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1.
BMC Infect Dis ; 21(1): 511, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-34074268

RESUMO

INTRODUCTION: Discontinuation of tuberculosis treatment (DTT) among children in sub-Saharan Africa is a major obstacle to effective tuberculosis (TB) control and has the potential to worsen the emergence of multi-drug resistant TB and death. DTT in children is understudied in Uganda. We examined the level and factors associated with DTT among children at four large health facilities in Kampala Capital City Authority and documented the reasons for DTT from treatment supporters and healthcare provider perspectives. METHODS: We conducted a retrospective analysis of records for children < 15 years diagnosed and treated for TB between January 2018 and December 2019. We held focus group discussions with treatment supporters and key informant interviews with healthcare providers. We defined DTT as the stoppage of TB treatment for 30 or more consecutive days. We used a stepwise generalized linear model to assess factors independently associated with DTT and content analysis for the qualitative data reported using sub-themes. RESULTS: Of 312 participants enrolled, 35 (11.2%) had discontinued TB treatment. The reasons for DTT included lack of privacy at healthcare facilities for children with TB and their treatment supporters, the disappearance of TB symptoms following treatment initiation, poor implementation of the community-based directly observed therapy short-course (CB-DOTS) strategy, insufficient funding to the TB program, and frequent stock-outs of TB drugs. DTT was more likely during the continuation phase of TB treatment compared to the intensive phase (Adjusted odds ratio (aOR), 5.22; 95% Confidence Interval (CI), 1.76-17.52) and when the treatment supporter was employed compared to when the treatment supporter was unemployed (aOR, 3.60; 95% CI, 1.34-11.38). CONCLUSION: Many children with TB discontinue TB treatment and this might exacerbate TB morbidity and mortality. To mitigate DTT, healthcare providers should ensure children with TB and their treatment supporters are accorded privacy during service provision and provide more information about TB symptom resolution and treatment duration versus the need to complete treatment. The district and national TB control programs should address gaps in funding to TB care, the supply of TB drugs, and the implementation of the CB-DOTS strategy.


Assuntos
Tuberculose/tratamento farmacológico , Adolescente , Criança , Pré-Escolar , Terapia Diretamente Observada , Feminino , Grupos Focais , Instalações de Saúde , Humanos , Lactente , Recém-Nascido , Masculino , Razão de Chances , Estudos Retrospectivos , Tuberculose/epidemiologia , Tuberculose/prevenção & controle , Uganda/epidemiologia
2.
Stud Health Technol Inform ; 282: 102-119, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34085962

RESUMO

For the creation of inclusive design solutions, designers require relevant knowledge about a diversity of users throughout the design process. Besides understanding users' needs and expectations, the ways in which users perceive and experience the environment contain valuable knowledge for designers. Since users' perceptions and experiences are mainly tacit by nature, they are much more difficult to communicate and therefore more difficult to externalize. Hence, more insight is needed into the ways designers can build knowledge on Universal Design through direct user contact. In a project called 'Light up for all' architecture students are asked to design a light switch and socket, elegant, usable and understandable to the greatest extent possible by everyone. Two workshops with user/experts are organized in the first stages of the design process in which students could gain insight into users' experiences and perceptions through direct contact. Three data collection techniques are used to analyze the teams' design processes: (1) a design diary, (2) observations of the workshops and (3) a focus group. By means of analyzing collected qualitative data, we have identified three different design aspects that affect designers' UD knowledge building process. First, findings give indications on values and limitations of working with selected design artefacts when externalizing users' experiences. Second, the value of stories clearly affected designers' deeper understanding about users' experiences. Finally, results show that in some situations, designers encountered contradictory information between observations and verbal conversations. These insights may help researchers to better understand designers' process of building knowledge on UD from users' experiences and perceptions, which may result in better incorporating users' experiences when designing for everyone.


