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2.
BMC Infect Dis ; 20(1): 737, 2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028228

RESUMO

BACKGROUND: Chronic hepatitis C virus (HCV), which is a concern in many countries, is the leading cause of liver cancer around the world. Since Taiwan launched its national health insurance system in 1995, it has managed to extend health coverage to 99% of the Taiwanese population, providing free but limited antiviral treatment each year since 2017. However, many people in rural areas are unaware that they have chronic HCV; nor do they realize that new drugs with high cure rates could drastically reduce their health burden. The aim of this study is to explore the implementation facilitators of and barriers to inviting potentially infected patients in rural areas to be transferred for HCV ribonucleic acid (RNA) confirmation and new drug treatment. METHODS: A descriptive and prospective study design with an interdisciplinary collaboration approach was implemented. After five elements of referral were developed, telephone counseling was conducted between August 2018 and May 2019 in Yunlin, Taiwan. The elements of referral developed by the research team were: (1) forming and coordinating physicians' schedules, (2) recruiting and training volunteers, (3) training the nursing staff, (4) raising funds or resources, and (5) connecting with village leaders. Thereafter, we collaborated with two district health centers, a private local hospital, and health clinics. Based on the medical records provided by these agencies, community adults that were HCV antibody (anti-HCV) positive were invited to join the program. RESULTS: Of the 1795 adults who were serum anti-HCV positive, 1149 (64%) accepted transfer to a qualified hospital; of these, 623 (54.2%) had an HCV infection. 552 (88.6%) of those infected started receiving direct-acting antivirals (DAAs) treatment. The top four barriers to accepting transfer were: (1) they perceived themselves to be healthy (n = 98, 32.3%); (2) mistrust of treatment/healthcare (n = 60, 20.2%); (3) limited transportation to the hospital (n = 52, 17.5%); and (4) work conflict (n = 30, 10.1%). CONCLUSION: An interdisciplinary collaboration approach significantly contributed to the invitation of CHC patients, as well as their acceptance of HCV RNA confirmation and free DAAs treatment. Using anti-HCV data from previous medical records for case-finding and collaborating with a hospital and health clinics proved to be an efficient strategy.


Assuntos
Antivirais/uso terapêutico , Hepacivirus/genética , Hepatite C Crônica/tratamento farmacológico , RNA Viral/metabolismo , Adulto , Feminino , Hepacivirus/isolamento & purificação , Anticorpos Anti-Hepatite C/sangue , Hepatite C Crônica/diagnóstico , Hepatite C Crônica/psicologia , Humanos , Comunicação Interdisciplinar , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Encaminhamento e Consulta , População Rural , Taiwan
3.
BMC Psychiatry ; 20(1): 489, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33023535

RESUMO

BACKGROUND: COVID-19 infection is a new disease that infects a large number of people, killing a ratio of whom every day in the world. Healthcare staff, especially nurses, experience a great deal of psychological distress during care of COVID-19 patients. Detecting factors that disturb nurses' mental health during care of these patients can help to reduce their psychological distress. Therefore, this study aimed to explore nurses' experiences of psychological distress during care of patients with COVID-19. METHODS: The present qualitative research was performed using the conventional content analysis method in Iran from March to May 2020. Participants in this study included the nurses caring for patients with COVID-19, and they were selected based on the purposeful sampling method. The data was collected through 20 phone call interviews and analyzed based on the method proposed by Lundman and Graneheim. RESULTS: Qualitative data analysis revealed 11 categories including death anxiety, anxiety due to the nature of the disease, anxiety caused by corpse burial, fear of infecting the family, distress about time wasting, emotional distress of delivering bad news, fear of being contaminated, the emergence of obsessive thoughts, the bad feeling of wearing personal protective equipment, conflict between fear and conscience, and the public ignorance of preventive measures. CONCLUSION: The data showed that the nurses experienced a variety of psychological distress during care of patients with COVID-19. Through proper planning by authorities, it is possible to manage the risk factors of mental health distress in nurses and improve their mental health status.


