humanos , Malaui , População Rural
11.
AIDS ; 35(12): 1997-2005, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34115646

RESUMO

OBJECTIVE: To measure associations between participation in community-based microfinance groups, retention in HIV care, and death among people with HIV (PWH) in low-resource settings. DESIGN AND METHODS: We prospectively analyzed data from 3609 patients enrolled in an HIV care program in western Kenya. HIV patients who were eligible and chose to participate in a Group Integrated Savings for Health Empowerment (GISHE) microfinance group were matched 1 : 2 on age, sex, year of enrollment in HIV care, and location of initial HIV clinic visit to patients not participating in GISHE. Follow-up data were abstracted from medical records from January 2018 through February 2020. Logistic regression analysis examined associations between GISHE participation and two outcomes: retention in HIV care (i.e. >1 HIV care visit attended within 6 months prior to the end of follow-up) and death. Socioeconomic factors associated with HIV outcomes were included in adjusted models. RESULTS: The study population was majority women (78.3%) with a median age of 37.4 years. Microfinance group participants were more likely to be retained in care relative to HIV patients not participating in a microfinance group [adjusted odds ratio (aOR) = 1.31, 95% confidence interval (CI) 1.01-1.71; P = 0.046]. Participation in group microfinance was associated with a reduced odds of death during the follow-up period (aOR = 0.57, 95% CI 0.28-1.09; P = 0.105). CONCLUSION: Participation in group-based microfinance appears to be associated with better HIV treatment outcomes. A randomized trial is needed to assess whether microfinance groups can improve clinical and socioeconomic outcomes among PWH in similar settings.


Assuntos
Infecções por HIV , Retenção nos Cuidados , Adulto , África Oriental , Empoderamento , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Fatores Socioeconômicos
13.
Malar J ; 20(1): 267, 2021 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-34120616

RESUMO

BACKGROUND: Severe malaria is associated with long-term mental health problems in Ugandan children. This study investigated the effect of a behavioural intervention for caregivers of children admitted with severe malaria, on the children's mental health outcomes 6 months after discharge. METHODS: This randomized controlled trial was conducted at Naguru Hospital in Kampala, Uganda from January 2018 to July 2019. Caregiver and child dyads were randomly assigned to either a psycho-educational arm providing information about hospital procedures during admission (control group), or to a behavioural arm providing information about the child's possible emotions and behaviour during and after admission, and providing age appropriate games for the caregiver and child (intervention group). Pre- and post-intervention assessments for caregiver anxiety and depression (Hopkins Symptom Checklist) and child mental health problems (Strength and Difficulties Questionnaire and the Child Behaviour Checklist) were done during admission and 6 months after discharge, respectively. T-tests, analysis of covariance, Chi-Square, and generalized estimating equations were used to compare outcomes between the two treatment arms. RESULTS: There were 120 caregiver-child dyads recruited at baseline with children aged 1.45 to 4.89 years (mean age 2.85 years, SD = 1.01). The intervention and control groups had similar sociodemographic, clinical and behavioural characteristics at baseline. Caregiver depression at baseline, mother's education and female child were associated with behavioural problems in the child at baseline (p < 0.05). At 6 months follow-up, there was no difference in the frequency of behavioural problems between the groups (6.8% vs. 10% in intervention vs control groups, respectively, p = 0.72). Caregiver depression and anxiety scores between the treatment arms did not differ at 6 months follow-up. CONCLUSION: This behavioural intervention for caregivers and their children admitted with severe malaria had no effect on the child's mental health outcomes at 6 months. Further studies need to develop interventions for mental health problems after severe malaria in children with longer follow-up time. Trail registration ClinicalTrials.gov Identifier: NCT03432039.


Assuntos
Terapia Comportamental/instrumentação , Cuidadores/psicologia , Saúde da Criança/estatística & dados numéricos , Empoderamento , Saúde Mental/estatística & dados numéricos , Pais/psicologia , Pré-Escolar , Humanos , Lactente , Uganda
14.
Health Info Libr J ; 38(2): 79-80, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34192406

RESUMO

When you think about a journal you probably think of it in terms of its interactions with authors, but relations extend beyond this and are embodied in the actions and values of the editorial team and board. The Health Information and Libraries Journal editorial team and board pride themselves in the support they provide to enable and build confidence in the contributing authors, and the referees who collaborate with them by providing constructive peer review.