Assuntos
Comunicação , Design Universal , Coleta de Dados , Grupos Focais , Humanos , Estudantes
3.
J Pak Med Assoc ; 71(5): 1476-1478, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34091638

RESUMO

This qualitative study aimed to explore medical students' experience of generation gap in their interactions with senior teachers (aged >55) in Japan. Focus group interviews were conducted with 28 medical students (20 to 30 years, mean age 22 ±2 years, classified as millennials, with only one year of studies since starting specialised courses for medicine. The participants were interviewed in groups of four, with each interview lasting 60 minutes. Topics covered included generation gap experienced in daily life and during their studies, and work-life balance issues. The discussions were recorded and transcribed, and content analysis was applied. Four specific influential generation-gap categories were identified - distinctive sociocultural backgrounds, more recent educational media tools and faster information dissemination speed, new-era values, and challenges in communication - that were consistent with findings from previous studies. More senior personnel involved in medical education need to consider these categories to enhance effectiveness of teaching.


Assuntos
Educação Médica , Estudantes de Medicina , Adulto , Grupos Focais , Humanos , Relação entre Gerações , Pesquisa Qualitativa , Adulto Jovem
4.
Afr J Reprod Health ; 25(1): 20-28, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34077107

RESUMO

Over the past 30 years, the Moroccan government has made enormous strides towards improving maternal health care for Moroccan women, but outcomes for rural women remain much worse than those of their urban counterparts. This study aimed to understand the experiences of women giving birth in rural Morocco, and to identify the barriers they face when accessing facility-based maternity care. Fifty-five participants were recruited from villages in Morocco's rural south to participate in focus group discussions (FGDs), using appreciative inquiry as the guiding framework. Several themes emerged from the analysis of the focus group data. Women felt well-cared for and safe giving birth both at home and in the large, tertiary care hospitals, but not in the small, primary care hospitals. Women who gave birth at the primary care hospitals reported a shortage of some equipment and supplies and poor treatment at the hands of hospital staff. Locating and paying for transportation was identified as the biggest hurdle in accessing maternity care at any hospital. The findings of this study indicate the need for change within primary care health facilities.


Assuntos
Acesso aos Serviços de Saúde/estatística & dados numéricos , Disparidades em Assistência à Saúde , Serviços de Saúde Materna/organização & administração , Serviços de Saúde Materna/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde , Adulto , Atitude do Pessoal de Saúde , Feminino , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Parto Domiciliar , Humanos , Saúde Materna , Tocologia , Gravidez , Pesquisa Qualitativa , Qualidade da Assistência à Saúde , População Rural
5.
Front Public Health ; 9: 662313, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34095067

RESUMO

Introduction: A new vision of resilience and well-being for Canadian military service members (SMs), Veterans and their families has been championed by the Canadian Armed Forces (CAF) and Veterans Affairs Canada (VAC). Operationalizing this vision, which aims to support those who serve/have served and their families as they navigate life during and post-service, requires the support of service providers (SPs). Training SPs to deliver complementary resilience-training programs Reaching In… Reaching Out (RIRO; for adults working with parents of young children) and Bounce Back and Thrive! (BBT; for parents of children aged 0-8 years of age) may support this vision. Objective: To assess the appropriateness of RIRO/BBT trainer training for SPs, and RIRO and BBT resilience-training for military populations and families. Methods: This qualitative descriptive study involved the delivery of RIRO/BBT trainer training to SPs (n = 20), followed by focus groups (n = 6) with SPs and organisational leaders (n = 4). Focus groups were recorded, and data were transcribed and thematically-analysed. Results: Several themes emerged: (1) RIRO/BBT trainer training enabled SPs to model resilience and deliver the resilience-training programs, (2) training was appropriate and adaptable for the CAF and SMs/CMFs, and (3) training could support the development of resilient communities. Discussion: RIRO/BBT trainer training and RIRO and BBT resilience-training programs use a holistic, integrated, experiential, and community approach to resilience-building and align with CAF and VAC initiatives. Once contextualised, such programs could support resilience-building in the military context.