Assuntos
Betacoronavirus , Esgotamento Profissional , Infecções por Coronavirus , Recursos Humanos de Enfermagem no Hospital/psicologia , Pandemias , Pneumonia Viral , Angústia Psicológica , Adulto , Feminino , Humanos , Entrevistas como Assunto , Irã (Geográfico) , Masculino
4.
BMC Psychiatry ; 20(1): 489, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: covidwho-818082

RESUMO

BACKGROUND: COVID-19 infection is a new disease that infects a large number of people, killing a ratio of whom every day in the world. Healthcare staff, especially nurses, experience a great deal of psychological distress during care of COVID-19 patients. Detecting factors that disturb nurses' mental health during care of these patients can help to reduce their psychological distress. Therefore, this study aimed to explore nurses' experiences of psychological distress during care of patients with COVID-19. METHODS: The present qualitative research was performed using the conventional content analysis method in Iran from March to May 2020. Participants in this study included the nurses caring for patients with COVID-19, and they were selected based on the purposeful sampling method. The data was collected through 20 phone call interviews and analyzed based on the method proposed by Lundman and Graneheim. RESULTS: Qualitative data analysis revealed 11 categories including death anxiety, anxiety due to the nature of the disease, anxiety caused by corpse burial, fear of infecting the family, distress about time wasting, emotional distress of delivering bad news, fear of being contaminated, the emergence of obsessive thoughts, the bad feeling of wearing personal protective equipment, conflict between fear and conscience, and the public ignorance of preventive measures. CONCLUSION: The data showed that the nurses experienced a variety of psychological distress during care of patients with COVID-19. Through proper planning by authorities, it is possible to manage the risk factors of mental health distress in nurses and improve their mental health status.


Assuntos
Betacoronavirus , Esgotamento Profissional , Infecções por Coronavirus , Recursos Humanos de Enfermagem no Hospital/psicologia , Pandemias , Pneumonia Viral , Angústia Psicológica , Adulto , Feminino , Humanos , Entrevistas como Assunto , Irã (Geográfico) , Masculino
6.
J UOEH ; 42(3): 231-236, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32879187

RESUMO

To reach the target of ending the dengue epidemic by 2030, all effort shall be made to minimize the dengue transmission across the country through effective, efficient, low-cost and sustainable programs. In Indonesia, the evidence of community empowerment on dengue prevention is insufficient. The objective of this study is to explore the opinion of community and larva monitoring workers (Jumantik cadre) on dengue prevention. A structured free listing interview was conducted in April-May 2019 by targeting two groups: the community and larva workers in one village of Sleman, Yogyakarta. Door to door interviews were done until the quota and saturation were reached. Each group was asked four free listing questions. The analysis was performed in these stages: transcribing, coding, combining by the question, and calculating the salience score. The most salient score about vector control in the larva cadre was not hanging up dirty clothes; in the community it was cleaning the bathtub. Both groups cited themself as the salient motivator in joining the vector control. Protecting the environment and keeping healthy were the reasons for participating in the vector control. The larva cadre stated community refusal as the main challenge. The community cited the importance of larva cadre: to monitor the presence of larva. Community empowerment on dengue vector control has not been effortlessly executed at the bottom level.


Assuntos
Participação da Comunidade , Dengue/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Adulto , Dengue/epidemiologia , Feminino , Humanos , Indonésia/epidemiologia , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Adulto Jovem
7.
Soc Work Public Health ; 35(7): 590-602, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: covidwho-791336

