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1.
Pan Afr Med J ; 33: 123, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31565114

RESUMO

Introduction: The proportion of antenatal attendants in Ghana who had at least four antenatal visits increased from 78% in 2008 to 87% in 2014. However, it is not known whether these visits followed the recommended timing of focused antenatal clinic attendance in Ghana. We sought to assess the adherence to the clinic schedule and its determinants in the Accra Metropolis. Methods: A cross-sectional study was conducted. Face-to-face interviews were conducted with postpartum women. Multiple logistic regression was used in the analysis of determinants of adherence to the recommended timing of clinic attendance. A p-value of <0.05 was considered statistically significant. Results: Among 446 focused antenatal care clinic attendants, 378 (84.8%) had four or more visits. Among these, 101 (26.7%) adhered to the recommended clinic schedule. Women who adhered were more likely to have had education up to Junior High School [AOR=3.31, 95%CI (1.03-10.61)] or Senior High School [AOR=4.47, 95%CI (1.14-17.51)], or have history of abortion [(AOR=3.36, 95%CI (1.69-7.96)]. For every week increase in gestational age at booking at the antenatal clinic, respondents were 34% less likely to complete all four antenatal visits at the recommended times. [(AOR=0.66, 95% (0.60-0.73)]. Conclusion: Majority of women receiving focused antenatal care in the Accra Metropolis have four or more visits but only about a quarter of them adhered to the recommended clinic schedule. Having high school education, history of abortion and early initiation of antenatal care were predictors of adherence to clinic schedule. Women should be educated on early initiation of antenatal care to enhance adherence.


Assuntos
Idade Gestacional , Cooperação do Paciente/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , Adulto , Estudos Transversais , Escolaridade , Feminino , Gana , Humanos , Entrevistas como Assunto , Modelos Logísticos , Gravidez , Fatores de Tempo , Adulto Jovem
2.
Pan Afr Med J ; 33: 166, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31565127

RESUMO

With its number of employees ranging from 45,310 to 46,000, the textile and apparel industry is the main private sector employer of labour in Lesotho. It has been reported that a third (an estimated 34%) of these workers are living with HIV. There is perception that textile factory workers living with HIV (TFWLWH) in Lesotho indulge in HIV risk-taking behaviours. However, no study has yet investigated or documented factors that influence risk-taking behaviours amongst these workers. Transmitting the disease to others, treatment complications and death consequent to HIV reinfection are complications associated with HIV risk-taking behaviours by seropositive individuals. Using an in-depth, face-to-face, semi-structured interview, this study obtained the perspectives of ten factory workers from three randomly selected textile factories in Maseru, Lesotho on factors that influence HIV-risk taking behaviour amongst TFWLWH in Lesotho. Analysis of the comments given by workers revealed four core themes, namely, peer pressure, communication, cultural norms and societal norms. Determining the predictors of HIV risk-taking behaviours amongst these workers will inform both present and future interventions aimed at supporting textile factory workers living with HIV in Lesotho. This supports the need for continued research to identify HIV risk-taking behaviours by people living with HIV countrywide, to decrease the incidence of new infections and complications arising from reinfection.


Assuntos
Infecções por HIV/epidemiologia , Assunção de Riscos , Indústria Têxtil , Adolescente , Adulto , Comunicação , Cultura , Feminino , Humanos , Entrevistas como Assunto , Lesoto/epidemiologia , Masculino , Infuência dos Pares , Setor Privado , Normas Sociais , Adulto Jovem
3.
Z Psychosom Med Psychother ; 65(3): 288-303, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31476999

RESUMO

Is the influence of religiousness on fearful, depressive and somatic symptoms and psychic traumatization overestimated? A representative cross-sectional study Objectives: The aim of this study is to prove if religious faith, spirituality and religious praxis are joined with lower depression, anxiety and physical pain-level and if subjects with traumatic experiences report more spirituality. Methods: In this consecutive study, 2508 adults of a representative sample in Germany were interviewed about religious faith and spirituality in relation to depression, anxiety, physical disorders as well as traumatic experiences. Results: Unlike our hypotheses people who are charged with mental (PHQ-4; Löwe et al. 2010) or physical disorders (GBB_8; Kliem et al. 2017) report more spirituality and more private religious/spiritual praxis than people without mental or physical problems. As expected people with traumatic experiences in their childhood (CTS; Grabe et al. 2012) describe significantly more spirituality than people without these experiences. Conclusions: Other than expected people with more mental or physical disorders report more spirituality and more private religious/spiritual praxis. It is to discuss if spirituality is less a protective factor for mental or physical disorders than disorders activate to look for spirituality and private religious/spiritual praxis.