Assuntos
Família Militar , Militares , Veteranos , Adulto , Canadá , Criança , Pré-Escolar , Grupos Focais , Humanos
6.
BMC Public Health ; 21(1): 1029, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34074273

RESUMO

BACKGROUND: In Bangladesh overweight and obesity among urban school children are on the rise. Urban school children tend to consume foods dense in calories and few fruits and vegetables which is associated with overweight and obesity. The current study explored the barriers and opportunities for promoting healthy diets among school children from the perspective of teachers and parents in Dhaka, Bangladesh. METHODS: We conducted 14 key informant interviews with teachers and principals, six focus group discussions with 31 mothers of school children (5 to 15 year old) and 14 structured observations of the school food environment. Inductive thematic analysis was performed manually. RESULTS: Schools were important for development of food preferences of children, however, most school cafeterias provided foods based on profit rather than health considerations. A shift in food culture resulted in making eating out acquire many meanings beyond convenience. Mothers, especially those who were employed, struggled to prepare healthy foods due to time pressure. Mothers were generally concerned about chemicals added to raw foods in markets which led to limited fruit and vegetable consumption. CONCLUSIONS: There were many challenges to promoting healthy foods to school children within and outside the school. It is important to formulate policies and guidance to create a supportive environment for healthy foods in and in the proximity of schools. It is also important to educate consumers about identifying and choosing healthy foods. Laws related to food safety should be adequately implemented to boost the population's confidence in safety of available healthy foods in the food system.


Assuntos
Serviços de Alimentação , Instituições Acadêmicas , Adolescente , Bangladesh , Criança , Pré-Escolar , Dieta Saudável , Feminino , Grupos Focais , Frutas , Humanos , Pesquisa Qualitativa , Verduras
7.
Cien Saude Colet ; 26(5): 1637-1646, 2021 May.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34076106

RESUMO

The work of Community Health Workers (ACS) was analyzed in light of Communities of Practice (CP) theory. This is a qualitative cross-sectional study carried out in four municipalities in Ceará. Six focus groups and six interviews were carried out with 45 Community Health Workers (ACS), observing ethical aspects. The data corpus was analyzed using the content analysis technique. The results show that ACS participation in the ESF is marked by experience in the community, and the main focus is monitoring priority groups. The practices put them before the diverse social and family complexities, generating reflections and building new meanings for themselves and their work process. The ACS CPs engage and share challenges and unique learning from work, characterized by close contact and relationships with the families of the territory, which reveals needs hardly perceived by other ESF professionals. The meaning of being ACS as one who listens, embraces, and perceives the needs of families invisible to services, is evident in the reification processes. The ACS better exercise their role as ESF articulators in the territories the greater the spaces for dialogue between them, the other team members, and management.


Assuntos
Serviços de Saúde Comunitária , Agentes Comunitários de Saúde , Brasil , Estudos Transversais , Grupos Focais , Humanos , Pesquisa Qualitativa
8.
BMC Public Health ; 21(1): 1091, 2021 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-34098911

RESUMO

BACKGROUND: The aim was to identify the most important determinants of practice for the implementation of person-centered tools which enhance work participation for patients with chronic health conditions. METHODS: A mixed-method study was conducted consisting of semi-structured interviews, a focus group and a survey. Various stakeholders were involved including (representatives of) workers with chronic health conditions, insurance physicians, occupational physicians, other healthcare professionals, researchers, employers, and policymakers. The semi-structured interviews were performed to identify implementation determinants, followed by a focus group to validate resulting determinants. To conclude, a survey was conducted to select the most important implementation determinants through prioritization by ranking the order of importance. The Tailored Implementation of Chronic Diseases checklist (TICD) was used as concept-driven coding frame for the qualitative analysis of the interviews and focus group. The self-developed survey was based on the domains of the TICD. The survey was analyzed by frequency count of first ranking of determinants per and between domains of the TICD. RESULTS: Various stakeholders participated (N = 27) in the interviews and focus group. The qualitative data retrieved yielded a list of determinants with additional in-depth themes according to the TICD. For the selection of the most important determinants, a survey with 101 respondents was conducted, consisting of occupational physicians, insurance physicians and workers with a chronic health condition. From the seven domains of the TICD, respondents emphasized the importance of taking into account the needs and factors associated with workers with a chronic health condition as this determinant ranked highest. Taking into account the individual needs and wishes of workers was mentioned to enable successful implementation, whereas stress of the workers was indicated to impede implementation. Other important determinants included 'being able to work with the tools' in terms of time and usability or 'cognitions, beliefs and attitudes of occupational and insurance physicians' to be able to use the tools. CONCLUSION: This study identified the most important determinants from the perspective of various stakeholders involved in the implementation of client-centered tools in occupational health for workers with chronic health conditions. Furthermore, by prioritizing the most important determinants, targeted implementation strategies can be developed.