RESUMO

The novel coronavirus pandemic has upended the world as we knew it and is a concern for governments globally. With cases still surging in different regions around the globe, the level of knowledge of COVID-19 and compliance with preventive measures still differ across cultural regions. Our study explored knowledge of COVID-19 and compliance with preventive measures among community members in Anambra State, Nigeria, using in-depth interviews (IDI). Data were sourced from 36 persons comprising 30 household heads age 48 years and above and six children age 13-17 years. Data were analyzed thematically. Findings revealed that a majority of the respondents believe that the COVID-19 pandemic is more of a hoax than reality. Other findings showed that this poor knowledge negatively affected their compliance with preventive measures to curb the spread of coronavirus. To improve knowledge on the coronavirus pandemic, we recommended dissemination of accurate information to ensure compliance with preventive measures.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adolescente , Adulto , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Feminino , Fidelidade a Diretrizes , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Pneumonia Viral/epidemiologia , Distância Social
8.
Vaccine ; 38(44): 6922-6929, 2020 10 14.
Artigo em Inglês | MEDLINE | ID: mdl-32893036

RESUMO

INTRODUCTION: Despite historical exclusion, there has been recent recognition of the need to address the health of pregnant women in research on vaccines against emerging pathogens. However, pregnant women's views and decision-making processes about vaccine research participation during infectious disease outbreaks remain underexplored. This study aims to examine women's decision-making processes around vaccine research participation during infectious disease outbreaks. METHODS: We conducted qualitative semi-structured in-depth interviews with pregnant and recently pregnant women (n = 13), eliciting their views on four hypothetical Zika Virus vaccine research scenarios and probing their decision-making processes around participation. After recorded interviews were transcribed, thematic analysis was conducted based on a priori and emergent themes. RESULTS: Most women interviewed were accepting of vaccine research scenarios. Three broad themes-evidence, risk, and trust-characterized women's decision-making processes. Women varied in how different types and levels of evidence impacted their considerations, which risks were most salient to their decision-making processes, and from whom they trusted recommendations about vaccine research participation. Exemplary quotes from each theme are presented, and lessons for vaccine development during the current COVID-19 pandemic and future outbreaks are discussed. CONCLUSION: Some pregnant women are accepting of participation in vaccine research during infectious disease outbreaks. Incorporating their priorities into trial design may facilitate their participation and generation of evidence for this important population.


Assuntos
Ensaios Clínicos como Assunto , Tomada de Decisões , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Gestantes/psicologia , Infecção por Zika virus/prevenção & controle , Adulto , Feminino , Humanos , Entrevistas como Assunto , Gravidez , Complicações Infecciosas na Gravidez/prevenção & controle , Medição de Risco , Vacinação , Vacinas , Vacinas Virais
9.
BMC Infect Dis ; 20(1): 675, 2020 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-32938422

RESUMO

INTRODUCTION: Person-centred care, an internationally recognised priority, describes the involvement of people in their care and treatment decisions, and the consideration of their needs and priorities within service delivery. Clarity is required regarding how it may be implemented in practice within different contexts. The standard multi-drug resistant tuberculosis (MDR-TB) treatment regimen is lengthy, toxic and insufficiently effective. 2019 World Health Organisation guidelines include a shorter (9-11-month) regimen and recommend that people with MDR-TB be involved in the choice of treatment option. We examine the perspectives and experiences of people with MDR-TB and health-care workers (HCW) regarding person-centred care in an MDR-TB programme in Karakalpakstan, Uzbekistan, run by Médecins Sans Frontières and the Ministry of Health. METHODS: A qualitative study comprising 48 interviews with 24 people with MDR-TB and 20 HCW was conducted in June-July 2019. Participants were recruited purposively to include a range of treatment-taking experiences and professional positions. Interview data were analysed thematically using coding to identify emerging patterns, concepts, and categories relating to person-centred care, with Nvivo12. RESULTS: People with MDR-TB were unfamiliar with shared decision-making and felt uncomfortable taking responsibility for their treatment choice. HCW were viewed as having greater knowledge and expertise, and patients trusted HCW to act in their best interests, deferring the choice of appropriate treatment course to them. HCW had concerns about involving people in treatment choices, preferring that doctors made decisions. People with MDR-TB wanted to be involved in discussions about their treatment, and have their preference sought, and were comfortable choosing whether treatment was ambulatory or hospital-based. Participants felt it important that people with MDR-TB had knowledge and understanding about their treatment and disease, to foster their sense of preparedness and ownership for treatment. Involving people in their care was said to motivate sustained treatment-taking, and it appeared important to have evidence of treatment need and effect. CONCLUSIONS: There is a preference for doctors choosing the treatment regimen, linked to shared decision-making unfamiliarity and practitioner-patient knowledge imbalance. Involving people in their care, through discussions, information, and preference-seeking could foster ownership and self-responsibility, supporting sustained engagement with treatment.