Assuntos
Ansiedade/psicologia , Depressão/psicologia , Medo/psicologia , Sintomas Inexplicáveis , Trauma Psicológico/psicologia , Religião e Psicologia , Espiritualidade , Adulto , Ansiedade/epidemiologia , Criança , Estudos Transversais , Depressão/epidemiologia , Alemanha/epidemiologia , Humanos , Entrevistas como Assunto , Trauma Psicológico/epidemiologia
4.
Z Psychosom Med Psychother ; 65(3): 257-271, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31476995

RESUMO

Experience of disease, relationship and sexuality in patients with COPD Objectives: We aimed to determine the impacts of chronic obstructive pulmonary disease (COPD) on the patient's relationship and sexuality. Methods: In a multicentric study 105, 52 of them female, non-selected COPD patients who were married or in a partnership were interviewed about their partnership and sexuality. Results: Average age was 64.1 ± 9.2 years. Patients with a more severe COPD had a lower Self-Illness-Separation (SIS), i. e. they reveal significantly higher burden of suffering. Life satisfaction and satisfaction with partnership, sexuality and sexual intercourse has decreased significantly since the diagnosis (p < 0.05). Desire and frequency to be sexually active have also decreased (p < 0.001). 61 % of the respondents felt increasingly dependent from their partner. Conclusion: The results underline that patients have a stage-dependent emotional distance to their illness, the partnership develops in direction of dependency, and sexuality deteriorates with increasing severity of the COPD. The PRISM test proved to be a great way to illustrate this development and to start a conversation with the patients about it. COPD patients and their partners should be referred to the potential impact of the disease on their partnership and sexuality and should be supported in their potential solutions considering gender-specific aspects.


Assuntos
Casamento/psicologia , Satisfação Pessoal , Doença Pulmonar Obstrutiva Crônica/psicologia , Qualidade de Vida , Sexualidade/psicologia , Idoso , Feminino , Humanos , Entrevistas como Assunto , Pessoa de Meia-Idade
5.
Z Gerontol Geriatr ; 52(6): 539-545, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31506819

RESUMO

BACKGROUND: Family caregivers are important players in both inpatient and domestic healthcare. As a result of increasing mobility many also perform care over geographical distances. OBJECTIVE: The article highlights the opportunities and challenges of distance caregiving from a distance caregivers' perspective. Data were collected as part of the binational research and development project on distance caregiving, which investigated various dimensions of distance caregiving with an interdisciplinary team from Germany (Protestant University Ludwigsburg) and Switzerland (Careum University of Applied Sciences Zurich). To date empirical results exist mainly for the Anglo-American region. This study provides hitherto lacking empirical findings for Germany and Switzerland. MATERIAL AND METHODS: The study was based on 49 guideline-based, partially narrative interviews (Germany: N = 35; Switzerland: N = 14) with distance caregivers, who at the time of data collection were caring for a person at least 60 years old. The software-supported data analysis (MAXQDA 10) was carried out using deductive and inductive structuring content analysis according to Mayring. RESULTS AND CONCLUSION: Distance caregivers provide substantial and diverse care and support tasks. A central challenge is the lack of up to date and reliable information regarding the care situation. This may lead to emotional strain; however, distance also results in relief for caregivers. A functioning network including well-defined agreements and transparent communication is crucial.


Assuntos
Cuidadores , Emoções , Telemedicina , Equilíbrio Trabalho-Vida , Idoso , Idoso de 80 Anos ou mais , Feminino , Alemanha , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Suíça
6.
Z Gerontol Geriatr ; 52(6): 552-556, 2019 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-31535187