Assuntos
Lista de Checagem , Projetos de Pesquisa , Doença Crônica , Grupos Focais , Pessoal de Saúde , Humanos , Pesquisa Qualitativa
9.
Reprod Health ; 18(1): 110, 2021 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-34078408

RESUMO

BACKGROUND: Pre-eclampsia is a leading cause of maternal and perinatal mortality and morbidity globally. Planned delivery between 34+0 and 36+6 weeks may reduce adverse pregnancy outcomes but is yet to be evaluated in a low and middle-income setting. Prior to designing a randomised controlled trial to evaluate this in India and Zambia, we carried out a 6-month feasibility study in order to better understand the proposed trial environment and guide development of our intervention. METHODS: We used mixed methods to understand the disease burden and current management of pre-eclampsia at our proposed trial sites and explore the acceptability of the intervention. We undertook a case notes review of women with pre-eclampsia who delivered at the proposed trial sites over a 3-month period, alongside facilitating focus group discussions with women and partners and conducting semi-structured interviews with healthcare providers. Descriptive statistics were used to analyse audit data. A thematic framework analysis was used for qualitative data. RESULTS: Case notes data (n = 326) showed that in our settings, 19.5% (n = 44) of women with pre-eclampsia delivering beyond 34 weeks experienced an adverse outcome. In women delivering between 34+0 and 36+6 weeks, there were similar numbers of antenatal stillbirths [n = 3 (3.3%)] and neonatal deaths [n = 3 (3.4%)]; median infant birthweight was 2.2 kg and 1.9 kg in Zambia and India respectively. Lived experience of women and healthcare providers was an important facilitator to the proposed intervention, highlighting the serious consequences of pre-eclampsia. A preference for spontaneous labour and limited neonatal resources were identified as potential barriers. CONCLUSIONS: This study demonstrated a clear need to evaluate the intervention and highlighted several challenges relating to trial context that enabled us to adapt our protocol and design an acceptable intervention. Our study demonstrates the importance of assessing feasibility when developing complex interventions, particularly in a low-resource setting. Additionally, it provides a unique insight into the management of pre-eclampsia at our trial settings and an understanding of the knowledge, attitudes and beliefs underpinning the acceptability of planned early delivery.


Assuntos
Parto Obstétrico , Pré-Eclâmpsia/epidemiologia , Nascimento Prematuro , Estudos de Viabilidade , Feminino , Grupos Focais , Humanos , Índia/epidemiologia , Lactente , Recém-Nascido , Gravidez , Zâmbia/epidemiologia
10.
BMC Med Educ ; 21(1): 339, 2021 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-34112155

RESUMO

BACKGROUND: With the strike of Covid-19, an unprecedented rapid shift to remote learning happened worldwide with a paradigm shift to online learning from an institutional adjuvant luxury package and learner choice into a forced solo choice. This raises the question of quality assurance. While some groups have already established standards for online courses, teaching and programs yet very little information is included on methodology of their development and very little emphasis is placed on the online learning experience. Nevertheless, no work has been done specifically for medical education institutions. AIM: To develop a set of descriptors for best practice in online learning in medical education utilizing existing expertise and needs. METHODS: This work utilizes a qualitative multistage approach to identify the descriptors of best practice in online learning starting with a question guided focus group, thematic analysis, Delphi technique and an expert consensus session done simultaneously for triangulation. This was done involving 32 institution in 19 countries. RESULTS: This materialized into the development of a set of standards, indicators, and development of a checklist for each standard area. The standard areas identified were organizational capacity, educational effectiveness, and human resources each of which listed a number of standards. Expert consensus sessions identified the need for qualification of data and thus the development of indicators for best practice. CONCLUSION: Standards are needed for online learning experience and their development and redesign is situational and needs to be enhanced methodologically in axes that are pertaining to the needs of the education community. Taking such axes into consideration by educators and institutions will lead to planning and implementing successful online learning activities, while taking them into consideration by the evaluators will help them conduct comprehensive audits and provide stakeholders with highly informative evaluation reports.