Assuntos
Causalidade , Empoderamento , Biblioteconomia/métodos , Políticas Editoriais , Humanos , Biblioteconomia/normas , Biblioteconomia/tendências , Editoração/tendências
15.
Bull Cancer ; 108(7-8): 677-685, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34175111

RESUMO

Clinical practice and medical research can expose to several situations with risks of conflicts of interests. Such situations can induce attenuations of their primary professional interest in favor of, so-called, secondary interests, and leading to bias in their judgement and actions. In this area, if financial conflicts of interests are consistent and frequently dominant, intellectual conflicts of interests have to be analyzed and considered, like those amplified and even induced by the current tremendous competition for scientific publication. In this article, after a contextual review of conflicts of interests in medicine, we will document and discuss more specifically those frequently induced by leaks of financial interests and those linked by evolutions of the current scientific expansion and competition.


Assuntos
Pesquisa Biomédica/ética , Conflito de Interesses/economia , Ética Médica , Editoração/ética , Viés , Pesquisa Biomédica/economia , Raciocínio Clínico , Comunicação , Competição Econômica , Empoderamento , Setor de Assistência à Saúde/economia , Setor de Assistência à Saúde/ética , Humanos , Poder Psicológico , Má Conduta Científica/ética
17.
BMC Health Serv Res ; 21(1): 573, 2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-34112174

RESUMO

BACKGROUND: During the past decade there has been some evaluation of transition programmes for adolescents with chronic conditions. However, this has rarely involved process evaluations focusing on mechanisms leading to outcomes, thus hampering implementation of these complex interventions. Our aim was to (I) describe adolescents' and parents' experiences of participating in a person-centred transition programme aiming to empower them in transition to adulthood and (II) explore the mechanisms of impact. METHODS: A qualitative process evaluation was performed, embedded in a randomized controlled trial evaluating the effectiveness of a transition programme for adolescents with congenital heart disease in Sweden. A purposive sample of 14 adolescents and 12 parents randomized to the intervention group were interviewed after participation in the programme. Data were analysed deductively and inductively in NVivo v12. RESULTS: Experiences of participation in the transition programme were generally positive. Meeting a transition coordinator trained in person-centred care and adolescent health and embarking on an educational process based on the adolescents' prerequisites in combination with peer support were considered key change mechanisms. However, support to parents were not sufficient for some participants, resulting in ambivalence about changing roles and the unmet needs of parents who required additional support. CONCLUSIONS: Participants experienced increased empowerment in several dimensions of this construct, thus demonstrating that the transition programme was largely implemented as intended and the evidence-based behaviour-change techniques used proved effective in reaching the outcome. These findings can inform future implementation of transition programmes and illuminate challenges associated with delivering a complex intervention for adolescents with chronic conditions.


Assuntos
Cardiopatias Congênitas , Pais , Adolescente , Adulto , Doença Crônica , Empoderamento , Humanos , Suécia
18.
BMC Womens Health ; 21(1): 230, 2021 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-34082722

RESUMO

BACKGROUND: Achieving gender equality and women's empowerment is a major global priority. The purpose of this study was to determine whether the Building the Resilience of Vulnerable Communities in Burkina Faso (BRB) project, an agricultural development program, improved women's empowerment, as measured by the project-level Women's Empowerment in Agriculture Index (pro-WEAI). METHODS: This study used a longitudinal, quasi-experimental study design. Participants included both treatment and comparison groups (total N = 751) comprising female members of savings groups and their husbands or main male household member in Burkina Faso. All participants completed the pro-WEAI questionnaire at both baseline and endline. The treatment group received a comprehensive intervention package consisting of agriculture loans and services, microenterprise loans, and education, nutrition education, and women's empowerment programs including gender-based discussions designed to facilitate personalized changes in gender relations. RESULTS: The proportion of the treatment group achieving empowerment did not change from baseline for women, but improved substantially for men. Women from the comparison group saw an increase in empowerment at endline while men saw a substantial decrease. Gender parity was high for women in both groups at baseline and increased slightly at endline. Women were more likely to have adequate empowerment in input in productive decisions, group membership, and membership in influential groups than men while men were more likely to have adequate empowerment in attitudes about domestic violence, control over use of income, and work balance than women. Participants from the treatment group reported an increase in the average number of empowerment indicators that they were adequate in while the comparison group saw a decrease in average adequacy over time (p = 0.002) after controlling for age, sex, and level of education. CONCLUSION: Despite starting at an empowerment disadvantage, the treatment group experienced gains in individual indicators of empowerment while the comparison group men and women experienced mixed results, with the women gaining, and the men losing empowerment. This research suggests that the BRB intervention may have provided some protection for the treatment group when they faced an economic down-turn prior to the endline, indicative of household resilience. Future research should consider and strengthen relationships between resilience and empowerment.