RESUMO

BACKGROUND: Caregiving from a distance is understudied as well as rarely sociopolitically debated in Germany. Accordingly, distance caregiving is a type of informal care work that has been little acknowledged in social law. OBJECTIVE: This article addresses the issue of how aware sociopolitical experts in Germany are of distance caregiving. Moreover, it points out the challenges the experts perceive in the legal framework and which solutions they can identify. MATERIAL AND METHODS: Guided interviews were conducted with six experts from sociopolitical areas in Germany with points of connection to care politics (ministries, associations, organizations). The interviews were analyzed based on the method of summarizing qualitative content analysis (according to Mayring). RESULTS: Even though distance caregiving has played a minor role among the sociopolitical experts, they were aware of individual aspects of this topic, mostly based on having been personally affected. Due to this experience they argued for a broader understanding of care including for example organizational support. They criticized the lack of sociopolitical consideration of distance caregivers and among other things demanded a functioning local support system. CONCLUSION: The interviews indicated a specific and personal awareness of distance caregiving; however, the findings pointed to stronger criticism of the overall situation regarding caregiving relatives. Thus, despite all recent reforms in distance caregiving there is still a need for action on the topic of caregiving relatives.


Assuntos
Cuidadores , Política , Telemedicina , Alemanha , Humanos , Entrevistas como Assunto
7.
Pan Afr Med J ; 33: 140, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31558938

RESUMO

Introduction: The aim of this study was to estimate the prevalence of Diabetes Mellitus (DM) and Impaired Fasting Glucose (IFG) in the peri-urban adult population living in the island of Anjouan, Comoros and to investigate the factors associated with diabetes mellitus. Methods: The survey was a cross-sectional study, in which a sample of 902 individuals (540 women and 362 men) aged 25 to 64 was selected using empirical sampling "quotas" or "reasoned choice" survey method. Hypertension and obesity abdominal measurements of these subjects were collected during face-to-face interviews and following day fasting blood glucose was measured in capillary blood. Results: Participation rate was 83.5%. The mean age of subjects was 39.5 ± 11.63 years. The sex ratio was 0.67. Overall crude diabetes and IFG prevalence were 8.5% and 8.1%, respectively. The risk factors for diabetes type 2 onset were a family history of diabetes (P = 0.006), older age (P = 0.000), glycemic control (P = 0.010), excess waist circumference (P = 0.03) and hypertension (p = 0.000), were significantly positively associated with DM, contrary to sex (P = 0.142). Conclusion: These high figures confirm that diabetes and factors associated do not spare Anjouan population. Awareness, primary prevention, are to set up for a better control of non-communicable diseases.


Assuntos
Glicemia/metabolismo , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Intolerância à Glucose/epidemiologia , Adulto , Fatores Etários , Doenças Cardiovasculares/etiologia , Comores/epidemiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Jejum , Feminino , Humanos , Hipertensão/epidemiologia , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/epidemiologia , Prevalência , Fatores de Risco , Circunferência da Cintura
8.
Codas ; 31(4): e20180218, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31483043

RESUMO

PURPOSE: To develop a short educational program about aphasia (SEPA) for family caregivers of people with aphasia and verify its effect in their burden and quality of life. METHODS: This is a quantitative experimental study. The participants included in the study were family caregivers of people with aphasia. They completed the Zarit interview scale and WHOQOL-Bref instruments pre- and post-intervention. The intervention was a short educational program about aphasia, administered in a group setting and conducted in two didactic sessions. RESULTS: Four participants were included in the study. In the group analysis, there was no significant difference in any measure. However, looking into the individual performances, all participants presented a trend for improvement in most of the scores. CONCLUSION: Possibly, family caregivers of people with aphasia might benefit from the SEPA. It would be relevant for future studies to include larger samples and consider new strategies to improve inclusion of participants.


Assuntos
Afasia/psicologia , Cuidadores/psicologia , Educação em Saúde/métodos , Qualidade de Vida , Adulto , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Avaliação de Programas e Projetos de Saúde , Fatores Socioeconômicos
9.
Rev Assoc Med Bras (1992) ; 65(8): 1048-1054, 2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31531600

RESUMO

INTRODUCTION: Medical Residency is a recognized form of professional qualification, but there are criticisms regarding the overload of work activities. Given the length of the daily and weekly workdays, residents develop practices that enable them to reconcile the Residency with their personal life. AIM: To describe time management strategies in the daily routine of Internal Medicine Medical Residents of a university hospital in São Paulo, Brasil. METHODS: Eight interviews were conducted with resident physicians of the second year, addressing aspects of personal and family life, theoretical study, practical activities, and work bonds. Content analysis was carried out using the MaxQDA software. RESULTS: Six thematic categories emerged from the reports: work organization at the Medical Residency; learning and/or professional activities; housing, financial planning, and household activities; time for leisure and interpersonal relationship; family planning/children; rest/sleep. DISCUSSION: Several strategies are adopted for time management: residing near the hospital, domestic activities helped by housekeepers, postponement of maternity leave, and social support centered on interacting with other residents. There are paid activities not associated with the Residency, which lead to reduced time for rest, study, and leisure, with a greater loss during work at night shifts. CONCLUSIONS: Residents experience a period of intense learning, which requires a high workload and complex work. The evaluation of the work organization of medical residents should include not only time for rest but also time management strategies for daily activities, which can reduce the negative outcomes associated with long working hours.