Assuntos
COVID-19 , Educação à Distância , Educação Médica , Grupos Focais , Humanos , SARS-CoV-2
11.
Reprod Health ; 18(1): 125, 2021 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-34118954

RESUMO

BACKGROUND: Sexual and reproductive health and rights are critical entitlements best supported through human rights-based approaches empowering rights-holders to claim their rights and duty bearers to fulfil their obligations. Implementing these requires information on the current needs and challenges faced by those seeking to claim their sexual and reproductive health and rights. We aimed to identify the underlying factors influencing the realisation of sexual and reproductive health and rights for adolescent girls and young women living Ugandan slums by: (1) exploring the role of relevant service providers and stakeholders; and (2) uncovering knowledge and gaps in protecting adolescent girls' and young women's sexual and reproductive health and rights. METHODS: Qualitative data were collected through focus groups and interviews focused on current knowledge, behaviours and attitudes towards sexual and reproductive health and rights among adolescent girls and young women, service providers and stakeholders. Data were analysed thematically using NVivo software. Ten in-depth interviews were conducted with key informants; two focus groups were held with adolescent girls and young women living in two slums in Uganda (21 participants in total); and three focus groups were held with community leaders, service providers, teachers and parents (30 participants in total). RESULTS: Adolescent girls and young women lacked information regarding their sexual health, services available, and redress mechanisms for rights violations. Formal sources of information were frequently inaccessible. Family members were sometimes the source of rights violations, and informal methods of redressing rights were often sought. Stigma and fear were common features both in healthcare and in the pursuit of formal justice, with duty-bearers habitually breaking confidentiality. Education and training were the predominant suggestions offered for change. CONCLUSIONS: Adolescent girls and young women continue to face obstacles in achieving their full sexual and reproductive health and rights. Targeted interventions for the realisation of adolescent girls' and young women's sexual and reproductive health and rights can address underlying causes and positively shift attitudes to promote health.


Assuntos
Áreas de Pobreza , Serviços de Saúde Reprodutiva , Saúde Reprodutiva , Direitos Sexuais e Reprodutivos , Saúde Sexual , Adolescente , Feminino , Grupos Focais , Promoção da Saúde , Humanos , Entrevistas como Assunto , Defesa do Paciente , Pesquisa Qualitativa , Comportamento Sexual , Uganda
12.
BMJ Open ; 11(6): e047025, 2021 06 15.
Artigo em Inglês | MEDLINE | ID: mdl-34130962

RESUMO

BACKGROUND: Prevalence of people with multimorbidity rises. Multimorbidity constitutes a challenge to the healthcare system, and treatment of patients with multimorbidity is prone to high-quality variations. Currently, no set of quality indicators (QIs) exists to assess quality of care, let alone incorporating the patient perspective. We therefore aim to identify aspects of quality of care relevant to the patients' perspective and match them to a literature-based set of QIs. METHODS: We conducted eight focus groups with patients with multimorbidity and three focus groups with patients' relatives using a semistructured guide. Data were analysed using Kuckartz's qualitative content analysis. We derived deductive categories from the literature, added inductive categories (new quality aspects) and translated them into QI. RESULTS: We created four new QIs based on the quality aspects relevant to patients/relatives. Two QIs (patient education/self-management, regular updates of medication plans) were consented by an expert panel, while two others were not (periodical check-ups, general practitioner-coordinated care). Half of the literature-based QIs, for example, assessment of biopsychosocial support needs, were supported by participants' accounts, while more technical domains regarding assessment and treatment regimens were not addressed in the focus groups. CONCLUSION: We show that focus groups with patients and relatives adding relevant aspects in QI development should be incorporated by default in QI development processes and constitute a reasonable addition to traditional QI development. Our QI set constitutes a framework for assessing the quality of care in the German healthcare system. It will facilitate implementation of treatment standards and increase the use of existing guidelines, hereby helping to reduce overuse, underuse and misuse of healthcare resources in the treatment of patients with multimorbidity. TRIAL REGISTRATION NUMBER: German clinical trials registry (DRKS00015718), Pre-Results.