Assuntos
Pessoal de Saúde/psicologia , Assistência Centrada no Paciente , Tuberculose Resistente a Múltiplos Medicamentos/psicologia , Adolescente , Adulto , Antituberculosos/uso terapêutico , Tomada de Decisão Clínica , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Tuberculose Resistente a Múltiplos Medicamentos/diagnóstico , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Uzbequistão , Adulto Jovem
10.
PLoS One ; 15(8): e0238239, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32866220

RESUMO

INTRODUCTION: Residency applications via virtual-interview could potentially mitigate the extensive cost and time required for customary in-person interviews. We outline the perception of medical students and residents on the use of virtual-interview for residency applications in lieu of in-person interviews. METHODS: We obtained 1824 responses from medical students and residents through an online questionnaire between March2019-Feb2020 in Texas-United States. The survey had 11 statements (five in favor of in-person interviews and 6 in favor of virtual interviews) that respondents could rank on a 5-point Likert scale. All statements' scores were summed based on the response given by each participant to create a total score between 11 and 55. The perception of the two groups was analyzed using an independent sample T-test and ANOVA. RESULTS: We received a total of 1711 responses from medical students and 113 from medical residents. Respondents were more female (82.2% of medical students and 47.8% of residents), with a mean age of 22.87±3.42 years old for medical students and 28.72±4.35 years old for residents. Both groups preferred in-person interviews; however, the residents were significantly more in favor (P = 0.03). Both groups agree that virtual-interviews should be as an option, though this was considerably higher in the medical students (P = 0.001). In the multivariate analysis, "travel distance" and "type of medical school" had a significant impact on choosing the virtual-interviews in both groups (p<0.01). CONCLUSIONS: In-person interviews are favored by both medical students and residents compared to virtual-interview services in normal circumstances. However, both groups agree that programs should offer the option of having virtual-interviews as an available choice. Distance to an interview location and the type of medical school were the factors that had a significant impact on perception of using virtual-interviews. Knowing about the applicants' attitude toward residency interviews and the national circumstances are essential when preparing the interview guides. Our findings are limited by the small sample size and the low response rate. Further extensive studies are warranted to better understand the perception of residency applicants toward virtual-interviews to improve the interview process in the United States.


Assuntos
Entrevistas como Assunto/métodos , Seleção de Pessoal/métodos , Estudantes de Medicina/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Internato e Residência/estatística & dados numéricos , Entrevistas como Assunto/estatística & dados numéricos , Masculino , Critérios de Admissão Escolar/estatística & dados numéricos , Faculdades de Medicina/estatística & dados numéricos , Inquéritos e Questionários , Texas , Estados Unidos , Adulto Jovem
11.
Artigo em Inglês | MEDLINE | ID: mdl-32899163