Assuntos
Medicina Interna/educação , Internato e Residência/estatística & dados numéricos , Gerenciamento do Tempo , Carga de Trabalho/estatística & dados numéricos , Adulto , Brasil , Feminino , Hospitais Universitários , Humanos , Medicina Interna/estatística & dados numéricos , Entrevistas como Assunto , Masculino , Pesquisa Qualitativa , Carga de Trabalho/psicologia
10.
West Afr J Med ; 36(2): 138-143, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31385600

RESUMO

BACKGROUND: Holistic ward round (HWR) is a polyadic, multiphasic, holistic model of neurosurgical patient care. It is a multidisciplinary ward round where all healthcare providers involved in patients care, the patients, the relations, as well as clergymen (depending on the patients' faith and need) collectively work to review patient's condition and make decisions in the patient's best interest. OBJECTIVES: The study assessed the effectiveness of the holistic model of care and identified the challenges facing this model of healthcare delivery. METHODS: The study was qualitative in design and In-depth Interviews (IDIs) were conducted with eighteen (18) participants who were purposively selected. They include neurosurgeons, nurses, medical social workers and physiotherapists. The data were thematically content analysed with the help of ATLAS.ti (v.7) software. RESULTS: The study found that patients and relations have immensely benefitted from the model of care through psychosocial support. The major challenges facing HWR were logistic, timing and common problems found in the Nigerian healthcare system. CONCLUSION: It was concluded that for HWR to effectively help spinal cord injured patients further, the healthcare providers, patients and their families require support in different forms from outside the hospital.


Assuntos
Saúde Holística , Equipe de Assistência ao Paciente , Assistência ao Paciente , Assistência Centrada no Paciente/métodos , Adulto , Feminino , Hospitais Universitários , Humanos , Relações Interprofissionais , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Neurocirurgiões , Neurocirurgia , Nigéria , Fisioterapeutas , Pesquisa Qualitativa , Assistentes Sociais
11.
Rev Fac Cien Med Univ Nac Cordoba ; 76(3): 193-197, 2019 08 29.
Artigo em Espanhol | MEDLINE | ID: mdl-31465190

RESUMO

Objective: The study was to explore elder's feeding process mind construction in different stages of life. Study selection, source and data extraction: Through a qualitative study with a phenomenological focus and using semi-structured interviews and discussion groups, it has been deepened into the perception of the childhood, adulthood and current experience towards the feeding process. As data sources, 28 elders that accomplished with the selection criterions of the investigation participated in it. Their answers were coded through the program NVivo 10 and for the conclusions it was used the content analysis through research triangulation. Data synthesis: For childhood, the feeding process is understood as healthy, associated to the availability of natural products and limited access to manufactured products. Adulthood was not considered as important in their feeding attention, situation that is opposed in their current life cycle, because it is perceived the necessity of a healthy feeding, though related to their health care. Conclusions: It is presented the meaning construction in elder people related to their feeding in key stages of their life, like in the childhood, adulthood and current experience as elder. Childhood and elderly stages are perceived as positive for a healthy feeding process.


Assuntos
Comportamento Alimentar , Conhecimentos, Atitudes e Prática em Saúde , Idoso , Chile , Humanos , Entrevistas como Assunto , Percepção , Pesquisa Qualitativa
12.
Presse Med ; 48(7-8 Pt 1): e209-e215, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31421945