Assuntos
Multimorbidade , Indicadores de Qualidade em Assistência à Saúde , Protocolos Clínicos , Atenção à Saúde , Grupos Focais , Humanos
13.
Rev Bras Enferm ; 74(6): e20200694, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34133669

RESUMO

OBJECTIVE: Understand the continuity of stimulation of neuro-psychomotor development in children with congenital Zika syndrome. METHOD: Descriptive-exploratory study with theoretical support in symbolic interactionism. Between August and November 2019, 12 health professionals were interviewed in depth; and to the focus group, seven caregivers of children with the syndrome. The analysis was thematic inductive. RESULTS: The continuation of neuro-psychomotor stimulation of children with Zika syndrome goes through: organizational difficulties (lack of doctors, professional unpreparedness, dissatisfaction and search for other services); socioenvironmental aspects (low maternal education, low socioeconomic level, difficulty in moving and lack of support); and conditions inherent to children (hospitalizations for respiratory crises, seizures, hypoactivity and social stigma). FINAL CONSIDERATIONS: A strengthened support network with qualified human resources is necessary in order to provide comprehensive care and avoid the discontinuity of neuro-psychomotor stimulation of children with congenital Zika syndrome.


Assuntos
Infecção por Zika virus , Zika virus , Cuidadores , Criança , Grupos Focais , Pessoal de Saúde , Humanos , Infecção por Zika virus/complicações
14.
Nurse Educ Pract ; 53: 103078, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34030028

RESUMO

AIM: This study was conducted to reveal the feelings, thoughts and opinions of male and female nursing students about gender perception in nursing. DESIGN AND METHODS: This descriptive study using qualitative methods sought to reveal gender perception among first- and fourth-year nursing students. The focus group interview (FGI) approach was used purposefully to obtain in-depth information about nursing students' gender perceptions and their underlying attitudes, beliefs and behaviours. There were 27 female and 17 male participants, of whom 23 were first-year and 21 were fourth-year nursing students. RESULTS: The analysis revealed four themes: (1) reasons for choosing the nursing profession, (2) gender perception, (3) religion and cultural factors and (4) occupational gender perception. The students reported that in certain units, gender would make a more positive difference for patients and themselves. The responses of male students regarding their professional gender perceptions also differed depending on whether they were first- or fourth-year students. CONCLUSIONS: Gender affects the perception of professional gender and to has a positive effect on the adoption of the profession during education by male students.


Assuntos
Bacharelado em Enfermagem , Estudantes de Enfermagem , Atitude , Feminino , Grupos Focais , Humanos , Masculino , Pesquisa Qualitativa , Turquia
15.
BMC Infect Dis ; 21(1): 472, 2021 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-34030652

RESUMO

BACKGROUND: HIV Pre-exposure prophylaxis (PrEP) is being considered for implementation among MSM nationwide in Vietnam. However, there may be concerns about potential obstacles for PrEP adherence among Vietnamese MSM. This study aims to assess the acceptability to use PrEP, potential barriers and facilitators, and the preferences for PrEP service accessibility and delivery among Vietnamese MSM. METHODS: Four focus group discussions (FGDs) were conducted with 30 HIV-negative MSM in January 2018 in Hanoi, Vietnam. FGDs explored MSM's awareness regarding PrEP, perceived benefits and barriers of PrEP use, and willingness to use PrEP. FGDs were audio-recorded and transcribed verbatim. Content analysis was used. RESULTS: The mean age of participants was 23.9 years old. Most participants realized the advantages of PrEP given its efficacy in HIV risk reduction and expressed high motivation and interest to use PrEP in the future. PrEP was considered as a supplement alongside condoms. Common concerns about PrEP included side-effects, forgetting to take the pill daily, stigmatization due to using PrEP, negative attitudes toward PrEP from other MSM and accessibility of PrEP. Participants would prefer an injectable PrEP regime if available as it was seen as easier to adhere to. Concerns were also raised that PrEP usage could be interpreted as an indication of engaging in sexual risk behavior for HIV, potentially causing suspicion in love relationships or by family and friends. Participants preferred to receive PrEP in civil business organizations and MSM-friendly clinics, and recommended that pharmacy stores would not be suitable for PrEP implementation due to lack of trust and fear of fake drugs. CONCLUSION: This study indicated a high level of willingness to use PrEP among MSM in Vietnam in combination with condom. Strategies to raise awareness of PrEP, reduce stigma towards PrEP, and improve the accessibility among MSM in Vietnam is needed. Existing MSM-friendly clinics were recommended to implement PrEP programs in Vietnam.