Assuntos
Agricultura , Empoderamento , Burkina Faso , Características da Família , Feminino , Humanos , Estudos Longitudinais , Masculino
19.
Afr J Reprod Health ; 25(s1): 13-25, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34077141

RESUMO

The government in Saudi Arabia in 2016 declared the necessity to overcome the ancestral oil-based economy and move towards a more diversified model. One of the significant steps to achieve this goal is to empower Saudi women, who form half of the Saudi population, to actively contribute their much-needed talents and skills to the Saudi labour market. However, there is a scarcity of existing scales to measure women empowerment in Saudi Arabia. The objective of this study was to construct and validate a reliable novel scale for the empowerment of Saudi women employed in higher education institutions. A methodological study was conducted from January to April 2020 among Saudi women academic and administrative staff (n=160) working in the higher educational institutions located in the northwestern and southern regions of Saudi Arabia. The tool underwent content and face validity as well as factor analyses. Internal consistency was analyzed through Cronbach's alpha and Pearson correlation coefficient. The data analysis was conducted using IBM SPSS version 23. A Cronbach's alpha value of 0.94 was obtained in reliability analysis. The results showed that the total women empowerment scale had an exceptional internal consistency (>9). The three domains of the scale and total woman empowerment scale had a score close to 1, indicating a high Intraclass Correlation Coefficient, and showed a high similarity between values at the second and third measurements. Self-esteem and self-efficacy subscales were the most important indicators of women's' personal empowerment. Furthermore, a highly positive correlation (p <0.01) was found between the total domains of empowerment scale. A novel women empowerment tool was developed and validated in Saudi women working as academic and administrative staff. This can serve as a reliable tool to measure women's empowerment in higher education institutions. It will eventually enable the formulation of strategies that facilitate women's empowerment and pave the path for a strong foundation for the development of the country.


Assuntos
Empoderamento , Poder Psicológico , Inquéritos e Questionários/normas , Adulto , Análise Fatorial , Feminino , Humanos , Psicometria , Reprodutibilidade dos Testes , Arábia Saudita , Autoeficácia
20.
Afr J Reprod Health ; 25(s1): 26-35, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34077142

RESUMO

Academic women in the Arab world, especially Saudi women, have numerous barriers inhibiting their leadership power at the workplace. The current study explores the perceived and real barriers to workplace empowerment among women at Saudi universities. A descriptive cross-sectional study was carried out at 15 Saudi governmental universities. A multistage cluster sampling technique was followed to select (5587 participants) The data collection started from the beginning of April to the beginning of September 2020. SPSS 23.0 was used to analyze data using descriptive statistics. Multiple linear regression was used to identify the real barriers to women empowerment at the workplace. The study showed that 52.1% of the study participants had moderate workplace empowerment, and only 10.2% have a low level. Regarding perceived barriers to workplace empowerment, 42.6% of the participants agree that male dominance was a barrier. Moreover, 36.2% of the participants agreed and strongly agree that the customs and traditions are a barrier to women empowerment at the workplace. Multiple linear regression showed that age, followed by years of experience (p <0.000), were the most significant demographic predictors of women empowerment at the workplace. Moreover, positive attitude, high self-esteem, and good knowledge (p <0.000) were considered other variables that positively predict women's empowerment at the workplace. The experience of gender-based violence (p <0.000) was a negative predictor of women empowerment at the workplace. The study concluded that around 62.3% of Saudi female academics and administrative staff have moderate or low workplace empowerment at Saudi Universities. Male dominance is perceived as the highest barrier.


Assuntos
Empoderamento , Autonomia Pessoal , Poder Psicológico , Local de Trabalho/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Arábia Saudita , Universidades
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