RESUMO

AIM: Identified Palliative Care Beds (Lits Identifiés Soins Palliatifs - LISPs) is a French specificity. Primarily created to integrate palliative care culture into conventional hospital units, the relevance of this measure became a controversial issue. Nowadays, hospital teams continue to frequently encounter complex situations regarding medical care for palliative patients. To the best of our knowledge, there is only one study, a quantitative one, bridging the gap about that subject. It showed failure in practicing palliative care work around LISP. Our study is based on a qualitative method that complements the quantitative study. It aimed to describe difficulties that limit palliative care practices in managing adult patients in LISP. METHOD: This qualitative exploratory survey was conducted with a sample of health service professionals (n=20), from senior physicians to caregivers. Each semi-structured interview included open questions regarding their experiences, feelings and difficulties with palliative care practices on LISP. It also included closed questions concerning interviewee's demographics and career course. The data for this research were submitted to a two-stage analysis: first, a global review of each interview was performed to identify trends. Then, a detailed breakdown, question by question, was implemented. RESULTS: From a quantitative perspective, the interviews revealed 305 difficulties, indicating the gaps and barriers limiting the implementation of a palliative approach in these services. From a qualitative perspective, five topics raised our attention by their recurrence in discourses: (1) partial knowledge about palliative care definition and legislation mostly due to a lack of training; (2) need for time; (3) need for human resources; (4) need for communication; (5) hard time in transitioning from curative to palliative care. PERSPECTIVE: This survey gives the opportunity to understand health service professionals' difficulties in practicing palliative care in conventional medical services. It raises the central issue of the pricing reform on the health institutes activity. It also provides angles of inquiry to improve LISP effectiveness. This qualitative and descriptive study was designed to explore difficulties in practicing palliative care around LISP. Nevertheless, according to the size of the sample, results will need to be confirmed by a more extensive qualitative survey.


Assuntos
Continuidade da Assistência ao Paciente , Unidades Hospitalares/organização & administração , Cuidados Paliativos/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Padrões de Prática Médica , Qualidade da Assistência à Saúde/organização & administração , Adulto , Atitude do Pessoal de Saúde , Cuidadores/organização & administração , Cuidadores/normas , Barreiras de Comunicação , Continuidade da Assistência ao Paciente/organização & administração , Continuidade da Assistência ao Paciente/normas , Assistência à Saúde/métodos , Assistência à Saúde/organização & administração , Assistência à Saúde/normas , Arquitetura de Instituições de Saúde/normas , França , Conhecimentos, Atitudes e Prática em Saúde , Número de Leitos em Hospital , Unidades Hospitalares/normas , Humanos , Entrevistas como Assunto , Satisfação no Emprego , Cuidados Paliativos/psicologia , Cuidados Paliativos/normas , Equipe de Assistência ao Paciente/normas , Padrões de Prática Médica/organização & administração , Padrões de Prática Médica/normas , Pesquisa Qualitativa , Qualidade da Assistência à Saúde/normas , Estudos Retrospectivos , Inquéritos e Questionários
13.
Implement Sci ; 14(1): 70, 2019 07 08.
Artigo em Inglês | MEDLINE | ID: mdl-31286964

RESUMO

BACKGROUND: Many interventions used in health care lack evidence of effectiveness and may be unnecessary or even cause harm, and should therefore be de-implemented. Lists of such ineffective, low-value practices are common, but these lists have little chance of leading to improvements without sufficient knowledge regarding how de-implementation can be governed and carried out. However, decisions regarding de-implementation are not only a matter of scientific evidence; the puzzle is far more complex with political, economic, and relational interests play a role. This project aims at exploring the governance of de-implementation of low-value practices from the perspectives of national and regional governments and senior management at provider organizations. METHODS: Theories of complexity science and organizational alignment are used, and interviews are conducted with stakeholders involved in the governance of low-value practice de-implementation, including national and regional governments (focusing on two contrasting regions in Sweden) and senior management at provider organizations. In addition, an ongoing process for governing de-implementation in accordance with current recommendations is followed over an 18-month period to explore how governance is conducted in practice. A framework for the governance of de-implementation and policy suggestions will be developed to guide de-implementation governance. DISCUSSION: This study contributes to knowledge about the governance of de-implementation of low-value care practices. The study provides rich empirical data from multiple system levels regarding how de-implementation of low-value practices is currently governed. The study also makes a theoretical contribution by applying the theories of complexity and organizational alignment, which may provide generalizable knowledge about the interplay between stakeholders across system levels and how and why certain factors influence the governance of de-implementation. The project employs a solution-oriented perspective by developing a framework for de-implementation of low-value practices and suggesting practical strategies to improve the governance of de-implementation. The framework and strategies can thereafter be evaluated for validity and impact in future studies.