RESUMO

Healthcare workers (HCWs) facing the COVID-19 pandemic are required to deal with unexpectedly traumatic situations, concern about contamination, and mounting patient deaths. As a means to address the changing needs of our hospital's HCWs, we conducted a narrative analysis study in the early stages of the covid-19 outbreak. A focus group of medical experts, conducted as the initial step, recommended that a bottom-up research tool be used for exploring HCWs' traumatic experiences and needs. We therefore conducted 450 semi-structured in-depth interviews with hospital personnel. The interviews were based on Maslow's Pyramid of Needs model, and the narratives were analyzed by applying the Listening Guide methodology. The interviewees expressed a need for physical and psychological security in the battle against Covid-19, in addition to the need for attachment and meaning. Importantly, we also found that the interview itself may serve as a therapeutic tool. In light of our findings, we recommended changes in hospital practices, which were subsequently implemented. Further research on HCWs' traumatic experiences and needs will provide evidence-based knowledge and may enable novel approaches in the battle against Covid-19. To conclude, the knowledge generated by listening to HCWs' narratives may provide suitable support programs for professionals.


Assuntos
Infecções por Coronavirus/epidemiologia , Recursos Humanos em Hospital/psicologia , Pneumonia Viral/epidemiologia , Betacoronavirus , Infecções por Coronavirus/psicologia , Humanos , Entrevistas como Assunto , Pandemias , Pneumonia Viral/psicologia
12.
Soc Work Public Health ; 35(7): 590-602, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32970541

RESUMO

The novel coronavirus pandemic has upended the world as we knew it and is a concern for governments globally. With cases still surging in different regions around the globe, the level of knowledge of COVID-19 and compliance with preventive measures still differ across cultural regions. Our study explored knowledge of COVID-19 and compliance with preventive measures among community members in Anambra State, Nigeria, using in-depth interviews (IDI). Data were sourced from 36 persons comprising 30 household heads age 48 years and above and six children age 13-17 years. Data were analyzed thematically. Findings revealed that a majority of the respondents believe that the COVID-19 pandemic is more of a hoax than reality. Other findings showed that this poor knowledge negatively affected their compliance with preventive measures to curb the spread of coronavirus. To improve knowledge on the coronavirus pandemic, we recommended dissemination of accurate information to ensure compliance with preventive measures.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/prevenção & controle , Conhecimentos, Atitudes e Prática em Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adolescente , Adulto , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Feminino , Fidelidade a Diretrizes , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Pneumonia Viral/epidemiologia , Distância Social
13.
J Subst Abuse Treat ; 118: 108124, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32893047

RESUMO

OBJECTIVE: The COVID-19 pandemic has transformed care delivery for patients with opioid use disorder (OUD); however, little is known about the experiences of front-line clinicians in the transition to telemedicine. This study described how, in the context of the early stages of the pandemic, clinicians used telemedicine for OUD in conjunction with in-person care, barriers encountered, and implications for quality of care. METHODS: In April 2020, we conducted semistructured interviews with clinicians waivered to prescribe buprenorphine. We used maximum variation sampling. We used standard qualitative analysis techniques, consisting of both inductive and deductive approaches, to identify and characterize themes. RESULTS: Eighteen clinicians representing 10 states participated. Nearly all interview participants were doing some telemedicine, and more than half were only doing telemedicine visits. Most participants reported changing their typical clinical care patterns to help patients remain at home and minimize exposure to COVID-19. Changes included waiving urine toxicology screening, sending patients home with a larger supply of OUD medications, and requiring fewer visits. Although several participants were serving new patients via telemedicine during the early weeks of the pandemic, others were not. Some clinicians identified positive impacts of telemedicine on the quality of their patient interactions, including increased access for patients. Others noted negative impacts including less structure and accountability, less information to inform clinical decision-making, challenges in establishing a connection, technological challenges, and shorter visits. CONCLUSIONS: In the context of the pandemic, buprenorphine prescribers quickly transitioned to providing telemedicine visits in high volume; nonetheless, there are still many unknowns, including the quality and safety of widespread use of telemedicine for OUD treatment.