Assuntos
Atenção à Saúde/métodos , Infecções por HIV/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Profilaxia Pré-Exposição , Adulto , Atenção à Saúde/organização & administração , Grupos Focais , Homossexualidade Masculina , Humanos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Pesquisa Qualitativa , Minorias Sexuais e de Gênero , Estigma Social , Vietnã , Adulto Jovem
16.
BMC Geriatr ; 21(1): 298, 2021 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-33964887

RESUMO

BACKGROUND: The rapid development of technology such as sensors and artificial intelligence in recent years enables monitoring frailty criteria to assess frailty early and accurately from a remote location such as a home. However, research shows technologies being abandoned or rejected by users due to a lack of compatibility and consumer involvement in selecting their assistive technology devices. This study aims to understand older adults' perceptions and preferences of technologies that can potentially assess frailty at home. METHODS: This study collected qualitative data through focus group meetings with 15 participants ages 65 and older. Researchers asked participants questions to achieve the goal of understanding their attitudes on the technologies. These questions include (1) the concerns or barriers of installing and using the presented technology in daily life at home, (2) the reasons participants like or dislike a particular technology, (3) what makes a specific technology more acceptable, and (4) participants' preferences in choosing technologies. Data were transcribed, coded and categorized, and finally synthesized to understand the attitudes towards presented technologies. RESULTS: Three focus group sessions were conducted with five participants in each session. In the findings, the attitudes and perspectives of participants on the technologies for assessing frailty were categorized into four themes: (A) general attitude towards using the technologies, (B) conditions for accepting certain technologies, (C) existing living habits or patterns related to using the technologies, and (D) constructive suggestions related to the technologies. CONCLUSIONS: Participants generally had positive attitudes towards allowing the technologies to be installed and used at their homes. They would accept some technologies if used under certain conditions. However, questions and concerns remain, such as concerns about privacy, functionality, and aesthetics. The study also found that older adults' living habits or patterns could affect the design and use of technology. Lastly, many valuable suggestions have been made by participants. These perspectives and insights can help improve the design and adoption of home-based frailty assessment technologies among older adults.


Assuntos
Fragilidade , Idoso , Inteligência Artificial , Atitude , Grupos Focais , Fragilidade/diagnóstico , Humanos , Tecnologia
17.
BMJ Open ; 11(5): e043516, 2021 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-33980517

RESUMO

OBJECTIVE: Child and adolescent obesity continues to be a major health issue internationally. This study aims to understand the views and experiences of caregivers and participants in a child and adolescent multidisciplinary programme for healthy lifestyle change. DESIGN: Qualitative focus group study. SETTING: Community-based healthy lifestyle intervention programme in a mixed urban-rural region of Aotearoa/New Zealand. PARTICIPANTS: Parents/caregivers (n=6) and children/adolescents (n=8) who participated in at least 6 months of an assessment and weekly session, family-based community intervention programme for children and adolescents affected by obesity. RESULTS: Findings covered participant experiences, healthy lifestyle changes due to participating in the programme, the delivery team, barriers to engagement and improvements. Across these domains, four key themes emerged from the focus groups for participants and their caregivers relating to their experience: knowledge-sharing, enabling a family to become self-determining in their process to achieve healthy lifestyle change; the importance of connectedness and a family-based programme; the sense of a collective journey and the importance of a nonjudgemental, respectful welcoming environment. Logistical challenges and recommendations for improvement were also identified. CONCLUSIONS: Policymakers need to consider the experiences of participants alongside quantitative outcomes when informing multidisciplinary intervention programmes for children and adolescents affected by obesity.Trial registration number Australian New Zealand Clinical Trials Registry (ANZCTR):12611000862943; Post-results.


Assuntos
Cuidadores , Estilo de Vida Saudável , Adolescente , Austrália , Criança , Grupos Focais , Humanos , Nova Zelândia
18.
N Z Med J ; 134(1535): 17-24, 2021 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-34012137

RESUMO

AIM: This study aimed to explore Maori (the indigenous people of Aotearoa New Zealand) understandings of frailty. METHOD: Focus groups were held with older Maori in supported living, health professionals working with older Maori and a rural community. A qualitative thematic analysis was conducted. RESULTS: Two interlinked, overarching themes emerged: (1) Frailty is a multidimensional experience, not simply a physical one. (2) The experience of frailty is a balance between deficits and strengths. The Waikare o te Waka o Meihana model provided a useful framework for structuring the thematic results. CONCLUSIONS: Culturally appropriate and comprehensive support and care for older Maori with frailty will be facilitated by a rounded strength-based approach and listening skills.