Assuntos
Tomada de Decisões , Assistência à Saúde/normas , Fechamento de Instituições de Saúde/métodos , Administração de Serviços de Saúde , Autonomia Profissional , Qualidade da Assistência à Saúde/normas , Humanos , Entrevistas como Assunto , Modelos Teóricos , Política Organizacional , Formulação de Políticas , Suécia
14.
Schmerz ; 33(4): 320-328, 2019 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-31267168

RESUMO

OBJECTIVE: This study examines the perspectives of patients and family caregivers on outpatient palliative care networks. It contrasts primary palliative care (AAPV) and specialized outpatient care (SAPV) services, particularly in regard to pain management. METHODS: The study is based on 27 semi-structured, problem-focussed interviews with 21 patients and 19 informal caregivers. Recruitment was based on purposive sampling in two regions of Brandenburg, Germany. The data were analysed using qualitative content analysis. RESULTS: In AAPV, the general practitioner (GP) is both the central point of contact as well as the coordinator of the care network. In SAPV, the GP plays a less important role. This can lead to conflicts between GPs and health care professionals of the palliative care team. Compared to AAPV, palliative care teams are attributed greater intervention capacities in acute situations as well as expertise in pain therapy. Thus, the option of parenteral administration of opioids is considered a benefit of specialized care. The use of nursing services varies considerably depending on the individual care network-in some cases care is completely taken over by relatives. Relatives are the closest to the patient within the care network and perform key tasks. CONCLUSION: The personal and professional composition of networks of outpatient palliative care varies individually according to care situation and form. Care networks of AAPV and SAPV differ with regard to the accessibility of health care professionals and pain therapy. Home-based palliative care is often made possible by informal care givers in the first place.


Assuntos
Serviços de Assistência Domiciliar , Cuidados Paliativos , Assistência Ambulatorial , Cuidadores/estatística & dados numéricos , Alemanha , Serviços de Assistência Domiciliar/estatística & dados numéricos , Humanos , Entrevistas como Assunto , Cuidados Paliativos/estatística & dados numéricos
15.
Hosp Pract (1995) ; 47(3): 155-162, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31328589

RESUMO

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


Assuntos
Serviço Hospitalar de Emergência , Política Organizacional , Transferência da Responsabilidade pelo Paciente , Humanos , Entrevistas como Assunto , Irã (Geográfico) , Corpo Clínico Hospitalar/educação , Corpo Clínico Hospitalar/psicologia , Administração dos Cuidados ao Paciente , Pesquisa Qualitativa , Qualidade da Assistência à Saúde
16.
Women Birth ; 32(5): 449-459, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31345659

RESUMO

PROBLEM: It is not well known how to prepare new multidisciplinary teams aiming to provide culturally safe maternity care for Aboriginal and Torres Strait Islander families in an urban setting. BACKGROUND: National policies recommend increasing the Aboriginal and Torres Strait Islander workforce and cultural competencies of the non-Indigenous workforce as key drivers of culturally safe care. QUESTION: What are the key learnings from staff experiences establishing multidisciplinary teams aiming to provide culturally safe maternity care that aims to privilege Indigenous ways of knowing, being and doing? METHODS: As part of a larger participatory action research project, semi-structured qualitative interviews were conducted December 2014-April 2015 with 21 Aboriginal and Torres Strait Islander and non-Indigenous healthcare staff. Thematic analysis was used to identify learnings for practice. FINDINGS: Four key learnings were identified for forming new teams aiming to provide culturally safe care: (a) having a shared understanding of what characterises cultural safety in the local program context; (b) understanding and valuing different roles and knowledges people bring to the team; (c) acknowledging the influence of race and culture on staff behaviour; and (d) acting on individual and organisational responsibilities for continuous improvement towards cultural safety. DISCUSSION: We present recommendations from our participatory action research approach to respond to these learnings in practice. CONCLUSION: A deliberate workforce investment at the early stages of team development is crucial when aiming to provide culturally safe maternity care that can respond to the unique needs of Aboriginal and Torres Strait Islander women and families.