Assuntos
Buprenorfina/administração & dosagem , Infecções por Coronavirus/epidemiologia , Transtornos Relacionados ao Uso de Opioides/terapia , Pneumonia Viral/epidemiologia , Telemedicina/estatística & dados numéricos , Tomada de Decisão Clínica , Infecções por Coronavirus/prevenção & controle , Assistência à Saúde/organização & administração , Assistência à Saúde/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Humanos , Entrevistas como Assunto , Tratamento de Substituição de Opiáceos/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Detecção do Abuso de Substâncias/estatística & dados numéricos
15.
J Subst Abuse Treat ; 118: 108124, 2020 11.
Artigo em Inglês | MEDLINE | ID: covidwho-733730

RESUMO

OBJECTIVE: The COVID-19 pandemic has transformed care delivery for patients with opioid use disorder (OUD); however, little is known about the experiences of front-line clinicians in the transition to telemedicine. This study described how, in the context of the early stages of the pandemic, clinicians used telemedicine for OUD in conjunction with in-person care, barriers encountered, and implications for quality of care. METHODS: In April 2020, we conducted semistructured interviews with clinicians waivered to prescribe buprenorphine. We used maximum variation sampling. We used standard qualitative analysis techniques, consisting of both inductive and deductive approaches, to identify and characterize themes. RESULTS: Eighteen clinicians representing 10 states participated. Nearly all interview participants were doing some telemedicine, and more than half were only doing telemedicine visits. Most participants reported changing their typical clinical care patterns to help patients remain at home and minimize exposure to COVID-19. Changes included waiving urine toxicology screening, sending patients home with a larger supply of OUD medications, and requiring fewer visits. Although several participants were serving new patients via telemedicine during the early weeks of the pandemic, others were not. Some clinicians identified positive impacts of telemedicine on the quality of their patient interactions, including increased access for patients. Others noted negative impacts including less structure and accountability, less information to inform clinical decision-making, challenges in establishing a connection, technological challenges, and shorter visits. CONCLUSIONS: In the context of the pandemic, buprenorphine prescribers quickly transitioned to providing telemedicine visits in high volume; nonetheless, there are still many unknowns, including the quality and safety of widespread use of telemedicine for OUD treatment.


Assuntos
Buprenorfina/administração & dosagem , Infecções por Coronavirus/epidemiologia , Transtornos Relacionados ao Uso de Opioides/terapia , Pneumonia Viral/epidemiologia , Telemedicina/estatística & dados numéricos , Tomada de Decisão Clínica , Infecções por Coronavirus/prevenção & controle , Assistência à Saúde/organização & administração , Assistência à Saúde/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Humanos , Entrevistas como Assunto , Tratamento de Substituição de Opiáceos/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Detecção do Abuso de Substâncias/estatística & dados numéricos
16.
Artigo em Inglês | MEDLINE | ID: covidwho-742792

RESUMO

Healthcare workers (HCWs) facing the COVID-19 pandemic are required to deal with unexpectedly traumatic situations, concern about contamination, and mounting patient deaths. As a means to address the changing needs of our hospital's HCWs, we conducted a narrative analysis study in the early stages of the covid-19 outbreak. A focus group of medical experts, conducted as the initial step, recommended that a bottom-up research tool be used for exploring HCWs' traumatic experiences and needs. We therefore conducted 450 semi-structured in-depth interviews with hospital personnel. The interviews were based on Maslow's Pyramid of Needs model, and the narratives were analyzed by applying the Listening Guide methodology. The interviewees expressed a need for physical and psychological security in the battle against Covid-19, in addition to the need for attachment and meaning. Importantly, we also found that the interview itself may serve as a therapeutic tool. In light of our findings, we recommended changes in hospital practices, which were subsequently implemented. Further research on HCWs' traumatic experiences and needs will provide evidence-based knowledge and may enable novel approaches in the battle against Covid-19. To conclude, the knowledge generated by listening to HCWs' narratives may provide suitable support programs for professionals.