Assuntos
Idoso Fragilizado , Fragilidade/etnologia , Grupo com Ancestrais Oceânicos/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cultura , Feminino , Grupos Focais , Idoso Fragilizado/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Grupo com Ancestrais Oceânicos/etnologia , Adulto Jovem
19.
BMC Health Serv Res ; 21(1): 445, 2021 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-33971874

RESUMO

BACKGROUND: Institutions of higher learning provide education, training, independence and life-long skills for young people. However, for students to achieve their optimal growth and intellectual development they need to be healthy psychologically, mentally and physically. This can be achieved through the development of effective health programs for all university students. This qualitative study was designed to explore Black male students' perspectives and experiences regarding the utilization of on-campus health services at the University of KwaZulu-Natal. METHODS: The study population was selected using purposive sampling. Data were collected using four focus group discussions (FGDs) with 36 participants and three key informant interviews. Thematic analysis was conducted to identify the key patterns and themes that emerged from the data. RESULTS: Emerging themes included poor knowledge and awareness, negative perceptions and attitudes, fear and lack of privacy, and negative experiences leading to poor access and utilization of campus health services. The findings suggested a need for more advocacy and awareness campaigns especially among first year students, campaigns for normalization of sexual health, addressing HIV stigma and discrimination, providing youth friendly services to improve students' use of sexual health services, and ultimately, their overall health and well-being. CONCLUSIONS: The findings give valuable insights from male students on the barriers and potential solutions to campus health services and highlight where improvements can be directed to increase access and use of health services by the study population.


Assuntos
Afro-Americanos , Universidades , Adolescente , Grupos Focais , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde , Pesquisa Qualitativa
20.
PLoS One ; 16(5): e0251033, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33951107

RESUMO

BACKGROUND: Contact tracing is an important tool for suppressing COVID-19 but has been difficult to adapt to the conditions of a public health emergency. This study explored the experiences and perspectives of volunteer contact tracers in order to identify facilitators, challenges, and novel solutions for implementing COVID-19 contact tracing. METHODS: As part of a study to evaluate an emergently established volunteer contact tracing program for COVID-19 in New Haven, Connecticut, April-June 2020, we conducted focus groups with 36 volunteer contact tracers, thematically analyzed the data, and synthesized the findings using the RE-AIM implementation framework. RESULTS: To successfully reach cases and contacts, participants recommended identifying clients' outreach preferences, engaging clients authentically, and addressing sources of mistrust. Participants felt that the effectiveness of successful isolation and quarantine was contingent on minimizing delays in reaching clients and on systematically assessing and addressing their nutritional, financial, and housing needs. They felt that successful adoption of a volunteer-driven contact tracing model depended on the ability to recruit self-motivated contact tracers and provide rapid training and consistent, supportive supervision. Participants noted that implementation could be enhanced with better management tools, such as more engaging interview scripts, user-friendly data management software, and protocols for special situations and populations. They also emphasized the value of coordinating outreach efforts with other involved providers and agencies. Finally, they believed that long-term maintenance of a volunteer-driven program requires monetary or educational incentives to sustain participation. CONCLUSIONS: This is one of the first studies to qualitatively examine implementation of a volunteer-run COVID-19 contact tracing program. Participants identified facilitators, barriers, and potential solutions for improving implementation of COVID-19 contact tracing in this context. These included standardized communication skills training, supportive supervision, and peer networking to improve implementation, as well as greater cooperation with outside agencies, flexible scheduling, and volunteer incentives to promote sustainability.


Assuntos
COVID-19/transmissão , Busca de Comunicante , Avaliação de Programas e Projetos de Saúde , Adulto , COVID-19/patologia , COVID-19/virologia , Feminino , Grupos Focais , Humanos , Entrevistas como Assunto , Masculino , Saúde Pública , SARS-CoV-2/isolamento & purificação , Estados Unidos , Voluntários/psicologia
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