Assuntos
Continuidade da Assistência ao Paciente , Competência Cultural , Assistência à Saúde Culturalmente Competente , Pesquisa sobre Serviços de Saúde/organização & administração , Serviços de Saúde Materna/organização & administração , Bem-Estar Materno/etnologia , Equipe de Assistência ao Paciente/organização & administração , Adulto , Pesquisa Participativa Baseada na Comunidade , Feminino , Serviços de Saúde do Indígena , Disparidades em Assistência à Saúde , Humanos , Entrevistas como Assunto , Obstetrícia , Grupo com Ancestrais Oceânicos , Pesquisa Qualitativa
17.
Rev. Ciênc. Plur ; 5(1): 34-51, jun. 2019. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1007338

RESUMO

Introdução:A assistência desumanizada no parto pode originar informações negativas que são transmitidas entre as gerações, acarretandoem representações sociais. Dessa forma,representações sociais do parto normal por parte do profissional enfermeiro, um dos protagonistas da assistência à saúde da mulher na atenção básica, são importante objeto de estudo, a partir do entendimento que estes profissionais constroem nas realidades em que vivem.Objetivo:Identificar as representações sociais de enfermeiras da atenção básica sobre parto normal.Método:Estudo descritivo, exploratório, qualitativo, realizado com 12 enfermeiras, responsáveis por Equipes de Saúde da Família e que tinham mais de 01 ano de experiência na atenção básica no município de Caruaru/PE, nordeste do Brasil. Foram realizadas entrevistas semi-estruturadas, guiadaspela questão norteadora: Fale-me sobre parto normal. As falas foram submetidas à análise de conteúdo temática proposta por Bardin e interpretadas à luz dos constructos da Teoria das Representações Sociais.Resultados:A partir da análise das falas, emergiram quatro categorias temáticas: Lei da vida, Desejo e negação do parto normal, Insegurança, Imposição para mulheres de baixa renda.Conclusões:As representações que emergiram das falas das enfermeiras apresentam o parto normal como um evento natural, permeado pelo auxílio divino, trazendo o desejo em vivenciá-lo. Entretanto, este fato não é suficiente para que haja uma escolha por este tipo de parto, devido a outros fatores,como a insegurança presente em diferentes momentos e aspectos, bem como a compreensão de que o parto normal é imposto nos serviços públicos de saúde. Dessa forma, compreender as representações sociais do parto normal, pela perspectiva da enfermagem atuante na atenção básica, propicia um olhar sob a educação em saúde no pré-natal, onde são reelaborados os conhecimentos que envolvem este evento (AU).


Introduction:Dehumanized careat birth may give rise to negative information that is transmitted between generations, giving rise to social representations. Thus, these social representations of normal childbirth by the nurse practitioner, one of the protagonists of the assistance to women's health in basic care, are an important object of study, based on the understanding that these professionals construct in the realities in which they live.Objective:To identify the social representations of primary care nurses on normal delivery.Methods:A descriptive, exploratory, qualitative study was carried out with 12 nurses, who were responsible for Family Health Teams and who had more than 01 years of experience in basic care in the city of Caruaru / PE, northeastern Brazil. Semi-structuredinterviews were conducted, guided by the guiding question: Tell me about normal delivery. The speeches were submitted to the analysis of thematic content proposed by Bardin and interpreted in the light of the constructs of Theory of Social Representations. Results:Based on the analysis of the speeches, four thematic categories emerged: Law of life, Desire and denial of normal birth, Insecurity, Imposition for low income women. Conclusions:The representations that emerged from the nurses' statements present normal childbirth as a natural event, permeated by divine help, bringing the desire to experience it. However, this fact is not enough to make a choice for this type of delivery, due to other factors such as the insecurity present at different times andaspects, as well as the understanding that normal delivery is imposed in public health services. In this way, understanding the social representations of normal childbirth, from the perspective of nursing acting in basic care, provides a perspective on prenatal health education, where the knowledge that involves this event is re-elaborated (AU).


Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Atenção Primária à Saúde , Estratégia Saúde da Família , Parto Normal , Enfermeiros , Brasil , Entrevistas como Assunto/métodos , Pesquisa Qualitativa
18.
Rehabil Nurs ; 44(4): 221-229, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31265440

RESUMO

PURPOSE: The aim of the study was to assess the feasibility, safety, and preliminary estimates of effectiveness of Tai Chi on functional outcomes in stroke survivors. DESIGN: A mixed-method study with a single-group repeated-measure design and in-depth interviews. METHODS: Fourteen stroke survivors with hemiplegia were recruited to participate in a Tai Chi program, twice weekly for 12 months. Outcomes included physical function, self-efficacy, and activity of daily living measured at 3-month intervals for 12 months. FINDINGS: Ten participants (mean age, 68.5 years) completed all assessments with significantly improved balance (χ = 14.08, p = .007), flexibility (χ = 11.70, p = .020), and self-efficacy (χ = 21.84, p < .001) over 12 months. Qualitative results highlighted the positive impact on physical improvement, psychological well-being, social support, and improved confidence in performing activities of daily living. CONCLUSION: An adapted Tai Chi program was safe, feasible, and well received in community-dwelling stroke survivors. CLINICAL RELEVANCE: The Tai Chi-based rehabilitation program shows promise for improving function and balance outcomes related to fall prevention in stroke survivors.