Assuntos
Infecções por Coronavirus/epidemiologia , Recursos Humanos em Hospital/psicologia , Pneumonia Viral/epidemiologia , Betacoronavirus , Infecções por Coronavirus/psicologia , Humanos , Entrevistas como Assunto , Pandemias , Pneumonia Viral/psicologia
17.
PLoS One ; 15(9): e0239234, 2020.
Artigo em Inglês | MEDLINE | ID: covidwho-768841

RESUMO

Effective and culturally appropriate hand-hygiene education is essential to promote health-related practices to control and prevent diseases such as Diarrhoea, Ebola and COVID-19. In this paper we outline and evaluate the Co-Creation processes underpinning a handwashing intervention for young children (A Germ's Journey) developed and delivered in India, Sierra Leone and the UK, and consider the implications surrounding Imperialist/Colonial discourse and the White Saviour Complex. The paper focuses both on the ways Co-Creation was conceptualised by our collaborators in all three countries and the catalysts and challenges encountered. Qualitative data have been drawn from in-depth interviews with five key stakeholders, focus group data from 37 teachers in Sierra Leone and responses to open-ended questionnaires completed by teachers in India (N = 66) and UK (N = 63). Data were analysed using thematic analysis and three themes, each with three constituent subthemes are presented. In the theme 'Representations of and Unique Approaches to Co-Creation' we explore the ways in which Co-Creation was constructed in relation to teamwork, innovative practice and more continuous models of evaluation. In 'Advantages of Co-Creation' we consider issues around shared ownership, improved outcomes and more meaningful insights alongside the mitigation of risks and short-circuiting of problems. In 'Challenges of Co-Creation' we discuss issues around timing and organisation, attracting and working with appropriate partners and understanding the importance of local context with inherent social, economic and structural barriers, especially in low-and-middle-income countries. We consider how theoretical elements of Co-Creation can inform effective international public health interventions; crucial during a global pandemic in which handwashing is the most effective method to control the transmission of COVID-19. Finally we reflect on some of the methodological challenges of our own work and in managing the potentially conflicting goals of the ethical and participatory values of Co-Creation with pragmatic considerations about ensuring an effective final 'product'.


Assuntos
Controle de Doenças Transmissíveis/métodos , Higiene das Mãos , Betacoronavirus , Criança , Doenças Transmissíveis/patologia , Doenças Transmissíveis/transmissão , Doenças Transmissíveis/virologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Grupos Focais , Humanos , Índia , Entrevistas como Assunto , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Professores Escolares/psicologia , Serra Leoa , Inquéritos e Questionários , Reino Unido
18.
Sante Publique ; 32(1): 103-111, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32985967

RESUMO

BACKGROUND: Outreach HIV testing strategies have significantly contributed to the increase in the number of people knowing their HIV status in sub-Saharan Africa. This article analyzes the articulation of donor and field constraints on the implementation of outreach HIV testing strategies in Côte d’Ivoire. METHODS: Qualitative research was conducted in three health districts (Man, Cocody-Bingerville and Aboisso) in Côte d’Ivoire in 2015-2016, through in-depth interviews with community providers, local leaders and people tested and through observation of outreach HIV testing activities. RESULTS: Implementing organizations feel “under pressure” to meet donors’ objectives that are deemed unattainable, as well as the lack of training and funding. As a result, providers do not observe systematically the rules of the “three Cs” (counselling, informed consent, confidentiality), and propose testing to individuals who are “off-target” (in terms of locations and populations). DISCUSSION: Implementing NGOs experience two types of constraints those resulting from the functioning of international aid (inadequate funding compared to actual costs, objectives too high, the important chain of intermediaries) and those related to the local context (spaces not adapted to guarantee confidentiality and the professional activity of target populations). CONCLUSION: The pressure that is exerted at different levels on implementing NGOs is detrimental to the quality of HIV testing. It is now essential to develop a more qualitative approach in defining strategies and evaluation criteria.