Assuntos
Reabilitação do Acidente Vascular Cerebral/normas , Acidente Vascular Cerebral/complicações , Acidente Vascular Cerebral/terapia , Tai Ji/métodos , Atividades Cotidianas , Idoso , Feminino , Humanos , Entrevistas como Assunto/métodos , Masculino , Pessoa de Meia-Idade , Autoeficácia , Reabilitação do Acidente Vascular Cerebral/métodos , Resultado do Tratamento
19.
Rev Bras Enferm ; 72(3): 707-714, 2019 Jun 27.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31269136

RESUMO

OBJECTIVE: to analyze patient safety incidents identified by caregivers of hospitalized children. METHOD: a qualitative, exploratory-descriptive study was carried out with 40 caregivers of children hospitalized in three hospital institutions in the city of Porto Alegre, Rio Grande do Sul State, Brazil, from April to December 2016. Semi-structured, recorded and transcribed interviews were carried out in their entirety, submitted to a thematic analysis using the NVivo 11.0 software. RESULTS: reports related to falls, infant feeding, patient/caregiver identification, medication process, communication, hand hygiene and hygiene of the hospital environment, spread of diseases, relations between caregivers and professionals and care processes/procedures were all cited. FINAL CONSIDERATIONS: communication and the relations among caregivers and professionals are the main contributory factors for patient safety incidents, interfering with the quality of care. The participation of caregivers and engagement in child care may be strategies to be developed to promote a safety culture.


Assuntos
Cuidadores/psicologia , Segurança do Paciente/normas , Brasil , Criança , Criança Hospitalizada/psicologia , Pré-Escolar , Hospitalização , Humanos , Entrevistas como Assunto/métodos , Pesquisa Qualitativa , Gestão de Riscos/métodos , Gestão de Riscos/tendências , Gestão da Segurança/métodos
20.
Niger J Clin Pract ; 22(7): 906-912, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31293253

RESUMO

Objective: The aim of this study was to investigate how Queen bee syndrome, which is known as the mobbing behaviors of female employees from other female employees or managers, as perceived by nurses who are predominantly female workers. Materials and Methods: The universe of the qualitative type patterned research was formed by 12 nurses between the ages of 20 and 40 who worked for at least one year in different parts of a private hospital on the Anatolian side of Istanbul province. Maximum diversity sampling method for purposes was used for sample selection. The research data were collected in the form of written recording and voice recording with an unstructured interview form, which includes the structure, gender, competence, support, conflict, and competition themes created by the researchers to evaluate the characteristics of Queen bee syndrome. Focus group interviews were held on 30 April 2018. The results were evaluated using descriptive analysis and indicator methods. Results: In the study, the nurses' responses to interview questions were examined and women managers felt more emotional than men managers, and therefore they were less successful in problem-solving than men managers, but they were more successful in communication among women. The majority of nurses stated that women managers are more suitable for management in healthcare, that they are open to change, but they are not enough for men to solve the problem due to the fact that they are more concerned with the details. In addition, a significant part of the nurses, more than one female managers can cause competition and conflict in the workplace, especially women managers with similar status, said that this situation is seen more. Conclusions: The results of this study indicate that the woman is adapting to the Queen bee syndrome because of her ambition, competition, and emotional approaches, but that she has not been able to produce enough of it due to the environment.


Assuntos
Atitude do Pessoal de Saúde , Recursos Humanos de Enfermagem no Hospital/psicologia , Local de Trabalho/psicologia , Adolescente , Adulto , Animais , Feminino , Grupos Focais , Hospitais Privados , Humanos , Relações Interprofissionais , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Enfermeiras Administradoras/organização & administração , Enfermeiras Administradoras/psicologia , Recursos Humanos de Enfermagem no Hospital/organização & administração , Percepção , Pesquisa Qualitativa , Adulto Jovem
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