Assuntos
Agentes Comunitários de Saúde , Aconselhamento , Infecções por HIV/diagnóstico , Programas de Rastreamento/métodos , Serviços Preventivos de Saúde/organização & administração , Fortalecimento Institucional , Costa do Marfim , Infecções por HIV/prevenção & controle , Humanos , Entrevistas como Assunto , Pesquisa Qualitativa
19.
PLoS One ; 15(9): e0239234, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32931509

RESUMO

Effective and culturally appropriate hand-hygiene education is essential to promote health-related practices to control and prevent diseases such as Diarrhoea, Ebola and COVID-19. In this paper we outline and evaluate the Co-Creation processes underpinning a handwashing intervention for young children (A Germ's Journey) developed and delivered in India, Sierra Leone and the UK, and consider the implications surrounding Imperialist/Colonial discourse and the White Saviour Complex. The paper focuses both on the ways Co-Creation was conceptualised by our collaborators in all three countries and the catalysts and challenges encountered. Qualitative data have been drawn from in-depth interviews with five key stakeholders, focus group data from 37 teachers in Sierra Leone and responses to open-ended questionnaires completed by teachers in India (N = 66) and UK (N = 63). Data were analysed using thematic analysis and three themes, each with three constituent subthemes are presented. In the theme 'Representations of and Unique Approaches to Co-Creation' we explore the ways in which Co-Creation was constructed in relation to teamwork, innovative practice and more continuous models of evaluation. In 'Advantages of Co-Creation' we consider issues around shared ownership, improved outcomes and more meaningful insights alongside the mitigation of risks and short-circuiting of problems. In 'Challenges of Co-Creation' we discuss issues around timing and organisation, attracting and working with appropriate partners and understanding the importance of local context with inherent social, economic and structural barriers, especially in low-and-middle-income countries. We consider how theoretical elements of Co-Creation can inform effective international public health interventions; crucial during a global pandemic in which handwashing is the most effective method to control the transmission of COVID-19. Finally we reflect on some of the methodological challenges of our own work and in managing the potentially conflicting goals of the ethical and participatory values of Co-Creation with pragmatic considerations about ensuring an effective final 'product'.


Assuntos
Controle de Doenças Transmissíveis/métodos , Higiene das Mãos , Betacoronavirus , Criança , Doenças Transmissíveis/patologia , Doenças Transmissíveis/transmissão , Doenças Transmissíveis/virologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Grupos Focais , Humanos , Índia , Entrevistas como Assunto , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Professores Escolares/psicologia , Serra Leoa , Inquéritos e Questionários , Reino Unido
20.
Medicine (Baltimore) ; 99(31): e21425, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756147

RESUMO

Best practices for how to respond are unclear when a medical error is discovered in a different system (inter-system medical error discovery or IMED). This qualitative study explored medical error professionals' views on disclosure, feedback, and reporting in these scenarios.We conducted semi-structured telephone interviews from January to September 2018 with 15 medical error professionals from 5 regions of the United States. Interview guides addressed perspectives on best practice, minimum obligations, and mediating factors with respect to IMED. Each transcript was coded independently by two investigators. Analysis followed the inductive approach of interpretive description.Medical error professionals expressed diverse views about minimum obligations and best practices for physicians when responding to IMED events. All cited practical barriers to disclosure, feedback, and reporting in these scenarios. There was general consensus that clear-cut, harmful errors should be disclosed to patients, and most advised investigation and feedback prior to disclosure. Respondents diverged in recommended best practices and thresholds for taking action. All noted the lack of guidance specific to IMED scenarios but differed in how they would extrapolate from more general guidance.While medical error professionals expressed consensus regarding obligations to disclose obvious errors, they differed on particulars. Guidelines or an algorithm could be very useful. Efforts to develop clear guidelines for IMED must take into account these factors, as well as practical and political challenges to communication about errors discovered across systems.


Assuntos
Atitude do Pessoal de Saúde , Guias como Assunto , Erros Médicos/prevenção & controle , Revelação da Verdade , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Estados Unidos
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